TECNO
(2026)Objective
To assess whether intra-arterial tenecteplase 3 mg post-EVT improves reperfusion in patients with incomplete reperfusion (eTICI 2a-2c) after thrombectomy.
Study Summary
• Early reperfusion (post-rand angio): 39% vs 36% (NS).
• Late reperfusion (24h perfusion): 51% vs 40% (NS).
• 90-day mRS 0-2: 28% vs 38% (NS) - numeric trend toward harm.
• sICH 5.2% vs 8.6% (NS); mortality 25% vs 17% (NS).
• >50% of patients still had reperfusion deficits despite IA-TNK.
• Late reperfusion (24h perfusion): 51% vs 40% (NS).
• 90-day mRS 0-2: 28% vs 38% (NS) - numeric trend toward harm.
• sICH 5.2% vs 8.6% (NS); mortality 25% vs 17% (NS).
• >50% of patients still had reperfusion deficits despite IA-TNK.
Intervention
IA tenecteplase 3 mg post-EVT vs no additional thrombolytic
Inclusion Criteria
Europe. ICA/M1-M3/A1-A2/P1-P2 occlusion; EVT within 12 h; incomplete reperfusion eTICI 2a-2c; ASPECTS >=5 (NCCT) or >=4 (DWI).
Study Design
Arms: IA-TNK 3 mg post-EVT vs no adjunctive lytic
Patients per Arm: IA-TNK n=79 vs Control n=80 (total 159)
Outcome
• Primary recanalization (early): 39% vs 36% (NS).
• Late reperfusion (24h): 51% vs 40% (NS).
• 90-day mRS 0-2: 28% vs 38% (NS).
• sICH: 5.2% vs 8.6% (NS).
• Mortality: 25% vs 17% (NS).
• Late reperfusion (24h): 51% vs 40% (NS).
• 90-day mRS 0-2: 28% vs 38% (NS).
• sICH: 5.2% vs 8.6% (NS).
• Mortality: 25% vs 17% (NS).