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Qiu, Zhongming, Li, Fengli, Xie, Dongjing, Yuan, Guangxiong, Nguyen, Thanh N., Zhou, Kai, Nogueira, Raul G., Saver, Jeffrey L., Campbell, Bruce C.V., Albers, Gregory W., Sang, Hongfei, Li, Linyu, Tian, Yan, Meng, Zhaoyou, Wang, Duolao 
ORCID: https://orcid.org/0000-0003-2788-2464, Zi, Wenjie and Yang, Qingwu
(2024)
'Efficacy and Safety of Intravenous Tenecteplase Before Endovascular Thrombectomy for Acute Ischemic Stroke: The Multicenter, Randomized, BRIDGE‐TNK Trial Protocol'. Journal of the American Heart Association, Vol 13, Issue 21, e036765.
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qiu-et-al-2024-efficacy-and-safety-of-intravenous-tenecteplase-before-endovascular-thrombectomy-for-acute-ischemic.pdf - Published Version Available under License Creative Commons Attribution Non-commercial No Derivatives. Download (356kB) | Preview |
Abstract
Background
Six randomized trials have not detected a difference between intravenous alteplase plus endovascular thrombectomy and endovascular thrombectomy alone in stroke. Tenecteplase, a recombinant human tenecteplase tissue‐type plasminogen activator, is a genetically modified variant of alteplase. It is unclear whether the outcomes are different if alteplase is replaced with tenecteplase. This trial aims to determine whether intravenous tenecteplase within 4.5 hours of time last known well confers benefit in patients with acute ischemic stroke with large‐vessel occlusion who undergo endovascular thrombectomy.
Methods
BRIDGE‐TNK (Thrombectomy With Versus Without rhTNK‐tPA in Stroke) is an investigator‐initiated, multicenter, prospective, randomized, open‐label trial with blinded end point evaluation conducted at 40 thrombectomy‐capable centers in China. This trial will randomize 544 patients with intravenous thrombolysis–eligible stroke (272 in each arm) with large‐vessel occlusion within 4.5 hours of last known well to receive bridging intravenous tenecteplase with endovascular thrombectomy (tenecteplase‐plus‐thrombectomy group) or endovascular thrombectomy alone (thrombectomy‐alone group). The primary outcome is the proportion of patients achieving functional independence, defined as a score of 0 to 2 on the modified Rankin Scale, at 90 days. Safety will be assessed via symptomatic intracranial hemorrhage at 48 hours and death at 90 days.
Conclusions
BRIDGE‐TNK will provide important data on the role of intravenous tenecteplase before endovascular thrombectomy in patients with acute ischemic stroke with large‐vessel occlusion who can be treated within 4.5 hours of last known well.
| Item Type: | Article |
|---|---|
| Subjects: | QV Pharmacology > Hematologic Agents > QV 190 Drugs affecting blood coagulation WB Practice of Medicine > WB 102.5 Clinical medicine - evidence-based practice |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1161/jaha.124.036765 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 11 Nov 2024 15:26 |
| Last Modified: | 11 Nov 2024 15:26 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/25541 |
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