Loading...
Tissue plasminogen activator (TPA, alteplase) has been approved for more than 25 years as a medication for select patients with acute ischemic stroke who meet treatment criteria. In recent years, increased interest has focused on tenecteplase (TNK) as an alternative to alteplase. Tenecteplase is administered as an intravenous bolus without the need for a 1-hour infusion, making it appealing for rapid treatment. Comparative trials thus far have been fairly modest in size. These authors conducted a pragmatic trial at 22 centers in Canada, in which patients who could be treated within 4.5 hours after symptom onset were randomized to alteplase or tenecteplase. Patients received either a tenecteplase bolus (0.25 mg/kg; 25 mg maximum) or an altep…