Comparison of tenecteplase vs. alteplase in addition to thrombectomy in patients with ischemic stroke caused by large vessel occlusion within 4.5 h: a network meta-analysis.

ABSTRACT:

Background

The optimal reperfusion approach for acute ischemic stroke (AIS) due to large vessel occlusion (LVO) remains under debate. While endovascular thrombectomy (EVT) is the standard treatment, the role of intravenous thrombolysis before EVT-particularly with alteplase or tenecteplase-remains under investigation. This network meta-analysis (NMA) aimed to compare the efficacy and safety of three strategies: EVT alone, alteplase with EVT, and tenecteplase with EVT.

Methods

A comprehensive search of Web of Science, PubMed, Cochrane Library and Embase was performed to find randomized controlled trials (RCTs) comparing the above interventions in AIS patients with LVO treated within 4.5 h of symptom onset. A Bayesian NMA framework was used to estimate pooled effects. The prim

SUBMITTER: Li W 

PROVIDER: S-EPMC12815846 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature