Actively Recruiting

Phase 3
Age: 18Years +
All Genders
NCT06994975

CHinese ischEmic Stroke Beyond 4.5 Hours With TeNecteplase Under Optimized Non-Contrast CT Selection

Led by Huashan Hospital · Updated on 2025-12-30

890

Participants Needed

2

Research Sites

134 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

The CHESTNUT trial is a multicenter, open-label, blinded-endpoint, randomized, controlled, phase 3 trial. The primary objective of this study is to explore the efficacy and safety of the dose of 0.25 mg/kg tenecteplase (TNK) in Chinese acute ischemic stroke (AIS) patients without substantial infarction on non-contrast computed tomography (NCCT) in an extended time window.

CONDITIONS

Official Title

CHinese ischEmic Stroke Beyond 4.5 Hours With TeNecteplase Under Optimized Non-Contrast CT Selection

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Suspected acute ischemic stroke of anterior cerebral circulation
  • Last known well time >4.5 hours
  • Age 18 years or older
  • Baseline NIHSS score greater than 5
  • Premorbid modified Rankin Scale (mRS) 1 or less
  • Infarct core volume less than 50 mL on automated NCCT post-processing and no visible hypodensity in more than one-third of the middle cerebral artery territory
  • Informed consent signed by patient or legally authorized representative
Not Eligible

You will not qualify if you...

  • Obvious hypodensity on NCCT related to current stroke with no expected benefit from thrombolysis
  • Planned endovascular thrombectomy at time of randomization
  • Allergy to tenecteplase or its ingredients
  • Rapidly improving symptoms
  • Any sign of acute intracranial or subarachnoid hemorrhage on baseline NCCT
  • History of intracranial hemorrhage
  • History of ischemic stroke or major head trauma within last 3 months
  • History of intracranial or intraspinal surgery within last 3 months
  • Gastrointestinal malignancy or bleeding within 21 days
  • Known bleeding disorders or abnormal blood clotting tests
  • Treatment with full-dose low-molecular-weight heparin within last 24 hours
  • Treatment with direct thrombin or factor Xa inhibitors within previous 48 hours unless coagulation tests are normal
  • Initial systolic blood pressure 180 mmHg or higher or diastolic 100 mmHg or higher
  • Initial glucose levels below 2.8 or above 22.22 mmol/L
  • Known or suspected aortic arch dissection
  • Clinical or imaging signs of Moyamoya disease or syndrome
  • Pregnancy or breastfeeding
  • Participation in another investigational drug or device study within past 30 days
  • Terminal illness with expected survival less than three months
  • Other conditions judged by investigators to make participation harmful

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Trial Site Locations

Total: 2 locations

1

Huashan Hospital

Shanghai, Shanghai Municipality, China, 200040

Actively Recruiting

2

Huashan Hospital, Fudan University

Shanghai, China

Not Yet Recruiting

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Research Team

X

Xin Cheng, MD, PhD

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

SINGLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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CHinese ischEmic Stroke Beyond 4.5 Hours With TeNecteplase Under Optimized Non-Contrast CT Selection | DecenTrialz