Evidence map›Paper›PMID 40819883›Full record

ArticleStroke and vascular neurology2026

Neuronavigation-assisted stereotactic minimally invasive puncture with tenecteplase for the treatment of acute spontaneous deep intracerebral haemorrhage (NAS-TNK): rationale and design of a multicentre randomised trial.

Mingze Wang, Zhiyou Wu, Jingyi Tang, Xiudan Bai, Shaozhi Zhao, Yang Ni, Pengqi Wang, Duolao Wang, Yong Cao

Abstract readClinical Trial Protocol
In one paragraph

Article in Stroke and vascular neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Surgery for spontaneous supratentorial intracerebral haemorrhage.The Cochrane database of systematic reviews · 2025
    Pooled it
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

9 authors.

Mingze WangDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Zhiyou WuDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Jingyi TangDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xiudan BaiDepartment of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China.
Shaozhi ZhaoDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yang NiDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Pengqi WangDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Duolao WangLiverpool School of Tropical Medicine, Liverpool, UK.
Yong CaoDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China caoyong@bjtth.org.ORCID http://orcid.org/0000-0002-8289-1120

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMinimally invasive puncture surgery followed by thrombolysis has been proven to be an effective approach for managing hypertensive intracerebral haemorrhage (ICH). Nevertheless, its impact on improving neurological outcomes remains controversial. The integration of neuronavigation-assisted stereotactic (NAS) technology will significantly help enhance the accuracy of catheter placement, while tenecteplase (TNK), a third-generation thrombolytic agent, offers stronger capabilities in breaking down platelet-rich clots and demonstrates increased fibrin selectivity, which could enhance the overall effectiveness of thrombolytic treatment. However, the efficacy and safety of combining NAS-assisted minimally invasive puncture with TNK (NAS-TNK) in reducing disability and mortality rates among patients with acute spontaneous deep ICH remain unknown.

aimTo describe the rationale and design of the NAS-TNK trial for the treatment of acute spontaneous deep ICH.

designNAS-TNK is a randomised, open-label, outcome-blinded multicentre trial, involving 732 participants with acute basal ganglia or thalamic haemorrhage with a haematoma volume ranging from 20 to 50 mL. This study will evaluate the efficacy and safety of NAS-TNK, administered every 24 hours at a dose of 0.009 mg/mL of haematoma volume, compared with participants receiving standard medical care. Each patient will undergo follow-up evaluations for a period of 180 days. STUDY OUTCOMES: The main measure of effectiveness is the percentage of participants achieving a modified Rankin Scale Score ranging from 0 to 3 at the 180-day mark. The primary safety outcome is the all-cause death at 30 days. DISCUSSION AND

conclusionThe NAS-TNK study will help improve our understanding of the benefits of NAS-TNK in patients with acute spontaneous deep ICH.

Indexed as

Basal Ganglia HemorrhageCerebral HemorrhageFibrinolytic AgentsNeuronavigationStereotaxic TechniquesTenecteplaseThrombolytic TherapyTissue Plasminogen ActivatorAcute DiseaseDisability EvaluationFemaleHumansMaleMulticenter Studies as TopicPuncturesRandomized Controlled Trials as TopicFibrinolytic AgentsTenecteplaseTissue Plasminogen ActivatorBlood PressureBrainHemorrhageNavigation

Identifiers

PMID40819883
PMCPMC13151869

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Registered trials

None linked

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.