Tenecteplase in acute ischemic stroke: a new era in thrombolysis

Tenecteplase (TNK) is a genetically engineered variant of alteplase, showing promise for acute ischemic stroke treatment. With a longer half-life and higher fibrin specificity, TNK enables more targeted and efficient clot dissolution. Clinical trials demonstrate potential advantages, including impro...

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Main Authors: Gisele Sampaio Silva, Eva Rocha, Octávio Marques Pontes-Neto, Sheila Ouriques Martins
Format: Article
Language:English
Published: Thieme Revinter Publicações 2025-05-01
Series:Arquivos de Neuro-Psiquiatria
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1808088
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author Gisele Sampaio Silva
Eva Rocha
Octávio Marques Pontes-Neto
Sheila Ouriques Martins
author_facet Gisele Sampaio Silva
Eva Rocha
Octávio Marques Pontes-Neto
Sheila Ouriques Martins
author_sort Gisele Sampaio Silva
collection DOAJ
description Tenecteplase (TNK) is a genetically engineered variant of alteplase, showing promise for acute ischemic stroke treatment. With a longer half-life and higher fibrin specificity, TNK enables more targeted and efficient clot dissolution. Clinical trials demonstrate potential advantages, including improved reperfusion rates and functional outcomes with lower systemic bleeding. Though not officially approved for this purpose by all regulatory agencies, TNK is used off-label and in acute stroke guidelines due to its ease of administration and effectiveness. The 0.25 mg/kg dosage within 4.5 hours of symptom onset was shown to be consistently effective and safe. Further trials are expected to identify patient subgroups that benefit most from TNK treatment. The present narrative review assesses the existing literature and evidence regarding the use of tenecteplase for the treatment of acute ischemic stroke.
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issn 0004-282X
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language English
publishDate 2025-05-01
publisher Thieme Revinter Publicações
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series Arquivos de Neuro-Psiquiatria
spelling doaj-art-8b6b96b17d9d4db8ba7471d0c6d8a4d22025-08-20T01:59:09ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria0004-282X1678-42272025-05-01830500101110.1055/s-0045-1808088Tenecteplase in acute ischemic stroke: a new era in thrombolysisGisele Sampaio Silva0https://orcid.org/0000-0002-3247-3123Eva Rocha1https://orcid.org/0000-0002-0981-3919Octávio Marques Pontes-Neto2https://orcid.org/0000-0003-0317-843XSheila Ouriques Martins3https://orcid.org/0000-0002-8452-712XUniversidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Departamento de Neurologia, Porto Alegre RS, Brazil.Tenecteplase (TNK) is a genetically engineered variant of alteplase, showing promise for acute ischemic stroke treatment. With a longer half-life and higher fibrin specificity, TNK enables more targeted and efficient clot dissolution. Clinical trials demonstrate potential advantages, including improved reperfusion rates and functional outcomes with lower systemic bleeding. Though not officially approved for this purpose by all regulatory agencies, TNK is used off-label and in acute stroke guidelines due to its ease of administration and effectiveness. The 0.25 mg/kg dosage within 4.5 hours of symptom onset was shown to be consistently effective and safe. Further trials are expected to identify patient subgroups that benefit most from TNK treatment. The present narrative review assesses the existing literature and evidence regarding the use of tenecteplase for the treatment of acute ischemic stroke.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1808088Ischemic StrokeThrombolytic TherapyTenecteplase
spellingShingle Gisele Sampaio Silva
Eva Rocha
Octávio Marques Pontes-Neto
Sheila Ouriques Martins
Tenecteplase in acute ischemic stroke: a new era in thrombolysis
Arquivos de Neuro-Psiquiatria
Ischemic Stroke
Thrombolytic Therapy
Tenecteplase
title Tenecteplase in acute ischemic stroke: a new era in thrombolysis
title_full Tenecteplase in acute ischemic stroke: a new era in thrombolysis
title_fullStr Tenecteplase in acute ischemic stroke: a new era in thrombolysis
title_full_unstemmed Tenecteplase in acute ischemic stroke: a new era in thrombolysis
title_short Tenecteplase in acute ischemic stroke: a new era in thrombolysis
title_sort tenecteplase in acute ischemic stroke a new era in thrombolysis
topic Ischemic Stroke
Thrombolytic Therapy
Tenecteplase
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1808088
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AT evarocha tenecteplaseinacuteischemicstrokeanewerainthrombolysis
AT octaviomarquespontesneto tenecteplaseinacuteischemicstrokeanewerainthrombolysis
AT sheilaouriquesmartins tenecteplaseinacuteischemicstrokeanewerainthrombolysis