Abstract Details

Title Initial Experience with Tenecteplase as the Intravenous Thrombolytic of Choice Before Mechanical Thrombectomy for Large Vessel Occlusion Acute Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 13-010

Objective We sought to describe our initial experience using tenecteplase (TNK) as the primary thrombolytic for patients presenting with large vessel occlusion acute ischemic stroke (LVO AIS).

Background In mechanical thrombectomy candidates, TNK has shown improved reperfusion and outcomes with a similar safety profile to alteplase. Furthermore, TNK may provide a more practical route of administration without the need for continued infusion after an initial bolus. We hoped to evaluate the feasibility of these recent findings in a “real-world” setting.

Design/Methods In this retrospective study, demographic, clinical, and imaging information from patients treated with TNK was collected. Data was compared to a group treated with mechanical thrombectomy and intravenous alteplase (tPA).

Results In total, 146 patients were evaluated. Of these, 127 patients received IV tPA. After implementing TNK within our stroke network in October of 2020, 19 patients were treated with this thrombolytic agent. All patients had either an LVO on CTA, or high suspicion based on high NIHSS. Baseline characteristics were similar in both groups. Patients who received TNK had clinical improvement prior to arrival to the angio-suite and prevented the need for a cerebral angiogram in 15.8% of cases, and clinical improvement and/or angiographic recanalization preventing the need for thrombectomy in 31.6%, with significant difference as compared with the IV tPA group. Length of hospitalization was shorter in patients treated with TNK. Additional trends favoring lower NIH at discharge and at 3 months were seen. Adverse outcomes were similar in both groups.

Conclusions

We were able to transition easily to adopt the use of TNK within our system. Intravenous TNK in patients with LVOAIS is feasible, safe and effective. In our cohort from “real world” patients, TNK was associated with lower need for thrombectomy, high recanalization rates and shorter hospitalization.

Authors/Disclosures
Steven F. Platko, MD PRESENTER	Dr. Platko has nothing to disclose.
Fatima Z. Bensabeur, MD (Wright State University - Miami Valley Hospital)	Mrs. Bensabeur has nothing to disclose.
Umran Ugur, MD (Premier Health Clinical Neuroscience Institute)	Dr. Ugur has nothing to disclose.
	No disclosure on file
	No disclosure on file
John B. Terry, MD (Premier Health Clinical Neuroscience Institute)	Dr. Terry has nothing to disclose.
Esteban Cheng-Ching, MD (Miami Valley Hospital)	Dr. Cheng-Ching has received publishing royalties from a publication relating to health care.

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