Tenecteplase vs. Alteplase in Large-Vessel Occlusion Stroke

Outcomes were comparable between tenecteplase and alteplase for large-vessel stroke.

In a broad group of patients with acute ischemic stroke, two recent trials — ACT (NEJM JW Neurol Jul 25 2022 and Lancet 2022; 400:161) and TRACE 2 (NEJM JW Neurol Mar 10 2023 and Lancet 2023; 401:645) —showed similar outcomes with either alteplase or tenecteplase. An important subset of patients is the group with large-vessel occlusion (LVO), whose neurologic deficits are more severe at presentation and who frequently receive thrombolysis before endovascular thrombectomy. In this prespecified analysis from the ACT trial, the authors compared outcomes in LVO patients assigned to either alteplase or tenecteplase and enrolled from 22 centers in Canada between December 2019 and January 2022. All patients received thrombolytic medication within …

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Tenecteplase vs. Alteplase in Large-Vessel Occlusion Stroke

Topics

Reviewing Author