Thrombolysis for acute ischemic stroke by tenecteplase in the emergency department of a Moroccan hospital

Abstract

IntroductionThrombolysis has radically changed the prognosis of acute ischemic stroke. Tenecteplase is a modified form of rt-PA with greater specificity for fibrin and a longer half-life. We report the experience of a Moroccan tertiary hospital in thrombolysis using Tenecteplase.MethodsWe conducted an open prospective study of all patients who were treated with Tenecteplase for an acute ischemic stroke admitted to our emergency department. Tenecteplase was administered intravenously at a dose of 0.4 mg/kg single bolus. The primary outcome measure was the proportion of patients achieving significant early neurological recovery defined as an improvement of 4 or more points on the NIHSS score at 24h.Results13 patients had been treated by intravenous thrombolysis. 31% were women. Mean age was 63 years old. The mean NIHSS score at admission was 14.3 and 24h after was at 9.1. The right middle cerebral artery was involved in 69% of cases. The carotid atherosclerosis was predominant 63.3% and the cardio embolic etiology 27%. The mean time to the first medical contact after the onset of symptoms was 3h 30 min. One patient presented a capsulo-lenticular hematoma of 5 mm3 in the same side of the ischemic stroke.ConclusionTenecteplase is a more interesting thrombolytic than alteplase, it seems to be more suitable for thrombolysis in our center.

Acute ischemic stroke thrombolysis with tenecteplase: An institutional experience from South India

“…reported a 24 h improvement of NIHSS score by >4 points in 77% (10/13) cases. [ 6 ] Among Indian patients, none of the studies have reported the results of tenecteplase in stroke thrombolysis so far. However, our observations regarding the efficacy of Tenecteplase are similar to the results of previous Indian data regarding alteplase.…”

“…We defined the primary clinical efficacy outcome as improvement in NIHSS score of 4 or more points after 24 h.[ 6 ] Secondary clinical efficacy outcome was disability assessment at 90 days based on mRS score, dichotomized as a favorable outcome (with a score of 0 or 1) or an unfavorable outcome (a score of 2–6). [ 2 ] The safety endpoints were death rate at 90 days and symptomatic intracranial hemorrhage (SICH), which is defined as any fresh intracranial bleeding resulting in clinical worsening with a decline of >4 points in score on NIHSS or death, as per European Cooperative Acute Stroke Study III study protocol.…”

Ischemic stroke in Morocco: a systematic review

“…As for the sex ratio ( n = 13), studies revealed a male predominance with a ratio ranging between 1.23 and 3.45 [16–19, 24–26, 36–40, 42]. A ratio of 1 has been reported only in ( n = 3) studies [23, 40, 41].…”

The impact of intravenous thrombolysis in acute ischemic stroke in National Medical College, Kolkata: initial experience

“…Primary clinical outcome was defined as improvement in NIHSS score of 4 or more points after 24 h. 3 Secondary clinical outcome was disability assessment at 90 days based on mRS score, dichotomized as a favorable outcome (with a score of 0 or 1) or an unfavorable outcome (a score of 2-6). 2 The safety endpoints were death rate at 90 days and symptomatic intracranial hemorrhage (sICH), which is defined as any fresh intracranial bleeding resulting in clinical worsening with a decline of >4 points in score on NIHSS or death, as per European Cooperative Acute Stroke Study III study protocol.…”