Thrombolysis
Effect of intravenous urokinase vs best medicine treatment on functional outcome for patients with acute minor stroke (TRUST): a randomized controlled trial
TRUST found no improvement in 90-day excellent functional outcome with one million units of intravenous urokinase versus guideline-based medical treatment for minor ischemic stroke within six hours; substantial crossover and sparse bleeding events limit stronger conclusions.
Fibrinogenase for injection in the treatment of acute ischaemic stroke: a randomised clinical trial — the Chinese snake-venom fibrinolytic that beat placebo on mRS at 90 days
In a 235-patient Chinese RCT of fibrinogenase for injection within 72 hours of AIS onset, the ordinal mRS distribution at 90 days favoured fibrinogenase over placebo (OR 2.38, 95% CI 1.49–3.85; p<0.001), with no excess bleeding or mortality.
Thrombus Migration After Tenecteplase Versus Alteplase in Acute Large Vessel Occlusion
In a matched multicenter cohort of 746 large-vessel-occlusion patients undergoing bridging therapy, tenecteplase produced nearly twice the thrombus migration of alteplase (19.3% vs 11.3%), concentrated in the first 60 minutes after IVT, and migration independently predicted functional independence.
Deep-Dive: JX10 — A Late-Window Anti-Inflammatory Thrombolytic Hits Phase 2a Safety Mark
JX10 phase 2a (n=90) — late-window (5–12h) thrombolytic met its primary safety endpoint (0% sICH vs 2.6% placebo) and showed a day-90 mRS 0–1 signal (40.4% vs 18.4%, P=0.03).
Deep-Dive: MR CLEAN M2 Registry — Bridging Therapy Edges Out Direct EVT for M2 Occlusions
MR CLEAN Registry M2 analysis (n=539): bridging IV thrombolysis before EVT improves 90-day mRS vs direct EVT (aOR 1.52, P=0.03); sICH and recanalization similar.
Deep-Dive: T-FLAVOR — Tenecteplase 0.25 mg/kg vs Low-Dose Alteplase in LVO Stroke
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).
Deep-Dive: ACTISAVE — Glenzocimab Fails to Beat Placebo on Top of tPA ± EVT
ACTISAVE failed to confirm a beneficial effect of glenzocimab on mRS in patients with acute ischemic stroke treated by thrombolysis ± thrombectomy.