ArticleEuropean stroke journal2024
Intravenous thrombolysis with tenecteplase versus alteplase combined with endovascular treatment of anterior circulation tandem occlusions: A pooled analysis of ETIS and TETRIS.
Article in European stroke journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 5 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 5 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Alteplase versus tenecteplase in acute ischemic stroke with large vessel occlusion: a systematic review and meta-analysis.European journal of clinical pharmacology · 2026Pooled it
- Intravenous thrombolysis before endovascular therapy for acute ischemic stroke due to tandem lesions: a systematic review and meta-analysis.Neurosurgical review · 2025Pooled it
- Risk factors for unexplained early neurological deterioration after intravenous thrombolysis: a meta-analysis.Neurosciences (Riyadh, Saudi Arabia) · 2025Pooled it
- Intravenous thrombolysis with tenecteplase versus alteplase in acute ischemic stroke tandem occlusions: a systematic review and meta-analysis of current available literature.Journal of thrombosis and thrombolysis · 2025Pooled it
- Tenecteplase versus alteplase in bridging therapy in patients with large vessel occlusion stroke: a meta-analysis.Frontiers in neurology · 2025Pooled it
- Trade-Off Between Early Reperfusion and First-Pass Effect With Tenecteplase Versus Alteplase Before Stroke Thrombectomy.Journal of the American Heart Association · 2026Article
- Predictors of functional outcome after endovascular thrombectomy in patients with large ischemic core based on DWI-ASPECTS.BMC neurology · 2026Article
- Thrombolytic agents, more options, more challenges.Stroke and vascular neurology · 2026Article
- Early reperfusion with tenecteplase vs alteplase before stroke thrombectomy: impact of clot burden, thrombus characteristics, and collateral status.Journal of neurology · 2026Article
- Management of tandem occlusions in acute ischaemic stroke.Therapeutic advances in neurological disorders · 2026Review
- Effect of intravenous alteplase before endovascular therapy for atherothrombotic stroke-related large vessel occlusion: subanalysis of the RESCUE AT-LVO registry.Stroke and vascular neurology · 2025Observational
- Switching from alteplase to tenecteplase for stroke thrombolysis: short-term effects on treatment metrics and early functional outcomes.BMC neurology · 2025Article
- Tenecteplase-What Have We Learned till Now? A Narrative Review.Life (Basel, Switzerland) · 2025Review
- Clot migration in patients treated with tenecteplase versus alteplase before mechanical thrombectomy.European stroke journal · 2025Article
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Authors and funding
22 authors at 13 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTandem occlusions are a singular large vessel occlusion entity involving specific endovascular and perioperative antithrombotic management. In this context, data on safety and efficacy of prior intravenous thrombolysis (IVT) with tenecteplase is scarce. We aimed to compare IVT with tenecteplase or alteplase in patients with acute tandem occlusions intended for endovascular treatment. PATIENTS AND
methodsA retrospective pooled analysis of two large observational registries (ETIS (Endovascular Treatment of Ischemic Stroke) and TETRIS (Tenecteplase Treatment in Ischemic Stroke)) was performed on consecutive patients presenting with anterior circulation tandem occlusion treated with IVT using either alteplase (ETIS) or tenecteplase (TETRIS) followed by endovascular treatment between January 2015 and June 2022. Sensitivity analyses on atherosclerosis related tandem occlusions and on patient treated with emergent carotid stenting were conducted. Propensity score overlap weighting analyses were performed.
resultsWe analyzed 753 patients: 124 in the tenecteplase and 629 in the alteplase group. The overall odds of favorable outcome (3-month modified Rankin score 0-2) were comparable between both groups (49.4% vs 47.1%; OR = 1.10, 95%CI 0.85-1.41). Early recanalization, final successful recanalization and mortality favored the use of tenecteplase. The occurrence of any intracranial hemorrhage (ICH) was more frequent after tenecteplase use (OR = 2.24; 95%CI 1.75-2.86). However, risks of symptomatic ICH and parenchymal hematoma remained similar. In atherosclerotic tandems, favorable outcome, mortality, parenchymal hematoma, early recanalization, and final successful recanalization favored the tenecteplase group. In the carotid stenting subgroup, PH were less frequent in the tenecteplase group (OR = 0.18; 95%CI 0.05-0.69).
conclusionIn patients with tandem occlusions, IVT with tenecteplase seemed reasonably safe in particular with increased early recanalization rates. These findings remain preliminary and should be further confirmed in randomized trials.
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