Intra-arterial tenecteplase post thrombectomy fails to enhance stroke recovery outcomes

Study details: The POST-TNK randomized trial evaluated the efficacy and safety of intra-arterial tenecteplase following endovascular reperfusion in 539 patients with large vessel occlusion acute ischemic stroke. Participants were randomly assigned to receive either intra-arterial tenecteplase or placebo after successful endovascular reperfusion. The primary outcome was the degree of reperfusion achieved, measured by the modified Thrombolysis in Cerebral Infarction (mTICI) score.

Results: Patients who received intra-arterial tenecteplase didn’t have significant improvements in Rankin Scale at 90 days compared with the placebo group (49.1% vs. 44.1%; 95% confidence interval 0.97-1.36; P = 0.11).

Clinical impact: In patients with large vessel occlusion stroke treated within 24 hours and achieving near-complete to complete reperfusion after endovascular thrombectomy, adding intra-arterial tenecteplase didn’t significantly improve the chances of being free from disability.

Source:

Huang J, et al; POST-TNK Investigators. (2025, January 13). JAMA. Intra-Arterial Tenecteplase Following Endovascular Reperfusion for Large Vessel Occlusion Acute Ischemic Stroke: The POST-TNK Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/39804681/