May 7, 2026 · JAMA · DOI: 10.1001/jama.2026.5164

Adjunctive Intra-Arterial Alteplase After Successful Thrombectomy for Acute Ischemic Stroke: The CHOICE-2 Randomized Clinical Trial

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The CHOICE-2 randomized clinical trial aimed to determine whether adjunctive intra-arterial alteplase after successful thrombectomy improves functional outcomes and cerebral reperfusion in patients with acute ischemic stroke due to large vessel occlusion. The results indicated that the combination treatment significantly increased the proportion of patients achieving an excellent functional outcome at 90 days compared to thrombectomy alone, although it was associated with higher mortality rates, necessitating further investigation.

Arturo Renú, María Dolores Fernández-Couto, Patricia de la Riva, Raquel Delgado-Mederos, María Herrera, Ana Morales, Mikel Terceño, Nicolás López-Hernández, Mario Martínez-Galdámez, Laura Dorado, Pedro Vega, Lluis Morales-Caba, Eva González, Maitane Alonso, Pedro Barredo Benítez, Rebeca Bermejo, Andrea Cabero-Arnold, José María Cabrera-Maqueda, Martha Vargas, Ángel Calleja Bonilla, Sergio Calleja, José Díaz-Pérez, Salvatore Rudilosso, Antonio Doncel-Moriano, María José Feal, José Ignacio Gallego, Paola Hurtado, Carlos Laredo, Laura Llull, Inés Bartolomé, Alberto Martínez-Calvo, Álvaro Ortega-Sánchez, Alejandro Rodríguez-Vázquez, Isabel Rodríguez-Caamaño, Alba Singla, Yolanda Silva, Diana Tarruella Hernández, Laura Oleaga, Luis San Román Manzanera, Joaquín Serena, María Mar Freijo, Natalia Pérez de la Ossa, Mar Castellanos, Juan Francisco Arenillas-Lara, Ferran Torres, Enrique C Leira, Sergio Amaro, Xabier Urra, Ángel Chamorro, CHOICE-2 Investigators

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