Table 1.

Descriptive explanation of the eligibility criteria

Inclusion Criteria	Exclusion Criteria
Age >18 years	Imaging shows >1/3 of the MCA territory infarct or more than one vascular territory
AIS symptom onset withing the past 4.5-24 h	Acute or previous intracranial hemorrhage
AIS consistent within Internal Carotid Artery (ICA), Middle Cerebral Artery (MCA) or Anterior Cerebral Artery (ACA) territory	Active internal organ bleeding
Baseline mRS 0-2	Known hypersensitivity to Tenecteplase
NIHSS score of >5 at baseline and prior to randomization	Seizures at stroke onset
Imaging eligibility is defined as: Perfusion lesion-ischemic core mismatch should be greater than 1.8. Difference between the volume of hypoperfusion and volume of the ischemic core should be greater than 10ml, and an ischemic-core volume should be >70ml.	Severe, uncontrolled hypertension
If CT perfusion is technically inadequate and CT perfusion shows a penumbra and core volume of 0ml then patients will be screened by brain MRI and then randomized. If there is MRI DWI-FLAIR (Difussion-weighted imaging/Fluid attenuated inversion recovery) mismatch or DWI-ASL perfusion (Diffusion-weighted imaging/Arterial spin labelling) mismatch	Treatment with thrombolytic agent within the last three months
	Gastrointestinal malignancy or gastrointestinal bleed within 21 days
	Occlusion in >1 vascular territory
	Patients on anti-coagulation therapy should not be randomized in the trial

AIS=Acute Ischemic Stroke, mRS=modified Rankin Scale, NIHSS=National Institutes of Health Stroke Scale, CT=Computed Tomography, MRI=Magnetic resonance imaging