Intra-arterial recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) thrombolysis for acute medium vessel occlusion (MeVO-TNK): Study rationale and design

The MeVO-TNK study is a prospective randomized clinical trial aimed at treating acute ischemic stroke caused by medium vessel occlusion. The study includes 60 patients randomly divided into two groups: one group will receive intra-arterial thrombolysis with tenecteplase plus standard medical therapy, and the other group will receive standard medical therapy alone. Patients in the intervention group may receive up to two boluses of tenecteplase at a dose of 0.0625 mg/kg. The primary outcome is the measurement of final infarct volume 72 hours after randomization. Secondary outcomes include functional results measured by the modified Rankin Scale at 90 days and treatment safety. The main safety outcome is the occurrence of symptomatic intracranial hemorrhage within 24 hours. The study should provide evidence on the efficacy and safety of this treatment method.