T-FLAVOR
(2025)Objective
To compare tenecteplase (0.25 mg/kg) versus low-dose alteplase (0.6 mg/kg) for early reperfusion prior to mechanical thrombectomy in Japanese patients with LVO stroke
Study Summary
• Tenecteplase achieved higher early substantial reperfusion than alteplase (10.3% vs 3.6%, p=0.03 per-protocol)
• No significant difference in 90-day functional outcomes (OR 1.47, p=0.11)
• Comparable safety with similar bleeding and mortality rates
• No significant difference in 90-day functional outcomes (OR 1.47, p=0.11)
• Comparable safety with similar bleeding and mortality rates
Intervention
Tenecteplase 0.25 mg/kg vs alteplase 0.6 mg/kg prior to mechanical thrombectomy
Inclusion Criteria
LVO-type ischemic stroke eligible for IVT (within 4.5 hours) and mechanical thrombectomy (within 6 hours)
Study Design
Arms: Tenecteplase 0.25 mg/kg vs Alteplase 0.6 mg/kg
Patients per Arm: 107 tenecteplase, 111 alteplase
Outcome
• Primary: Substantial reperfusion (mTICI ≥2b) 10.3% vs 3.6% (absolute difference 7.4%, 95% CI 0.8–14.0, p=0.03 per-protocol)
• 90-day functional outcome: OR 1.47 (95% CI 0.92–2.35, p=0.11)
• Major bleeding: 1.9% vs 0% (p=0.15)
• 90-day mortality: 6.5% vs 9.9% (p=0.36)
• 90-day functional outcome: OR 1.47 (95% CI 0.92–2.35, p=0.11)
• Major bleeding: 1.9% vs 0% (p=0.15)
• 90-day mortality: 6.5% vs 9.9% (p=0.36)