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Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion
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| Zeitschriftentitel: | Stroke |
|---|---|
| Personen und Körperschaften: | , , , , , , , , , , , , , , , , , , , , , , , , , |
| In: | Stroke, 51, 2020, Suppl_1 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Ovid Technologies (Wolters Kluwer Health)
|
| Schlagwörter: |
| author_facet |
Alemseged, Fana Puetz, Volker Boulouis, Gregoire Rocco, Alessandro Kleinig, Timothy Wu, Teddy Ng, Felix Shah, Darshan Arba, Francesco Kaiser, Daniel Williams, Cameron Francesca, Di Giuliano Morotti, Andrea Oxley, Thomas Sallustio, Fabrizio Sharma, Gagan Bush, Steven Dowling, Richard Yan, Bernard Mitchell, Peter Diomedi, Marina Donnan, Geoffrey A Parsons, Mark Davis, Stephen M Yassi, Nawaf Campbell, Bruce C Alemseged, Fana Puetz, Volker Boulouis, Gregoire Rocco, Alessandro Kleinig, Timothy Wu, Teddy Ng, Felix Shah, Darshan Arba, Francesco Kaiser, Daniel Williams, Cameron Francesca, Di Giuliano Morotti, Andrea Oxley, Thomas Sallustio, Fabrizio Sharma, Gagan Bush, Steven Dowling, Richard Yan, Bernard Mitchell, Peter Diomedi, Marina Donnan, Geoffrey A Parsons, Mark Davis, Stephen M Yassi, Nawaf Campbell, Bruce C |
|---|---|
| author |
Alemseged, Fana Puetz, Volker Boulouis, Gregoire Rocco, Alessandro Kleinig, Timothy Wu, Teddy Ng, Felix Shah, Darshan Arba, Francesco Kaiser, Daniel Williams, Cameron Francesca, Di Giuliano Morotti, Andrea Oxley, Thomas Sallustio, Fabrizio Sharma, Gagan Bush, Steven Dowling, Richard Yan, Bernard Mitchell, Peter Diomedi, Marina Donnan, Geoffrey A Parsons, Mark Davis, Stephen M Yassi, Nawaf Campbell, Bruce C |
| spellingShingle |
Alemseged, Fana Puetz, Volker Boulouis, Gregoire Rocco, Alessandro Kleinig, Timothy Wu, Teddy Ng, Felix Shah, Darshan Arba, Francesco Kaiser, Daniel Williams, Cameron Francesca, Di Giuliano Morotti, Andrea Oxley, Thomas Sallustio, Fabrizio Sharma, Gagan Bush, Steven Dowling, Richard Yan, Bernard Mitchell, Peter Diomedi, Marina Donnan, Geoffrey A Parsons, Mark Davis, Stephen M Yassi, Nawaf Campbell, Bruce C Stroke Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion Advanced and Specialized Nursing Cardiology and Cardiovascular Medicine Neurology (clinical) |
| author_sort |
alemseged, fana |
| spelling |
Alemseged, Fana Puetz, Volker Boulouis, Gregoire Rocco, Alessandro Kleinig, Timothy Wu, Teddy Ng, Felix Shah, Darshan Arba, Francesco Kaiser, Daniel Williams, Cameron Francesca, Di Giuliano Morotti, Andrea Oxley, Thomas Sallustio, Fabrizio Sharma, Gagan Bush, Steven Dowling, Richard Yan, Bernard Mitchell, Peter Diomedi, Marina Donnan, Geoffrey A Parsons, Mark Davis, Stephen M Yassi, Nawaf Campbell, Bruce C 0039-2499 1524-4628 Ovid Technologies (Wolters Kluwer Health) Advanced and Specialized Nursing Cardiology and Cardiovascular Medicine Neurology (clinical) http://dx.doi.org/10.1161/str.51.suppl_1.tmp13 <jats:p> <jats:bold>Background:</jats:bold> Tenecteplase (TNK) is a genetically modified variant of alteplase with greater fibrin specificity and longer half-life than alteplase. The recent Tenecteplase versus Alteplase before Endovascular Therapy for Ischemic Stroke (EXTEND-IA TNK) trial demonstrated that increased reperfusion with TNK compared to alteplase prior to endovascular thrombectomy (EVT) in large vessel occlusion ischaemic strokes. However, only 6 patients with basilar artery occlusion (BAO) were included. We aimed to investigate the efficacy of TNK versus alteplase before EVT in patients with basilar artery occlusion (BAO). </jats:p> <jats:p> <jats:bold>Methods:</jats:bold> Clinical and procedural data of consecutive BAO diagnosed on CT Angiography or MR Angiography from the multisite international Basilar Artery Treatment and MANagement (BATMAN) collaboration were retrospectively analysed. The primary outcome was reperfusion of greater than 50% of the involved ischemic territory or absence of retrievable thrombus at the time of the initial angiographic assessment. </jats:p> <jats:p> <jats:bold>Results:</jats:bold> We included 119 BAO patients treated with intravenous thrombolysis prior to EVT; mean age 68 (SD 14), median NIHSS 16 (IQR 7-32). Eleven patients were treated with TNK (0.25mg/kg or 0.4mg/kg) and 108 with alteplase (0.9mg/kg). Overall, 113 patients had catheter angiography or early repeat imaging after thrombolysis. Reperfusion of greater than 50% of the ischemic territory or absence of retrievable thrombus occurred in 4/11 (36%) of patients treated with TNK vs 8/102 (8%) treated with alteplase (p=0.02). Onset-to-needle time did not differ between the two groups (p=0.4). Needle-to-groin-puncture time was 61 (IQR 33-100) mins in patients reperfused with TNK vs 111 (IQR 86-198) mins in patients reperfused with alteplase (p=0.048). Overall, the rate of symptomatic haemorrhage was 3/119 (2.5%). No differences were found in the rate of symptomatic intracranial haemorrhage (p=0.3) between the two thrombolytic agents. </jats:p> <jats:p> <jats:bold>Conclusions:</jats:bold> Despite shorter needle-to-groin-puncture times, tenecteplase was associated with an increased rate of reperfusion in comparison with alteplase before EVT in BAO. Randomized controlled trials to compare tenecteplase with alteplase in BAO patients before endovascular thrombectomy are warranted. </jats:p> Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion Stroke |
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10.1161/str.51.suppl_1.tmp13 |
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Ovid Technologies (Wolters Kluwer Health), 2020 |
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| title |
Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| title_unstemmed |
Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| title_full |
Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| title_fullStr |
Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| title_full_unstemmed |
Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| title_short |
Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| title_sort |
abstract tmp13: tenecteplase versus alteplase before endovascular therapy in basilar artery occlusion |
| topic |
Advanced and Specialized Nursing Cardiology and Cardiovascular Medicine Neurology (clinical) |
| url |
http://dx.doi.org/10.1161/str.51.suppl_1.tmp13 |
| publishDate |
2020 |
| physical |
|
| description |
<jats:p>
<jats:bold>Background:</jats:bold>
Tenecteplase (TNK) is a genetically modified variant of alteplase with greater fibrin specificity and longer half-life than alteplase. The recent Tenecteplase versus Alteplase before Endovascular Therapy for Ischemic Stroke (EXTEND-IA TNK) trial demonstrated that increased reperfusion with TNK compared to alteplase prior to endovascular thrombectomy (EVT) in large vessel occlusion ischaemic strokes. However, only 6 patients with basilar artery occlusion (BAO) were included. We aimed to investigate the efficacy of TNK versus alteplase before EVT in patients with basilar artery occlusion (BAO).
</jats:p>
<jats:p>
<jats:bold>Methods:</jats:bold>
Clinical and procedural data of consecutive BAO diagnosed on CT Angiography or MR Angiography from the multisite international Basilar Artery Treatment and MANagement (BATMAN) collaboration were retrospectively analysed. The primary outcome was reperfusion of greater than 50% of the involved ischemic territory or absence of retrievable thrombus at the time of the initial angiographic assessment.
</jats:p>
<jats:p>
<jats:bold>Results:</jats:bold>
We included 119 BAO patients treated with intravenous thrombolysis prior to EVT; mean age 68 (SD 14), median NIHSS 16 (IQR 7-32). Eleven patients were treated with TNK (0.25mg/kg or 0.4mg/kg) and 108 with alteplase (0.9mg/kg). Overall, 113 patients had catheter angiography or early repeat imaging after thrombolysis. Reperfusion of greater than 50% of the ischemic territory or absence of retrievable thrombus occurred in 4/11 (36%) of patients treated with TNK vs 8/102 (8%) treated with alteplase (p=0.02). Onset-to-needle time did not differ between the two groups (p=0.4). Needle-to-groin-puncture time was 61 (IQR 33-100) mins in patients reperfused with TNK vs 111 (IQR 86-198) mins in patients reperfused with alteplase (p=0.048). Overall, the rate of symptomatic haemorrhage was 3/119 (2.5%). No differences were found in the rate of symptomatic intracranial haemorrhage (p=0.3) between the two thrombolytic agents.
</jats:p>
<jats:p>
<jats:bold>Conclusions:</jats:bold>
Despite shorter needle-to-groin-puncture times, tenecteplase was associated with an increased rate of reperfusion in comparison with alteplase before EVT in BAO. Randomized controlled trials to compare tenecteplase with alteplase in BAO patients before endovascular thrombectomy are warranted.
</jats:p> |
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| author | Alemseged, Fana, Puetz, Volker, Boulouis, Gregoire, Rocco, Alessandro, Kleinig, Timothy, Wu, Teddy, Ng, Felix, Shah, Darshan, Arba, Francesco, Kaiser, Daniel, Williams, Cameron, Francesca, Di Giuliano, Morotti, Andrea, Oxley, Thomas, Sallustio, Fabrizio, Sharma, Gagan, Bush, Steven, Dowling, Richard, Yan, Bernard, Mitchell, Peter, Diomedi, Marina, Donnan, Geoffrey A, Parsons, Mark, Davis, Stephen M, Yassi, Nawaf, Campbell, Bruce C |
| author_facet | Alemseged, Fana, Puetz, Volker, Boulouis, Gregoire, Rocco, Alessandro, Kleinig, Timothy, Wu, Teddy, Ng, Felix, Shah, Darshan, Arba, Francesco, Kaiser, Daniel, Williams, Cameron, Francesca, Di Giuliano, Morotti, Andrea, Oxley, Thomas, Sallustio, Fabrizio, Sharma, Gagan, Bush, Steven, Dowling, Richard, Yan, Bernard, Mitchell, Peter, Diomedi, Marina, Donnan, Geoffrey A, Parsons, Mark, Davis, Stephen M, Yassi, Nawaf, Campbell, Bruce C, Alemseged, Fana, Puetz, Volker, Boulouis, Gregoire, Rocco, Alessandro, Kleinig, Timothy, Wu, Teddy, Ng, Felix, Shah, Darshan, Arba, Francesco, Kaiser, Daniel, Williams, Cameron, Francesca, Di Giuliano, Morotti, Andrea, Oxley, Thomas, Sallustio, Fabrizio, Sharma, Gagan, Bush, Steven, Dowling, Richard, Yan, Bernard, Mitchell, Peter, Diomedi, Marina, Donnan, Geoffrey A, Parsons, Mark, Davis, Stephen M, Yassi, Nawaf, Campbell, Bruce C |
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| description | <jats:p> <jats:bold>Background:</jats:bold> Tenecteplase (TNK) is a genetically modified variant of alteplase with greater fibrin specificity and longer half-life than alteplase. The recent Tenecteplase versus Alteplase before Endovascular Therapy for Ischemic Stroke (EXTEND-IA TNK) trial demonstrated that increased reperfusion with TNK compared to alteplase prior to endovascular thrombectomy (EVT) in large vessel occlusion ischaemic strokes. However, only 6 patients with basilar artery occlusion (BAO) were included. We aimed to investigate the efficacy of TNK versus alteplase before EVT in patients with basilar artery occlusion (BAO). </jats:p> <jats:p> <jats:bold>Methods:</jats:bold> Clinical and procedural data of consecutive BAO diagnosed on CT Angiography or MR Angiography from the multisite international Basilar Artery Treatment and MANagement (BATMAN) collaboration were retrospectively analysed. The primary outcome was reperfusion of greater than 50% of the involved ischemic territory or absence of retrievable thrombus at the time of the initial angiographic assessment. </jats:p> <jats:p> <jats:bold>Results:</jats:bold> We included 119 BAO patients treated with intravenous thrombolysis prior to EVT; mean age 68 (SD 14), median NIHSS 16 (IQR 7-32). Eleven patients were treated with TNK (0.25mg/kg or 0.4mg/kg) and 108 with alteplase (0.9mg/kg). Overall, 113 patients had catheter angiography or early repeat imaging after thrombolysis. Reperfusion of greater than 50% of the ischemic territory or absence of retrievable thrombus occurred in 4/11 (36%) of patients treated with TNK vs 8/102 (8%) treated with alteplase (p=0.02). Onset-to-needle time did not differ between the two groups (p=0.4). Needle-to-groin-puncture time was 61 (IQR 33-100) mins in patients reperfused with TNK vs 111 (IQR 86-198) mins in patients reperfused with alteplase (p=0.048). Overall, the rate of symptomatic haemorrhage was 3/119 (2.5%). No differences were found in the rate of symptomatic intracranial haemorrhage (p=0.3) between the two thrombolytic agents. </jats:p> <jats:p> <jats:bold>Conclusions:</jats:bold> Despite shorter needle-to-groin-puncture times, tenecteplase was associated with an increased rate of reperfusion in comparison with alteplase before EVT in BAO. Randomized controlled trials to compare tenecteplase with alteplase in BAO patients before endovascular thrombectomy are warranted. </jats:p> |
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| spelling | Alemseged, Fana Puetz, Volker Boulouis, Gregoire Rocco, Alessandro Kleinig, Timothy Wu, Teddy Ng, Felix Shah, Darshan Arba, Francesco Kaiser, Daniel Williams, Cameron Francesca, Di Giuliano Morotti, Andrea Oxley, Thomas Sallustio, Fabrizio Sharma, Gagan Bush, Steven Dowling, Richard Yan, Bernard Mitchell, Peter Diomedi, Marina Donnan, Geoffrey A Parsons, Mark Davis, Stephen M Yassi, Nawaf Campbell, Bruce C 0039-2499 1524-4628 Ovid Technologies (Wolters Kluwer Health) Advanced and Specialized Nursing Cardiology and Cardiovascular Medicine Neurology (clinical) http://dx.doi.org/10.1161/str.51.suppl_1.tmp13 <jats:p> <jats:bold>Background:</jats:bold> Tenecteplase (TNK) is a genetically modified variant of alteplase with greater fibrin specificity and longer half-life than alteplase. The recent Tenecteplase versus Alteplase before Endovascular Therapy for Ischemic Stroke (EXTEND-IA TNK) trial demonstrated that increased reperfusion with TNK compared to alteplase prior to endovascular thrombectomy (EVT) in large vessel occlusion ischaemic strokes. However, only 6 patients with basilar artery occlusion (BAO) were included. We aimed to investigate the efficacy of TNK versus alteplase before EVT in patients with basilar artery occlusion (BAO). </jats:p> <jats:p> <jats:bold>Methods:</jats:bold> Clinical and procedural data of consecutive BAO diagnosed on CT Angiography or MR Angiography from the multisite international Basilar Artery Treatment and MANagement (BATMAN) collaboration were retrospectively analysed. The primary outcome was reperfusion of greater than 50% of the involved ischemic territory or absence of retrievable thrombus at the time of the initial angiographic assessment. </jats:p> <jats:p> <jats:bold>Results:</jats:bold> We included 119 BAO patients treated with intravenous thrombolysis prior to EVT; mean age 68 (SD 14), median NIHSS 16 (IQR 7-32). Eleven patients were treated with TNK (0.25mg/kg or 0.4mg/kg) and 108 with alteplase (0.9mg/kg). Overall, 113 patients had catheter angiography or early repeat imaging after thrombolysis. Reperfusion of greater than 50% of the ischemic territory or absence of retrievable thrombus occurred in 4/11 (36%) of patients treated with TNK vs 8/102 (8%) treated with alteplase (p=0.02). Onset-to-needle time did not differ between the two groups (p=0.4). Needle-to-groin-puncture time was 61 (IQR 33-100) mins in patients reperfused with TNK vs 111 (IQR 86-198) mins in patients reperfused with alteplase (p=0.048). Overall, the rate of symptomatic haemorrhage was 3/119 (2.5%). No differences were found in the rate of symptomatic intracranial haemorrhage (p=0.3) between the two thrombolytic agents. </jats:p> <jats:p> <jats:bold>Conclusions:</jats:bold> Despite shorter needle-to-groin-puncture times, tenecteplase was associated with an increased rate of reperfusion in comparison with alteplase before EVT in BAO. Randomized controlled trials to compare tenecteplase with alteplase in BAO patients before endovascular thrombectomy are warranted. </jats:p> Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion Stroke |
| spellingShingle | Alemseged, Fana, Puetz, Volker, Boulouis, Gregoire, Rocco, Alessandro, Kleinig, Timothy, Wu, Teddy, Ng, Felix, Shah, Darshan, Arba, Francesco, Kaiser, Daniel, Williams, Cameron, Francesca, Di Giuliano, Morotti, Andrea, Oxley, Thomas, Sallustio, Fabrizio, Sharma, Gagan, Bush, Steven, Dowling, Richard, Yan, Bernard, Mitchell, Peter, Diomedi, Marina, Donnan, Geoffrey A, Parsons, Mark, Davis, Stephen M, Yassi, Nawaf, Campbell, Bruce C, Stroke, Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion, Advanced and Specialized Nursing, Cardiology and Cardiovascular Medicine, Neurology (clinical) |
| title | Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| title_full | Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| title_fullStr | Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| title_full_unstemmed | Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| title_short | Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| title_sort | abstract tmp13: tenecteplase versus alteplase before endovascular therapy in basilar artery occlusion |
| title_unstemmed | Abstract TMP13: Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion |
| topic | Advanced and Specialized Nursing, Cardiology and Cardiovascular Medicine, Neurology (clinical) |
| url | http://dx.doi.org/10.1161/str.51.suppl_1.tmp13 |