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Safety and Efficacy of Tenecteplase vs Alteplase in Patients With Large Vessel Occlusion Stroke
This prespecified secondary analysis of the ACT randomized clinical trial evaluates the safety and efficacy of tenecteplase compared to alteplase among patients with large vessel occlusion stroke.
Source: JAMA Neurology - July 10, 2023 Category: Neurology Source Type: research

Symptomatic Intracranial Hemorrhage With Tenecteplase vs Alteplase in Patients With Acute Ischemic Stroke
This cohort study evaluates rates of symptomatic intracranial hemorrhage following stroke with tenecteplase vs alteplase.
Source: JAMA Neurology - May 30, 2023 Category: Neurology Source Type: research

Dual Thrombolytic Therapy With Mutant Prourokinase and Small Bolus Alteplase for Ischemic Stroke
This randomized clinical trial of individuals with ischemic stroke assesses the safety and efficacy of treatment with a dual plasminogen activator vs usual treatment with intravenous alteplase.
Source: JAMA Neurology - May 22, 2023 Category: Neurology Source Type: research

Outcomes After Endovascular Thrombectomy With or Without Alteplase in Routine Clinical Practice
This cohort study investigates the outcomes of combination endovascular thrombectomy with alteplase compared with endovascular thrombectomy alone for the treatment of patients with acute ischemic stroke attributable to large vessel occlusion.
Source: JAMA Neurology - June 13, 2022 Category: Neurology Source Type: research

Stroke Thrombolysis With Tenecteplase to Reduce Spread of Coronavirus Disease 2019 and Alteplase Shortage
This Viewpoint advocates for expanded usage of tenecteplase in patients with stroke as a means of avoiding coronavirus disease 2019 spread and easing potential shortages of alteplase.
Source: JAMA Neurology - July 20, 2020 Category: Neurology Source Type: research

Thrombolysis Works in Lacunar Infarct, Complicating Imaging Selection
A new, exploratory analysis of the Efficacy and Safety of MRI-Based Thrombolysis in Wake-up Stroke (WAKE-UP) trial by Barow and colleagues in this issue ofJAMA Neurology provides unique and compelling data suggesting that thrombolysis improves clinical outcomes after acute lacunar infarction. The European Union –commissioned, 500-patient, randomized, double-blind, placebo-controlled WAKE-UP trial of alteplase captured the magnetic resonance imaging (MRI) and magnetic resonance angiography of patients with acute ischemic stroke prior to thrombolysis. This allowed categorization of infarcts as lacunar vs n onlacunar, using...
Source: JAMA Neurology - March 25, 2019 Category: Neurology Source Type: research

Optimizing Prehospital Triage for Patients With Stroke Involving Large Vessel Occlusion
The past 20 years have witnessed a revolution in the paradigm of acute ischemic stroke treatment. In 1996, intravenous alteplase was shown to improve outcomes among patients treated within 3 hours of stroke onset. This finding upended the historical therapeutic nihilism about stroke, and with it the leisurely armchair approach to stroke treatment. The concept of so-called acute ischemic stroke emerged. This changed the nature and practice of vascular neurology, created a vigorous and sometimes controversial debate between vascular neurologists and emergency physicians about the merits of alteplase, and paved the way for mo...
Source: JAMA Neurology - September 4, 2018 Category: Neurology Source Type: research

Errors in Abstract and Figures 2 and 3
This article was c orrected online.
Source: JAMA Neurology - January 2, 2018 Category: Neurology Source Type: research

Low-Dose vs Standard-Dose Alteplase for Patients With Acute Ischemic Stroke
This secondary analysis reports on the association of low-dose and standard-dose intravenous alteplase treatment with age, ethnicity (Asian vs non-Asian), and severity of acute ischemic stroke among patients in the ENCHANTED randomized clinical trial.
Source: JAMA Neurology - October 2, 2017 Category: Neurology Source Type: research

Endovascular Therapy for Acute Ischemic Stroke
Patients with an occlusion of the distal internal carotid or proximal middle cerebral artery have among the most severe types of ischemic stroke that typically produce life-altering disabilities. Prior to a few months ago, the standard of care for such patients included intravenous (IV) alteplase and comprehensive peristroke care to avoid complications, including measures to prevent another stroke and comprehensive rehabilitation.
Source: JAMA Neurology - August 3, 2015 Category: Neurology Source Type: research

Progress in Intravenous Thrombolytic Therapy for Acute Stroke
This review traces the development of intravenous thrombolysis to date, considers the shortcomings of alteplase, and examines alternative thrombolytic approaches currently in the pipeline, including the role of neuroimaging and the possibility of combination therapies.
Source: JAMA Neurology - June 1, 2015 Category: Neurology Source Type: research