TNKASE (tenecteplase) / Roche, Boehringer Ingelheim - LARVOL DELTA

ASSENT 3 Plus: A Trial on Efficacy and Safety of Full Dose Tenecteplase Combined With Unfractionated Heparin (UFH) or Enoxaparin in Acute Myocardial Infarction (AMI) in the Prehospital Setting (clinicaltrials.gov) - P3 | N=1606 | Completed | Sponsor: Boehringer Ingelheim

New P3 trial • Cardiovascular • Myocardial Infarction

Clot Dissolving Treatment for Blood Clots in the Lungs (clinicaltrials.gov) - P3 | N=87 | Terminated | Sponsor: Jeffrey Kline | N=200 ➔ 87

Enrollment change • Cardiovascular • Pulmonary Embolism • Respiratory Diseases • Thrombosis

Clot Dissolving Treatment for Blood Clots in the Lungs (clinicaltrials.gov) - P3 | N=87 | Terminated | Sponsor: Jeffrey Kline | Recruiting ➔ Terminated; PI changed institution and impossible to solve problem with contract's sites

Trial termination • Cardiovascular • Pulmonary Embolism • Respiratory Diseases • Thrombosis

ASSENT 3: Full Dose Tenecteplase (TNK-tPA) Together With Heparin Sodium, Full Dose Tenecteplase With Enoxaparin, Half Dose Tenecteplase Together With Abciximab and Heparin Sodium in Patients With Acute Myocardial Infarction (AMI) (clinicaltrials.gov) - P3 | N=5989 | Completed | Sponsor: Boehringer Ingelheim

New P3 trial • Cardiovascular • Myocardial Infarction

STREAM-Strategic Reperfusion (With Tenecteplase and Antithrombotic Treatment) Early After Myocardial Infarction (clinicaltrials.gov) - P3 | N=1891 | Completed | Sponsor: Boehringer Ingelheim | Active, not recruiting ➔ Completed

Trial completion • Cardiovascular • Myocardial Infarction

Low-Dose Tenecteplase in Covid-19 Diagnosed With Pulmonary Embolism (clinicaltrials.gov) - P4 | N=45 | Recruiting | Sponsor: Cedars-Sinai Medical Center | Active, not recruiting ➔ Recruiting

Enrollment open • Cardiovascular • Infectious Disease • Novel Coronavirus Disease • Pulmonary Embolism • Respiratory Diseases

Which Therapy for Acute Heart Attacks? (The WEST Study) (clinicaltrials.gov) - P2/3 | N=300 | Completed | Sponsor: University of Alberta | Recruiting ➔ Completed

Trial completion • Cardiovascular • Myocardial Infarction

Low-Dose Tenecteplase in Covid-19 Diagnosed With Pulmonary Embolism (clinicaltrials.gov) - P4 | N=2 | Terminated | Sponsor: Cedars-Sinai Medical Center | N=45 ➔ 2 | Trial completion date: Jun 2022 ➔ Aug 2021 | Recruiting ➔ Terminated | Trial primary completion date: Dec 2021 ➔ Jul 2021; Identification of eligible patients was slower than anticipated.

Enrollment change • Trial completion date • Trial primary completion date • Trial termination • Cardiovascular • Infectious Disease • Novel Coronavirus Disease • Pulmonary Embolism • Respiratory Diseases

STRATEGY-PE: Real-World Treatment Strategies for Intermediate-High Risk Pulmonary Embolism (clinicaltrials.gov) - P=N/A | N=1300 | Not yet recruiting | Sponsor: Nanjing First Hospital, Nanjing Medical University

HEOR • New trial • Real-world evidence • Cardiovascular • Respiratory Diseases • Venous Thromboembolism

Delayed Aneurysmal Rupture following Flow Diverter Placement despite Adjunctive Coiling: Case Report. (PubMed, Case Rep Neurol) - "In our case, in-stent thrombosis occurred on postoperative day 4 and subsequently progressed to aneurysmal rupture, despite the presence of coils within the aneurysm sac. Rupture on the fourth day after Surpass Evolve flow diverter placement - despite initial coil embolization - along with aneurysmal thrombosis, partial recanalization, thrombus extension into the parent vessel, and subsequent treatment with intra-arterial eptifibatide and tenecteplase highlights the profound hemodynamic instability in giant aneurysms that can contribute to post-procedural rupture."

Journal • Cardiovascular • Hematological Disorders • Subarachnoid Hemorrhage • Thrombosis

Tenecteplase in acute ischemic stroke: an updated meta-analysis. (PubMed, Front Neurol) - "Tenecteplase (TNK) has emerged as a promising alternative to alteplase (tPA) for intravenous thrombolysis in acute ischemic stroke (AIS). Further high-quality RCTs are warranted to confirm these findings. CRD420251030320."

Clinical • Journal • Retrospective data • Review • Cardiovascular • Ischemic stroke

UTOPIA: Unknown Time of Onset Stroke RePerfusIon Without Advanced Imaging (clinicaltrials.gov) - P3 | N=352 | Recruiting | Sponsor: First Affiliated Hospital of Guangxi Medical University | Not yet recruiting ➔ Recruiting

Enrollment open • Cardiovascular • Ischemic stroke

Anesthesia for acute ischemic stroke after the 2026 AHA/ASA guideline: a peri-thrombectomy practice framework. (PubMed, J Anesth) - "The 2026 American Heart Association/American Stroke Association guideline for acute ischemic stroke expands eligibility for endovascular thrombectomy, broadens the role of tenecteplase, recommends against routine intensive post-reperfusion systolic blood pressure lowering, introduces an explicit recommendation against intensive glucose control to 80-130 mg/dL, and includes dedicated pediatric recommendations...Practice-model variation is acknowledged, and the framework distinguishes physiologic and escalation principles applicable across staffing models from elements specific to continuous anesthesia-led care. Areas of substantive uncertainty include posterior-circulation anesthetic technique, pediatric peri-procedural management, and the role of intraprocedural neuromonitoring."

Journal • Review • Anesthesia • Cardiovascular • Ischemic stroke • Pediatrics

Door-to-Needle Optimization in Acute Ischemic Stroke: A Review of Rapid Emergency Department Interventions. (PubMed, Cardiol Cardiovasc Med) - "National registry data from the Target: Stroke initiative confirm that these gains scale across a hospital network with concurrent reductions in mortality and symptomatic hemorrhage. The review closes with the trade-off between speed and diagnostic certainty, the reassuring safety profile of thrombolysis in stroke mimics, and the way tenecteplase, imaging-based patient selection, and endovascular thrombectomy are reshaping what the metric measures."

Journal • Cardiovascular • Hematological Disorders • Ischemic stroke

Challenge in perioperative management: Approach and management of Hypovolaemic shock secondary to cardiac tamponade and ventricular rupture, in an adult patient taken to thoracotomy after receiving a thrombolytic therapy with 1 Tenecteplase dose in context of an inferior acute myocardial infarction. (ASA 2026) - "Despite all strategies applied due to patient`s high-risk profile, the patient´s outcome was not satisfactory. This case underscores the necessity of specialized goal directed anaesthetic management and multidisciplinary protocols to mitigate catastrophic outcomes during anaesthesia in patients with ventricular ruptures."

Clinical • Cardiovascular • Myocardial Infarction

A Tale of Two Infarcts: Anesthetic Management of Simultaneous Acute Ischemic Stroke and STEMI (ASA 2026) - "Despite concerns regarding general anesthesia without in-house catheterization availability, the patient received stroke-dose tenecteplase (22.5 mg) and underwent mechanical thrombectomy (TICI 3)...The patient later suffered a right M1 reocclusion and transitioned to medical management. This case highlights anesthesiology's critical role in navigating severe hemodynamic risks during concurrent cardio-cerebral infarctions by balancing cerebral perfusion against the demands of an actively ischemic myocardium."

Cardiovascular • CNS Disorders • Ischemic stroke

Intra-Arterial Tenecteplase After Endovascular Thrombectomy for Acute Stroke: One-Year Outcomes of the ANGEL-TNK Randomized Clinical Trial. (PubMed, JAMA) - No abstract available

Clinical • Journal • Cardiovascular

Risk factors for hemorrhagic transformation after tenecteplase therapy in acute ischemic stroke: A retrospective observational study. (PubMed, Medicine (Baltimore)) - "The model showed acceptable apparent calibration and discrimination (area under the receiver operating characteristic curve = 0.86); however, 14 candidate variables were evaluated for only 28 events (approximately 2 events per variable), creating a substantial risk of overfitting. These findings are hypothesis-generating and require validation in larger independent cohorts."

Journal • Observational data • Retrospective data • Cardiovascular • Hematological Disorders • Ischemic stroke

Cost-effectiveness of Tenecteplase Versus Alteplase for Acute Ischemic Stroke in Canada Based on the AcT Trial. (PubMed, Can J Neurol Sci) - "This analysis represents the first to assess the cost-effectiveness of tenecteplase as an alternative to alteplase in the treatment of AIS in the Canadian setting. Though all benefits related to its simplified bolus administration were not considered, results robustly demonstrate tenecteplase represents a high-value strategy. Together with the accumulating clinical evidence, this study may help support decisions to adopt tenecteplase on hospital formularies."

HEOR • Journal • Cardiovascular • Ischemic stroke

TNK-FLOW: Intra-Arterial Tenecteplase Following Endovascular Thrombectomy for Large Vessel Occlusion Stroke (clinicaltrials.gov) - P2 | N=40 | Enrolling by invitation | Sponsor: Wake Forest University Health Sciences | Trial completion date: Dec 2026 ➔ Jun 2028 | Trial primary completion date: Sep 2026 ➔ Jun 2028

Trial completion date • Trial primary completion date • Cardiovascular • Ischemic stroke

When a side-locked headache becomes a stroke code: indomethacin-responsive hemicrania continua with transient hemiplegia. (PubMed, Proc (Bayl Univ Med Cent)) - "Emergent multimodal neuroimaging was negative; intravenous tenecteplase was administered for suspected ischemic stroke. After the postthrombolysis safety window, an oral indomethacin trial led to complete headache resolution and rapid clearing of deficits. This case illustrates that hemicrania continua can manifest with hemiplegic features due to overlapping cortical spreading depression biology and highlights the diagnostic utility of an inpatient indomethacin trial."

Journal • Cardiovascular • CNS Disorders • Depression • Ischemic stroke • Migraine • Ophthalmology • Pain • Psychiatry

Serum sCD40L and galectin-3 in the prognosis prediction of patients with acute ischemic stroke. (PubMed, J Med Biochem) - "All patients received emergencytreatment with tenecteplase (TNK-tPA) combined withXuesaitong...For predicting poor prognosis, serum galectin-3 and scd40ldemonstrated AUCs of 0.774 and 0.838, respectively; theirspecificities were 67.58% and 75.36% , respectively, whiletheir sensitivities were 75.06% and 80.04% , respectively.The combined prediction of serum galectin-3 and scd40lfor poor prognosis was less effective, with an AUC of 0.919,a specificity of 60.05%, and a sensitivity of 90.63%. Both sCD40L and serum galectin-3 levelshave some prognostic value for poor prognosis and ineffective treatment in AIS patients, and combining their detection can significantly improve predictive efficacy."

Journal • Cardiovascular • Ischemic stroke • CD40LG • LGALS3

IAT-MEVO: Intra-arterial Thrombolysis For Acute Ischemic Stroke With Medium Vessel Occlusion (clinicaltrials.gov) - P3 | N=372 | Recruiting | Sponsor: The First Affiliated Hospital with Nanjing Medical University | Not yet recruiting ➔ Recruiting | Trial completion date: Aug 2029 ➔ May 2029 | Trial primary completion date: Jul 2028 ➔ Jan 2029

Enrollment open • Trial completion date • Trial primary completion date • Cardiovascular • Ischemic stroke

Tenecteplase Before Thrombectomy at 4.5 to 24 Hours for Basilar Artery Occlusion: The ATTENTION LATE Randomized Clinical Trial. (PubMed, JAMA) - P3 | "Among patients with moderate to severe basilar artery occlusion admitted directly to EVT-capable centers who presented 4.5 to 24 hours after stroke onset, the addition of intravenous tenecteplase before EVT did not result in improved functional outcomes compared with EVT alone. ClinicalTrials.gov Identifier: NCT05701956."

Clinical • Journal • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders

Tenecteplase Before Thrombectomy at 4.5 to 24 Hours for Basilar Artery Occlusion: Research Summary. (PubMed, JAMA) - No abstract available

Journal