Tests a clot-dissolving drug given into the artery after stroke thrombectomy
Tests tenecteplase given into the artery in adults with ischemic stroke and poor blood flow.
Plain-language title generated from the registry record
Registry title: Improving Neuroprotective Strategy for Ischemic Stroke With Poor Recanalization After Thrombectomy by Intra-arterial TNK (INSIST-TNK)
Key facts
- Where
- Shenyang, ChinaSee the site
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults with a sudden stroke from a blocked large brain artery, whose blood flow was not restored well enough after clot removal by a catheter.
- Age
- 18 years or older
- Sex
- All sexes can join
- Disease stage
- Acute ischemic stroke with a large vessel blocked in the front part of the brain circulation. The person qualified for mechanical thrombectomy. Blood flow was still insufficient (mTICI 1/2a) after the procedure.
- Earlier treatment
- Must have had endovascular treatment (clot removal) with insufficient blood flow afterwards. Cannot have had more than 3 passes of the thrombectomy device.
Main reasons for not taking part
- Blood flow already sufficient after the procedure (TICI 2b-3)
- Stroke caused by bleeding in the brain (cerebral or subarachnoid hemorrhage)
- Clotting disorders, a tendency to bleed, or low platelets (under 100000/mm3)
- Severe liver or kidney problems, or needing dialysis
- Severe uncontrolled high blood pressure (systolic over 200mmHg or diastolic over 110 mmHg)
Read by machine on 9 November 2026.
Where in China
- General Hospital of Northern Theater CommandShenyang, ChinaTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Hui-Sheng Chen
- Trial code
- NCT04201964
- Record updated
- 11 September 2026
- Original description
In 2015, five randomized trials showed efficacy of endovascular thrombectomy over standard medical care in patients with acute ischemic stroke caused by occlusion of arteries of the proximal anterior circulation. However, sufficient recanalization (mTICI2b-3) can 't be acquired in all patients under thrombectomy. There is a lack of evidence that whether salvage intra-arterial thrombolysis is beneficial for patients with insufficient recanalization after endovascular thrombectomy. The EXTEND-IA TNK study indicated that tenecteplase before thrombectomy was associated with a higher incidence of reperfusion and better functional outcome than alteplase among patients with ischemic stroke treated within 4.5 hours after symptom onset. This study intends to explore the proportion of sufficient recanalization (2b/3) after intra-arterial tenecteplase administration in patients undergoing thrombectomy with insufficient recanalization (1/2a).Read full original descriptionShow less
Improving Neuroprotective Strategy for Ischemic Stroke With Poor Recanalization After Thrombectomy by Intra-arterial TNK (INSIST-TNK): a Prospective, Single Arm, Pilot Study
In 2015, five randomized trials showed efficacy of endovascular thrombectomy over standard medical care in patients with acute ischemic stroke caused by occlusion of arteries of the proximal anterior circulation. However, sufficient recanalization (mTICI2b-3) can 't be acquired in all patients under thrombectomy. There is a lack of evidence that whether salvage intra-arterial thrombolysis is beneficial for patients with insufficient recanalization after endovascular thrombectomy. The EXTEND-IA TNK study indicated that tenecteplase before thrombectomy was associated with a higher incidence of reperfusion and better functional outcome than alteplase among patients with ischemic stroke treated within 4.5 hours after symptom onset. This study intends to explore the proportion of sufficient recanalization (2b/3) after intra-arterial tenecteplase administration in patients undergoing thrombectomy with insufficient recanalization (1/2a).
Inclusion: Age ≥18 years; Patients who presented with acute ischemic stroke and a large vessel occlusion in the anterior circulation and met the criteria of mechanical thrombectomy; insufficient perfusion (mTICI 1/2a) after endovascular treatment; The availability of informed consent.
Exclusion: Hemorrhagic stroke: cerebral hemorrhage, subarachnoid hemorrhage; Coagulation disorders, systematic hemorrhagic tendency, thrombocytopenia ( <100000/mm3); Severe uncontrolled hypertension (systolic blood pressure over 200mmHg or diastolic blood pressure over 110 mmHg); Patients allergic to any ingredient of drugs in our study; Severe hepatic or renal dysfunction, increase in ALT or AST (more than 2 times of upper limit of normal value), increase in serum creatinine (more than 1.5 times of upper limit of normal value) or requiring dialysis; Sufficient recanalization (TICI 2b-3); More than 3 times of thrombectomy device passes; Unsuitable for this clinical studies assessed by researcher.