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Related Experiment Video

Updated: Jan 31, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Tenecteplase versus alteplase for acute ischemic stroke.

Hemanshu Prabhakar¹, Indu Kapoor¹, Charu Mahajan¹

¹Department of Neuroanaesthesiology and Neurocritical Care, All India Institute of Medical Sciences, New Delhi, India.

The Cochrane Database of Systematic Reviews

|January 29, 2026

Summary

This summary is machine-generated.

This review compares tenecteplase and alteplase for acute ischemic stroke, assessing benefits and harms in large vessel occlusion and non-large vessel occlusion. It also explores effects across diverse demographic groups to inform health equity.

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Area of Science:

Neurology
Pharmacology
Clinical Trials

Background:

Acute ischemic stroke is a leading cause of disability worldwide.
Thrombolytic therapy, such as alteplase, is a cornerstone of acute ischemic stroke treatment.
Tenecteplase is a newer thrombolytic agent with potential advantages.

Purpose of the Study:

To systematically review and synthesize evidence on the benefits and harms of tenecteplase versus alteplase for acute ischemic stroke.
To evaluate treatment effects in patients with large vessel occlusion (LVO) and non-large vessel occlusion (non-LVO) stroke.
To explore potential health inequities by examining intervention effects across different demographic subgroups and income settings.

Main Methods:

This is a protocol for a Cochrane Review of intervention studies.
The review will include randomized controlled trials comparing tenecteplase with alteplase.
Data will be synthesized using meta-analysis where appropriate, with subgroup analyses planned for demographic factors and country income levels.

Main Results:

Primary outcomes will include measures of death and disability (e.g., modified Rankin Scale).
Secondary outcomes will include rates of symptomatic intracerebral hemorrhage and other adverse events.
Subgroup analyses will investigate treatment effects by age, sex, ethnicity, and country income.

Conclusions:

The findings will inform clinical decision-making regarding the optimal choice of thrombolytic therapy for acute ischemic stroke.
This review will highlight potential disparities in treatment effectiveness and guide strategies to promote health equity in stroke care.
Evidence synthesis will support evidence-based guidelines for acute ischemic stroke management.