Most commonly used for stroke streptokinase or tenecteplase
Reading File
Reading File
Finding Sources
Searching PubMed
"Stroke"[MeSH Terms] AND tenecteplase
Searching the Web
2026 acute ischemic stroke thrombolysis tenecteplase alteplase guideline
For acute ischemic stroke, tenecteplase is now commonly used in many stroke centers as the IV thrombolytic, particularly when mechanical thrombectomy is planned. It is a single IV bolus and is generally favored over alteplase in several modern protocols.
Streptokinase is not used for acute ischemic stroke because trials showed an unacceptably high risk of intracranial bleeding and death.
Important distinction:
- Tenecteplase: used for eligible acute ischemic stroke patients, usually within 4.5 hours of onset, per local stroke protocol.
- Streptokinase: not recommended for ischemic stroke.
- Neither thrombolytic should be given until brain imaging excludes intracranial hemorrhage. Hemorrhagic stroke requires a completely different approach.
The European Stroke Organisation recommends tenecteplase 0.25 mg/kg as a safe and effective alternative to alteplase for eligible patients within 4.5 hours, and favors it in many settings because it is given as a bolus. ESO recommendation Recent systematic reviews also support tenecteplase's efficacy and safety, though choice remains protocol- and country-dependent (PMIDs: 40891051, 41318668).
This is a shared conversation. Sign in to Orris to start your own chat.