What question did this study set out to answer?

To assess whether intravenous tenecteplase improves 90-day functional recovery compared to standard care across subgroups defined by baseline arterial occlusion status in minor ischaemic stroke.

September 1, 2026European Stroke JournalOpen Access

Tenecteplase versus standard care for minor ischaemic stroke according to the baseline occlusion status in TEMPO-2 trial

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To assess whether intravenous tenecteplase improves 90-day functional recovery compared to standard care across subgroups defined by baseline arterial occlusion status in minor ischaemic stroke.
Secondary analysis of the randomised, controlled, blinded TEMPO-2 trial (NCT02398656) involving 881 patients presenting with minor ischaemic stroke (NIHSS ≤ 5) within 12 hours of onset.
Patients were categorized into three baseline occlusion subgroups: complete occlusion (revised arterial occlusive lesion score 0), near occlusion (score 1), and no visible occlusion with focal perfusion abnormality.
The primary outcome was return to pre-stroke functional status or better on the 90-day modified Rankin Scale, analyzed via generalized linear models adjusted for age, sex, onset-to-randomization time, and baseline stroke severity.
Among 881 patients, baseline status was complete occlusion in 434 (216 tenecteplase vs 218 control), near occlusion in 194 (92 vs 102), and no visible occlusion in 253 (123 vs 130).
Tenecteplase did not significantly alter the primary outcome in patients with complete occlusion (adjusted RR 1.00, 95% CI 0.89–1.12) or near occlusion (adjusted RR 0.85, 95% CI 0.71–1.01).
Functional recovery rates showed no significant difference between treatment arms in patients without visible arterial occlusion (adjusted RR 1.03, 95% CI 0.90–1.18).

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Implication

Randomized trial reveals tenecteplase does not improve 90-day functional recovery across baseline occlusion categories in minor ischaemic stroke, indicating no subgroup-specific benefit.

Cite This Study

Räty et al. (2026) studied this question.

synapsesocial.com/papers/6aa941e93863d2665e25639b https://doi.org/10.1093/esj/aakag111

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Implication

Randomized trial reveals tenecteplase does not improve 90-day functional recovery across baseline occlusion categories in minor ischaemic stroke, indicating no subgroup-specific benefit.

Tenecteplase versus standard care for minor ischaemic stroke according to the baseline occlusion status in TEMPO-2 trial

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Discussion

Implication

Cite This Study

Tenecteplase versus standard care for minor ischaemic stroke according to the baseline occlusion status in TEMPO-2 trial

Key Points

Discussion

Implication

Cite This Study

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