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.

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.