{
  "abstract": "Background Despite successful reperfusion after thrombectomy for large vessel occlusion (LVO) stroke, up to half of patients are dependent or dead at 3-month follow-up.The aim of the current study is to demonstrate safety and efficacy of administering adjunct intra-arterial (IA) tenecteplase in anterior circulation LVO patients who have achieved successful reperfusion defined as eTICI 2b50 to 3.Methods ANGEL-TNK is a multicentre, open-label, assessor-blinded endpoint, prospective randomised, controlled trial that will enrol up to 256 patients. Patients who meet inclusion criteria with anterior circulation LVO stroke and successful reperfusion will be randomised to receive IA tenecteplase or best medical management at 1:1 ratio.Results The primary endpoint is a 90-day excellent outcome defined as modified Rankin Scale (mRS) 0–1. The primary safety endpoint is symptomatic intracranial haemorrhage within 48 hours from randomisation. Secondary endpoints include 90-day ordinal mRS, mRS 0–2, mRS 0–3, all-cause mortality and any intracranial haemorrhage.Conclusion In patients with anterior circulation LVO stroke, the ANGEL-TNK trial will inform whether adjunct IA tenecteplase administered after successful thrombectomy reperfusion improves patient outcomes.Trial registration number NCT05624190.",
  "authors": [
    {
      "affiliations": [
        "Cerebrovascular Disease Department, Neurological Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Xiaochuan Huo"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Gang Luo"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Dapeng Sun"
    },
    {
      "affiliations": [
        "Neurology, Radiology, Boston Medical Center, Boston, Massachusetts, USA"
      ],
      "name": "Thanh Nguyen"
    },
    {
      "affiliations": [
        "Neurology, Radiology, Boston Medical Center, Boston, Massachusetts, USA"
      ],
      "name": "Mohamad Abdalkader"
    },
    {
      "affiliations": [
        "Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China"
      ],
      "name": "Wenhuo Chen"
    },
    {
      "affiliations": [
        "Department of Neurology, Affiliated Chenzhou Hospital, Southern Medical University (The First People’s Hospital of Chenzhou), The First People's Hospital of Chenzhou, Chenzhou, China"
      ],
      "name": "Xiaoxi Yao"
    },
    {
      "affiliations": [
        "Department of Emergency, Xiangtan Central Hospital, Xiangtan, China"
      ],
      "name": "Guangxiong Yuan"
    },
    {
      "affiliations": [
        "Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China"
      ],
      "name": "Tingyu Yi"
    },
    {
      "affiliations": [
        "Department of Neurology, Linyi People's Hospital, Linyi, Shandong, China"
      ],
      "name": "Hongxin Han"
    },
    {
      "affiliations": [
        "China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Yuesong Pan"
    },
    {
      "affiliations": [
        "Cooper Hospital University Medical Center, Camden, New Jersey, USA"
      ],
      "name": "Tudor G Jovin"
    },
    {
      "affiliations": [
        "University of California Los Angeles, Los Angeles, California, USA"
      ],
      "name": "David S Liebeskind"
    },
    {
      "affiliations": [
        "China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Liping Liu"
    },
    {
      "affiliations": [
        "Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Xingquan Zhao"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China"
      ],
      "name": "Zeguang Ren"
    },
    {
      "affiliations": [
        "China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Yilong Wang"
    },
    {
      "affiliations": [
        "China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Yongjun Wang"
    },
    {
      "affiliations": [
        "Department of Neurology at Melbourne Brain Center, The University of Melbourne Medicine at Royal Melbourne Hospital, Parkville, Victoria, Australia"
      ],
      "name": "Bernard Yan"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Zhongrong Miao"
    }
  ],
  "title": "Intra-arterial tenecteplase after successful endovascular therapy (ANGEL-TNK): protocol of a multicentre, open-label, blinded end-point, prospective, randomised trial",
  "uid": "04fd6617-3660-50bc-ab09-54c9be6673a5"
}