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.
By
Kathryn Wighton
May 14, 2026
1
Intravenous tenecteplase prior to endovascular treatment did not improve functional independence at 90 days in acute ischemic stroke patients.
2
The TNK-PLUS trial enrolled 391 adults with proximal middle cerebral artery occlusion, comparing tenecteplase plus EVT to EVT alone.
3
Functional independence was achieved in 44% of the tenecteplase group and 43% of the EVT-only group, with no significant difference.
4
Reperfusion rates were slightly higher in the tenecteplase group, but this did not translate to better functional outcomes.
5
The trial's findings may not apply to patients without immediate access to endovascular treatment due to different thrombolytic dwell times.
