Evaluating Tenecteplase Treatment Versus Standard Care for Adults with Acute Ischemic Stroke Caused by Medium Vessel Occlusion within 4.5 to 24 Hours

What this Trial Is About

Researchers are studying adult patients who have had an acute ischemic stroke caused by blockage in medium-sized brain blood vessels. This trial aims to evaluate the effectiveness and safety of tenecteplase compared to standard medical care in patients treated within 4.5 to 24 hours after stroke symptoms begin. The study focuses on a specific group with confirmed medium vessel occlusions and uses imaging methods to select participants based on brain blood flow and damage. Participants will be randomly assigned to receive either a single intravenous dose of tenecteplase 0.25 mg per kilogram, up to 25 mg or standard medical treatment, which may include aspirin andor clopidogrel, following national stroke care guidelines. Treatments will be given between 4.5 and 24 hours after the patient was last seen well. The trial is controlled, randomized, and open-label with blinded evaluation of outcomes. During the study, participants will be monitored through clinical assessments including the National Institutes of Health Stroke Scale and the modified Rankin scale to measure disability at 90 days. Imaging tests such as CT or MRI perfusion scans will be used to evaluate brain blood flow and damage. Researchers will track neurological improvement, adverse events, bleeding events, and quality of life up to one year after treatment. The main outcome is the proportion of patients achieving minimal disability at 90 days post-treatment.

Advancing Reperfusion Therapy for Ischemic Stroke (ARTS): Tenecteplase in Medium Vessel Occlusion (MeVO) for Acute Ischemic Stroke