Related Experiment Video
Updated: Nov 27, 2025
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Intravenous Thrombolysis With Tenecteplase in Patients With Large Vessel Occlusions: Systematic Review and
Aristeidis H Katsanos1, Apostolos Safouris2,3, Amrou Sarraj4
1Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, Canada (A.H.K., A.S.).
Stroke
|December 4, 2020
Summary
Tenecteplase offers better outcomes than alteplase for acute ischemic stroke patients with large vessel occlusions. This review found tenecteplase improved recanalization and functional recovery at three months.
Area of Science:
- Neurology
- Clinical Trials
- Pharmacology
Background:
- Acute ischemic stroke with large vessel occlusions (LVOs) requires effective thrombolytic therapy.
- Intravenous tenecteplase is emerging as a potential alternative to alteplase.
- Comparing tenecteplase and alteplase for LVOs is crucial for optimizing patient outcomes.
Purpose of the Study:
- To systematically review and meta-analyze randomized controlled trials comparing tenecteplase and alteplase for acute ischemic stroke with LVOs.
- To evaluate the efficacy and safety of tenecteplase versus alteplase in this patient population.
- To determine the optimal thrombolytic agent for improving functional outcomes in LVO stroke.
Main Methods:
- Searched MEDLINE and Scopus for relevant randomized controlled clinical trials.
- Included studies focused on acute ischemic stroke patients with confirmed LVOs receiving intravenous thrombolysis.
- Primary outcome was modified Rankin Scale score of 0 to 2 at 3 months.
Main Results:
- Four trials with 433 patients were included.
- Tenecteplase showed significantly higher odds of favorable functional outcomes (mRS 0-2) and successful recanalization compared to alteplase.
- No significant differences were observed in neurological improvement, hemorrhage rates, or mortality.
Conclusions:
- Intravenous tenecteplase demonstrates superior recanalization and clinical outcomes in acute ischemic stroke patients with LVOs compared to alteplase.
- Tenecteplase represents a promising and effective treatment option for LVO stroke.
- Further research may solidify tenecteplase's role in stroke management.
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