Effect of Baseline ASPECTS on Tenecteplase Efficacy Before Thrombectomy in Acute Large-Vessel Occlusion Stroke: A Post Hoc Analysis of the BRIDGE-TNK Randomized Trial.
NeurologyAug 20, 2026 (epub)
Xianjun Huang, Junfeng Xu, Jeffrey L Saver et al.
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In 30 seconds
This post hoc analysis of the BRIDGE-TNK randomized trial evaluated the impact of baseline ischemic extent, measured by ASPECTS, on the efficacy of intravenous tenecteplase before thrombectomy in 550 patients with acute large-vessel occlusion stroke. The study found that functional independence at 90 days was significantly higher in the tenecteplase plus thrombectomy group compared to thrombectomy alone in patients with ASPECTS <8 (adjusted risk ratio 1.67).
Key findings
- Functional independence at 90 days was 1.67 times higher with tenecteplase plus thrombectomy in ASPECTS <8 patients.
- No significant difference in symptomatic intracranial hemorrhage rates between treatment groups in either ASPECTS subgroup.
- Ninety-day mortality was numerically higher with tenecteplase plus thrombectomy in ASPECTS 8-10 subgroup.
Why it matters
Understanding the influence of baseline ischemic extent on treatment outcomes can guide clinicians in making informed decisions regarding thrombolysis and thrombectomy in acute stroke management.