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Effectiveness and Safety of Tecneplase vs. Alteplase in the Acute Treatment of Ischemic Stroke

Not all hospitals have interventional radiology services. This fact implies that in centers where this resource is not available, the treatment of stroke in the acute phase must be adapted and individualized. The aim of the study is to determine and compare the combined effect of thrombolysis and th...

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Autores principales: Estella, Ángel, Pérez Ruiz, Miriam, Serrano, Juan José
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503588/
https://www.ncbi.nlm.nih.gov/pubmed/36143310
http://dx.doi.org/10.3390/jpm12091525
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author Estella, Ángel
Pérez Ruiz, Miriam
Serrano, Juan José
author_facet Estella, Ángel
Pérez Ruiz, Miriam
Serrano, Juan José
author_sort Estella, Ángel
collection PubMed
description Not all hospitals have interventional radiology services. This fact implies that in centers where this resource is not available, the treatment of stroke in the acute phase must be adapted and individualized. The aim of the study is to determine and compare the combined effect of thrombolysis and thrombectomy effectiveness and safety of tenecteplase versus alteplase in the acute treatment of ischemic stroke in patients who are candidates for endovascular therapy according to clinical practice guidelines. This paper details a retrospective multicenter cohort study of patients with ischemic stroke admitted in three hospitals between 2018 and 2020. The main outcome variables were the degree of recanalization and the functional outcome at 3 months; safety variables were mortality and the occurrence of intracranial hemorrhage (ICH). In total, 100 patients were included, 20 of which were treated with tenecteplase (TNK) and 80 with alteplase (rtPA). Of those treated with TNK, 75% obtained a successful recanalization compared to 83.8% in those treated with rtPA (OR 0.58; 95% CI 0.18–1.88; p = 0.56). No differences were found in obtaining an excellent functional result at 3 months (35% TNK vs. 58.8% rtPA; p = 0.38). Tenecteplase showed worse neurological results after 24 h (unfavorable result of 70% with TNK vs. 45% with rtPA; OR = 5.4; 95% CI 1.57–18.6). No significant differences were identified in mortality; 17.5% with rtPA and 20% with TNK (p = 0.79), nor in the appearance of intracranial hemorrhage ICH (15.2% with rtPA vs. 30% with TNK (p = 0.12). In our series, there were not significant differences shown regarding effectiveness and safety between tenecteplase and alteplase.
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spelling pubmed-95035882022-09-24 Effectiveness and Safety of Tecneplase vs. Alteplase in the Acute Treatment of Ischemic Stroke Estella, Ángel Pérez Ruiz, Miriam Serrano, Juan José J Pers Med Article Not all hospitals have interventional radiology services. This fact implies that in centers where this resource is not available, the treatment of stroke in the acute phase must be adapted and individualized. The aim of the study is to determine and compare the combined effect of thrombolysis and thrombectomy effectiveness and safety of tenecteplase versus alteplase in the acute treatment of ischemic stroke in patients who are candidates for endovascular therapy according to clinical practice guidelines. This paper details a retrospective multicenter cohort study of patients with ischemic stroke admitted in three hospitals between 2018 and 2020. The main outcome variables were the degree of recanalization and the functional outcome at 3 months; safety variables were mortality and the occurrence of intracranial hemorrhage (ICH). In total, 100 patients were included, 20 of which were treated with tenecteplase (TNK) and 80 with alteplase (rtPA). Of those treated with TNK, 75% obtained a successful recanalization compared to 83.8% in those treated with rtPA (OR 0.58; 95% CI 0.18–1.88; p = 0.56). No differences were found in obtaining an excellent functional result at 3 months (35% TNK vs. 58.8% rtPA; p = 0.38). Tenecteplase showed worse neurological results after 24 h (unfavorable result of 70% with TNK vs. 45% with rtPA; OR = 5.4; 95% CI 1.57–18.6). No significant differences were identified in mortality; 17.5% with rtPA and 20% with TNK (p = 0.79), nor in the appearance of intracranial hemorrhage ICH (15.2% with rtPA vs. 30% with TNK (p = 0.12). In our series, there were not significant differences shown regarding effectiveness and safety between tenecteplase and alteplase. MDPI 2022-09-17 /pmc/articles/PMC9503588/ /pubmed/36143310 http://dx.doi.org/10.3390/jpm12091525 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Estella, Ángel
Pérez Ruiz, Miriam
Serrano, Juan José
Effectiveness and Safety of Tecneplase vs. Alteplase in the Acute Treatment of Ischemic Stroke
title Effectiveness and Safety of Tecneplase vs. Alteplase in the Acute Treatment of Ischemic Stroke
title_full Effectiveness and Safety of Tecneplase vs. Alteplase in the Acute Treatment of Ischemic Stroke
title_fullStr Effectiveness and Safety of Tecneplase vs. Alteplase in the Acute Treatment of Ischemic Stroke
title_full_unstemmed Effectiveness and Safety of Tecneplase vs. Alteplase in the Acute Treatment of Ischemic Stroke
title_short Effectiveness and Safety of Tecneplase vs. Alteplase in the Acute Treatment of Ischemic Stroke
title_sort effectiveness and safety of tecneplase vs. alteplase in the acute treatment of ischemic stroke
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503588/
https://www.ncbi.nlm.nih.gov/pubmed/36143310
http://dx.doi.org/10.3390/jpm12091525
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