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Tenecteplase in Pediatric Stroke: Ready or Not.

Jenny L Wilson1, Michaela Waak2, Megan Barry3

  • 1Division of Pediatric Neurology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon.

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Summary

Pediatric stroke experts show willingness to use tenecteplase (TNK) for acute childhood stroke, despite limited familiarity and hospital preparedness. Further data on TNK use in children is needed.

Keywords:
Ischemic strokePediatric strokeTenecteplaseThrombolysis

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Area of Science:

  • Pediatric Neurology
  • Thrombotic Stroke Treatment

Background:

  • Intravenous thrombolysis is an off-label treatment for acute childhood stroke.
  • Tenecteplase (TNK) is widely used for adult stroke, but data on its use in children is scarce.

Purpose of the Study:

  • To assess pediatric stroke experts' experience and preferences regarding tenecteplase (TNK) use in children with stroke.

Main Methods:

  • An online survey was distributed to members of the International Pediatric Stroke Organization in April 2023.

Main Results:

  • Most respondents (81.2%) reported limited familiarity with TNK.
  • 70% were willing to treat pediatric stroke with TNK, and 81.8% would consider it in a hypothetical scenario.
  • Few hospitals had TNK in their stroke protocol (9.1%) or on formulary (21.2%).

Conclusions:

  • A majority of pediatric neurologists are open to using TNK for childhood stroke.
  • Limited provider experience, data, and hospital preparedness highlight a need for further research and standardization.