Evidence map›Paper›PMID 42062620›Full record

ArticleTranslational stroke research2026

Efficacy and Safety of Intravenous Thrombolysis with Tenecteplase in Patients with Wake-Up Branch Atheromatous Disease.

Lili Zhu, Ying Zhang, Jiarong Li, Liang Song, Haoran Li, Yang Yang, Lijuan Liu, Shaolei Zhang, Xiaofei Gao, Weifeng Chen and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Translational stroke research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Lili ZhuDepartment of Neurology, The Fifth Clinical Medical College of Henan, University of Chinese Medicine (Zhengzhou People's Hospital), No. 33 Huanghe Road, Jinshui District, Zhengzhou, Henan Province, 450003, China.ORCID http://orcid.org/0009-0001-6653-6065
Ying ZhangDepartment of Neurology, The Fifth Clinical Medical College of Henan, University of Chinese Medicine (Zhengzhou People's Hospital), No. 33 Huanghe Road, Jinshui District, Zhengzhou, Henan Province, 450003, China.ORCID http://orcid.org/0009-0000-2330-3352
Jiarong LiDepartment of Neurology, The Fifth Clinical Medical College of Henan, University of Chinese Medicine (Zhengzhou People's Hospital), No. 33 Huanghe Road, Jinshui District, Zhengzhou, Henan Province, 450003, China.ORCID http://orcid.org/0009-0008-5338-4358
Liang SongDepartment of Neurology, The Fifth Clinical Medical College of Henan, University of Chinese Medicine (Zhengzhou People's Hospital), No. 33 Huanghe Road, Jinshui District, Zhengzhou, Henan Province, 450003, China.ORCID http://orcid.org/0009-0002-1187-9666
Haoran LiDepartment of Neurology, The Fifth Clinical Medical College of Henan, University of Chinese Medicine (Zhengzhou People's Hospital), No. 33 Huanghe Road, Jinshui District, Zhengzhou, Henan Province, 450003, China.ORCID http://orcid.org/0000-0003-2298-7953
Yang YangDepartment of Neurology, Hopeshine-Minsheng Hospital of Xinzheng, No. 126, Jiefang North Road, Xinzheng City, Zhengzhou, 451100, China.ORCID http://orcid.org/0009-0003-7825-6233
Lijuan LiuDepartment of Neurology, People's Hospital of Zhongmu, Zhongmu County, No. 64, Jiefang Road, Chengguan, Zhongmu, 451450, China.ORCID http://orcid.org/0009-0008-5293-9673
Shaolei ZhangDepartment of Neurology, Zhengzhou Zhongkang Hospital, No. 298, Nongye Road, Xinmi City, Zhengzhou, 450007, China.ORCID http://orcid.org/0009-0009-5732-7526
Xiaofei GaoDepartment of Neurology, Dengfeng People's Hospital, No. 2, Zhongyue Street, Dengfeng, 452470, China.ORCID http://orcid.org/0009-0009-7198-0628
Weifeng ChenDepartment of Neurology, Xingyang People's Hospital, No. 22, Suohe West Road, Xingyang, 450100, China.ORCID http://orcid.org/0009-0006-6678-1657
Guo RuiDepartment of Neurology, Zhengzhou Hospital of Traditional Chinese Medicine, No. 65, Cultural Palace Road, Zhengzhou, 450007, China.ORCID http://orcid.org/0009-0007-2317-0597
Haiqiang QinDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.ORCID http://orcid.org/0000-0003-4500-7508
Mingbo TianOffice of Research Administration, The Fifth Clinical Medical College of Henan, University of Chinese Medicine (Zhengzhou People's Hospital), No. 33 Huanghe Road, Jinshui District, Zhengzhou, 450003, China.ORCID http://orcid.org/0009-0007-5265-6473
Shengqi FuDepartment of Neurology, The Fifth Clinical Medical College of Henan, University of Chinese Medicine (Zhengzhou People's Hospital), No. 33 Huanghe Road, Jinshui District, Zhengzhou, Henan Province, 450003, China. shengqifu@126.com.ORCID http://orcid.org/0009-0004-9937-1676

Funding

Henan Province Medical Science and Technology Research Project LHG20230712Henan Province Medical Science and Technology Research Project LHGJ20240880Henan Provincial Science and Technology Research Program 242102310048
6 · The paper itself

Abstract

Branch atheromatous disease (BAD), a subtype of acute ischemic stroke (AIS), is associated with a high risk of early neurological deterioration (END) and poor prognosis. Wake-up stroke (WUS), comprising 20%-30% of AIS cases, is typically excluded from thrombolysis because of unknown onset time. Using diffusion-weighted imaging/fluid-attenuated inversion recovery (DWI/FLAIR) mismatch, we evaluated the efficacy and safety of Tenecteplase (TNK) thrombolysis in patients with BAD-related WUS. We retrospectively recruited 1,062 patients from seven Zhengzhou hospitals between January 2021 and June 2025. The patients received either TNK (n = 338) or dual antiplatelet therapy (n = 724). Propensity score matching (PSM; 1:1, caliper 0.02) yielded 292 matched pairs. Early neurological changes were evaluated using the National Institutes of Health Stroke Scale (NIHSS), and 90-day outcomes were evaluated using the modified Rankin Scale (mRS). After PSM, TNK significantly reduced the risk of END (odds ratio [OR] = 0.425, 95% confidence interval [CI]: 0.262-0.689; P < 0.001). Patients treated with TNK were more likely to achieve good functional outcomes (modified Rankin Scale [mRS] 0-1 and 0-2) with fewer poor outcomes (mRS ≥ 4). There were no significant differences in symptomatic intracranial hemorrhage, other bleeding events, or mortality among the groups. DWI/FLAIR mismatch-guided TNK thrombolysis appears to overcome the limitations of an unknown onset time in WUS and may counteract the progressive pathophysiology of BAD. TNK intravenous thrombolysis may be a safe and effective treatment for patients with wake-up BAD and DWI/FLAIR mismatches.

Indexed as

Fibrinolytic AgentsIschemic StrokePlaque, AtheroscleroticTenecteplaseThrombolytic TherapyAgedAged, 80 and overDiffusion Magnetic Resonance ImagingFemaleHumansMaleMiddle AgedRetrospective StudiesTissue Plasminogen ActivatorTreatment OutcomeFibrinolytic AgentsTenecteplaseTissue Plasminogen ActivatorBranch atheromatous diseaseDWI/FLAIR mismatchEarly neurological deteriorationIntravenous thrombolysisTenecteplaseWake-up stroke

Identifiers

PMID42062620
PMCPMC13132950

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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.