% 0期刊文章% Vignan Yogendrakumar % Peter j .米切尔一列昂尼德•Churilov % %一个蒂莫西·j·Kleinig % Nawaf Yassi %一个文森特Thijs %泰迪吴%沾光沙%一个海伦·m·杜威彼得·贝利% %一个崔菲利普·m %爱丽丝马% Tissa韦杰%卡洛斯Garcia-Esperon %杰弗里云%一个Dennis j . Cordato Ronil诉钱德拉% %一个伯纳德燕% Gagan Sharma %谈话帕特里夏·m·德斯蒙德马克•帕森斯(george w . bush) % %的杰弗里·A·唐南%斯蒂芬·m·戴维斯的布鲁斯坎贝尔的简历% % EXTEND-IA秋明石油公司调查员% T Tenecteplase安全性和有效性和溶栓串联病变患者中风% B的事后分析EXTEND-IA秋明石油公司试验% D R 10.1212 / WNL 2023%。0000000000207138 % J半岛投注体育官网神经病学% P e1900-e1911 % V 100% N 18% X背景和目标的安全性和有效性tenecteplase(秋明石油公司)串联病变患者(TL)中风是未知的。我们进行一个比较分析秋明石油公司和患者溶栓TLs。方法:我们首先比较秋明石油公司的治疗效果和患者的溶栓TLs使用EXTEND-IA秋明石油公司个体患者数据试验。我们在初始评估颅内再灌注血管造影评估和90天的改良Rankin规模(夫人)序数物流和弗斯回归模型。因为2关键结果,死亡率和症状性颅内出血(西奇),数量很少,在那些接受溶栓在EXTEND-IA秋明石油公司试验,我们生成的汇集估计这些结果通过补充试验数据估计入射通过荟萃分析研究确定在系统回顾。然后计算未经调整的风险差异比较集中发病率估计对于那些接受溶栓试验中观察到的那些接收秋明石油公司。结果七十一483名患者(15%)的患者拥有一个TL EXTEND-IA秋明石油公司试验。TLs,观察颅内再灌注在11/56(20%)的TNK-treated病人vs 1/15 (7%) alteplase-treated病人(调整后的优势比2.19;95%可信区间0.28 - -17.29)。无显著差异在观察90天的夫人(共同调整优势比1.48;95%可信区间0.44 - -5.00)。 A pooled study-level proportion of alteplase-associated mortality and sICH was 0.14 (95% CI 0.08–0.21) and 0.09 (95% CI 0.04–0.16), respectively. Compared with a mortality rate of 0.09 (95% CI 0.03–0.20) and an sICH rate of 0.07 (95% CI 0.02–0.17) in TNK-treated patients, no significant difference was observed.Discussion Functional outcomes, mortality, and sICH did not significantly differ between patients with TLs treated with TNK and those treated with alteplase.Classification of Evidence This study provides Class III evidence that TNK is associated with similar rates of intracranial reperfusion, functional outcome, mortality, and sICH compared with alteplase in patients with acute stroke due to TLs. However, the CIs do not rule out clinically important differences.Trial Registration Information clinicaltrials.gov/ct2/show/NCT02388061; clinicaltrials.gov/ct2/show/NCT03340493.CTA=CT angiography; DSA=digital subtraction angiography; eICA=extracranial internal carotid artery; eTICI=extended treatment in cerebral ischemia; LVO=large vessel occlusion; mRS=modified Rankin scale; NIHSS=NIH Stroke Scale; sICH=symptomatic intracranial hemorrhage; TL=tandem lesion; TNK=tenecteplase %U //www.ebmtp.com/content/neurology/100/18/e1900.full.pdf