A research team led by Prof. HU Wei and Prof. LIU Xinfeng from the Department of Neurology at the First Affiliated Hospital of the University of Science and Technology of China (USTC), also known as Anhui Provincial Hospital, has published a significant clinical study in The British Medical Journal (BMJ). They introduced the Intra-arterial tenecteplase after successful endovascular recanalisation in patients with acute posterior circulation arterial occlusion(ATTENTION-IA) is expected to further improve the functional prognosis of patients and enhance their quality of life, which is of breakthrough significance for the treatment of patients with acute basilar artery occlusion within 24 hours of onset.
The study addresses the treatment of acute basilar artery occlusion (ABAO), a severe type of ischemic stroke associated with high mortality and disability rates. Even with successful endovascular recanalization (EVT), over half of the patients in previous trials—including the original ATTENTION study—still experienced poor outcomes.
Distribution of modified Rankin scale scores (functional outcomes) at 90 days in the intention-to-treat population (no patients lost to follow-up).(Image by Prof. HU’s team)
To further improve recovery rates, the ATTENTION-IA clinical trial explored the effect of adding intra-arterial thrombolysis using tenecteplase immediately after EVT. The results are promising: 34.6% of patients receiving the combined “bridging therapy” (mechanical thrombectomy plus intra-arterial thrombolysis) achieved excellent functional outcomes (modified Rankin Scale score 0–1 at 90 days), compared to only 26.0% in the EVT-only group.
These findings highlight the potential of this combined approach to significantly enhance treatment effectiveness for ABAO, improving patients’ long-term neurological function and quality of life.
The ATTENTION-IA trial represents a major step forward in stroke intervention research and may influence future clinical guidelines for managing acute posterior circulation strokes.
Paper link: https://doi.org/10.1136/bmj-2024-080489
(Written by SHEN Xinyi, Edited by ZHAO Zheqian, USTC News Center)
