Extended Time Window Intravenous Tenecteplase Thrombolysis Registry for Acute Ischemic Stroke

The EXTEND-TNK Registry is a prospective, multicenter, observational cohort study designed to evaluate the effectiveness and safety of intravenous tenecteplase administered beyond 4.5 hours after last known well in patients with acute ischemic stroke (AIS) in routine clinical practice across China.

This prospective, multicenter, observational cohort registry enrolls adult patients (≥18 years) with acute ischemic stroke who receive intravenous tenecteplase more than 4.5 hours after last known well. Patient selection, imaging strategies, thrombolytic dosing, and concomitant therapies are determined by treating physicians according to local clinical practice, without study-mandated intervention. The primary outcome is the proportion of patients achieving a modified Rankin Scale (mRS) score of 0-1 at 90±14 days. This registry describes real-world patient characteristics, treatment patterns, and outcomes of extended time window intravenous tenecteplase, and explores factors associated with clinical outcomes to inform patient selection and future clinical practice.

Inclusion Criteria: * 1\. Age ≥ 18 years; * 2\. Clinical diagnosed of acute ischemic stroke; * 3\. Time from last known well (LKW) to initiation of intravenous thrombolysis \> 4.5 hours (including wake-up stroke and unwitnessed stroke); * 4\. Received intravenous tenecteplase; * 5\. Provided written informed consent. Exclusion Criteria: * 1\. Any condition judged by the investigator to make the participant unsuitable for study participation or follow-up (e.g., psychiatric disorders, cognitive impairment, or emotional disturbances).