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Ashish Pemawat: The INSTANT Trial Opens New Questions in Acute Stroke Therapy

Ashish Pemawat/LinkedIn

Jul 18, 2026, 18:12

Ashish Pemawat: The INSTANT Trial Opens New Questions in Acute Stroke Therapy

Ashish Pemawat, Associate Director of Institute of Neurosciences, shared on LinkedIn about a recent article by INSTANT Trial Authors, published in JAMA, adding:

”Can adjunctive tirofiban improve outcomes after intravenous thrombolysis? The INSTANT Trial offers an intriguing perspective.

The recently published INSTANT Trial in JAMA evaluated intravenous tirofiban after tenecteplase in patients with acute ischemic stroke who had no large- or medium-vessel occlusion and no cardioembolic source.

The study demonstrated a higher rate of excellent functional outcomes at 90 days with tirofiban (mRS 0–1: 63.8% vs. 52.2%) without a significant increase in serious safety events.

While these findings are not yet practice-changing, they introduce an exciting concept: can adjunctive antiplatelet therapy enhance reperfusion in selected patients who are not candidates for thrombectomy?

The INSTANT trial is an important step toward refining acute stroke therapy beyond recanalization alone.”

Title: Intravenous Tirofiban After Tenecteplase in Acute Ischemic Stroke: The INSTANT Randomized Clinical Trial

Authors: INSTANT Trial Authors for the INSTANT Investigators

Ashish Pemawat: The INSTANT Trial Opens New Questions in Acute Stroke Therapy