Gibson CM, Kumar V, Gopalakrishnan L, et al. - In order to determine whether low-dose intracoronary (IC) tenecteplase (TNK) during primary percutaneous coronary intervention (PPCI) for ST segment elevation myocardial infarction affords a safe and feasible option for reducing thrombotic burden and distal embolization, researchers undertook the ICE-T-TIMI-49 study, wherein, they randomized 40 PPCI patients to a volume matched bolus of IC TNK (4 mg) (n = 20) or IC saline placebo (n = 20) prior to and after PPCI. They focused on the percent diameter stenosis of the culprit lesion after first bolus (primary endpoint). According to findings, low-dose IC TNK administration seemed safe and was well tolerated during PPCI. While this strategy failed to improve percent stenosis, there was a trend towards decreased thrombus burden with less hyperemia (a marker of distal embolization).