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A secondary analysis of the BRIDGE-TNK trial reveals that tenecteplase given before thrombectomy helps cardioembolic stroke patients but not those with large artery atherosclerosis. Among cardioembolic patients, functional independence at 90 days jumped from 40.5% to 55.8% with tenecteplase. Meanwhile, atherosclerotic stroke patients saw no functional benefit — and potentially higher mortality.
A new secondary analysis of the BRIDGE-TNK trial is adding important nuance to how tenecteplase is used before endovascular thrombectomy (EVT) in stroke care. The findings, presented at the World Stroke Congress 2026 in Seoul, show that the clot-dissolving drug's benefits aren't one-size-fits-all — stroke cause matters a lot.
Among the 502 patients analyzed, those with cardioembolic (CE) stroke saw a meaningful boost in 90-day functional independence when given tenecteplase before EVT (55.8% vs. 40.5%). But patients with large artery atherosclerosis (LAA) saw no such benefit — and faced notably higher mortality in the tenecteplase group.
By the Numbers:
Why it matters: These findings suggest clinicians may need to tailor pre-thrombectomy thrombolysis decisions based on stroke etiology, potentially sparing LAA patients from a treatment that offers no functional gain and may carry increased mortality risk.
