Tenecteplase Fails to Boost EVT Outcomes
Phase 3 stroke trial leaves open the possibility of clinically meaningful benefit or harm in selected late-window patients.
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By
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Kathryn Wighton
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May 14, 2026
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Clinical Scorecard: Tenecteplase Fails to Boost EVT Outcomes
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Intravenous tenecteplase prior to endovascular treatment did not improve outcomes. |
| Target Population | |
| Care Setting | |
Key Highlights
- No significant improvement in functional independence at 90 days with tenecteplase prior to EVT compared to EVT alone.
- Functional independence occurred in 44% of tenecteplase patients vs. 43% in EVT alone.
- Median time from symptom onset to randomization was approximately 10 hours.
- Symptomatic intracranial hemorrhage occurred in 5% of tenecteplase patients vs. 3% in EVT alone.
Guideline-Based Recommendations
Diagnosis
Management
- Consider endovascular treatment alone for patients presenting within 4.5 to 24 hours.
Monitoring & Follow-up
Risks
Patient & Prescribing Data
391 adults enrolled in the TNK-PLUS trial across 40 centers in China.
Median time from hospital admission to tenecteplase administration was 90 minutes.
Clinical Best Practices
- Assess salvageable brain tissue using imaging criteria before considering thrombolysis.
- Evaluate the timing of treatment administration in relation to endovascular procedures.
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