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| http://dx.doi.org/10.1177/09727531221125589 | DOI Listing |
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Should we switch to tenecteplase for all ischemic strokes? Evidence and logistics.
Int J Stroke
January 2025
School of Cardiovascular & Metabolic Health, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, UK.
Recent clinical trials provide robust evidence of non-inferiority of tenecteplase 0.25 mg/kg over alteplase 0.9 mg/kg in acute ischemic stroke treated within 4.
View Article and Find Full Text PDFAngioedema Secondary to Tenecteplase Use in a Patient with Acute Ischemic Stroke: A Case Report.
Clin Pract Cases Emerg Med
August 2024
University of Maryland Medical Center, Department of Emergency Medicine, Baltimore, Maryland.
Introduction: Angioedema, a swelling of the subcutaneous or submucosal layers of the skin or gastrointestinal tract, is a potential complication to thrombolytic therapy in the treatment of acute ischemic strokes. In these cases, angioedema develops due to increased levels of bradykinin as a result of the activation of the fibrinolytic pathway and contact activation system. Angioedema can involve the tongue, larynx, and vocal cords, leading to occlusion of the airway and death due to asphyxiation.
View Article and Find Full Text PDFPerfusion Abnormalities on 24-Hour Perfusion Imaging in Patients With Complete Endovascular Reperfusion.
Stroke
September 2024
Department of Diagnostic and Interventional Neuroradiology (A.M., A.I., S.Z., E.I.P., B.L.S., T.D., A.H., R.W., J.G., J.K.), University of Bern, Switzerland.
Background: Perfusion abnormalities in the infarct and salvaged penumbra have been proposed as a potential reason for poor clinical outcome (modified Rankin Scale score >2) despite complete angiographic reperfusion (Thrombolysis in Cerebral Infarction [TICI3]). In this study, we aimed to identify different microvascular perfusion patterns and their association with clinical outcomes among TICI3 patients.
Methods: University Hospital Bern's stroke registry of all patients between February 2015 and December 2021.
Tenecteplase versus alteplase before stroke thrombectomy: outcomes after system-wide transitions in Pennsylvania.
J Neurol
August 2024
Department of Neurosurgery, Geisinger, Danville, PA, USA.
Article Synopsis
- The study investigates the transition from alteplase (TPA) to tenecteplase (TNK) in four Pennsylvania stroke systems for patients with large vessel occlusion (LVO) strokes who received intravenous thrombolysis before endovascular treatment (EVT) from January 2020 to June 2023.
- Among 635 patients, nearly half were treated with TNK and the other half with TPA, showing similar functional outcomes at 90 days (47.6% for TNK vs. 49.7% for TPA).
- Results indicated comparable rates for early recanalization, successful reperfusion, risk of symptomatic intracranial hemorrhage, and 90-day mortality between the TNK
Worldwide Survey on Approach to Thrombolysis in Acute Ischemic Stroke With Large Vessel Occlusion.
Neurol Clin Pract
August 2024
Department of Internal Medicine (NS), Neurology Division, University of Manitoba, Winnipeg, Canada; Department of Clinical Neurosciences (NS, NK, AG), University of Calgary, Alberta, Canada; Department of Diagnostic and Interventional Neuroradiology (NK), Royal University Hospital, University of Saskatchewan, Saskatoon, Canada; Division of Neurology (AGZV), Children's National Hospital, Washington, DC; and Kelowna General Hospital (AT), University of British Columbia, Canada.
Background And Objectives: With recent trials suggesting that endovascular thrombectomy (EVT) alone may be noninferior to combined intravenous thrombolysis (IVT) with alteplase and EVT and that tenecteplase is non-inferior to alteplase in treating acute ischemic stroke, we sought to understand current practices around the world for treating acute ischemic stroke with large vessel occlusion (LVO) depending on the center of practice (IVT-capable vs IVT and EVT-capable stroke center).
Methods: The electronic survey launched by the Practice Current section of Neurology: Clinical Practice included 6 clinical and 8 demographic questions. A single-case scenario was presented of a 65-year-old man presenting with right hemiplegia with aphasia with a duration of 1 hour.
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