[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100454565":3},{"organization":4,"armGroups":7,"interventions":20,"overallOfficials":33,"centralContacts":43,"locations":52,"responsibleParty":192,"collaborators":194,"id":203,"slug":204,"hasResults":205,"nctId":206,"briefTitle":207,"officialTitle":208,"acronym":209,"eligibilityCriteria":210,"healthyVolunteers":205,"sex":211,"minAge":212,"maxAge":213,"enrollmentInfo":214,"targetDuration":32,"studyType":217,"phases":218,"briefSummary":220,"conditions":221,"keywords":224,"overallStatus":54,"whyStopped":32,"lastUpdateSubmitDate":227,"lastUpdatePostDateStruct":228,"startDateStruct":231,"completionDateStruct":233,"leadSponsor":235,"locationsCount":236},{"fullName":5,"class":6},"Hospital Moinhos de Vento","OTHER",[8,14],{"label":9,"type":10,"description":11,"interventionNames":12},"Mechanical Thrombectomy preceded by TNK","EXPERIMENTAL","Subjects assigned to this arm will receive an intravenous bolus of tenecteplase (0.25mg\u002Fkg) before the mechanical thrombectomy.",[13],"Drug: Tenecteplase",{"label":15,"type":16,"description":17,"interventionNames":18},"Mechanical Thrombectomy preceded by Placebo","PLACEBO_COMPARATOR","Subjects assigned to this arm will receive an intravenous bolus of matching placebo (with the same volume of infusion as of 0.25mg\u002Fkg of tenecteplase) before the mechanical thrombectomy.",[19],"Drug: Placebo",[21,28],{"type":22,"name":23,"description":24,"armGroupLabels":25,"otherNames":26},"DRUG","Tenecteplase","Intravenous thrombolysis with tenecteplase 0.25mg\u002Fkg",[9],[27],"TNK",{"type":22,"name":29,"description":30,"armGroupLabels":31,"otherNames":32},"Placebo","Intravenous administration of placebo, matching the volume of tenecteplase 0.25mg\u002Fkg",[15],null,[34,38,40],{"name":35,"affiliation":36,"role":37},"Octavio M Pontes-Neto, MD, PhD","Hospital de Clínicas da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo","PRINCIPAL_INVESTIGATOR",{"name":39,"affiliation":5,"role":37},"Sheila CO Martins, MD, PhD",{"name":41,"affiliation":42,"role":37},"Raul G Nogueira, MD","University of Pittsburgh Medical College",[44,48],{"name":35,"role":45,"phone":46,"phoneExt":32,"email":47},"CONTACT","+551636053779","opontesneto@fmrp.usp.br",{"name":49,"role":45,"phone":50,"phoneExt":32,"email":51},"Leonardo A Carbonera, MD, MSc","+555135378195","leonardo.carbonera@hmv.org.br",[53,69,80,91,102,113,121,132,143,154,162,170,181],{"facility":5,"status":54,"city":55,"state":56,"zip":57,"country":58,"countryCode":59,"cosmosGeoPoint":60,"geoPoint":65,"contacts":66},"RECRUITING","Porto Alegre","Rio Grande do Sul","90035000","Brazil","BR",{"type":61,"coordinates":62},"Point",[63,64],-51.23019,-30.03283,{"lat":64,"lon":63},[67],{"name":68,"role":45,"phone":32,"phoneExt":32,"email":32},"Sheila Martins",{"facility":70,"status":54,"city":71,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":72,"geoPoint":76,"contacts":77},"Hospital das Clínicas Botucatu","Botucatu",{"type":61,"coordinates":73},[74,75],-48.445,-22.88583,{"lat":75,"lon":74},[78],{"name":79,"role":45,"phone":32,"phoneExt":32,"email":32},"Rodrigo Bazan, MD",{"facility":81,"status":54,"city":82,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":83,"geoPoint":87,"contacts":88},"Hospital de Base do Distrito Federal","Brasília",{"type":61,"coordinates":84},[85,86],-47.92972,-15.77972,{"lat":86,"lon":85},[89],{"name":90,"role":45,"phone":32,"phoneExt":32,"email":32},"Leticia Rebello",{"facility":92,"status":54,"city":93,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":94,"geoPoint":98,"contacts":99},"Hospital das Clínicas da UFPR","Curitiba",{"type":61,"coordinates":95},[96,97],-49.27306,-25.42778,{"lat":97,"lon":96},[100],{"name":101,"role":45,"phone":32,"phoneExt":32,"email":32},"Viviane Zetola",{"facility":103,"status":54,"city":104,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":105,"geoPoint":109,"contacts":110},"Hospital Geral de Fortaleza","Fortaleza",{"type":61,"coordinates":106},[107,108],-38.54306,-3.71722,{"lat":108,"lon":107},[111],{"name":112,"role":45,"phone":32,"phoneExt":32,"email":32},"Francisco Mont'Alverne, MD",{"facility":114,"status":54,"city":55,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":115,"geoPoint":117,"contacts":118},"Hospital de Clinicas de Porto Alegre",{"type":61,"coordinates":116},[63,64],{"lat":64,"lon":63},[119],{"name":120,"role":45,"phone":32,"phoneExt":32,"email":32},"Rosane Brondani",{"facility":122,"status":54,"city":123,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":124,"geoPoint":128,"contacts":129},"Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto","Ribeirão Preto",{"type":61,"coordinates":125},[126,127],-47.81028,-21.1775,{"lat":127,"lon":126},[130],{"name":131,"role":45,"phone":32,"phoneExt":32,"email":32},"Otavio Pontes Neto, MD",{"facility":133,"status":54,"city":134,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":135,"geoPoint":139,"contacts":140},"Hospital de Base de Rio Preto","São José do Rio Preto",{"type":61,"coordinates":136},[137,138],-49.37944,-20.81972,{"lat":138,"lon":137},[141],{"name":142,"role":45,"phone":32,"phoneExt":32,"email":32},"Raquel Hidalgo",{"facility":144,"status":54,"city":145,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":146,"geoPoint":150,"contacts":151},"Hospital das Clínicas de São Paulo","São Paulo",{"type":61,"coordinates":147},[148,149],-46.63611,-23.5475,{"lat":149,"lon":148},[152],{"name":153,"role":45,"phone":32,"phoneExt":32,"email":32},"Guilherme Diogo",{"facility":155,"status":54,"city":145,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":156,"geoPoint":158,"contacts":159},"Hospital Sao Paulo",{"type":61,"coordinates":157},[148,149],{"lat":149,"lon":148},[160],{"name":161,"role":45,"phone":32,"phoneExt":32,"email":32},"Gisele Sampaio",{"facility":163,"status":54,"city":145,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":164,"geoPoint":166,"contacts":167},"Santa Casa de Misericordia de Sao Paulo",{"type":61,"coordinates":165},[148,149],{"lat":149,"lon":148},[168],{"name":169,"role":45,"phone":32,"phoneExt":32,"email":32},"Rubens Gagliardi",{"facility":171,"status":54,"city":172,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":173,"geoPoint":177,"contacts":178},"Hospital Universitário de Uberlândia","Uberlândia",{"type":61,"coordinates":174},[175,176],-48.27722,-18.91861,{"lat":176,"lon":175},[179],{"name":180,"role":45,"phone":32,"phoneExt":32,"email":32},"Jullyanna Shinosaki",{"facility":182,"status":54,"city":183,"state":32,"zip":32,"country":58,"countryCode":59,"cosmosGeoPoint":184,"geoPoint":188,"contacts":189},"Hospital Estadual Central","Vitória",{"type":61,"coordinates":185},[186,187],-40.33778,-20.31944,{"lat":187,"lon":186},[190],{"name":191,"role":45,"phone":32,"phoneExt":32,"email":32},"José Fiorot JR, MD",{"type":193,"investigatorFullName":32,"investigatorTitle":32,"investigatorAffiliation":32,"oldNameTitle":32,"oldOrganization":32},"SPONSOR",[195,198,201],{"name":196,"class":197},"Ministry of Health, Brazil","OTHER_GOV",{"name":199,"class":200},"Boehringer Ingelheim","INDUSTRY",{"name":202,"class":200},"Medtronic","100454565","phase-3-randomization-to-endovascular-treatment-alone-or-preceded-by-systemic-thrombolysis-with-tenecteplase-in-ischemic-stroke-100454565",false,"NCT05199194","Randomization to Endovascular Treatment Alone or Preceded by Systemic Thrombolysis With Tenecteplase in Ischemic Stroke","Randomization to EndoVascular Treatment Alone or Preceded by Systemic Thrombolysis With Tenecteplase in Acute Ischemic Stroke Due to Large Intracranial VEssel OcclusioN Trial - DIRECT Thrombectomy vs. Intravenous TNK Plus Thrombectomy","DIRECT-TNK","Inclusion Criteria:\n\n* Acute ischemic stroke where a patient is eligible for IV thrombolytic treatment within 4.5 hours of stroke onset.\n* No significant pre-stroke functional disability (mRS ≤ 1)\n* Baseline NIHSS scores obtained before randomization must be equal to or higher than 6 points\n* Age equal ≥ 18 and =\\\u003C 85 years\n* Occlusion (TICI 0-1) of the ICA or proximal MCA segments (M1 or M2) suitable for endovascular treatment, as evidenced by CTA, MRA, or angiogram, with or without concomitant cervical carotid stenosis or occlusion.\n* Patient randomized within 4.5 hours of symptom onset. Symptoms onset is defined as the point in time the patient was last seen well (at baseline). Treatment start is defined as groin puncture, max 90 minutes after randomization.\n\n  * Patients who have woken up with the symptoms and who have a mismatch FLAIR-DWI according to the WAKE-UP Trial will be considered as having a time window of \\\u003C4.5h.\n* Informed consent obtained from the patient or acceptable patient surrogate.\n\nExclusion Criteria:\n\n* Known hemorrhagic diathesis, coagulation factor deficiency, or oral anticoagulant therapy with INR \\> 1.7 or direct oral anticoagulants such as thrombin antagonists (ex: dabigatran) or X factor (ex: rivaroxaban, apixaban, edoxaban) at the least 48 hours.\n* Baseline platelet count \\\u003C 100.000\u002FμL\n* Baseline blood glucose of \\\u003C 50mg\u002FdL or \\> 400mg\u002Fdl\n* Severe, sustained hypertension (SBP \\> 185 mm Hg or DBP \\> 110 mm Hg) NOTE: If the blood pressure can be successfully reduced and maintained at the acceptable level using AHA guidelines recommended medication (including iv antihypertensive drips), the patient can be enrolled.\n* Patients in coma (NIHSS item of consciousness \\>1) (Intubated patients for transfer could be randomized only in case an NIHSS is obtained by a neurologist prior transportation).\n* Seizures at stroke onset which would preclude obtaining a baseline NIHSS\n* Serious, advanced, or terminal illness with anticipated life expectancy of less than one year.\n* History of life-threatening allergy (more than rash) to contrast medium.\n* Subjects who has received IV t-PA treatment before the randomization.\n* Renal failure with serum creatinine ≥ 3 mg\u002Fdl\n* Woman of childbearing potential who is known to be pregnant or who has a positive pregnancy test on admission.\n* Subject participating in a study involving an investigational drug or device that would impact this study.\n* Cerebral vasculitis, endocarditis or subarachnoid hemorrhage.\n* Patients with a pre-existing neurological or psychiatric disease that would confound the neurological or functional evaluations.\n* Unlikely to be available for 90-day follow-up (e.g. no fixed home address, visitor from overseas).\n* Hypodensity on CT more than one third of MCA territory or hypersignal in more than one third of MCA territory on MR-DWI.\n* ASPECTS score \\\u003C 6 (no contrast at least 5 mm cut imaging on CT) or on MR-DWI sequence.\n* CT or MR evidence of hemorrhage (the presence of \\\u003C 5 GRE, SWI, SWAN microbleeds is allowed).\n* Significant mass effect with midline shift.\n* Evidence of ipsilateral carotid occlusion, high grade stenosis or arterial dissection in the extracranial or petrous segment of the internal carotid artery that cannot be treated or will prevent access to the intracranial clot or excessive tortuosity of cervical vessels precluding device delivery\u002Fdeployment.\n* Subjects with occlusions in multiple vascular territories (e.g., bilateral anterior circulation, or anterior\u002Fposterior circulation).\n* Evidence of intracranial tumor (except small meningioma).","ALL","18 Years","85 Years",{"count":215,"type":216},398,"ESTIMATED","INTERVENTIONAL",[219],"PHASE3","A phase III randomized, multi-center, double-blinded, placebo-controlled clinical trial that will examine two strategies for the treatment of acute ischemic stroke associated with a large vessel anterior occlusion within 4.5 hours from symptoms onset: direct endovascular treatment vs. endovascular treatment preceded by intravenous tenecteplase.",[222,223],"Stroke, Ischemic","Stroke, Acute",[23,27,225,226],"MT","Mechanical Thrombectomy","2025-04-02",{"date":229,"type":230},"2025-04-04","ACTUAL",{"date":232,"type":230},"2022-05-27",{"date":234,"type":216},"2027-07",{"name":5,"class":6},13]