20.500.12556/DiRROS-27739 Tenecteplase - what have we learned till now? a narrative review Tenecteplase (TNK), a genetically modified tissue plasminogen activator, has emerged as a promising alternative to alteplase (ALT) for intravenous thrombolysis (IVT) in acute ischemic stroke (AIS). Our aim was to synthesize the current clinical evidence on TNK use in AIS patients, comparing efficacy, safety, and workflow benefits to ALT. A narrative review was conducted by searching PubMed and Scopus (January 2024–March 2025) for studies comparing TNK and ALT in AIS. A total of 35 eligible papers were included. Data were grouped by treatment scenario: IVT-only, bridging before endovascular therapy (EVT), and intra-arterial thrombolysis (IAT). The results showed that TNK is non-inferior— and in some analyses, superior—to ALT regarding functional outcomes, especially in large vessel occlusion. TNK facilitates shorter treatment delays due to its single-bolus administration. While some trials report higher rates of intracranial hemorrhage, overall safety and mortality are comparable. In conclusion, TNK appears to exert equivalent or superior efficacy and safety compared to ALT in multiple AIS scenarios. Its pharmacological and logistical advantages support its broader clinical adoption. Further trials are needed, especially for IAT, central retinal artery occlusion, and patients on dabigatran tenecteplase acute ischemic stroke treatment narrative review alteplase true false true Angleški jezik Ni določen Neznano 2026-02-23 15:14:42 2026-02-23 15:14:43 2026-02-24 04:02:04 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 28. 8. 2025; str. 1-15 iss. 9, (1356) Vol. 15 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 61 2075-1729 10.3390/life15091356 246915331 RAZ_Zupan_Matija_2025.pdf RAZ_Zupan_Matija_2025.pdf 1 1CBBCE99929487C5AA0513BB515A94DC f50db0665b7f95f1468079348f51dd92e10804564b2fb05776fb89b5a0fbaf7f 246f863f-10c2-11f1-9cb0-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=40755 https://doi.org/10.3390/life15091356 0 34c4177d-10c2-11f1-9cb0-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=40756 Univerzitetni klinični center Ljubljana 0 0 0