Effect of Baseline ASPECTS on Tenecteplase Efficacy Before Thrombectomy in Acute Large-Vessel Occlusion…

Randomized trialNeurology· Sep 2026

Effect of Baseline ASPECTS on Tenecteplase Efficacy Before Thrombectomy in Acute Large-Vessel Occlusion Stroke: A Post Hoc Analysis of the BRIDGE-TNK Randomized Trial.

Xianjun Huang, Junfeng Xu, Jeffrey L Saver … Zibao Li

NeuroendovascularRandomized trialQ1IF 3.8

Tenecteplase before thrombectomy improved functional independence in stroke with Alberta Stroke Program Early Computed Tomography Score <8

Effect of Baseline ASPECTS on Tenecteplase Efficacy Before Thrombectomy in Acute Large-Vessel Occlusion Stroke: A Post Hoc Analysis of the BRIDGE-TNK Randomized Trial.

Xianjun Huang … Zibao Li

Neurology · Sep 2026 · Q1 in Neurology

Background

The impact of ischemic extent on the efficacy and safety of intravenous thrombolysis before thrombectomy remains uncertain.

Purpose

The aim of this study was to evaluate whether the baseline ischemic extent, measured by the Alberta Stroke Program Early Computed Tomography Score (Alberta Stroke Program Early Computed Tomography Score), modifies outcomes of intravenous tenecteplase administered before endovascular thrombectomy.

Methods

This was a post hoc analysis of the BRIDGE-TNK (thrombectomy with vs without rhTNK-tPA in stroke) trial, conducted across China from May 2022 to September 2024.

n = 550 patients

Results

67% higher rate of functional independence with tenecteplase added

aRR 1.67 (95% CI 1.18 to 2.35)

null 0

1.18

2.35

CI excludes the null - significant

More results

Among 550 patients, 241 (43.8%) had Alberta Stroke Program Early Computed Tomography Score <8 (median [interquartile range, IQR] age, 69 [61-77] years; 56.4% male) and 309 had Alberta Stroke Program Early Computed Tomography Score 8-10 (median [IQR] age, 70 [61-77] years; 59.5% male).

More results

Rates of sICH did not differ significantly between treatment groups in either Alberta Stroke Program Early Computed Tomography Score subgroups (Alberta Stroke Program Early Computed Tomography Score <8: 10.0% vs 11.2%; Alberta Stroke Program Early Computed Tomography Score 8-10: 7.5% vs 2.8%; p interaction = 0.11).

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Conclusion

Prospective confirmation in randomized trials is required before practice change.

Effect of Baseline ASPECTS on Tenecteplase Efficacy Before Thrombectomy in Acute Large-Vessel Occlusion Stroke: A Post Hoc Analysis of the BRIDGE-TNK Randomized Trial.

Effect of Baseline ASPECTS on Tenecteplase Efficacy Before Thrombectomy in Acute Large-Vessel Occlusion Stroke: A Post Hoc Analysis of the BRIDGE-TNK Randomized Trial.

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