{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:32:02Z","timestamp":1791570722282,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effectiveness and safety of tenecteplase (TNK) versus alteplase (TPA) in patients with basilar artery occlusion prior to endovascular treatment (EVT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective multicenter study (BAO\u2010TNK), we analyzed consecutive BAO patients from 14\u2009U.S. stroke systems who received TNK or TPA within 4.5\u2009h of last known well and were referred for EVT (01\/2020\u201008\/2024). Multivariable logistic regression models were adjusted for age, sex, NIH Stroke Scale (NIHSS), posterior circulation Alberta Stroke Program Early CT Score (pc\u2010ASPECTS), last\u2010known\u2010well\u2010to\u2010door time, and stroke etiology. Outcomes included 90\u2010day modified Rankin Scale (mRS), reperfusion rates, and intracranial hemorrhage (ICH) per Heidelberg classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 163 BAO patients, 75 (46.0%) received TNK and 88 (54.0%) received TPA. Rates of 90\u2010day good functional outcome (mRS 0\u20133) were comparable between groups (TNK: 61.8% vs. TPA: 48.8%, adjusted odds ratio [aOR] 1.372, 95% CI 0.616\u20133.054,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.439). No significant differences were observed in rates of pre\u2010thrombectomy early reperfusion (18.7% vs. 14.8%, aOR 0.933, 95% CI 0.369\u20132.359,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.884), post\u2010thrombectomy final reperfusion (97.3% vs. 92.0%, aOR 2.133, 95% CI 0.376\u201312.116,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.393), 90\u2010day mortality (32.4% vs. 39.5%, aOR 0.989, 95% CI 0.436\u20132.244,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.979), or symptomatic ICH (4.0% vs. 4.5%, aOR 1.319, 95% CI 0.245\u20137.114,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.747). Predictors of favorable outcome included younger age, lower NIHSS, higher pc\u2010ASPECTS, shorter LKW\u2010to\u2010puncture time, and non\u2010atherothrombotic stroke etiology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>In BAO stroke, TNK and TPA administered within 4.5\u2009h pre\u2010EVT were associated with similar functional outcomes, reperfusion success and hemorrhage rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70240","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T14:04:56Z","timestamp":1763129096000},"page":"574-580","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Basilar Artery Occlusion Stroke Managed With Tenecteplase Versus Alteplase Before Endovascular Treatment (BAO\u2010TNK)"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2111-5523","authenticated-orcid":false,"given":"Rahul R.","family":"Karamchandani","sequence":"first","affiliation":[{"name":"Department of Neurology Wake Forest University School of Medicine, Neurosciences Institute, Advocate Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan N.","family":"Wolman","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging Warren Alpert School of Medicine at Brown University, Rhode Island Hospital  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler M.","family":"Bielinski","sequence":"additional","affiliation":[{"name":"Geisinger College of Health Sciences  Scranton Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Semmes Murphey Clinic University of Tennessee Health Sciences Center  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy B.","family":"Rhoten","sequence":"additional","affiliation":[{"name":"Department of Neurology Wake Forest University School of Medicine, Neurosciences Institute, Advocate Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh V.","family":"Jayaraman","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging Warren Alpert School of Medicine at Brown University, Rhode Island Hospital  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian T.","family":"Sidebottom","sequence":"additional","affiliation":[{"name":"Department of Neurology, Semmes Murphey Clinic University of Tennessee Health Sciences Center  Memphis Tennessee 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