Tenecteplase in acute ischemic stroke: a new era in thrombolysis

Abstract

Tenecteplase (TNK) is a genetically engineered variant of alteplase, showing promise for acute ischemic stroke treatment. With a longer half-life and higher fibrin specificity, TNK enables more targeted and efficient clot dissolution. Clinical trials demonstrate potential advantages, including improved reperfusion rates and functional outcomes with lower systemic bleeding. Though not officially approved for this purpose by all regulatory agencies, TNK is used off-label and in acute stroke guidelines due to its ease of administration and effectiveness. The 0.25 mg/kg dosage within 4.5 hours of symptom onset was shown to be consistently effective and safe. Further trials are expected to identify patient subgroups that benefit most from TNK treatment. The present narrative review assesses the existing literature and evidence regarding the use of tenecteplase for the treatment of acute ischemic stroke.

Keywords

Ischemic Stroke - Thrombolytic Therapy - Tenecteplase

Authors' Contributions

Conceptualization: GSS, ER; Data curation: GSS, ER; Formal analysis: GSS; Project administration: GSS, ER; Supervision: GSS; Writing – original draft: GSS, ER; Writing – review & editing: GSS, ER, OMPN, SCOM. GSS and ER contributed equally to the manuscript.

Editor-in-Chief: Ayrton Roberto Massaro.

Associate Editor: Jamary Oliveira Filho.

Publikationsverlauf

Eingereicht: 19. August 2024

Angenommen: 13. Februar 2025

Artikel online veröffentlicht:
01. Juni 2025

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