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E-189 Outcomes of tenecteplase versus alteplase after mechanical thrombectomy in a multiethnic stroke consortium registry
  1. M Gaub,
  2. D Ramaswamy,
  3. A Cardentey,
  4. S Bandela,
  5. G Gealogo,
  6. J Mascitelli,
  7. F Al Saiegh,
  8. L Birnbaum
  1. Neurosurgery, University of Texas Health Science Center San Antonio, San Antonio, TX, USA


Introduction Intravenous (IV) tenecteplase (TNK) has emerged as an alternative to IV alteplase (tPA) in the treatment of acute ischemic stroke. Prior studies have shown non-inferiority with better reperfusion and functional outcomes after mechanical thrombectomy (MT) with TNK versus tPA.

Methods Prospective thrombolytic data from a multi-center US stroke consortium was collected over a 30-month period between 2019 and 2022. National Institutes of Health stroke scale (NIHSS) at presentation, site of vessel occlusion, post-MT Thrombolysis in Cerebral Infarction (TICI) score, discharge modified Rankin Scale (mRS), discharge ambulatory status, and post-MT intracranial hemorrhage (ICH) were analyzed using non-parametric tests. ICH included parenchymal hematoma Type 2, intraventricular hemorrhage, subarachnoid hemorrhage, remote site of intraparenchymal hemorrhage outside the area of infarction, and other positive findings.

Results A total of 168 patients were included for analysis, of which a third were Hispanic. With exception of ethnicity, there were no differences in patient demographics or stroke location/severity between groups (table 1). Clinical and radiographic outcome variables were comparable between groups (table 2).

Conclusion In this prospective, multi-center stroke consortium study, IV TNK in comparison to tPA prior to MT for ischemic stroke resulted in non-inferior outcomes related to angiographic reperfusion and functional status at discharge. These findings compliment the current literature and include a large Hispanic US cohort. Further analysis will include expansion of contributing centers and use of propensity scoring.

Abstract E-189 Table 1 and 2

Disclosures M. Gaub: None. D. Ramaswamy: None. A. Cardentey: None. S. Bandela: None. G. Gealogo: None. J. Mascitelli: None. F. Al Saiegh: None. L. Birnbaum: 2; C; Rapid AI, Imperative Care.

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