The Primary Experience with Tenecteplase Thrombolysis for Acute Ischemic Stroke: A Report from Iran

Background & Objective: Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) has been considered as primary therapy in ischemic stroke patients. Alteplase is prescripted as the thrombolytic therapy for more than two decades. Tenecteplase is a new type of tPA that is reported to have beneficial effects in recent years. The present research focused on the effectiveness and the side effects of tenecteplase in the ischemic stroke.  Materials & Methods: Here we administrated ۰.۲۵ mg/kg tenecteplase in ۳۶ individuals with acute ischemic stroke in the first ۴.۵ hours of stroke occurrence. The NIHSS in baseline, ۲۴ hours, ۷ days after and the modified Rankin scale (mRS) at ۹۰ days were assessed. The primary efficacy outcome was reduction of at least ۴ points in the NIHSS during ۷ days and the secondary efficacy outcome was defined as mRS ۰ and ۱ at ۹۰ days. The safety outcome was evaluated based on the symptomatic intracranial hemorrhage (ICH) and death occurance during ۹۰ days. Results: The mean NIHSS at baseline was ۱۲.۷±۴.۶, and the mean NIHSS corresponding to ۲۴ hours after admission was ۹.۶±۴.۸. The mean ۷-day NIHSS was ۷.۶±۴.۴. The primary and secondary efficacy outcomes were met in ۱۸ (۵۰%) and ۲۲ (۶۱.۱ %) of the patients respectively. Symptomatic ICH was observed in one patient with lung cancer who died of respiratory failure.   Conclusion: This study confirmed the efficacy and safety of tenecteplase in thrombolysis for acute ischemic stroke treatment. Tenecteplase appears to be an appropriate therapy as thrombolytic agent against ischemic stroke.

Keywords:

Tenecteplase , Ischemic Stroke , Thrombolysis , Alteplase , Tissue Plasminogen Activator