Innovative Clot Removal Technique May Enhance Stroke Recovery

Recent research presented at the American Stroke Association's International Stroke Conference 2025 indicates that a novel approach to treating ischemic strokes may lead to improved patient outcomes. The study highlights the effectiveness of removing a blood clot from a large artery in the brain, followed by the administration of the clot-dissolving drug tenecteplase.

Approximately 20% of strokes caused by clots are due to blockages in large vessels within the brain. Current medical standards in the U.S. and China emphasize the urgent removal of these clots using minimally invasive endovascular techniques. These methods involve using a catheter or stent to retrieve the clot, thereby restoring blood flow and preventing further damage to brain tissue.

Without timely intervention, studies suggest that over 80% of individuals suffering from strokes caused by large vessel occlusions may face severe disabilities, with around 20% succumbing to the condition. Even with successful clot removal, up to half of these patients may experience negative outcomes three months later.

Dr. Xiaochuan Huo, director of the neurological disease center at Beijing Anzhen Hospital, led the research aimed at determining whether administering tenecteplase directly into the affected artery post-clot removal could enhance blood flow, particularly in smaller vessels. This approach intends to minimize the extent of brain tissue deprived of blood supply.

The study involved 256 participants from 19 medical centers across China, all of whom underwent treatment within a 24-hour window after being identified as having a stroke. Participants were divided into two groups: one received tenecteplase alongside standard care, while the other group was given standard medical treatment alone after successful endovascular therapy.

Key findings from the study include:

• Stroke survivors who received the tenecteplase injection were 44% more likely to achieve favorable outcomes (defined as a modified Rankin score of 0-1) after 90 days compared to those who received standard care alone (40.5% versus 26.4%).
• Incidences of brain hemorrhages within two days post-treatment were comparable between the two groups (5.6% for tenecteplase patients versus 6.2% for standard treatment).
• Mortality rates within 90 days were similar, showing 21.4% in the tenecteplase group and 21.7% in the standard care group.

Dr. Huo emphasized that administering tenecteplase intra-arterially after successful thrombectomy could significantly enhance the chances of favorable recovery, allowing stroke survivors to regain independence and reintegrate into society.

The research team is continuing to monitor participants to evaluate long-term outcomes over a one-year period. Dr. Huo noted that these findings could potentially influence future treatment guidelines for patients who have undergone successful clot removal. However, further analyses, including an individual meta-analysis of data from this and similar studies, are necessary to solidify treatment recommendations.

It is important to note that the study did not encompass patients who had been treated with intravenous clot-dissolving medications or anticoagulants during their endovascular procedures. Consequently, the benefits observed with intra-arterial tenecteplase may not extend to those receiving such treatments.

The results of this study underscore the importance of ongoing innovation in stroke treatment methodologies, aiming to improve recovery rates and quality of life for survivors of ischemic strokes.