Intra-arterial Thrombolysis After Endovascular Thrombectomy in AIS
Official title: A Multicentre,Prospective,Randomized,Open Label,Blinded-endpoint Trial for Reperfusion Enhancement After Completing Thrombectomy Using Intraarterial Thrombolysis(REACT-IA-Thrombolysis Domain)Embedded in A Multi-faCtorial,mulTi-arm, Multi-staGe,Randomised,gLOBal Adaptive pLatform Trial for Stroke(ACT-GLOBAL) NCT06352632
Run by University of Calgary · NCT07687056 · Data updated 2026-11-12
This trial tests whether giving intra-arterial thrombolysis with tenecteplase or alteplase after endovascular thrombectomy helps improve recovery in adults with acute ischemic stroke.
Quick facts
| Phase | Phase 3 |
|---|---|
| Study type | Interventional |
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 1500 (estimated) |
| Sponsor | University of Calgary Academic / other |
| Locations | 13 sites (Sydney, Barangaroo and 12 other locations) |
| Status | Recruiting |
| Started | August 11, 2026 |
| Main results expected | December 31, 2030 |
| Study ends | March 31, 2031 |
| Registry record updated | October 21, 2026 |
| Trial ID | NCT07687056 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults aged 18 or older with acute ischemic stroke who undergo endovascular thrombectomy.
✕Probably not a fit
Patients who do not have distal occlusions or who are not suitable candidates for intra-arterial thrombolysis may see no benefit.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This is a large, international, randomized trial embedded in the ACT-GLOBAL platform. It compares the use of intra-arterial thrombolytic therapy (tenecteplase or alteplase) versus no intra-arterial thrombolysis after endovascular thrombectomy in patients with acute ischemic stroke. The study uses a PROBE design with blinded outcome assessment and will enroll up to 1,500 participants, followed for 90 days. Randomization is stratified by country/region and thrombolytic agent to maintain balance across key covariates. Primary outcome is functional status at Day 90 measured by the modified Rankin Scale via centralized assessment.
Why it matters
Potential benefit: If successful, the approach could improve functional recovery for stroke patients who have distal occlusions after thrombectomy.
How similar studies have gone: Earlier small studies and meta-analyses have suggested safety and potential benefit with intra-arterial thrombolysis after thrombectomy, but definitive evidence has been lacking.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: 1. Age ≥18 years 2. Clinical diagnosis of stroke Exclusion Criteria: There are no platform level exclusion criteria.
Where it's running
-
University of Calgary- Foothills Medical Centre
Calgary, Alberta, Canada Recruiting -
The George Institute for Global Health
Sydney, Barangaroo, Australia Not yet recruiting -
University of Alberta
Edmonton, Alberta, Canada Not yet recruiting -
Kelowna Regional Hospital
Kelowna, British Columbia, Canada Not yet recruiting -
Royal Columbian Hospital
New Westminster, British Columbia, Canada Not yet recruiting -
University of British Columbia
Vancouver, British Columbia, Canada Not yet recruiting
Show 7 more locations
-
University of Manitoba - Winnipeg Health Science Centre
Winnipeg, Manitoba, Canada Not yet recruiting -
Health Sciences North Horizon Sante-Nord
Greater Sudbury, Ontario, Canada Not yet recruiting -
Ottawa Civic Hospital
Ottawa, Ontario, Canada Not yet recruiting -
Sunnybrook Health Science Centre
Toronto, Ontario, Canada Not yet recruiting -
CHUM -Centre Hospitalier de l'Universite de Montreal
Montreal, Quebec, Canada Not yet recruiting -
CIUSSS de l'Estrie - CHUS Fleurimont Hôpital (Sherbrooke)
Sherbrooke, Quebec, Canada Not yet recruiting -
Royal University Hospital
Saskatoon, Saskatchewan, Canada Not yet recruiting
Study contacts
- Principal investigator: Bijoy K Menon, MD — University of Calgary
- Study coordinator: Bijoy K Menon, MD
- Email: bkmmenon@ucalgary.ca
- Phone: 403-944-8107
Similar studies
Other studies for the same condition or treatment. Recruiting studies are listed first.
-
Mobilisation After Endovascular Stroke Treatment
This study checks whether moving around 12 hours after endovascular stroke treatment is as safe as moving around 24 hours for people with an acute ischemic stroke.
-
NeuroAiD test in mild to moderate ischemic stroke patients
This study tests whether adding MLC901 (NeuroAiD II) to standard stroke care helps adults who recently had an ischemic stroke recover better than standard care alone.
-
Factors affecting outcomes after endovascular treatment for large-vessel stroke
This study tests how different factors influence recovery after mechanical clot removal in adults with acute ischemic stroke due to large vessel blockage.
-
Intra-arterial Alteplase after successful reperfusion following mechanical thrombectomy
This trial tests whether giving a small amount of alteplase directly into the artery after a successful thrombectomy helps adults with acute ischemic stroke recover better.
-
Minocycline after successful recanalization in acute anterior circulation stroke
This trial tests whether adding minocycline after a successful endovascular thrombectomy helps people recover better after an acute anterior circulation stroke.
-
Minocycline after successful reopening of posterior circulation stroke with endovascular therapy
This trial tests whether adding minocycline after successful thrombectomy helps people recover better from a posterior circulation stroke.
How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.