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The two treatments that have been proven to improve outcomes following acute ischemic strokes are intravenous (IV) thrombolysis and mechanical thrombectomy (MT). It is common to administer thrombolysis first and then take patients to the angiogram suite for thrombectomy. Alteplase is currently the only approved agent for thrombolysis. These authors tested whether tenecteplase, a modified variant of alteplase with greater fibrin specificity and a longer half life, would be superior to IV alteplase in patients who are candidates for MT. Tenecteplase is FDA approved for use in treating myocardial infarction.
Over a 2.5-year period, 202 patients (mean age, 71; 73% with middle cerebral artery occlusions; 24% with internal carotid occlusions) were…