Intra-arterial tenecteplase for treatment of acute ischemic stroke: Feasibility and comparative outcomes

Alexandros L. Georgiadis, Muhammad Zeeshan Memon, Qaisar A. Shah, Gabriela Vazquez, Nauman A. Tariq, M. Fareed K. Suri, Robert A. Taylor, Adnan I. Qureshi

Research output: Contribution to journalArticle

Abstract

Objective: Tenecteplase (TNK) is a third-generation thrombolytic agent. We evaluated the safety and feasibility of intra-arterial (IA) administration of TNK in patients with acute ischemic stroke. Methods: Patients who received endovascular treatment for acute ischemic stroke were identified from prospectively collected databases at three university hospitals. We compared clinical and radiological outcomes of patients treated with TNK to those treated with other IA thrombolytics or mechanical thrombectomy alone. Primary outcome measures were favorable functional outcome at 30 days (modified Rankin Scale score of 0-2), and rate of intracranial hemorrhage (ICH). Early neurological improvement, angiographic recanalization, time to recanalization, and mortality at 30 days were additional outcome measures. Results: We identified 114 patients (mean age 67 ± 15 years, 54 were women). Thirty-three patients received IA TNK, 48 received alteplase (n= 11) or reteplase (n= 37), and 33 patients had mechanical thrombectomy alone. Stroke severity was similar among the three groups. No difference between the groups was found in the secondary outcome measures and ICH. Borderline statistical significance was seen toward favorable functional outcome at 1 month in the TNK-treated patients [odds ratio (OR) = 2.8; 95% confidence interval (CI) .96-8.1,P= .063 vs. other thrombolytics, and OR = 3.0, 95% CI .97-9.5,P= .06 vs. mechanical thrombectomy alone]. Conclusion: Our study demonstrates that administration of IA TNK in acute stroke is safe and results in rates of favorable outcomes that are comparable to those observed with currently used drugs. Additional studies are needed to further determine the safety and efficacy of IA TNK in acute stroke treatment.

Original languageEnglish (US)
Pages (from-to)249-254
Number of pages6
JournalJournal of Neuroimaging
Volume22
Issue number3
DOIs
StatePublished - Jul 1 2012

Keywords

  • Alteplase
  • Intra-arterial
  • Ischemic stroke
  • Reteplase
  • Tenecteplase
  • Thrombectomy
  • Tissue plasminogen activator

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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  • Cite this

    Georgiadis, A. L., Memon, M. Z., Shah, Q. A., Vazquez, G., Tariq, N. A., Suri, M. F. K., Taylor, R. A., & Qureshi, A. I. (2012). Intra-arterial tenecteplase for treatment of acute ischemic stroke: Feasibility and comparative outcomes. Journal of Neuroimaging, 22(3), 249-254. https://doi.org/10.1111/j.1552-6569.2011.00628.x