Tenecteplase for Acute Ischemic Stroke: Improved Handling in Emergency Conditions

: Tenecteplase, a genetically modified recombinant tissue plasminogen activator with a long half-life, has recently been proposed as a valid alternative to alteplase for thrombolysis in patients with acute ischemic stroke. According to clinical studies and trials, tenecteplase has several practical advantages over alteplase, including administration by single bolus rather than continuous infusion, shorter treatment duration, and possibly associated with fewer complications. Not only do these features increase the efficiency of emergency department workflow, but they also enable faster reperfusion and more rapid transfer to thrombectomy-capable centers. Although clinical evidence strongly suggests that tenecteplase has greater efficacy and safety, its use may lead to implemented "bridging therapy" in terms of rapid administration of a full dose of intravenous fibrinolytics before endovascular thrombectomy, enhanced recanalization rates, and improved efficacy of thrombolytic treatment in ischemic stroke patients.