Tenecteplase Efficacy in Patients With Distal Occlusions: Secondary Analysis of the TASTE Randomized Clinical Trial.
StrokeJul 22, 2026 (epub)
Vignan Yogendrakumar, Justin Phung, Hannah T Johns et al.
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In 30 seconds
This secondary analysis of the TASTE randomized clinical trial evaluated the efficacy of tenecteplase versus alteplase in patients with distal occlusions, specifically those involving M3 and beyond, anterior, and posterior cerebral artery territories. Among 492 patients, tenecteplase was associated with a higher proportion achieving a modified Rankin Scale (mRS) score of 0 to 1 at 90 days for distal occlusions (77% vs 63%; adjusted risk ratio, 1.23).
Key findings
- Tenecteplase led to a higher mRS score of 0 to 1 at 90 days for distal occlusions (77% vs 63%).
- For distal M2 occlusions, tenecteplase showed a mRS score of 0 to 1 of 65% compared to 58% for alteplase.
- In anterior cerebral artery occlusions, tenecteplase had a mRS score of 0 to 1 of 57% versus 38% for alteplase.
- No significant treatment differences were observed for proximal M2 or posterior cerebral artery occlusions.
Why it matters
Understanding the differential efficacy of thrombolytic agents in various occlusion sites can guide treatment decisions in acute ischemic stroke, potentially improving patient outcomes.