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Updated: Sep 22, 2025
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Tenecteplase in Ischemic Stroke: Challenge and Opportunity.
Guangshuo Li1, Chuanying Wang1, Shang Wang1,2
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Neuropsychiatric Disease and Treatment
|May 19, 2022
Summary
Tenecteplase (TNK) shows higher recanalization rates than alteplase for ischemic stroke without increasing hemorrhage risk. Further trials are needed to confirm TNK
Area of Science:
- Neurology
- Pharmacology
- Biotechnology
Background:
- Intravenous thrombolysis is standard for ischemic stroke.
- Alteplase has been the primary treatment for over two decades.
- Limitations of alteplase include low recanalization and hemorrhage risk.
Purpose of the Study:
- To review clinical trials of tenecteplase (TNK) as an alternative to alteplase for ischemic stroke.
- To evaluate TNK's efficacy and safety compared to alteplase.
- To explore TNK's pharmacokinetic advantages.
Main Methods:
- Systematic review of clinical trials involving TNK in ischemic stroke patients.
- Comparison of recanalization rates, intracerebral hemorrhage, and functional outcomes between TNK and alteplase.
- Analysis of TNK's performance in specific patient subgroups, including those with imaging mismatch or undergoing mechanical thrombectomy.
Main Results:
- TNK demonstrated higher recanalization rates than alteplase.
- No significant increase in intracerebral hemorrhage was observed with TNK.
- TNK showed superiority in recanalization for patients meeting imaging mismatch criteria or undergoing mechanical thrombectomy.
- Functional outcomes and early neurological improvement were not consistently superior with TNK compared to alteplase in all trials.
Conclusions:
- Tenecteplase (TNK) presents a promising alternative to alteplase for ischemic stroke treatment.
- TNK offers improved recanalization rates and comparable safety profiles.
- Further clinical trials focusing on functional outcomes are essential to establish TNK's role in ischemic stroke therapy.
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