{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T09:14:14Z","timestamp":1775207654563,"version":"3.50.1"},"reference-count":16,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Adjunct intra-arterial (IA) tenecteplase (TNK) may improve microvascular patency postthrombectomy in acute ischemic stroke (AIS) patients. We determined the effect of IA-TNK on infarct volume in large vessel occlusion (LVO) AIS.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We analyzed the clinical data of AIS-LVO patients who received IA-TNK after endovascular thrombectomy (EVT) and EVT alone. Infarct volume on postintervention magnetic resonance imaging (MRI) (24\u201348 h postprocedure) was calculated using 3D Slicer software. We compared infarct volumes between the groups using one-way analysis of variance, and Pearson correlation assessed the relationship between infarct volume and last known modified Rankin scale (mRS). Statistical analysis was performed using R (version 4.1.2).<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 56 patients with LVO-AIS who underwent EVT were included; 14 patients received adjunctive IA-TNK and 42 received EVT alone. Postprocedure, the proportion of patients who achieved thrombolysis in cerebral infarction \u22652b was 100% versus 88.0% in patients who received adjunctive IA-TNK and those who received EVT alone. The mean (\u00b1standard error) infarct volume on postintervention MRI was significantly smaller in those who received IA-TNK (33.0 \u00b1 9.2 cm\n 3<\/jats:sup>\n vs. 58.8 \u00b1 10.1 cm\n 3<\/jats:sup>\n ,\n P<\/jats:italic>\n = 0.06). The median (interquartile range) last known mRS was 2.5 (1\u20134) versus 3.0 (2\u20136) with 50% versus 35.7% achieved mRS 0\u20132 in patients who IA TNK and those who received EVT alone. A significant correlation was found between infarct volume and last known mRS in the overall cohort.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Adjunctive IA-TNK with EVT in LVO-AIS patients resulted in smaller postintervention infarct volumes compared to EVT alone.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_36_2026","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T08:17:21Z","timestamp":1775204241000},"page":"196","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of adjunctive intra-arterial tenecteplase on infarct volume in acute ischemic stroke patients undergoing thrombectomy"],"prefix":"10.25259","volume":"17","author":[{"given":"Muhammad","family":"Shakir","sequence":"first","affiliation":[{"name":"Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarada","family":"Prasad","sequence":"additional","affiliation":[{"name":"University of Missouri Columbia, Medical School, Columbia, MO, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yilung","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Missouri, Columbia, MO, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatem","family":"Tolba","sequence":"additional","affiliation":[{"name":"Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rami","family":"Fakih","sequence":"additional","affiliation":[{"name":"Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan I.","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"10.25259\/SNI_36_2026\/ref-1","doi-asserted-by":"crossref","first-page":"107898","DOI":"10.1016\/j.clineuro.2023.107898","article-title":"Adjuvant intra-arterial thrombolysis during mechanical thrombectomy is an effective means of improving outcomes for patients with large vessel occlusion stroke: A systematic review and meta-analysis","volume":"232","author":"Chang","year":"2023","journal-title":"Clin Neurol Neurosurg"},{"key":"10.25259\/SNI_36_2026\/ref-2","doi-asserted-by":"crossref","first-page":"3241","DOI":"10.1161\/STROKEAHA.115.010721","article-title":"Alteplase reduces downstream microvascular thrombosis and improves the benefit of large artery recanalization in stroke","volume":"46","author":"Desilles","year":"2015","journal-title":"Stroke"},{"key":"10.25259\/SNI_36_2026\/ref-3","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1016\/S0140-6736(16)00163-X","article-title":"Endovascular thrombectomy after large-vessel ischaemic stroke: A meta-analysis of individual patient data from five randomised trials","volume":"387","author":"Goyal","year":"2016","journal-title":"Lancet"},{"key":"10.25259\/SNI_36_2026\/ref-4","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1159\/000528250","article-title":"Microcirculation no-reflow phenomenon after acute ischemic stroke","volume":"86","author":"Hu","year":"2023","journal-title":"Eur Neurol"},{"key":"10.25259\/SNI_36_2026\/ref-5","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1001\/jama.2024.23466","article-title":"Intra-arterial tenecteplase following endovascular reperfusion for large vessel 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within 4\u20225 h of onset (ATTEST-2): A randomised, parallel group, open-label trial","volume":"23","author":"Muir","year":"2024","journal-title":"Lancet Neurol"},{"key":"10.25259\/SNI_36_2026\/ref-9","doi-asserted-by":"crossref","first-page":"e790","DOI":"10.1212\/WNL.0000000000013210","article-title":"Prevalence and significance of impaired microvascular tissue reperfusion despite macrovascular angiographic reperfusion (no-reflow)","volume":"98","author":"Ng","year":"2022","journal-title":"Neurology"},{"key":"10.25259\/SNI_36_2026\/ref-10","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1177\/17474930231184369","article-title":"Mechanical thrombectomy with intra-arterial thrombolysis versus mechanical thrombectomy alone in patients with acute ischemic stroke: A systematic review and meta-analysis","volume":"19","author":"Qureshi","year":"2024","journal-title":"Int J Stroke"},{"key":"10.25259\/SNI_36_2026\/ref-11","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1001\/jama.2022.1645","article-title":"Effect of intra-arterial alteplase vs placebo following successful thrombectomy on functional outcomes in patients with large vessel occlusion acute ischemic stroke: The CHOICE randomized clinical trial","volume":"327","author":"Ren\u00fa","year":"2022","journal-title":"JAMA"},{"key":"10.25259\/SNI_36_2026\/ref-12","doi-asserted-by":"crossref","first-page":"2472","DOI":"10.1161\/STROKEAHA.123.044240","article-title":"No-reflow post-recanalization in acute ischemic stroke: Mechanisms, measurements, and molecular markers","volume":"54","author":"Sperring","year":"2023","journal-title":"Stroke"},{"key":"10.25259\/SNI_36_2026\/ref-13","doi-asserted-by":"crossref","first-page":"2536","DOI":"10.1161\/STROKEAHA.124.045755","article-title":"Emerging adjuvant thrombolytic therapies for acute ischemic stroke 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