ASA: Intra-Arterial Tenecteplase Beneficial for Large Vessel Occlusion

TUESDAY, Feb. 18, 2025 (HealthDay News) — For patients with large vessel occlusion presenting between 4.5 and 24 hours, intra-arterial tenecteplase after successful thrombectomy results in improved likelihood of excellent outcome (modified Rankin scale score 0 to 1), according to a study presented at the annual American Stroke Association International Stroke Conference, held from Feb. 5 to 7 in Los Angeles.

Xiaochuan Huo, M.D., Ph.D., from Beijing Anzhen Hospital, and colleagues conducted a multicenter, prospective, randomized trial involving patients with acute anterior circulation large vessel occlusion treated between 4.5 and 24 hours from the time last known to be well. After successful endovascular recanalization, patients were randomly assigned to receive intra-arterial tenecteplase or standard medical management (127 and 129 participants, respectively).

The researchers found that the percentage of patients with a modified Rankin scale score of 0 or 1 at 90 days was higher with intra-arterial tenecteplase versus standard medical treatment after endovascular therapy (40.5 versus 26.4 percent; relative rate, 1.44; 95 percent confidence interval, 1.06 to 1.95). Mortality at 90 days did not differ significantly between the groups and was 21.4 and 21.7 percent with intra-arterial tenecteplase and standard medical treatment, respectively. There was no significant difference seen in the incidence of symptomatic intracranial hemorrhage within 48 hours after treatment (5.6 and 6.2 percent with intra-arterial tenecteplase and standard medical treatment, respectively).

“Intra-arterial tenecteplase after successful thrombectomy could improve the percentage of people with an excellent outcome,” Huo said in a statement. “It could also improve the rate of large vessel occlusion stroke survivors who can return to society and live independently.”

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