Repeated Thrombolysis Using Tenecteplase in a Patient With Early Recurrent Ischaemic Stroke

Ischaemic stroke is responsible for significant morbidity and mortality. Reperfusion therapy with intravenous thrombolysis is used to improve outcomes in patients with acute ischaemic stroke within 4.5 hours of symptom onset, but is generally contraindicated in early recurrent ischaemic stroke. Despite this, cases have been reported of patients who have had repeated thrombolysis using alteplase and achieved a good outcome. Tenecteplase, a variant of alteplase with higher specificity for fibrin and a longer half-life, is increasingly used as an alternative thrombolytic agent. However, there are no previously reported cases of repeated thrombolysis using tenecteplase. Here we report the first case of a 69-year-old male patient who received repeated thrombolysis with tenecteplase, rather than alteplase, in early recurrent ischaemic stroke.