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ESOC 2026 | Aims of RESILIENT-EXTEND-IV: tenecteplase in extended-window acute ischemic stroke

Gisele Sampaio Silva, MD, PhD, Federal University of São Paulo, São Paulo, Brazil, discusses the Phase III RESILIENT-EXTEND-IV trial (NCT05199662), which is exploring the effectiveness of extending stroke intravenous thrombolysis in evolving non-large vessel occlusion treated with tenecteplase. This interview took place at the 12th European Stroke Organisation Conference (ESOC) in Maastricht, The Netherlands.

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Transcript

The RESILIENT-EXTEND-IV trial is a trial that is evaluating tenecteplase, TNK, in the late time window for patients without middle cerebral vessel occlusion. So it’s actually very similar to the OPTION trial. It’s been held in Brazil, in centers in Brazil, and the idea is that we can add data to the safety and efficacy of TNK in this late-time window. And you have a very important difference from the Optimal trial is that we are not using advanced neuroimaging in all patients...

The RESILIENT-EXTEND-IV trial is a trial that is evaluating tenecteplase, TNK, in the late time window for patients without middle cerebral vessel occlusion. So it’s actually very similar to the OPTION trial. It’s been held in Brazil, in centers in Brazil, and the idea is that we can add data to the safety and efficacy of TNK in this late-time window. And you have a very important difference from the Optimal trial is that we are not using advanced neuroimaging in all patients. So some patients are being evaluated just with plain CT and CTA. So we hope to add important evidence regarding thrombolysis in the late time window with a more pragmatic approach.

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