Tenecteplase Before Thrombectomy at 4.5 to 24 Hours for Basilar Artery Occlusion: The ATTENTION LATE Randomized Clinical Trial.

Intravenous tenecteplase before thrombectomy does not improve 90-day functional independence in basilar artery occlusion patients presenting 4.5 to 24 hours after stroke onset.

• Why it matters: Determining effective treatment options for late-presenting basilar artery occlusion is critical, as current evidence on pre-thrombectomy thrombolysis benefits remains limited and uncertain.
• What they did: A multicenter, randomized trial enrolled 330 patients with moderate to severe basilar artery occlusion within 4.5 to 24 hours, comparing tenecteplase plus EVT versus EVT alone, focusing on functional independence at 90 days.
• The result: Adding tenecteplase did not significantly increase functional independence or reduce mortality or hemorrhage risk, indicating EVT alone remains the standard approach in this patient group.