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Intra-Arterial Tenecteplase for Stroke After Mechanical Thrombectomy

This study is looking at whether a drug called tenecteplase, given directly into an artery (intra-arterial), can improve blood flow in very small blood vessels in the brain after a stroke. This is for patients who have had a specific type of stroke called an acute ischemic stroke from a large vessel occlusion, and have already had a procedure called mechanical thrombectomy to remove the clot. Researchers will give a single dose of tenecteplase and then measure changes in blood flow in the small vessels of the brain. The study aims to enroll 20 participants who are at least 18 years old and can follow the study plan. The current recruitment status is unclear.

Study design
This is a small, single-arm study, meaning all 20 participants will receive the tenecteplase treatment. It is also an open-label study, so both you and your doctors will know you are receiving the treatment.
What's involved
You would receive a single dose of tenecteplase through a catheter after your mechanical thrombectomy. Your blood flow will be measured before and after the drug is given, and imaging will be done at 24 hours and 72 hours after treatment.
Compensation
Not stated in the trial record.
Follow-up
Your functional outcome will be assessed at 90 days after treatment.

AI-generated from the public study record. Only the study team can confirm whether you're eligible — confirm details with them before making decisions.

NCT06904911

Intra-Arterial Tenecteplase to Improve the Microvascular Hemodynamics After Mechanical Thrombectomy

Recruiting
PHASE2Ages 18+InterventionalTreatment
University of Pennsylvania
~20 participants
Updated 2026-08-18 on ClinicalTrials.gov
What's tested:intra-arterial tenecteplase administration

At a glance

Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Change in microvascular cerebral circulation time (mCCT)
Measured over The change in mCCT will be calculated as mCCT immediately preceding intra-arterial tenecteplase minus the mCCT immediately following intra-arterial tenecteplase

Conditions

Acute Ischemic Stroke From Large Vessel Occlusion

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NCT06904911

Where you'd take part

This study runs at 1 site. They're the same protocol — you choose where, and that choice sets who your contact draft is addressed to.

  • Hospital of the University of Pennsylvania

    Philadelphia, Pennsylvaniastudy coordinator listed

    Recruiting

Sites open and close at different times, so the status above is per site — it can differ from the study's overall status.

Study leadership

  • Christopher Favilla, MD · PRINCIPAL_INVESTIGATOR · University of Pennsylvania

Who to contact

Nichole Gallatti
[email protected]
215-349-8651
Email the study team

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Eligibility criteria

Inclusion

Patient/legally authorized representative has signed the Informed Consent Form
At least 18 years of age
Ability to comply with the study protocol, in the investigator's judgment
Acute ischemic stroke attributed to anterior circulation large vessel occlusion (of the internal carotid artery or first segment of the middle cerebral artery based on CTA, MRA, or catheter angiogram) being treated with mechanical thrombectomy
NIHSS ≥ 6 at the initiation of endovascular therapy (arterial puncture)
Time from stroke onset to IA-TNK administration \< 24 hours. Stroke onset is defined as the time the patient was last known to be at their neurologic baseline
ASPECTS ≥ 6 on pre-MT CT imaging
If treated \> 6 hours from stroke onset, CTP imaging must demonstrates favorable mismatch profile (based on RAPID processing: infarct core \<70 mL, mismatch ratio ≥ 1.8 and mismatch volume ≥ 15 mL)
Qualifying neuroimaging (CT and CTP, if applicable) must be obtained \<120 minutes prior to arterial puncture.

Exclusion

Current participation in another investigational drug or device study
Known hypersensitivity or allergy to any ingredients of tenecteplase
Active internal bleeding
Known bleeding diathesis (Alzheimer's patients taking lecanemab)
Known hereditary or acquired hemorrhagic diathesis, coagulation factor deficiency; recent oral anticoagulant therapy with INR \> 1.7
Use of one of the new oral anticoagulants within the last 48 hours (dabigatran, rivaroxaban, apixaban, edoxaban)
Treatment with a thrombolytic within the last 3 months prior to randomization, inclusive of intravenous thrombolysis during the index stroke.
Baseline platelet count \< 100,000/microliter (results must be available prior to treatment)
Baseline blood glucose \> 400 mg/dL (22.20 mmol/L)
Baseline blood glucose \< 50 mg/dL needs to be normalized prior to randomization
Intracranial or intraspinal surgery or trauma within 2 months
Other serious, advanced, or terminal illness (investigator's judgment) or life expectancy is less than 6 months
History of acute ischemic stroke in the last 90 days
History of hemorrhagic stroke
Presumed septic embolus; suspicion of bacterial endocarditis
Any other condition that, in the opinion of the investigator, precludes an endovascular procedure or poses a significant hazard to the patient if an endovascular procedure was to be performed
Pregnant
Systolic BP \>185 mmHg or diastolic BP \>110 mmHg, refractory to treatment
Suspicion of aortic dissection
Known allergy to iodine or iodinated contrast
Subject who requires hemodialysis or peritoneal dialysis, or who have a contraindication to an angiogram
Renal failure as defined by a serum creatinine \> 3.0 mg/dl or GFR \< 30
Known intracranial neoplasm
GI bleeding within the past 21 days
Pre-existing medical or neurological disease that will confound the neurological or functional evaluations
Premorbid (prior to the index stroke) modified Rankin Scale (mRS) score ≥ 3
ASPECTS \<6 on pre-MT CT imaging
Acute intracranial hemorrhage or contrast extravasation on CT before or immediately after MT (prior to study drug administration)
Significant mass effect with midline shift on non-contrast CT before or immediately after MT
Cervical or intracranial stent placement during endovascular therapy
Acute symptomatic arterial occlusions in more than one vascular territory confirmed on CTA, MRA, or catheter angiography

What this trial measures

  • Change in microvascular cerebral circulation time (mCCT)The change in mCCT will be calculated as mCCT immediately preceding intra-arterial tenecteplase minus the mCCT immediately following intra-arterial tenecteplase

    mCCT will be assessed by quantitative angiography, calculated as the difference between the time-to-peak of the Rolandic artery and Rolandic vein.