Tenecteplase or Alteplase Better in Patients with Acute Ischemic Stroke Due to Large Vessel Occlusion : A Single Center Observational Study

Simple item page
dc.contributor.authorTeivane, Agnete
dc.contributor.authorJurjāns, Kristaps
dc.contributor.authorVētra, Jānis
dc.contributor.authorGrigorjeva, Jekaterina
dc.contributor.authorKupcs, Karlis
dc.contributor.authorMasiliūnas, Rytis
dc.contributor.authorMiglāne, Evija
dc.contributor.institutionDepartment of Neurology and Neurosurgery
dc.contributor.institutionRed Cross Medical College of Rīga Stradiņš University
dc.contributor.institutionDepartment of Radiology
dc.date.accessioned2022-11-15T11:20:02Z
dc.date.available2022-11-15T11:20:02Z
dc.date.issued2022-08-28
dc.descriptionPublisher Copyright: © 2022 by the authors.
dc.description.abstractBackground and Objectives: The study aimed to investigate the efficacy of intravenous thrombolysis with Tenecteplase before thrombectomy for acute ischemic stroke (AIS) patients compared with previous results using Alteplase. Previous trials for Tenecteplase have indicated an increased incidence of vascular reperfusion. In April 2021, we started to primarily give Tenecteplase to patients eligible to undergo thrombectomy. Materials and Methods: In this retrospective observational single-center non-randomized study, we analyzed directly admitted patients with AIS who had occlusion of the internal carotid, middle cerebral, or basilar artery and who underwent thrombectomy, as well as the recanalization rate for these patients at the first angiographic assessment (mTICI score 2b–3), and complications. Results: We included 184 patients (demographic characteristics did not differ between Tenecteplase and Alteplase groups (mean age 68.4 vs. 73.0 years; female sex 53.3% vs. 51.1%, NIHSS 14 (IQR 4–26) vs. 15 (2–31). Forty-five patients received Tenecteplase and 139 Alteplase before endovascular treatment (EVT). Pre-EVT (endovascular treatment) recanalization was more likely to occur with Tenecteplase rather than Alteplase (22.2% vs. 8.6%, p = 0.02). Successful reperfusion (mTICI 2b–3) after EVT was achieved in 155 patients (42 (93.4%) vs. 113 (81.3), p = 0.07). Hemorrhagic imbibition occurred in 15 (33.3%) Tenecteplase-treated patients compared with 39 (28.1%) Alteplase-treated patients (p = 0.5). Patients treated with Tenecteplase had higher odds of excellent functional outcome than Alteplase-treated patients (Tenecteplase 48.6% vs. Alteplase 26.1%; OR 0.37 (95% CI 0.17–0.81), p = 0.01). Conclusions: Tenecteplase (25 mg/kg) could have superior clinical efficacy over Alteplase for AIS patients with large-vessel occlusion (LVO), administered before EVT. The improvement in reperfusion rate and the better excellent functional outcome could come without an increased safety concern.en
dc.description.statusPeer reviewed
dc.format.extent880020
dc.identifier.citationTeivane, A, Jurjāns, K, Vētra, J, Grigorjeva, J, Kupcs, K, Masiliūnas, R & Miglāne, E 2022, 'Tenecteplase or Alteplase Better in Patients with Acute Ischemic Stroke Due to Large Vessel Occlusion : A Single Center Observational Study', Medicina (Lithuania), vol. 58, no. 9, 1169. https://doi.org/10.3390/medicina58091169
dc.identifier.doi10.3390/medicina58091169
dc.identifier.issn1010-660X
dc.identifier.otherunpaywall: 10.3390/medicina58091169
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/9783
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85138404437&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofMedicina (Lithuania)
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectAged
dc.subjectBrain Ischemia/complications
dc.subjectEndovascular Procedures/methods
dc.subjectFemale
dc.subjectFibrinolytic Agents/therapeutic use
dc.subjectHumans
dc.subjectIschemic Stroke/drug therapy
dc.subjectRetrospective Studies
dc.subjectStroke/drug therapy
dc.subjectTenecteplase/therapeutic use
dc.subjectThrombectomy/methods
dc.subjectTissue Plasminogen Activator/therapeutic use
dc.subjectTreatment Outcome
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.titleTenecteplase or Alteplase Better in Patients with Acute Ischemic Stroke Due to Large Vessel Occlusion : A Single Center Observational Studyen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

Files

Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
Tenecteplase_or_Alteplase_Better_in_Patients.pdf
Size:
859.39 KB
Format:
Adobe Portable Document Format
Download

Collections

Research outputs from Pure / Zinātniskās darbības rezultāti no ZDIS Pure