Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec;11(6):e885-e889.
doi: 10.1212/CPJ.0000000000001096.

Early Experience With Tenecteplase at a Comprehensive Stroke Center

Spozhmy Panezai  1 , Ilya Dubinsky  1 , Sindhu Sahito  1 , Nancy Gadallah  1 , Laura Suhan  1 , Siddhart Mehta  1 , Jawad Kirmani  1
Affiliations
Review

Early Experience With Tenecteplase at a Comprehensive Stroke Center

Spozhmy Panezai et al. Neurol Clin Pract. 2021 Dec.

Abstract

Purpose of review: Tenecteplase has been studied and recommended as an alternative thrombolytic agent in patients with acute stroke. A brief review of clinical trials and guidelines pertinent to our clinical decision algorithm is described. This is followed by operational steps that were made to create and implement a clinical pathway based on available evidence in which tenecteplase is used in select patients with stroke at our comprehensive stroke center.

Recent findings: A number of patients have been treated at our center with IV tenecteplase. A case is presented to illustrate the successful implementation of this new process.

Summary: Development of our protocol is discussed in detail to enable other centers to create their own clinical pathways for thrombolytic treatment of acute ischemic stroke using tenecteplase.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Case 1
(A) CT of the head revealing hyperdense left MCA. (B) CTA documenting left MCA M1 occlusion. (C) Cerebral angiography demonstrating recanalization of the left MCA after tenecteplase IV bolus. CTA = CT angiography; MCA = middle cerebral artery.
Figure 2
Figure 2. HMH JFK Stroke and Neurovascular Center's Acute Stroke Treatment Clinical Pathway
Code NI = Code Neurointervention; Code BB = Code Brain Bleed; IAT = intra-arterial thrombolysis; LVO = large-vessel occlusion; CTP = CT perfusion; MRP = magnetic resonance perfusion; NCCU = neurocritical care unit.
Figure 3
Figure 3. Code Stroke Box With Separately Packaged Thrombolytic Agents
See this image and copyright information in PMC

References

    1. Powers WJ, Rabinstein AA, Ackerson T, et al. . Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019;50:e344-e418. - PubMed
    1. Logallo N, Kvistad CE, Thomassen L. Therapeutic potential of tenecteplase in the management of acute ischemic stroke. CNS Drugs. 2015;29:811-818. - PubMed
    1. Dunn CJ, Goa KL. Tenecteplase: a review of its pharmacology and therapeutic efficacy in patients with acute myocardial infarction. Am J Cardiovasc Drugs. 2001;1:51-66. - PubMed
    1. Van De Werf F, Adgey J, Ardissino D, et al. . Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial. Lancet. 1999;354:716-722. - PubMed
    1. Burgos AM, Saver JL. Evidence that tenecteplase is noninferior to alteplase for acute ischemic stroke: meta-analysis of 5 randomized trials. Stroke. 2019;50(8):2156-2162. - PubMed