PT  - JOURNAL ARTICLE
AU  - Huo, Xiaochuan
AU  - Luo, Gang
AU  - Sun, Dapeng
AU  - Nguyen, Thanh
AU  - Abdalkader, Mohamad
AU  - Chen, Wenhuo
AU  - Yao, Xiaoxi
AU  - Yuan, Guangxiong
AU  - Yi, Tingyu
AU  - Han, Hongxin
AU  - Pan, Yuesong
AU  - Jovin, Tudor G
AU  - Liebeskind, David S
AU  - Liu, Liping
AU  - Zhao, Xingquan
AU  - Ren, Zeguang
AU  - Wang, Yilong
AU  - Wang, Yongjun
AU  - Yan, Bernard
AU  - Miao, Zhongrong
TI  - Intra-arterial tenecteplase after successful endovascular therapy (ANGEL-TNK): protocol of a multicentre, open-label, blinded end-point, prospective, randomised trial
AID  - 10.1136/svn-2024-003318
DP  - 2024 Oct 02
TA  - Stroke and Vascular Neurology
PG  - svn-2024-003318
4099  - http://svn.bmj.com/content/early/2024/11/21/svn-2024-003318.short
4100  - http://svn.bmj.com/content/early/2024/11/21/svn-2024-003318.full
AB  - Background Despite successful reperfusion after thrombectomy for large vessel occlusion (LVO) stroke, up to half of patients are dependent or dead at 3-month follow-up.The aim of the current study is to demonstrate safety and efficacy of administering adjunct intra-arterial (IA) tenecteplase in anterior circulation LVO patients who have achieved successful reperfusion defined as eTICI 2b50 to 3.Methods ANGEL-TNK is a multicentre, open-label, assessor-blinded endpoint, prospective randomised, controlled trial that will enrol up to 256 patients. Patients who meet inclusion criteria with anterior circulation LVO stroke and successful reperfusion will be randomised to receive IA tenecteplase or best medical management at 1:1 ratio.Results The primary endpoint is a 90-day excellent outcome defined as modified Rankin Scale (mRS) 0–1. The primary safety endpoint is symptomatic intracranial haemorrhage within 48 hours from randomisation. Secondary endpoints include 90-day ordinal mRS, mRS 0–2, mRS 0–3, all-cause mortality and any intracranial haemorrhage.Conclusion In patients with anterior circulation LVO stroke, the ANGEL-TNK trial will inform whether adjunct IA tenecteplase administered after successful thrombectomy reperfusion improves patient outcomes.Trial registration number NCT05624190.Data are available upon reasonable request.