Large-Vessel-Occlusion

• Tenecteplase in Large-Vessel Occlusion — Bridging, Extended-Window, and the 4.5-Hour Wall

  September 14, 2026

  Meta-analysis of five RCTs (n=2,054) finds IV tenecteplase improves mRS outcomes in LVO versus no thrombolysis; bridging within 4.5 h before EVT and extended-window use without EVT show benefit, but bridging 4.5–24 h does not.

• Deep-Dive: ZODIAC — Laying LVO Patients Flat Before Thrombectomy Cuts Pre-Procedure Deterioration 26-Fold

  August 12, 2026

  ZODIAC phase III RCT (n=92, stopped early for efficacy): 0° vs 30° head-of-bed positioning before thrombectomy — END HR 34.40 (95% CI 4.65–254.37), P<0.001; exploratory mortality P=0.03.

• Deep-Dive: T-FLAVOR — Tenecteplase 0.25 mg/kg vs Low-Dose Alteplase in LVO Stroke

  August 11, 2026

  T-FLAVOR Japanese phase 2 (n=218): tenecteplase vs low-dose alteplase for LVO bridging — substantial reperfusion 10.3% vs 3.6% (90% CI 0.89–12.1; 95% CI −0.19% to 13.2%; mRS shift favors TNK numerically).