{
  "abstract": "Background and purpose One clinical trial demonstrated the beneficial effect of intravenous tenecteplase for large vessel occlusion patients not undergoing endovascular thrombectomy (EVT) within 4.5–24 hours. However, for those with acute basilar artery occlusion (BAO) presenting beyond the 4.5-hour therapeutic window, it remains unknown whether intravenous thrombolysis before EVT is beneficial. This study hypothesised that treatment of acute BAO patients with intravenous tenecteplase before EVT will result in better clinical outcomes vs EVT alone within 4.5–24 hours.Methods and design ATTENTION LATE is a prospective, multicentre, randomised, controlled, open-label trial with blinded endpoint assessment. This study will enrol patients with acute BAO who present within 4.5–24 hours of symptom onset. These patients will be randomised 1:1 to either intravenous tenecteplase bridging to EVT or EVT alone.Study outcomes A score of 0–2 on the modified Rankin Scale at 90 days will serve as the primary endpoint.Discussion The ATTENTION LATE trial evaluates whether administering intravenous tenecteplase is safe and effective for acute BAO patients prior to EVT beyond the 4.5-hour time frame. This trial could establish the basis for expanding the eligible patient population to receive intravenous thrombolysis and extending the time window for acute BAO.Trial registration number NCT05701956.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Rui Li"
    },
    {
      "affiliations": [
        "Department of Radiology and Neurology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA"
      ],
      "name": "Thanh Nguyen"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Chunrong Tao"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Jun Sun"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Pengfei Xu"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Cong Luo"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Li Wang"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Tianlong Liu"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Jianlong Song"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Xiaozhong Jing"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Anmo Wang"
    },
    {
      "affiliations": [
        "The Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, Missouri, USA"
      ],
      "name": "Adnan I Qureshi"
    },
    {
      "affiliations": [
        "Department of Radiology and Neurology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA"
      ],
      "name": "Mohamad Abdalkader"
    },
    {
      "affiliations": [
        "Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"
      ],
      "name": "Jeffrey L Saver"
    },
    {
      "affiliations": [
        "The UPMC Stroke Institute, Department of Neurology and Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"
      ],
      "name": "Raul G Nogueira"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Wei Hu"
    }
  ],
  "title": "Intravenous tenecteplase before endovascular thrombectomy in patients with acute basilar artery occlusion within 4.5–24 hours: study protocol and rationale",
  "uid": "275b1d5f-c2c8-5f22-b655-d2ad66e59e68"
}