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Tenecteplase in wake-up ischemic stroke trial: Protocol for a randomized-controlled trial.

Melinda B Roaldsen1,2, Haakon Lindekleiv3, Agnethe Eltoft1,2

  • 1Department of Neurology, University Hospital of North Norway, Tromsø, Norway.

International Journal of Stroke : Official Journal of the International Stroke Society
|January 15, 2021
PubMed
Summary
This summary is machine-generated.

Tenecteplase may be safe and effective for wake-up ischemic stroke patients selected by non-contrast CT. The Tenecteplase in Wake-up Ischemic Stroke Trial (TWIST) compares tenecteplase plus standard care to standard care alone.

Keywords:
TWISTTenecteplaseacute ischemic strokeintravenous thrombolysiswake-up stroke

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Area of Science:

  • Neurology
  • Emergency Medicine
  • Clinical Trials

Background:

  • Intravenous thrombolysis benefits select ischemic stroke patients with salvageable tissue.
  • The efficacy of thrombolysis in wake-up stroke patients not meeting advanced imaging criteria is unknown.
  • Non-contrast CT criteria may allow safe selection for thrombolytic treatment in wake-up strokes.

Purpose of the Study:

  • To evaluate the effect and safety of tenecteplase in wake-up ischemic stroke patients.
  • To compare tenecteplase plus standard care against standard care alone.
  • To assess treatment in patients selected using non-contrast CT criteria.

Main Methods:

  • The Tenecteplase in Wake-up Ischemic Stroke Trial (TWIST) is an international, multi-centre, randomized controlled trial.
  • 300 patients will receive tenecteplase plus standard care, and 300 will receive standard care alone.
  • The primary outcome is the modified Rankin Scale at three months, assessed within 4.5 hours of awakening.

Main Results:

  • This section is not available in the provided abstract.

Conclusions:

  • The TWIST trial aims to determine the efficacy and safety of tenecteplase for wake-up ischemic stroke patients identified via non-contrast CT.
  • Results will inform treatment guidelines for a broader population of wake-up stroke patients.