Tenecteplase, alteplase, and endovascular thrombectomy in extended-window acute ischemic stroke with intracranial large-vessel occlusion: a Bayesian network meta-analysis
Oct 2026· Journal of Neurology· Vol 273· 0 citations· 28 references
Medicine
TL;DR
Among imaging-selected patients with confirmed intracranial LVO or BAO treated 4.5 to 24 hours after onset or last known well, EVT had the most consistent evidence of benefit versus placebo or best medical care.
IntroductionThe role of intravenous tenecteplase (TNK) in patients with acute ischemic stroke presenting 4.5-24 hours after last known well remains uncertain.MethodsWe performed a systematic review and frequentist and Bayesian meta-analysis of Randomized Controlled Trials (RCTs) comparing TNK-containing with trial-spec...
J. V. Andrade Fernandes, G. C. N. Tudella, Leonardo Reischoffer Do Nascimento et al.· The Neuroradiology Journal· 0 citations
BACKGROUND
Mechanical thrombectomy (MT) is a key intervention for acute ischemic stroke due to large vessel occlusion (LVO). Various MT strategies - stent retriever (SR), aspiration (Asp), and their combination (SR + Asp) - are widely used, but the optimal approach remains unclear.
OBJECTIVES
This network meta-analys...
A. Gulia, M. Srivastava, M. Nath et al.· Acta neurologica Taiwanica· 0 citations
Background: Successful endovascular thrombectomy does not always result in optimal neurological recovery in patients with acute ischemic stroke, likely because macrovascular recanalization may not fully restore distal or microvascular perfusion. Adjunctive intra-arterial thrombolysis (IAT) has emerged as a potential st...
M. M. Al-Salihi, M. S. Al-Jebur, Ahmad Abuaisheh et al.· Neurology International· 0 citations
Background Tenecteplase can be given as a single bolus, but comparative estimates from routine stroke care are susceptible to treatment-selection bias. Methods: We reviewed 269 adults treated at one center with intravenous tenecteplase (n = 110) or alteplase (n = 159) within 4.5 h of symptom onset from March 2024 throu...
BACKGROUND
Endovascular treatment (EVT) is the standard of care for acute basilar artery occlusion (BAO) although the role of bridging intravenous thrombolysis (IVT) with alteplase prior to EVT remains debated. Whether the effect of bridging IVT differs across EVT techniques has not been systematically assessed.
METH...
Muhammad Jaffar, K. Ahmed, S. Abu-Rumeileh et al.· Journal of the American Hear...· 0 citations
BACKGROUND AND OBJECTIVES
Intravenous thrombolysis (IVT) is the standard treatment for acute ischemic stroke within 4.5 hours of onset. However, imaging-based selection may extend the treatment window. This systematic review and meta-analysis evaluated the efficacy and safety of IVT administered beyond 4.5 hours after...
S. Rahmati, Mohammadreza Alinejadfard, Y. Zarinfar et al.· Neurology Clinical Practice· 0 citations
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