A phase 3 trial published in JAMA examined the effectiveness of intravenous tenecteplase before endovascular treatment for acute ischemic stroke caused by proximal middle cerebral artery occlusion in 391 adults. The results revealed no significant difference in 90-day functional independence (44% for tenecteplase group vs. 43% for endovascular treatment only). Key findings included similar baseline characteristics, a median age of 68 years, and a slight increase in symmetry for symptomatic hemorrhages. The researchers concluded that the intervention did not translate to better functional outcomes, emphasizing caution in applying these findings to hospitals without endovascular capabilities.
Adjunctive tirofiban was associated with higher rates of excellent 90-day outcomes after inadequate tenecteplase response in selected stroke patients, though adjusted analyses were not significant.
