{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T15:55:45Z","timestamp":1786636545965,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"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":["Brain and Behavior"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Whether to use tenecteplase for acute ischemic stroke patients in the extended window has so far been little studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this meta\u2010analysis, we included all the randomized controlled trials comparing tenecteplase with control at 4.5 to 24\u00a0h after the last known well of acute ischemic stroke with large vessel occlusion. A systematic search was performed in PubMed, Web of Science, Embase, and Cochrane Central Register of Controlled Trials databases, up to 12th June, 2024. Our primary outcome was an excellent functional outcome with a modified Rankin scale score (mRS) of 0\u20131 at 90 days. Our safety outcomes included mRS 5\u20136 at 90\u00a0days, mortality within 90\u00a0days, symptomatic intracranial hemorrhage and parenchymal hematoma Type 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ultimately, three studies involving 1198 patients were included in the pooled analysis, where tenecteplase exhibited a higher rate of mRS 0\u20131 at 90\u00a0days (OR, 1.36; 95%CI, 1.07\u20131.75;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01) and recanalization (OR, 3.30; 95%CI, 1.59\u20136.84;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001). For other outcomes, no significant differences were found between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This meta\u2010analysis of randomized controlled trials manifested that tenecteplase within a 4.5\u2010 to 24\u2010h time window of large vessel occlusion stroke was superior to control for an excellent functional outcome (mRS 0\u20131) without safety concerns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71037","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T06:42:22Z","timestamp":1763793742000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tenecteplase for Ischemic Stroke due to Large Vessel Occlusion at 4.5 to 24 Hours: A Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1002","volume":"15","author":[{"given":"Shuangzhe","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixin","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjun","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kejia","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yizhe","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yige","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyun","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases  Beijing China"},{"name":"Chinese Institute for Brain Research  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/23969873221150022"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2310392"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713973"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.063366"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987321989865"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004062"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(19)31053\u20100"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1716405"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.124.048375"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1474\u20104422(08)70044\u20109"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(14)60584\u20105"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1474\u20104422(24)00369\u20107"},{"key":"e_1_2_12_14_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins J. 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