Stroke etiology influences tenecteplase effectiveness in BRIDGE-TNK trial

An analysis of the BRIDGE-TNK trial, presented at the World Stroke Congress 2026 in Seoul, indicates that a patient's stroke etiology significantly affects the benefits of administering tenecteplase before endovascular thrombectomy (EVT).

Researchers found that patients with cardioembolism (CE) were more likely to achieve functional independence when receiving tenecteplase plus EVT (55.8%) compared to EVT alone (40.5%). In contrast, no functional benefit was observed in patients with large artery atherosclerosis (LAA) strokes, where functional independence rates were similar between the tenecteplase plus EVT group (46.3%) and the EVT-only group (49.4%).

The study also noted differences in mortality. Ninety-day mortality was 29.3% for those receiving tenecteplase plus EVT compared to 14.1% for those receiving EVT alone, suggesting that the underlying stroke mechanism is a critical factor when considering bridging thrombolysis treatments.