A new study suggests that injecting the clot-dissolving drug tenecteplase directly into a brain artery after removing a blood clot may help stroke survivors recover better. The research was presented at the American Stroke Association’s International Stroke Conference 2025 and could lead to changes in how strokes caused by large blood clots are treated.
Improving Stroke Treatment
Ischemic strokes, caused by blood clots blocking arteries in the brain, are the most common type of stroke. About 20% of these strokes happen when a clot blocks a large artery, known as a large vessel occlusion.
The standard treatment for these strokes involves removing the clot using a thin tube (catheter) or a stent, a procedure called endovascular treatment. While this can restore blood flow, it does not always improve circulation in smaller blood vessels. As a result, many patients still experience disability or death.
Dr. Xiaochuan Huo, the study’s lead researcher from Beijing Anzhen Hospital in China, explained that after removing a clot, smaller blood vessels may still be blocked, preventing full recovery.
This study tested whether injecting tenecteplase directly into the affected artery could improve blood flow in these smaller vessels, reducing brain damage and leading to better outcomes.
Study Details
The study, conducted at 19 centers in China, involved 255 stroke patients who received clot removal treatment between 4.5 and 24 hours after their symptoms started. Participants were randomly assigned to one of two groups:
- One group received tenecteplase injected into the artery where the clot was removed.
- The other group received standard medical care without the additional drug.
Researchers assessed recovery using the modified Rankin Scale, which measures disability levels from 0 (no symptoms) to 6 (death), with a score of 0-1 indicating an excellent recovery.
Key Findings
- Better Recovery: Patients who received tenecteplase were 44% more likely to have little or no disability after 90 days compared to those who received only standard treatment (40.5% vs. 26.4%).
- No Increase in Brain Bleeding: The risk of brain bleeding within two days of treatment was similar in both groups (5.6% with tenecteplase vs. 6.2% without it).
- No Difference in Death Rates: About 21% of patients in both groups died within 90 days, showing that the additional treatment did not increase the risk of death.
Potential Impact on Stroke Treatment
Dr. Huo noted that this approach could help more stroke survivors regain independence and return to their daily lives. “Intra-arterial tenecteplase after successful clot removal could improve the percentage of people with an excellent outcome,” he said.
The researchers are continuing to follow the participants for one year to assess long-term outcomes. They also plan to compare their results with other studies to determine if this treatment should become a new standard for stroke care.
Study Considerations
The study only included patients who did not receive intravenous clot-dissolving drugs or blood-thinning medications during their stroke treatment. This means the findings may not apply to patients who received those treatments.
If confirmed in larger studies, this research could change how doctors treat stroke survivors and offer hope for better recovery even after severe strokes.
If you care about stroke, please read studies that diets high in flavonoids could help reduce stroke risk, and MIND diet could slow down cognitive decline after stroke.
For more information about health, please see recent studies about how Mediterranean diet could protect your brain health, and wild blueberries can benefit your heart and brain.
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