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Effect of Intravenous Tenecteplase Dose on Cerebral Reperfusion Before Thrombectomy in Patients With Large Vessel Occlusion Ischemic Stroke

By Currents Editor posted 03-02-2020 10:13

  

Journal of the American Medical Association (02/20/20) doi: 10.1001/jama.2020.1511

Campbell, Bruce C. V.; Mitchell, Peter J.; Churilov, Leonid; et al.

While I.V. thrombolysis with tenecteplase is superior to alteplase in improving cerebral reperfusion in ischemic stroke patients, it was unknown if tenecteplase's performance is influenced by dose. To explore, researchers in Australia and New Zealand assembled a trial population of 300 adults with ischemic stroke caused by large vessel occlusion. Participants in the EXTEND-IA TNK study Part II were randomized by a ratio of 1:1 to receive either 0.40 mg/kg or 0.25 mg/kg of tenecteplase, administered as a bolus before endovascular thrombectomy. The primary endpoint was reperfusion of more than 50% of the involved ischemic territory before thrombectomy. The share of patients who satisfied this goal was 19.3% for both groups, signifying no additional benefit to giving patients a higher dose.

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