Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): global stroke fact sheet 2022. Int J Stroke. 2022;17(1):18–29. https://doi.org/10.1177/17474930211065917.

Article  PubMed  Google Scholar 

Fan J, Li X, Yu X, Liu Z, Jiang Y, Fang Y, et al. Global burden, risk factors analysis, and prediction study of ischemic stroke, 1990–2030. Neurology. 2023. https://doi.org/10.1212/WNL.0000000000207387.

Article  PubMed  PubMed Central  Google Scholar 

Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: a Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2019;50(12):e344–418. https://doi.org/10.1161/STR.0000000000000211.

Article  PubMed  Google Scholar 

Ahmed N, Audebert H, Turc G, Cordonnier C, Christensen H, Sacco S, et al. Consensus statements and recommendations from the ESO-Karolinska Stroke Update Conference, Stockholm 11–13 November 2018. Eur Stroke J. 2019;4(4):307–17. https://doi.org/10.1177/2396987319863606.

Article  PubMed  PubMed Central  Google Scholar 

The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke (NINDS Study). N Engl J Med. 1995;333(24):1581–1587. https://doi.org/10.1056/NEJM199512143332401.

Miller DJ, Simpson JR, Silver B, Silver B. Safety of thrombolysis in acute ischemic stroke: a review of complications, risk factors, and newer technologies. Neurohospitalist. 2011;1:138–47. https://doi.org/10.1177/1941875211408731.

Article  PubMed  PubMed Central  Google Scholar 

Bhatia R, Hill MD, Shobha N, Menon B, Bal S, Kochar P, et al. Low rates of acute recanalization with intravenous recombinant tissue plasminogen activator in ischemic stroke: real-world experience and a call for action. Stroke. 2010;41(10):2254–8. https://doi.org/10.1161/STROKEAHA.110.592535.

Article  CAS  PubMed  Google Scholar 

Yeo LLL, Paliwal P, Teoh HL, Seet RC, Chan BP, Liang S, et al. Timing of recanalization after intravenous thrombolysis and functional outcomes after acute ischemic stroke. JAMA Neurol. 2013;70(3):353–8. https://doi.org/10.1001/2013.jamaneurol.547.

Article  PubMed  Google Scholar 

Yepes M, Roussel BD, Ali C, Vivien D. Tissue-type plasminogen activator in the ischemic brain: more than a thrombolytic. Trends Neurosci. 2009;32(1):48–55. https://doi.org/10.1016/j.tins.2008.09.006.

Article  CAS  PubMed  Google Scholar 

Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT-2) Investigators, Van De Werf F, Adgey J, Ardissino D, Armstrong PW, Aylward P, Barbash G, et al. Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial. Lancet. 1999;354(9180):716–22. https://doi.org/10.1016/s0140-6736(99)07403-6.

Article  Google Scholar 

Bivard A, Zhao H, Churilov L, Campbell BCV, Coote S, Yassi N, TASTE-A collaborators, et al. Comparison of tenecteplase with alteplase for the early treatment of ischaemic stroke in the Melbourne Mobile Stroke Unit (TASTE-A): a phase 2, randomised, open-label trial. Lancet Neurol. 2022;21(6):520–7. https://doi.org/10.1016/S1474-4422(22)00171-5.

Article  CAS  PubMed  Google Scholar 

Heran M, Lindsay P, Gubitz G, Yu A, Ganesh A, Lund R, et al. Canadian stroke best practice recommendations: acute stroke management, 7th edition practice guidelines update, 2022. Canad J Neurol Sci. 2022;19:1–94. https://doi.org/10.1017/cjn.2022.344.

Article  Google Scholar 

Oliveira M, Fidalgo M, Fontão L, Antão J, Marques S, Afreixo V, et al. Tenecteplase for thrombolysis in stroke patients: systematic review with meta-analysis. Am J Emerg Med. 2021;42:31–7. https://doi.org/10.1016/j.ajem.2020.12.026.

Article  CAS  PubMed  Google Scholar 

Kobeissi H, Ghozy S, Turfe B, Bilgin C, Kadirvel R, Kallmes DF, et al. Tenecteplase vs. alteplase for treatment of acute ischemic stroke: a systematic review and meta-analysis of randomized trials. Front Neurol. 2023;14:1102463. https://doi.org/10.3389/fneur.2023.1102463.

Article  PubMed  PubMed Central  Google Scholar 

Li S, Pan Y, Wang Z, Liang Z, Chen H, Wang D, et al. Safety and efficacy of tenecteplase versus alteplase in patients with acute ischaemic stroke (TRACE): a multicentre, randomised, open label, blinded-endpoint (PROBE) controlled phase II study. Stroke Vasc Neurol. 2022;7(1): e000978. https://doi.org/10.1136/svn-2021-000978.

Article  Google Scholar 

Kvistad CE, Næss H, Helleberg BH, Idicula T, Hagberg G, Nordby LM, et al. Tenecteplase versus alteplase for the management of acute ischaemic stroke in Norway (NOR-TEST 2, part A): a phase 3, randomised, open-label, blinded endpoint, non-inferiority trial. Lancet Neurol. 2022;21(6):511–9. https://doi.org/10.1016/S1474-4422(22)00124-7.

Article  CAS  PubMed  Google Scholar 

Menon BK, Buck BH, Singh N, Deschaintre Y, Almekhlafi MA, Coutts SB, AcT Trial Investigators, et al. Intravenous tenecteplase compared with alteplase for acute ischaemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial. Lancet. 2022;400(10347):161–9. https://doi.org/10.1016/S0140-6736(22)01054-6.

Article  CAS  PubMed  Google Scholar 

Wang Y, Li S, Pan Y, Li H, Parsons MW, Campbell BCV, TRACE-2 Investigators, et al. Tenecteplase versus alteplase in acute ischaemic cerebrovascular events (TRACE-2): a phase 3, multicentre, open-label, randomised controlled, non-inferiority trial. Lancet. 2023;401(10377):645–54. https://doi.org/10.1016/S0140-6736(22)02600-9.

Article  CAS  PubMed  Google Scholar 

Ferguson E, Yadav K. Intravenous tenecteplase compared with alteplase for acute ischemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial. CJEM. 2023;25(2):121–2. https://doi.org/10.1007/s43678-022-00432-8.

Article  PubMed  Google Scholar 

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372: n71. https://doi.org/10.1136/bmj.n71.

Article  PubMed  PubMed Central  Google Scholar 

Sterne JA, Savovic J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366: l4898.

Article  PubMed  Google Scholar 

Parsons M, Spratt N, Bivard A, Campbell B, Chung K, Miteff F, et al. A randomized trial of tenecteplase versus alteplase for acute ischemic stroke. N Engl J Med. 2012;366(12):1099–107. https://doi.org/10.1056/NEJMoa1109842.

Article  CAS  PubMed  Google Scholar 

Haley EC Jr, Thompson JL, Grotta JC, Lyden PD, Hemmen TG, Brown DL, Tenecteplase in Stroke Investigators, et al. Phase IIB/III trial of tenecteplase in acute ischemic stroke: results of a prematurely terminated randomized clinical trial. Stroke. 2010;41(4):707–11. https://doi.org/10.1161/STROKEAHA.109.572040.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Huang X, Cheripelli BK, Lloyd SM, Kalladka D, Moreton FC, Siddiqui A, et al. Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study. Lancet Neurol. 2015;14(4):368–76. https://doi.org/10.1016/S1474-4422(15)70017-7.

Article  CAS  PubMed  Google Scholar 

Logallo N, Novotny V, Assmus J, Kvistad CE, Alteheld L, Rønning OM, et al. Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial. Lancet Neurol. 2017;16(10):781–8. https://doi.org/10.1016/S1474-4422(17)30253-3.

Article  CAS  PubMed  Google Scholar 

Campbell BCV, Mitchell PJ, Churilov L, Yassi N, Kleinig TJ, Dowling RJ, EXTEND-IA TNK Investigators, et al. Tenecteplase versus alteplase before thrombectomy for ischemic stroke. N Engl J Med. 2018;378(17):1573–82. https://doi.org/10.1056/NEJMoa1716405.

Article  CAS  PubMed  Google Scholar 

Thelengana A, Radhakrishnan DM, Prasad M, Kumar A, Prasad K. Tenecteplase versus alteplase in acute ischemic stroke: systematic review and meta-analysis. Acta Neurol Belg. 2019;119(3):359–67. https://doi.org/10.1007/s13760-018-0933-9.

Article  CAS  PubMed  Google Scholar 

Frühwald T, Gärtner U, Stöckmann N, Marxsen JH, Gramsch C, Roessler FC. In vitro examination of the thrombolytic efficacy of tenecteplase and therapeutic ultrasound compared to rt-PA. BMC Neurol. 2019;19(1):181. https://doi.org/10.1186/s12883-019-1404-5.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Burgos AM, Saver JL. Evidence that tenecteplase is noninferior to alteplase for acute ischemic stroke: meta-analysis of 5 randomized trials. Stroke. 2019;50(8):2156–62. https://doi.org/10.1161/STROKEAHA.119.025080.

Article  CAS  PubMed  Google Scholar 

NCT03854500. The Norwegian Tenecteplase Stroke Trial 2 (NOR-TEST 2). https://www.clinicaltrials.gov/study/NCT03854500?distance=50&cond=stroke&intr=Tenecteplase%20&term=Alteplase&rank=2. Accessed 15 Jun 2023.

NCT05281549. Thrombolysis Treated With TNK-tPA in Acute Ischemic Stroke Patients (3T Stroke-II). https://www.clinicaltrials.gov/study/NCT05281549?distance=50&cond=stroke&intr=Tenecteplase%20&term=Alteplase&rank=3. Accessed 15 Jun 2023.

NCT05745259. Thrombolysis Treated With TNK-tPA in Acute Ischemic Stroke Patients (3T Stroke-III). https://www.clinicaltrials.gov/study/NCT05745259?distance=50&cond=stroke&intr=Tenecteplase%20&term=Alteplase&rank=5. Accessed 15 Jun 2023.

NCT05626972. Tenecteplase Compared to Alteplase for Patients With Large Vessel Occlusion Suspicion Before Thrombectomy. https://www.clinicaltrials.gov/study/NCT05626972?distance=50&cond=stroke&intr=Tenecteplase%20&term=Alteplase&rank=9. Accessed 15 Jun 2023.

NCT04915729. A Study in Chinese Patients to Compare How Tenecteplase and Alteplase Given After a Stroke Improve Recovering of Physical Activity. https://www.clinicaltrials.gov/study/NCT04915729?distance=50&cond=stroke&intr=Tenecteplase%20&term=Alteplase&rank=6. Accessed 15 Jun 2023.