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Introduction <p>Branch atheromatous disease (BAD) is a common subtype of acute ischemic stroke characterized by atherosclerosis. Patients with BAD are highly prone to early neurological deterioration. Intravenous thrombolysis can restore blood flow. We investigated the efficacy of tenecteplase (TNK) intravenous thrombolysis in BAD treatment.</p> Methods <p>We retrospectively examined data from patients with BAD admitted to 13 hospitals in Zhengzhou between January 2020 and December 2024. Participants were categorized into TNK and dual antiplatelet therapy (DAPT) groups. Propensity score matching was performed to reduce subgroup heterogeneity.</p> Results <p>We included 1980 patients (TNK: 621, DAPT: 1359) matched in 522 pairs of participants. After propensity score matching, intravenous TNK administration within 4.5&#xa0;h of stroke onset was associated with reduced early neurological deterioration (unadjusted odds ratio [OR] = 1.796, 95% confidence interval [CI]: 1.303–2.477, <i>P</i> &lt; 0.001) and improved clinical outcomes 90&#xa0;days post-stroke. In the TNK group, more patients achieved good functional prognosis (modified Rankin scale [mRS] 0–1; unadjusted OR = 0.648, 95% CI 0.506–0.830, <i>P</i> &lt; 0.001) and were functionally independent (mRS 0–2) at 90&#xa0;days post-stroke (unadjusted OR = 0.725, 95% CI 0.546–0.963, <i>P</i> = 0.026). The dependence rate (mRS ≥ 4) in the TNK group was significantly lower than that in the DAPT group (unadjusted OR = 1.576, 95% CI 1.062–2.339, <i>P</i> = 0.024). Mortality (unadjusted OR = 2.351, 95% CI 0.605–9.143; <i>P</i> = 0.217), symptomatic intracranial hemorrhage (unadjusted OR = 0.595, 95% CI 0.215–1.650; <i>P</i> = 0.319), and other bleeding events (unadjusted OR = 1.371, 95% CI 0.680–2.764; <i>P</i> = 0.378) did not differ significantly.</p> Conclusion <p>TNK intravenous thrombolysis may be a safe and effective treatment for patients with BAD.</p>

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Efficacy and Safety of Tenecteplase in the Treatment of Acute Branch Atheromatous Disease: A Retrospective Multicenter Case–Control Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月31日

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  • Lili Zhu,
  • Shengqi Fu,
  • Ying Zhang,
  • Baoyang Shi,
  • Haoran Li,
  • Fanchao Meng,
  • Peng Ji,
  • Dongya Zhang,
  • Yanjun Zhang,
  • Yuan Xu,
  • Bo Jiang,
  • Xiaofei Gao,
  • Lijuan Liu,
  • Weifeng Chen,
  • Li Ruan,
  • Shaolei Zhang,
  • Yang Yang

摘要

Introduction

Branch atheromatous disease (BAD) is a common subtype of acute ischemic stroke characterized by atherosclerosis. Patients with BAD are highly prone to early neurological deterioration. Intravenous thrombolysis can restore blood flow. We investigated the efficacy of tenecteplase (TNK) intravenous thrombolysis in BAD treatment.

Methods

We retrospectively examined data from patients with BAD admitted to 13 hospitals in Zhengzhou between January 2020 and December 2024. Participants were categorized into TNK and dual antiplatelet therapy (DAPT) groups. Propensity score matching was performed to reduce subgroup heterogeneity.

Results

We included 1980 patients (TNK: 621, DAPT: 1359) matched in 522 pairs of participants. After propensity score matching, intravenous TNK administration within 4.5 h of stroke onset was associated with reduced early neurological deterioration (unadjusted odds ratio [OR] = 1.796, 95% confidence interval [CI]: 1.303–2.477, P < 0.001) and improved clinical outcomes 90 days post-stroke. In the TNK group, more patients achieved good functional prognosis (modified Rankin scale [mRS] 0–1; unadjusted OR = 0.648, 95% CI 0.506–0.830, P < 0.001) and were functionally independent (mRS 0–2) at 90 days post-stroke (unadjusted OR = 0.725, 95% CI 0.546–0.963, P = 0.026). The dependence rate (mRS ≥ 4) in the TNK group was significantly lower than that in the DAPT group (unadjusted OR = 1.576, 95% CI 1.062–2.339, P = 0.024). Mortality (unadjusted OR = 2.351, 95% CI 0.605–9.143; P = 0.217), symptomatic intracranial hemorrhage (unadjusted OR = 0.595, 95% CI 0.215–1.650; P = 0.319), and other bleeding events (unadjusted OR = 1.371, 95% CI 0.680–2.764; P = 0.378) did not differ significantly.

Conclusion

TNK intravenous thrombolysis may be a safe and effective treatment for patients with BAD.