EXTEND-IA TNK was a randomised clinical trial comparing different clot dissolving agents for patients with stroke due to occlusion of a large blocked blood vessel in the brain who were planned to have endovascular thrombectomy (minimally invasive surgery to remove the blood clot).

This is particularly relevant to rural patients as thrombolysis can be delivered at all VST hospitals but, if clot retrieval is required, patients then need to be transferred to Melbourne which can take several hours. The longer the delay to opening the blocked artery, the greater the risk of disability due to the stroke.

Part 1 of the trial found that tenecteplase was more effective than the traditionally used medicine called alteplase in opening the blocked artery prior to the thrombectomy procedure.

Part 2 of the trial compared two doses of tenecteplase and involved 9 of the 17 VST hospitals. This was the first randomised trial of stroke thrombolysis to include patients recruited via telemedicine, providing rural patients access to cutting edge stroke research. The trial has now completed recruitment and is being analysed.