Research Highlights:
Embargoed until 11:27 a.m. PT/2:27 p.m. ET Friday, Feb. 7, 20 25
LOS ANGELES, Feb. 7, 2025 — Removing a blood clot from a large brain artery, then injecting the clot-dissolving drug tenecteplase into the artery resulted in stroke survivors being more likely to have better function 90 days after their stroke than those receiving standard clot removal, according to preliminary late-breaking science presented today at the American Stroke Association’s International Stroke Conference 2025 . The conference, in Los Angeles, Feb. 5-7, 2025, is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.
About 1 in 5 clot-caused (ischemic) strokes result from a clot obstructing a large artery (large vessel occlusions) in the brain. The standard of care in the U.S. per the American Heart Association/American Stroke Association 2019 Guidelines for the Early Management of Patients with Acute Ischemic Stroke and in China for this type of stroke is prompt removal of the clot to restore blood flow using minimally invasive endovascular treatment – a procedure that inserts a slim catheter (small tube) and/or a stent into an artery to retrieve the clot and restore blood flow, preventing further brain damage.
Without treatment, more than 80% of people with strokes caused by large vessel occlusions are disabled, and 20% die, based on prior studies. Even when clots are successfully removed, up to half of the people may die or be disabled three months later.
”Endovascular treatment can help restore blood flow in a blocked large blood vessel. However, it might not improve blood flow in the smaller vessels and microcirculation in the area. This clinical trial tests whether delivering tenecteplase directly into the affected artery after endovascular treatment can break up blood clots in the small vessels and improve blood flow, reducing the amount of brain tissue that lacks blood supply,” said Xiaochuan Huo, M.D., Ph.D., lead author of the study and director of the neurological disease center at Beijing Anzhen Hospital in China.
The current study, conducted at 19 centers in China, evaluated the safety and effectiveness of injecting tenecteplase directly into a large brain artery (intra-arterial injection) near where a clot was removed and restoring blood flow. All participants had large vessel occlusions and were treated between 4.5 hours and 24 hours after the last time they were observed to be well. According to the study protocols, 127 patients received tenecteplase and successfully underwent endovascular therapy, and 129 received standard medical care (in the full analysis population for the final results) after successful endovascular therapy. Disability was measured by a score of 0-1 on the modified Rankin Scale with ratings from 0 (no disability) to 6 (death).
The analysis found:
“Intra-arterial tenecteplase after successful thrombectomy could improve the percentage of people with an excellent outcome. It could also improve the rate of large vessel occlusion stroke survivors who can return to society and live independently,” Huo said.
The researchers are following the participants to assess their one-year outcomes. Huo said their results may someday be used to change treatment guidelines for stroke survivors who have undergone successful clot removal. “We still need to directly analyze the individual data of participants in this and other trials – an individual meta-analysis – in order to release a high evidence-based recommendation,” Huo said.
The study did not include patients treated with intravenous clot-busting drugs or medications that reduce blood clotting, like heparin and anti-platelet drugs, during their endovascular procedures. This means that the benefits of intra-arterial tenecteplase shown in this study may not apply to people who received those treatments.
Study background, details and design:
Study co-authors, funding and disclosures are available in the abstract.
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About the American Stroke Association
The American Stroke Association is devoted to saving people from stroke — the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit stroke.org . Follow us on Facebook , X .
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