Key result
Alteplase before thrombectomy is linked to ~86% more transfusions than tenecteplase despite similar hemorrhagic stroke risk.
Why the study?
Tenecteplase is increasingly used prior to mechanical thrombectomy in AIS-LVO, but its efficacy and safety profile compared to alteplase have been controversial.
Does alteplase compared to tenecteplase reduce bleeding complications in adult patients with acute ischemic stroke from large vessel occlusion undergoing mechanical thrombectomy?
Does alteplase compared to tenecteplase reduce bleeding complications in adult patients with acute ischemic stroke from large vessel occlusion undergoing mechanical thrombectomy?
In patients with acute ischemic stroke undergoing mechanical thrombectomy, alteplase and tenecteplase demonstrated similar risks of hemorrhagic stroke and major bleeding, though alteplase was associated with higher transfusion rates.
No takes yet. Share an insight, caveat, or question.
Tenecteplase may be preferred to alteplase to reduce transfusions before thrombectomy; extends observational evidence of similar hemorrhagic stroke risk.
Camp et al. (2026) studied this question. Alteplase and tenecteplase had similar hemorrhagic stroke risks (4.7% vs 5.8%) before thrombectomy, but alteplase required significantly more blood transfusions (4.1% vs 2.2%).
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