This multicenter randomized trial in China compared intravenous tenecteplase followed by endovascular thrombectomy (EVT) against EVT alone in 330 patients with moderate to severe basilar artery occlusion presenting 4.5 to 24 hours after stroke onset. The trial reported that functional independence at 90 days occurred in 30% of patients in both groups, with no significant difference, and symptomatic intracranial hemorrhage and 90-day mortality were similar between groups. The authors concluded that adding tenecteplase before EVT did not improve functional outcomes compared with EVT alone in this population.