Tenecteplase Boosts Late-Window Reperfusion but Not 90-Day Function

For neurology pharmacists, this Chinese phase IIb trial shows 0.25 mg/kg tenecteplase improves imaging-defined reperfusion in the 4.5- to 24-hour window without changing clinical outcomes.

tenecteplasethrombolysisacute ischemic strokelarge vessel occlusionperfusion imagingendovascular treatmentextended time windowCHABLIS-T IIphase IIb RCTneuropharmacology Neurology / Neuropharmacology

Background Information

Tenecteplase enhances late-window stroke reperfusion without added hemorrhage risk.

Extending thrombolysis treatment to 24 hours with imaging selection could increase options for stroke patients. Tenecteplase showed a 33.3% major reperfusion rate compared to 10.8% with best medical treatment, without increased hemorrhagic risk. While tenecteplase improves reperfusion in an extended window, the 90-day clinical outcomes did not improve; further large-scale studies are needed. Tenecteplase extends thrombolysis efficacy for stroke up to 24 hours with specific imaging criteria.

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Authors: Cheng X, Hong L, Lin L, Churilov L, Ling Y, Yang N, Fu J, Lu G, Yue Y, Zhang J, Wang F, Wang Z, Zhao Y, Zhou X, Peng Z, Wu D, Zhao L, Zhai Q, Yu X, Fang Q, Shao X, Tang Y, Zhang D, Geng Y, Zhang Y, Fan B, Zhang B, Yin C, Chen Y, Zhang Y, Liu X, Li S, Yang L, Parsons M, Dong Q, CHABLIS-T II Collaborators

Citation: Cheng X, Hong L, Lin L, et al. Tenecteplase Thrombolysis for Stroke up to 24 Hours After Onset With Perfusion Imaging Selection: The CHABLIS-T II Randomized Clinical Trial. Stroke. 2025;56(2):344-354. doi:10.1161/STROKEAHA.124.048375

Article Links: PubMed · Journal / DOI

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