{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:09:49Z","timestamp":1787497789742,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Tenecteplase improves reperfusion compared to alteplase in patients with large vessel occlusions. To determine whether this improvement varies across the spectrum of thrombolytic agent to reperfusion assessment times, we performed a comparative analysis of tenecteplase and alteplase reperfusion rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with large vessel occlusion and treatment with thrombolysis were pooled from the Melbourne Stroke Registry, and the EXTEND\u2010IA and EXTEND\u2010IA TNK trials. The primary outcome, thrombolytic\u2010induced reperfusion, was defined as the absence of retrievable thrombus or\u2009&gt;50% reperfusion at imaging reassessment. We compared the treatment effect of tenecteplase and alteplase, accounting for thrombolytic to assessment exposure times, via Poisson modeling. We compared 90\u2010day outcomes of patients who achieved reperfusion with a thrombolytic to patients who achieved reperfusion via endovascular therapy using ordinal logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 893 patients included in the primary analysis, thrombolytic\u2010induced reperfusion was observed in 184 (21%) patients. Tenecteplase was associated with higher rates of reperfusion (adjusted incidence rate ratio [aIRR] =\u20091.50, 95% confidence interval [CI] =\u20091.09\u20132.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.01). Findings were consistent in patient subgroups with first segment (aIRR\u00a0=\u00a01.41, 95% CI\u00a0=\u00a00.93\u20132.14) and second segment (aIRR\u00a0=\u00a02.07, 95% CI\u00a0=\u00a00.98\u20134.37) middle cerebral artery occlusions. Increased thrombolytic to reperfusion assessment times were associated with reperfusion (tenecteplase: adjusted risk ratio [aRR] =\u20091.08 per 15\u2009minutes, 95% CI\u00a0=\u00a01.04\u20131.13 vs alteplase: aRR\u00a0=\u00a01.06 per 15\u2009minutes, 95% CI\u00a0=\u00a01.00\u20131.13). No significant treatment\u2010by\u2010time interaction was observed (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.87). Reperfusion via thrombolysis was associated with improved 90\u2010day modified Rankin Scale scores (adjusted common odds ratio\u00a0=\u00a02.15, 95% CI\u00a0=\u00a01.54\u20133.01) compared to patients who achieved reperfusion following endovascular therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Tenecteplase, compared to alteplase, increases prethrombectomy reperfusion, regardless of the time from administration to reperfusion assessment. Prethrombectomy reperfusion is associated with better clinical outcomes. ANN NEUROL 2023;93:489\u2013499<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.26547","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T01:40:05Z","timestamp":1668649205000},"page":"489-499","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Tenecteplase Improves Reperfusion across Time in Large Vessel Stroke"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8814-6853","authenticated-orcid":false,"given":"Vignan","family":"Yogendrakumar","sequence":"first","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Beharry","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"},{"name":"Department of Medicine, Austin Health University of Melbourne  Heidelberg Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonid","family":"Churilov","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khairunnisa","family":"Alidin","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Ugalde","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Pesavento","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Weir","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Radiology Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Kleinig","sequence":"additional","affiliation":[{"name":"Department of Neurology Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawaf","family":"Yassi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"},{"name":"Population Health and Immunity Division Walter and Eliza Hall Institute of Medical Research  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Thijs","sequence":"additional","affiliation":[{"name":"Department of Medicine, Austin Health University of Melbourne  Heidelberg Victoria Australia"},{"name":"Florey Institute of Neuroscience and Mental Health University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teddy Y.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology Christchurch Hospital  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darshan G.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurology Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen M.","family":"Dewey","sequence":"additional","affiliation":[{"name":"Eastern Health and Eastern Health Clinical School, Department of Neurosciences Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tissa","family":"Wijeratne","sequence":"additional","affiliation":[{"name":"Melbourne Medical School, Department of Medicine and Neurology University of Melbourne and Western Health, Sunshine Hospital  St Albans Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"},{"name":"Department of Radiology Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia M.","family":"Desmond","sequence":"additional","affiliation":[{"name":"Department of Radiology Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gagan","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.","family":"Parsons","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"},{"name":"Department of Neurology Liverpool Hospital, University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey A.","family":"Donnan","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3632-9433","authenticated-orcid":false,"given":"Bruce C. V.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Royal Melbourne Stroke Registry and EXTEND\u2010IA TNK Collaborators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2021-017441"},{"key":"e_1_2_10_3_1","article-title":"Immediate recanalization of large\u2010vessel occlusions by tissue plasminogen activator occurs in 28% of patients treated in a Mobile stroke unit","volume":"2","author":"Czap AL","year":"2022","journal-title":"Stroke Vasc Interv Neurol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021840"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.6959"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1716405"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.022335"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.12498"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.031591"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.14132649"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4048"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2003.tb00153.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1109842"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004062"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00171-5"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2018.01998"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25978"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1511"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414792"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1813046"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1706442"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713973"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.10.3032"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-015-0280-9"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2019.01648"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.017235"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.4404"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.730250"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182695916"}],"container-title":["Annals of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ana.26547","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ana.26547","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ana.26547","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T10:18:23Z","timestamp":1717755503000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ana.26547"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,30]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1002\/ana.26547"],"URL":"https:\/\/doi.org\/10.1002\/ana.26547","archive":["Portico"],"relation":{},"ISSN":["0364-5134","1531-8249"],"issn-type":[{"value":"0364-5134","type":"print"},{"value":"1531-8249","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,30]]},"assertion":[{"value":"2022-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}