Intravenous Tenecteplase Enhances Outcomes Before Thrombectomy in Stroke Patients

Recent research published in the New England Journal of Medicine highlights the benefits of administering intravenous tenecteplase prior to endovascular thrombectomy in patients experiencing acute ischemic stroke caused by large-vessel occlusion. The study, conducted by Dr. Zhongming Qiu and colleagues in China, investigated whether adding tenecteplase could improve functional outcomes. Involving 550 patients presenting within 4.5 hours of stroke onset, the trial compared two groups: one receiving tenecteplase followed by thrombectomy, and another undergoing thrombectomy alone.

Results showed that 52.9% of patients who received tenecteplase achieved functional independence at 90 days, compared to 44.1% in the thrombectomy-only group. Early reperfusion was more successful in the tenecteplase group, with 6.1% achieving reperfusion before thrombectomy versus 1.1% in the control group. Post-procedure outcomes indicated similar rates of successful reperfusion after thrombectomy in both groups. Although symptomatic intracranial hemorrhage was slightly higher in the tenecteplase group (8.5% vs. 6.7%), mortality rates at 90 days were comparable (22.3% vs. 19.9%). The authors note that while the primary outcome favors tenecteplase, secondary outcomes were less conclusive, warranting further investigation.

This study suggests that adding tenecteplase to the treatment protocol for eligible stroke patients can potentially improve long-term functional recovery, emphasizing the importance of timely intervention. The findings were supported by funding from China Shijiazhuang Pharmaceutical Company Recomgen Pharmaceutical, and the research aligns with ongoing efforts to optimize stroke management strategies.

Source: https://medicalxpress.com/news/2025-05-intravenous-tenecteplase-beneficial-endovascular-thrombectomy.html