Evidence map›Paper›PMID 39809509›Full record

Trial reportBMJ (Clinical research ed.)2025

Intra-arterial tenecteplase after successful endovascular recanalisation in patients with acute posterior circulation arterial occlusion (ATTENTION-IA): multicentre randomised controlled trial.

Wei Hu, Chunrong Tao, Li Wang, Zhongjun Chen, Di Li, Wenhuo Chen, Tingyu Yi, Lihua Xu, Chuanqing Yu, Tao Wang and 45 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05684172 (Trial of Intra-arterial Tenecteplase Following Successful Endovascular Thrombectomy on Safety and Efficacy in Patients With Large Vessel Occlusion of Posterior Circulation - a Multicenter Randomized Clinical Trial), which is not on this map. Cited by 30 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05684172 phase2 / phase3completednot on this map

Trial of Intra-arterial Tenecteplase Following Successful Endovascular Thrombectomy on Safety and Efficacy in Patients With Large Vessel Occlusion of Posterior Circulation - a Multicenter Randomized Clinical Trial (ATTENTION IA)

TypeinterventionalSponsorThe First Affiliated Hospital of University of Science and Technology of ChinaRan2023 to 2023Enrolled208ConditionsAcute Ischemic Stroke, Intracranial Artery Occlusion, Endovascular ThrombectomyArmsTenecteplase, endovascular thrombectomy alone
3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 12 syntheses or guidelines pooled it.

  1. Pooled it
  2. Intra-arterial tenecteplase in acute ischemic stroke after successful endovascular thrombectomy: a meta-analysis of randomized controlled trials.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Article
  14. Article
  15. Article
  16. Advances in Reperfusion Therapy and Cytoprotection for Acute Ischemic Stroke.Journal of cardiovascular development and disease · 2026
    Review
  17. Article
  18. Review
  19. Article
  20. ESO annual stroke evidence update 2025.European stroke journal · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

55 authors.

Wei HuDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Chunrong TaoDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Li WangDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Zhongjun ChenDepartment of Neurological Intervention and Neurological Intensive Care, Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, China.
Di LiDepartment of Neurological Intervention and Neurological Intensive Care, Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, China.
Wenhuo ChenDepartment of Neurology, Zhangzhou Affiliated Hospital of Fujian medical University, Zhangzhou, China.
Tingyu YiDepartment of Neurology, Zhangzhou Affiliated Hospital of Fujian medical University, Zhangzhou, China.
Lihua XuDepartment of Neurology, Jiamusi Central Hospital, Jiamusi, China.
Chuanqing YuDepartment of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan, Huainan, China.
Tao WangDepartment of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan, Huainan, China.
Xiaoxi YaoDepartment of Neurology, The First People's Hospital of Chenzhou, Chenzhou, China.
Tao CuiDepartment of Neurology, Taihe County People's Hospital, Tiahe, China.
Guangxiong YuanDepartment of Emergency, Xiangtan Central Hospital, Xiangtan, China.
Junfeng SuDepartment of Neurology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China.
Li ChenDepartment of Neurology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China.
Zhiming ZhouDepartment of Neurology, Yijishan Hospital of Wannan Medical College, Wuhu, China.
Zhengfei MaDepartment of Neurology, Suzhou Hospital of Anhui Medical University, Suzhou, China.
Junjun WangDepartment of Neurology, Wan Bei General Hospital of Wanbei Coal power Group, Suzhou, China.
Benxiao WangDepartment of Neurology, Wan Bei General Hospital of Wanbei Coal power Group, Suzhou, China.
Hongxing HanDepartment of Neurology, Linyi People's Hospital, Linyi, China.
Hao WangDepartment of Neurology, Linyi People's Hospital, Linyi, China.
Jie ChenDepartment of Neurosurgery, Tongling People's Hospital, Tongling, China.
Peiyang ZhouDepartment of neurology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China.
Zhihua CaoDepartment of neurology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China.
Youquan RenDepartment of Neurology, Linquan Country People's Hospital, Linquan, China.
Xueli CaiDepartment of Neurology, Lishui Municipal Central Hospital, Lishui, China.
Huaizhang ShiDepartment of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Guang ZhangDepartment of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Liping YuDepartment of Neurology, The First People's Hospital of Xianyang, Xianyang, China.
Xingyun YuanDepartment of Neurology, The First People's Hospital of Xianyang, Xianyang, China.
Jinglun LiDepartment of Neurology, The Affiliated Hospital of South West Medical University, Luzhou, China.
Guoyong ZengDepartment of Neurology, Ganzhou people's Hospital, Ganzhou, Jiangxi, China.
Chuyuan NiDepartment of Neurology, Huangshan City people's Hospital, Huangshan, China.
Tong LiDepartment of Neurology, Nanning Second People's Hospital, Nanning, China.
Yingchun WuDepartment of Neurology, Ordos Central Hospital, Ordos, China.
Yuwen LiDepartment of Neurology, Heze Municipal Hospital, Heze, Shandong, China.
Kai LiDepartment of Neurology, Heze Municipal Hospital, Heze, Shandong, China.
Yong LiuDepartment of Neurology, Lu'an Hospital of Anhui Medical University, Lu'an, China.
Yao WangDepartment of Neurology, Sixian People's Hospital, Sixian, China.
Yu JinDepartment of Neurology, Bozhou People's Hospital, Bozhou, China.
Hanwen LiuDepartment of Neurology, Guangdong Provincial People's Hospital Ganzhou Hospital, Ganzhou Municipal Hospital, Ganzhou, China.
Jianshang WenDepartment of Neurology, Shucheng People's Hospital, Shucheng, China.
Jun SunDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Yuyou ZhuDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Rui LiDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Chao ZhangDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Tianlong LiuDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Jianlong SongDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Li WangDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Juan ChengDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Adnan I Qureshithe Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, USA.
Thanh N NguyenDepartment of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
Jeffrey L SaverDepartment of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Raul G Nogueirathe UPMC Stroke Institute, Department of Neurology and Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Xinfeng LiuDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.ORCID 0000-0002-8182-9632

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess whether intra-arterial tenecteplase administered after successful endovascular recanalisation improves outcomes in patients with acute arterial occlusion of the posterior circulation.

designMulticentre randomised controlled trial.

setting31 hospitals in China, 24 January 2023 to 24 August 2023.

participants208 patients with successful recanalisation (grade 2b50-3 on the extended thrombolysis in cerebral infarction scale) of an occlusion in the V4 segment of the vertebral artery; proximal, middle, or distal segment of the basilar artery; or P1 segment of the posterior cerebral artery: 104 were randomly allocated to receive tenecteplase and 104 to receive standard care.

interventionsIntra-arterial tenecteplase (0.0625 mg/kg, maximum dose 6.25 mg) administered proximal to the residual thrombus (if still present) or distal to the origin of the main pontine perforator branches over 15 seconds, or endovascular treatment only (control group).

main outcome measuresThe primary outcome was freedom from disability (modified Rankin scale score 0 or 1) at 90 days after randomisation. Primary safety outcomes included symptomatic intracranial haemorrhage within 36 hours and all cause mortality at 90 days. All efficacy and safety analyses were conducted by intention to treat and adjusted for age, pre-stroke modified Rankin scale score, time from onset of moderate to severe stroke (National Institutes of Health stroke scale score ≥6) to randomisation, hypertension, and baseline stroke severity.

resultsAt 90 days, 36 patients (34.6%) in the tenecteplase group and 27 (26.0%) in the control group had a modified Rankin scale score of 0 or 1 (adjusted risk ratio 1.36, 95% confidence interval 0.92 to 2.02; P=0.12). Mortality at 90 days was similar between the tenecteplase and control groups: 29 (27.9%)

conclusionsIn patients with acute ischaemic stroke due to acute posterior large or proximal vessel occlusion, intra-arterial tenecteplase administered after successful recanalisation was not associated with a statistically significant reduction in combined disability and mortality at 90 days.

trial registrationClinicalTrials.gov NCT05684172.

Indexed as

Arterial Occlusive DiseasesEndovascular ProceduresFibrinolytic AgentsTenecteplaseAgedChinaFemaleHumansMaleMiddle AgedTreatment OutcomeFibrinolytic AgentsTenecteplase

Identifiers

PMID39809509
PMCPMC11729139

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.