Xu Z, et al. - Experts evaluated the efficacy and safety of tenecteplase vs alteplase for acute ischemic stroke (AIS) by analyzing data from relevant randomized controlled trials (RCTs). A better early neurological improvement was provided by tenecteplase than alteplase. Better early neurological improvement and a lower risk of any intracranial hemorrhage (ICH) tendency was especially shown by the 0.25 mg/kg dose of tenecteplase vs alteplase. Moreover, a lower risk of any ICH was demonstrated by the tenecteplase, in serious stroke at baseline subgroup.