Clot-dissolving medicine given into the artery after stroke clot removal
Tests tenecteplase or alteplase after thrombectomy in adults with acute ischemic stroke.
Plain-language title generated from the registry record
Registry title: ACT-GLOBAL IA Thrombolysis(ACT-REACT-004)Domain Within the ACT-GLOBAL Adaptive Platform Trial-NCT06352632
Key facts
- Where
- Calgary, Edmonton, Greater Sudbury, Kelowna, Montreal, New Westminster, Ottawa, Saskatoon, Sherbrooke, Toronto, Vancouver, and Winnipeg, CanadaSee the 12 sites
- Phase
- Phase 3
Where in Canada
- University of Calgary- Foothills Medical CentreCalgary, CanadaTaking people
- University of AlbertaEdmonton, CanadaNot yet recruiting
- Health Sciences North Horizon Sante-NordGreater Sudbury, CanadaNot yet recruiting
- Kelowna Regional HospitalKelowna, CanadaNot yet recruiting
- CHUM - Centre Hospitalier de l'Universite de MontrealMontreal, CanadaNot yet recruiting
- Royal Columbian HospitalNew Westminster, CanadaNot yet recruiting
- Ottawa Civic HospitalOttawa, CanadaNot yet recruiting
- Royal University HospitalSaskatoon, CanadaNot yet recruiting
- CIUSSS de l'Estrie - CHUS Fleurimont Hôpital (Sherbrooke)Sherbrooke, CanadaNot yet recruiting
- Sunnybrook Health Science CentreToronto, CanadaNot yet recruiting
- University of British ColumbiaVancouver, CanadaNot yet recruiting
- University of Manitoba - Winnipeg Health Science CentreWinnipeg, CanadaNot yet recruiting
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
- University of Calgary
- Trial code
- NCT07687056
- Record updated
- 21 October 2026
- Original description
Study Design and Duration:Read full original descriptionShow less
A Multicentre,Prospective,Randomized,Open Label,Blinded-endpoint Trial for Reperfusion Enhancement After Completing Thrombectomy Using Intraarterial Thrombolysis(REACT-IA-Thrombolysis Domain)Embedded in A Multi-faCtorial,mulTi-arm, Multi-staGe,Randomised,gLOBal Adaptive pLatform Trial for Stroke(ACT-GLOBAL) NCT06352632
Study Design and Duration:
This domain will be conducted as part of ACT-GLOBAL platform trial and will have the nested domain name of REACT. It has a prospective, randomised, controlled, open-label, parallel group with blinded endpoint assessment (PROBE) design of up to 1,500 subjects with Acute Ischemic Stroke (AIS) who undergo EVT. Randomisation will be stratified by country/ region, and the IA thrombolytic agent (tenecteplase or alteplase). Minimal sufficient balance algorithm will operate within each stratum to preserve balance on key covariates while maintaining allocation randomness.
Participants will be followed for 90 days (or until death, if prior to 90 days). The end of the trial is defined as the date that all participants have completed their Day 90 assessment. Primary outcome data will be determined by simplified, structured method of assessment using the modified Rankin scale (mRS), conducted through centralized telephone interviews or online media performed by central trial personnel blinded to treatment assignment and received.
Domain Interventions:
The intervention group will receive a single dose of local intraarterial thrombolysis using either tenecteplase (at a dose of 0.0625mg/kg; maximum dose of 6.25mg) or alteplase (0.225 mg/kg; maximum dose, 20mg) at the end of EVT procedure plus standard of care while the control group will receive standard of care alone. The selection of the thrombolytic agent will be determined according to local availability. The dose of intraarterial thrombolysis will be increased if the above dose meets prespecified posterior probabilities at the first or second interims.
In all eligible patients:
1. Local intra-arterial thrombolysis using either tenecteplase at a dose of 0.0625mg/kg "maximum dose of 6.25mg" or alteplase "0.225 mg/kg; maximum dose, 20mg* 2. No intra-arterial thrombolysis.
* The dose of IA thrombolysis may be doubled to 0.125 mg/kg tenecteplase or 0.45 mg/kg alteplase if this dose shows futility at pre-specified interims Randomization will be stratified by country/ region, the IA thrombolytic agent used (tenecteplase or alteplase). IA thrombolysis will be administered as a one-time treatment.
Inclusion: Age ≥18 years; Clinical diagnosis of stroke.
Exclusion: There are no platform level exclusion criteria.