Tenecteplase Before Interhospital Transfer for EVT in Acute Anterior Circulation LVO at 4.5-24 Hours

This study will address the efficacy and safety of Tenecteplase administered in non-endovascular capable center (nECC) in patients with acute ischemic stroke (AIS) caused by anterior circulation large vessel occlusion (acLVO) who present in the 4.5- to 24-hour time window before interhospital transfer to an endovascular capable center (ECC) for endovascular treatment (EVT). * Primary objective: To evaluate the efficacy and safety of Tenecteplase administration at a nECC before EVT transfer compared with standard of care * Secondary objective: To evaluate the impact of time from needle-to-arterial puncture on clinical outcomes Patients who meet inclusion criteria will be randomized to Tenecteplase (0.25mg/kg, maximum 25mg) before transfer or standard of care. A single bolus dose should be injected over 5 seconds.

NCT Number	NCT07253181
Lead Sponsor	Xuanwu Hospital, Beijing Collaborators: Boehringer Ingelheim (China) Investment Co., Ltd, Jeffrey Saver, Maarten Lansberg, Thanh N. Nguyen, Pierre Seners, Jens Fiehler, Raul G. Nogueira
Conditions	Acute Ischemic Stroke, Large Vessel Occlusion, Transportation of Patients
Enrollment	572 participants
Start Date	2026-01-06
Primary Completion	2028-03-30 (estimated)
Study Completion	2028-03-30 (estimated)
Updated on ClinicalTrials.gov	2026-03-19