{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T20:45:32Z","timestamp":1784234732839,"version":"3.55.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Minor stroke and transient ischemic attack with an intracranial occlusion are associated with neurological deterioration and disability. Tenecteplase (TNK\u2013tissue-type plasminogen activator) compared with alteplase is easier to administer, has a longer half-life, higher fibrin specificity, possibly a lower rate of intracranial hemorrhage, and may be an ideal thrombolytic agent in this population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>TNK\u2013Tissue-Type Plasminogen Activator Evaluation for Minor Ischemic Stroke With Proven Occlusion (TEMPO-1) was a multicenter, prospective, uncontrolled, TNK\u2013tissue-type plasminogen activator dose-escalation, safety, and feasibility trial. Patients with a National Institutes of Health Stroke Scale \u22645 within 12 hours of symptom onset, intracranial arterial occlusion on computed tomographic angiography and absence of well-evolved infarction were eligible. Fifty patients were enrolled; 25 patients at a dose of 0.1 mg\/kg, and 25 patients at 0.25 mg\/kg. Primary outcome was the rate of drug-related serious adverse events. Secondary outcomes included recanalization and 90-day neurological outcome (modified Rankin Scale, 0\u20131).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              Median baseline National Institutes of Health Stroke Scale was 2.5 (interquartile range, 1), and median age was 71 (interquartile range, 22) years. There were no drug-related serious adverse events in tier 1. In tier 2, there was 1 symptomatic intracranial hemorrhage (4%; 95% confidence interval, 0.01\u201320.0). Stroke progression occurred in 6% of cases. Overall, 66% had excellent functional outcome (modified Rankin Scale, 0\u20131) at 90 days. Recanalization rates were high; 0.1 mg\/kg (39% complete and 17% partial), 0.25 mg\/kg (52% complete and 9% partial). Complete recanalization was significantly related to excellent functional outcome (modified Rankin Scale, 0\u20131) at 90 days (relative risk, 1.65; 95% confidence interval, 1.09\u20132.5;\n              <jats:italic>P<\/jats:italic>\n              =0.026).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Administration of TNK\u2013tissue-type plasminogen activator in minor stroke with intracranial occlusion is both feasible and safe. A larger randomized controlled trial is needed to prove that this treatment is efficacious.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT01654445.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.114.008504","type":"journal-article","created":{"date-parts":[[2015,2,13]],"date-time":"2015-02-13T04:16:50Z","timestamp":1423801010000},"page":"769-774","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":128,"title":["Tenecteplase\u2013Tissue-Type Plasminogen Activator Evaluation for Minor Ischemic Stroke With Proven Occlusion"],"prefix":"10.1161","volume":"46","author":[{"given":"Shelagh B.","family":"Coutts","sequence":"first","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e9ronique","family":"Dubuc","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Mandzia","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Kenney","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Demchuk","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric E.","family":"Smith","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suresh","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayank","family":"Goyal","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivanand","family":"Patil","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijoy K.","family":"Menon","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Barber","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dar","family":"Dowlatshahi","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thalia","family":"Field","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Negar","family":"Asdaghi","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Christine","family":"Camden","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Hill","sequence":"additional","affiliation":[{"name":"From the Calgary Stroke Program, Departments of Clinical Neurosciences (S.B.C., V.D., J.M., C.K., A.M.D., E.E.S., S.S., M.G., B.K.M., P.A.B., M.D.H.), Radiology (S.B.C., A.M.D., E.E.S., M.G., S.P., B.K.M., M.D.H.), Community Health Sciences (E.E.S., M.D.H.), and Medicine (M.D.H.), and Hotchkiss Brain Institute (S.B.C., A.M.D., E.E.S., M.G., B.K.M., P.A.B., M.D.H.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine (Neurology), Ottawa Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002881"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000109767.11426.17"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.613208"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.8.1015"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.482554"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000185798.78817.f3"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000237520.88777.71"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0070996"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.637421"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)07403-6"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200241150-00001"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1109842"},{"key":"e_1_3_4_14_2","unstructured":"TNK-tPA Evaluation for Minor Ischemic Stroke With Proven Occlusion (TEMPO-1) clinical trial listing. Clinical trials.gov Web site. https:\/\/www.Clinicaltrials.Gov\/ct2\/show\/nct01654445. Accessed January 1 2015."},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60149-4"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.32.2.438"},{"key":"e_1_3_4_17_2","first-page":"1581","article-title":"The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group.","volume":"333","author":"Tissue Plasminogen Activator for Acute Ischemic Stroke","year":"1995","unstructured":"Tissue Plasminogen Activator for Acute Ischemic Stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. N Engl J Med. 1995;333:1581\u20131587.","journal-title":"N Engl J Med"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.513234"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.2307\/2531693"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.071253"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000572"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.665141"},{"key":"e_1_3_4_23_2","first-page":"156","article-title":"Effect of thrombolysis in a minor stroke population. Analysis of minor stroke patients treated in the ist-3 study.","volume":"37","author":"Coutts SB","year":"2014","unstructured":"Coutts SB, Lindley RI, Hill MD, Cohen G, J.M. W, Sandercock P, et al.. Effect of thrombolysis in a minor stroke population. Analysis of minor stroke patients treated in the ist-3 study. Cerebrovasc Dis. 2014;37:156.","journal-title":"Cerebrovasc Dis"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4048"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60584-5"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)80089-3"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.000126"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000154872.73240.e9"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.572040"},{"key":"e_1_3_4_30_2","unstructured":"Coutts SB Wein TH Lindsay MP Buck B Cote R Ellis P et al.. Canadian Stroke Best Practice Recommendations: secondary prevention of stroke guidelines update 2014 [published online ahead of print December 23 2014]. Int J Stroke. http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijs.12439\/full. Accessed January 1 2015."},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411587"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.114.008504","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:18:25Z","timestamp":1715609905000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.114.008504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,3]]}},"alternative-id":["10.1161\/STROKEAHA.114.008504"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.114.008504","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3]]},"assertion":[{"value":"2014-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-01-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-02-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}