When a person suffers a major stroke caused by a large blockage in a main artery, every second counts. Doctors often use a procedure called endovascular thrombectomy to physically remove the clot. However, new data suggests that adding certain clot-busting medications—called intra-arterial thrombolysis—can further improve the chances of a patient regaining their independence.
A large review of over 2,000 patients found that combining the mechanical procedure with specific doses of alteplase or tenecteplase led to significantly better functional outcomes. These are cases where patients achieved an excellent recovery, meaning they could move and speak well after 90 days. While both medications showed promise for these high-level recoveries, some differences appeared in safety.
Not all combinations were equal. For example, a specific lower dose of tenecteplase was linked to a higher risk of brain bleeding. Because this study analyzed data from multiple sources rather than one single trial, the results are not yet definitive. Doctors will need more head-to-head trials to confirm exactly which combination is safest and most effective for every individual patient.
