Tenecteplase before thrombectomy at 4.5 to 24 hours for basilar artery occlusion

Intravenous tenecteplase administered 4.5 to 24 hours after ischemic stroke non–large vessel occlusion improved functional outcomes at 90 days compared to standard care. However, it also increased the risk of symptomatic intracranial hemorrhage.

A study published in JAMA found that intravenous tenecteplase prior to endovascular treatment did not improve clinical outcomes compared to EVT alone for patients with proximal middle cerebral artery occlusion. The results suggest that EVT may be the preferred treatment option for this patient population.

Intravenous thrombolysis (IVT) plus thrombectomy demonstrates significant benefits over thrombectomy alone when administered within a short timeframe after symptom onset. This study, based on individual participant data from six randomized clinical trials, found IVT before thrombectomy to be time-dependent and statistically significant.

Adjunctive intravenous tirofiban increased the likelihood of an excellent outcome at 90 days in patients with acute ischemic stroke who had inadequate response to tenecteplase. The study found improved outcomes in these patients, providing new insights into treatment options.

A randomized clinical trial of 1,680 patients with acute ischemic stroke due to large-vessel occlusion found no significant improvement in disability with adjunctive methylprednisolone. The study suggests that methylprednisolone may not be effective as an adjunct therapy after endovascular thrombectomy for this patient population.

A new study published in the Chinese Neurosurgical Journal found that most basilar trunk artery aneurysms can be treated effectively using endovascular techniques, resulting in encouraging long-term recovery rates. However, larger aneurysms pose higher treatment risks and are associated with complications and poorer outcomes.