ArticleStroke and vascular neurology2025
Intra-arterial tenecteplase after successful endovascular therapy (ANGEL-TNK): protocol of a multicentre, open-label, blinded end-point, prospective, randomised trial.
Article in Stroke and vascular neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 10 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Intra-arterial Recombinant Human Tenecteplase Tissue-type Plasminogen Activator rhTNK-tPA) Thrombolysis for Acute Large Vessel Occlusion After Successful Mechanical Thrombectomy Recanalization -- A Multicenter, Prospective, Randomized, Open-label, Blinded End-point Trial (ANGEL-TNK)
INtra-arterial AltEplase folloWing successfuL reperfusIoN After mEchanical Thrombectomy
Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Intra-Arterial Thrombolysis Following Endovascular Recanalization for Large Vessel Occlusion Stroke: A Systematic Review and Meta-Analysis.Neurology · 2025Pooled it
- The Added Benefit of Intra-Arterial Thrombolysis After Successful Recanalization by Endovascular Treatment: A Systematic Review and Meta-Analysis of Randomized-Controlled Clinical Trials.European journal of neurology · 2025Pooled it
- Efficacy and safety of intra-arterial thrombolysis after endovascular reperfusion for acute ischemic stroke: a systematic review and meta-analysis of randomized trials.International journal of surgery (London, England) · 2025Pooled it
- Occlusion site and outcomes in intra-arterial tenecteplase after successful endovascular therapy: a secondary analysis of the ANGEL-TNK trial.Journal of neurointerventional surgery · 2026Trial
- Chemical Optimization of Cerebral Embolectomy 2 (CHOICE 2) trial: study protocol.Stroke and vascular neurology · 2026Trial
- Trial
- Safety and efficacy of intra-arterial tenecteplase for non-complete reperfusion of intracranial occlusions: Methodology of a randomized, controlled, multicenter study.European stroke journal · 2026Article
- Intra-Arterial Thrombolysis After Successful Thrombectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Stroke (Hoboken, N.J.) · 2025Article
- Intravenous Argatroban or Eptifibatide in Patients Undergoing Mechanical Thrombectomy: A Subgroup Analysis of the MOST Randomized Clinical Trial.JAMA neurology · 2025Article
- Adjunctive intra-arterial thrombolysis after thrombectomy: Findings from the RITE registry.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite successful reperfusion after thrombectomy for large vessel occlusion (LVO) stroke, up to half of patients are dependent or dead at 3-month follow-up.The aim of the current study is to demonstrate safety and efficacy of administering adjunct intra-arterial (IA) tenecteplase in anterior circulation LVO patients who have achieved successful reperfusion defined as eTICI 2b50 to 3.
methodsANGEL-TNK is a multicentre, open-label, assessor-blinded endpoint, prospective randomised, controlled trial that will enrol up to 256 patients. Patients who meet inclusion criteria with anterior circulation LVO stroke and successful reperfusion will be randomised to receive IA tenecteplase or best medical management at 1:1 ratio.
resultsThe primary endpoint is a 90-day excellent outcome defined as modified Rankin Scale (mRS) 0-1. The primary safety endpoint is symptomatic intracranial haemorrhage within 48 hours from randomisation. Secondary endpoints include 90-day ordinal mRS, mRS 0-2, mRS 0-3, all-cause mortality and any intracranial haemorrhage.
conclusionIn patients with anterior circulation LVO stroke, the ANGEL-TNK trial will inform whether adjunct IA tenecteplase administered after successful thrombectomy reperfusion improves patient outcomes. TRIAL REGISTRATION NUMBER: NCT05624190.
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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 OpenQuestion graph.