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Bridging thrombolysis with tenecteplase versus endovascular thrombectomy alone for large-vessel anterior circulation stroke: a target trial emulation analysis.
J Neurol Neurosurg Psychiatry
January 2025
Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Background: Whether bridging thrombolysis with tenecteplase is beneficial compared with thrombectomy alone in patients who had a stroke with large-vessel occlusion remains unclear.
Methods: This is a causal inference study of observational data from the trials SWIFT DIRECT and EXTEND-IA TNK Parts 1 and 2 applying target trial emulation. We compared patients receiving thrombectomy alone to patients receiving tenecteplase 0.
Safety of tenecteplase vs. alteplase in telestroke: a large multistate experience (STAT).
Front Neurol
January 2025
TeleSpecialists, LLC, Fort Myers, FL, United States.
Introduction: Prompt treatment with IV thrombolytics (IVT) in acute ischemic stroke (AIS) patients is critical for improved recovery and survival. Recently, hospital systems have switched to the IVT tenecteplase (TNK) instead of the FDA-approved alteplase (tPA) for treatment. Multiple studies and meta-analyses evaluating the efficacy and safety of TNK demonstrate similar or superior outcomes when compared to tPA.
View Article and Find Full Text PDFSafety and efficacy of intravenous thrombolysis: a systematic review and meta-analysis of 93,057 minor stroke patients.
BMC Neurol
January 2025
Department of Neurology, RWTH Aachen University, Pauwels Street 30, Aachen, 52074, Germany.
Background: The definition of minor ischemic stroke (MIS) is a topic of debate, however, the most accepted definition is a stroke with National Institutes of Health Stroke Scale (NIHSS) ≤ 5. Intravenous thrombolysis (IVT) is a crucial treatment option for acute ischemic stroke (AIS) including: alteplase, recombinant human tissue-type plasminogen activator (r-tPA), and the recently approved tenecteplase. However, there is a debate regarding its safety and efficacy.
View Article and Find Full Text PDFThrombolytic therapy for patients with acute ischemic stroke: systematic review and network meta-analysis of randomized trials.
Front Neurol
January 2025
Department of Pharmacy, Aerospace Center Hospital, Beijing, China.
Objective: To systematically compare the benefits and risks of all thrombolytic agents (tenecteplase, reteplase, and alteplase) at different doses for thrombolytic therapy in patients with acute ischemic stroke (AIS).
Background: Alteplase is the cornerstone treatment for AIS, but alternative thrombolytic agents are needed. The efficacy and safety of tenecteplase and reteplase, compared to alteplase, remain unclear, as does the optimal dosing for these treatments.
Prourokinase vs Standard Care for Patients With Mild Ischemic Stroke: The PUMICE Randomized Clinical Trial.
JAMA Neurol
January 2025
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Importance: Trials have not demonstrated superiority of alteplase or tenecteplase vs standard care in patients with mild stroke and have raised safety concerns. Prourokinase is an alternative fibrinolytic that may have a favorable safety profile, and the benefit-risk profile of prourokinase in mild stroke is unknown.
Objective: To investigate the efficacy and safety of prourokinase in mild ischemic stroke within 4.
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