| Title: |
Abstract WP028: Efficacy and Safety of Tenecteplase versus Alteplase Across Different Treatment Time Windows: A Monocentric One-Year Stroke Center Experience |
| Authors: |
Sekita, Alexander; Mers, Lena; Bogdanova, Anna; Engelhorn, Tobias; Singer, Ludwig; Schwab, Stefan; Gerner, Stefan |
| Source: |
Stroke ; volume 57, issue Suppl_1 ; ISSN 0039-2499 1524-4628 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2026 |
| Description: |
Introduction: Tenecteplase (TNK) offers pharmacological advantages over alteplase (rt-PA) and is increasingly adopted as the primary thrombolytic agent for intravenous thrombolysis (IVT) in acute ischemic stroke (AIS). Our tertiary-care stroke center transitioned from rt-PA to TNK in June 2024, enabling real-world evaluation across conventional and extended treatment time windows. This study aimed to compare efficacy and safety outcomes one year before and after transition. Methods: We retrospectively analyzed our institutional stroke registry, including all AIS patients treated with IVT one year before (rt-PA: June 2023–May 2024) and one year after transition (TNK: June 2024–May 2025). IVT was analyzed in both the conventional (≤4.5h) and extended (>4.5h) treatment windows, as well as in off-label scenarios such as treatment under oral anticoagulation (OAC). Primary endpoints included treatment metrics (door-to-needle [DTN], imaging-to-needle, door-to-groin, and door-to-recanalization times). Safety endpoints comprised any intracranial hemorrhage (ICH) and symptomatic ICH (sICH; SITS-MOST). Results: A total of 591 patients received IVT (rt-PA: n=278; TNK: n=313), 69% within ≤4.5h and 31% beyond 4.5h. DTN times were significantly shorter with TNK compared to rt-PA (31 min [IQR 22–48] vs. 35 min [26–54]; p=0.002), driven by reduced imaging-to-needle times (12 min [7–25] vs. 16 min [9–29]; p |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1161/str.57.suppl_1.wp028 |
| Availability: |
https://doi.org/10.1161/str.57.suppl_1.wp028 |
| Accession Number: |
edsbas.D797B7D1 |
| Database: |
BASE |