ESOC 2022 | Top data from ESOC 2022: ATTENTION, AcT, and TASTE-A
Raul Nogueira, MD, University of Pittsburgh, Pittsburgh, PA, comments on several major highlights from the European Stroke Organisation Conference 2022, highlighting data that is likely to be practice changing. The ATTENTION trial (NCT04751708) was a multicenter, randomized controlled clinical trial investigating the use of endovascular treatment compared to best medical management (BMM) for patients with acute ischemic stroke with basilar artery occlusion. Strongly positive results were presented at the meeting, with favorable outcomes (modified Rankin scale score of 0-3) seen in 46% versus 24% in the thrombectomy and BMM arms, respectively, giving a number needed to treat of 4. Additionally, several trials were presented looking at the use of tenecteplase for intravenous thrombolysis. Data suggested tenecteplase was as, if not more, efficacious than alteplase (AcT trial; NCT03889249), easier to use, and feasible in a mobile stroke unit setting (TASTE-A trial; NCT04071613). This interview took place at European Stroke Organisation Conference 2022 in Lyon, France.
Transcript (edited for clarity)
I’m a little bit biased, but I’m very excited about the results of ATTENTION. We just ran the analysis and got the results just a few days prior to the conference. And I’m really looking forward to seeing the second trial tomorrow. You always want further confirmation. You always want kind of more reassurance from two trials. So I’m specifically happy about we finally conquered this territory of the basilar artery occlusion, in terms of scientific proof...
I’m a little bit biased, but I’m very excited about the results of ATTENTION. We just ran the analysis and got the results just a few days prior to the conference. And I’m really looking forward to seeing the second trial tomorrow. You always want further confirmation. You always want kind of more reassurance from two trials. So I’m specifically happy about we finally conquered this territory of the basilar artery occlusion, in terms of scientific proof.
The other things that I think were very important in the conference is the advancements in intravenous thrombolysis with TNK. There were studies showing the feasibility with very important signals of improvement by giving TNK in mobile stroke units. The AcT study help us feeling more comfortable with the whole concept of switching from alteplase to tenecteplase. That’s a lot easier to use, potentially a little more efficacious prior to thrombectomy, and who knows maybe safer. But we also learned that we have to stick with the lower dose of 0.25 milligrams because 0.4 milligrams actually cause more hemorrhage.
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