RT Journal Article SR Electronic T1 E-189 Outcomes of tenecteplase versus alteplase after mechanical thrombectomy in a multiethnic stroke consortium registry JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP A190 OP A191 DO 10.1136/jnis-2023-SNIS.288 VO 15 IS Suppl 1 A1 Gaub, M A1 Ramaswamy, D A1 Cardentey, A A1 Bandela, S A1 Gealogo, G A1 Mascitelli, J A1 Al Saiegh, F A1 Birnbaum, L YR 2023 UL http://jnis.bmj.com/content/15/Suppl_1/A190.abstract AB 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.View this table: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.