Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke
BCV Campbell, PJ Mitchell, L Churilov, N Yassi, TJ Kleinig, RJ Dowling, B Yan, SJ Bush, HM Dewey, V Thijs, R Scroop, M Simpson, M Brooks, H Asadi, TY Wu, DG Shah, T Wijeratne, T Ang, F Miteff, CR Levi Show all
NEW ENGLAND JOURNAL OF MEDICINE | MASSACHUSETTS MEDICAL SOC | Published : 2018
BACKGROUND: Intravenous infusion of alteplase is used for thrombolysis before endovascular thrombectomy for ischemic stroke. Tenecteplase, which is more fibrin-specific and has longer activity than alteplase, is given as a bolus and may increase the incidence of vascular reperfusion. METHODS: We randomly assigned patients with ischemic stroke who had occlusion of the internal carotid, basilar, or middle cerebral artery and who were eligible to undergo thrombectomy to receive tenecteplase (at a dose of 0.25 mg per kilogram of body weight; maximum dose, 25 mg) or alteplase (at a dose of 0.9 mg per kilogram; maximum dose, 90 mg) within 4.5 hours after symptom onset. The primary outcome was repe..View full abstract
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Funded by the National Health and Medical Research Council of Australia and others; EXTEND-IA TNK ClinicalTrials.gov number, NCT02388061.