Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe 
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  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Clinical, Review, Journal:  Tenecteplase vs. alteplase for acute ischemic stroke: a systematic review. (Pubmed Central) -  Jan 6, 2022   
    The available evidence suggests that tenecteplase appears to be a better thrombolytic agent for acute ischemic stroke when compared to alteplase.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Clinical, Retrospective data, Review:  Direct Endovascular Thrombectomy or With Prior Intravenous Thrombolysis for Acute Ischemic Stroke: A Meta-Analysis. (Pubmed Central) -  Jan 1, 2022   
    Among pre-specified secondary outcomes, no significant between-group differences were found in excellent outcome (mRS score ≤ 1) (OR, 1.12 [95% CI, 0.85-1.47]; P = 0.418), mortality at 90 days (OR, 0.93 [95% CI, 0.68-1.29]; P = 0.673), successful reperfusion (thrombolysis in cerebral infarction 2b-3) (OR, 0.75 [95% CI, 0.54-1.05]; P = 0.099), and symptomatic intracranial hemorrhage (OR, 0.72 [95% CI, 0.45-1.15]; P = 0.171). Among patients with acute ischemic stroke in the anterior circulation within 4.5 h from the onset, endovascular thrombectomy alone was non-inferior to combined intravenous thrombolysis and endovascular thrombectomy.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Journal:  Stroke Care in Pakistan. (Pubmed Central) -  Dec 31, 2021   
    There is a high proportion of young stroke with poor stroke outcomes. Acute stroke care is scarce in Pakistan due to the small number of neurologists (1 neurologist per 1 million population), few stroke units, and limited availability of alteplase (recombinant tissue plasminogen activator) in the country.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Clinical, Journal, HEOR:  Cost-Effectiveness of Magnetic Resonance Imaging-Guided Thrombolysis for Patients With Stroke With Unknown Time of Onset. (Pubmed Central) -  Dec 30, 2021   
    Acute stroke care is scarce in Pakistan due to the small number of neurologists (1 neurologist per 1 million population), few stroke units, and limited availability of alteplase (recombinant tissue plasminogen activator) in the country. Magnetic resonance imaging-guided IV-tpa compared to placebo is cost-effective in patients with ischemic stroke with unknown time of onset.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Journal:  Association of time from last known well to alteplase administration and outcomes in acute stroke. (Pubmed Central) -  Dec 22, 2021   
    Our small, retrospective data shows no association between OTT and either hemorrhagic conversion or mRS at 90 days. This data lends support that time may not be the ideal indicator for identifying patients who will benefit from tPA administration.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Journal:  Left hemispheric cortical watershed infarcts triggered by carotid sinus self-massage. (Pubmed Central) -  Dec 21, 2021   
    After excluding other contraindications, an intravenous thrombolysis with weight-adapted alteplase was performed...In general, watershed infarcts after carotid sinus self-massage follow a rare ischaemic stroke mechanism. This case emphasises the importance of a detailed anamnestic evaluation to determine the aetiological classification of ischaemic stroke as well as educating patients' (poststroke) behaviour.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Comparison Of Transradial Artery Versus Transfemoral Artery Access Mechanical Thrombectomy At A Comprehensive Stroke Center (Hall B2, Poster Hall; Board No. MP72) -  Dec 21, 2021 - Abstract #ISC2022ISC_918;    
    A binary logistic regression analysis was performed, controlling for age, sex, NIHSS, type of anesthesia (general vs. moderate), laterality, and location of clot (internal carotid or middle cerebral artery), ASPECTS≥6, presenting mean arterial pressure, blood glucose, Hb A1C, LDL, intravenous alteplase... Our study demonstrates no significant difference between TRA and TRF approaches with respect to various time, technical and outcome parameters, with a notable exception of a significantly higher rate of conversion from TRA to TRF approach.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Improve Patient Outcomes In A Specialized Neurological Emergency Department (Hall B2, Poster Hall; Board No. MP36) -  Dec 21, 2021 - Abstract #ISC2022ISC_879;    
    Phase III of the American Heart Association/American Stroke Association initiative set more aggressive targets for timely treatment with IV alteplase...Implementation of a Neuro ED led to swift management and improved symptoms for stroke patients. A dedicated Neuro ED is highly effective in improving DTN times, DTCT times, and overall stroke outcomes.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    The Effect Of Neuroprotectant NA1 On Early Infarct Growth Following Endovascular Therapy: The REPERFUSE-NA1 Study (Room 208-210) -  Dec 21, 2021 - Abstract #ISC2022ISC_834;    
    P3
    Median DWI volume growth was 55.1% for NA1 patients who received alteplase compared to 41.3% for NA1 patients who did not receive alteplase (p=0.65)...Between the NA1 and the placebo groups, lesion growth in the white matter (1.96 mL v 2.77mL), cortical gray matter (3.93 mL v 4.07 mL) and basal ganglia (1.62 mL v 0.89 mL) did not differ significantly.CONCLUSION There was substantial infarct growth early after EVT, with the largest absolute growth in cortical grey matter. No significant effect of NA1 on early infarct growth was observed.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Unmet Need In Acute Ischemic Stroke Patients Not Treated With Alteplase (Riverside Room R06-R09) -  Dec 21, 2021 - Abstract #ISC2022ISC_830;    
    Patients within the GWTG-Stroke registry not treated with IV alteplase have a high risk of re-admission and mortality and have high total in-hospital and post-discharge costs. This study may inform future efforts to address the unmet need to improve the scope of IV alteplase delivery along with other aspects of AIS care and, consequently, outcomes in this patient population.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    A Comparison Of Thrombus Characteristics In Patients With Anterior Circulation Stroke And Posterior Circulation Stroke In The Mr Clean Registry (Hall B2, Poster Hall; Board No. P152) -  Dec 21, 2021 - Abstract #ISC2022ISC_708;    
    Radiological thrombus characteristics between PCS and ACS patients were compared with univariable and multivariable linear regression with adjustments for baseline differences which could influence thrombus characteristics (age, gender, TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria and intravenous alteplase treatment...CONCLUSION PCS thrombi are significantly longer and denser than ACS thrombi. After adjustment for stroke etiology, only thrombus length was significantly different between PCS and ACS patients.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Association Of 24-hour Blood Pressure Parameters Post-thrombectomy With Functional Outcomes According To Collateral Status (Hall B2, Poster Hall; Board No. P149) -  Dec 21, 2021 - Abstract #ISC2022ISC_706;    
    A binary logistic regression analysis was performed, controlling for age, sex, NIHSS, ASPECTS≥6, TICI score≥2b, time to thrombectomy, LDL, Hemoglobin A1C, intravenous alteplase, with the 24 hour post MT BP parameters as the predictors... Various higher 24 hour BP parameters post MT are associated with a bad functional outcome or mortality in patients with good collaterals, unlike in patients with bad collaterals.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Rates Of Symptomatic Intracerebral Hemorrhage After Tpa At Rural Telemedicine Spoke And Hub Sites (Hall B2, Poster Hall; Board No. P46) -  Dec 21, 2021 - Abstract #ISC2022ISC_597;    
    Rate of sICH in this setting was similar to rate reported in the literature. Furthermore, though there was a statistically significant difference between the populations studied, the likelihood of sICH remained similar.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Association Of Pre-mechanical Thrombectomy Collateral Scores With Functional Outcome In Short Versus Extended Window For Thrombectomy (Hall B2, Poster Hall; Board No. MP65) -  Dec 21, 2021 - Abstract #ISC2022ISC_440;    
    Our study demonstrates that good collateral grades on Mass and modified-Tan scales are associated with a good functional outcome for patients who present to the ED in the short window for MT. We did not find an association of any pre-MT collateral scores with a good functional outcome for patients presenting in the extended window for MT.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim
    Reduced Hospital Costs For Ischemic Stroke Treated With Tenecteplase (Hall B2, Poster Hall; Board No. MP52) -  Dec 21, 2021 - Abstract #ISC2022ISC_426;    
    An expanded analysis including other markets that switched to TNK in our national hospital system is in progress. If the current results generalize, the savings potential with a switch to TNK as the standard could be substantial for the health care system.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    The Safety And Feasibility Of Early Mobility In Acute Ischemic Stroke Patients After IV Alteplase (Hall B2, Poster Hall; Board No. MP28) -  Dec 21, 2021 - Abstract #ISC2022ISC_401;    
    Our study demonstrates that instituting early mobilization as soon as 6 hours after alteplase infusion completion is safe and feasible mild acute stroke patients. Future studies should explore efforts to increase the number of patients who receive early mobilization and investigate functional outcomes between patients receiving early mobilization compared to standard medical care.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim
    Tenecteplase For The Treatment Of Acute Ischemic Stroke: A Systematic Review And Meta-analysis Of Real World Evidence (Hall B2, Poster Hall; Board No. MP4) -  Dec 21, 2021 - Abstract #ISC2022ISC_375;    
    Larger prospective ‘real-life’ studies are required to validate our findings. Real world evidence suggests that tenecteplase has a comparable efficacy and safety profile to alteplase for the treatment of AIS, while being possibly superior in achieving successful reperfusion and early neurological improvement.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Effect Of Intravenous Alteplase On Ischemic Stroke Mortality Is Dependent On Stroke Severity (Riverside Room R06-R09) -  Dec 21, 2021 - Abstract #ISC2022ISC_345;    
    As seen in Figure 1, both cohorts had separation at NIHSS of ≥18, at which point tPA began to have a benefit for both in-hospital and 90-day mortality. Nearly identical results were seen when patients who received endovascular therapy were excluded.ConclusionIn patients with acute ischemic stroke, tPA administration is associated with a reduction of both in-hospital and 90-day mortality for patients with severe stroke (NIHSS≥18).
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Safety Of Tenecteplase And Alteplase In Tandem Lesion Stroke: A Pooled Analysis Of The Extend-IA TNK Trials (Riverside Room R06-R09) -  Dec 21, 2021 - Abstract #ISC2022ISC_343;    
    Although patients with TL in the anterior circulation were at higher risk of hemorrhagic complications, these did not significantly differ between the TNK and tPA groups. A numeric increase in bleeding with TNK was not accompanied by an increase in mortality or worse functional outcome.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Factors Affecting Door To Recanalization Times At A Comprehensive Stroke Center (Hall B2, Poster Hall; Board No. P163) -  Dec 21, 2021 - Abstract #ISC2022ISC_236;    
    A binary logistic regression analysis was performed, controlling for age, sex, NIHSS, presenting mean arterial pressure (MAP), presenting serum calcium level, Hb A1C, LDL, intravenous alteplase, left hemispheric location, location of the clot (internal carotid artery vs. middle cerebral artery), ≥50% ipsilateral stenosis, ASPECTS≥6, general anesthesia, transradial approach, number of passes, arrival to the emergency department on night shift (7 pm to 7 am) and on weekends... Parameters of arrival on the weekend, higher serum calcium level, higher MAP, left hemispheric occlusion, use of general anesthesia, and female sex were associated with DTRp of ≥120 minutes.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Impact Of Patient Age On Sex Disparities In Intravenous Alteplase Administration For Acute Ischemic Stroke (Hall B2, Poster Hall; Board No. P73) -  Dec 21, 2021 - Abstract #ISC2022ISC_142;    
    After stratification, female patients aged ≥75 were 1.5% (95% CI -2.3, -0.7, p<0.001) less likely than men to receive tPA (Figure 1).ConclusionIn the most recent sample of the NIS, women with acute ischemic stroke are no longer less likely than men to receive tPA. We show this holds true after adjustment for stroke severity, although there is still a disparity in older patients aged ≥75, with women being 1.5% less likely than men to receive tPA.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Promoting Staff Engagement Through Recognition Of Stroke Excellence (Hall B2, Poster Hall; Board No. P35) -  Dec 21, 2021 - Abstract #ISC2022ISC_101;    
    Staff engagement plays a significant role in caring for the acute stroke population and has a positive impact on decreasing DTN and DIDO times. “Recognition of Stroke Excellence” helps to promote a collaborative approach by fostering teamwork and improving staff morale.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Unmet Need In Acute Ischemic Stroke Patients Arriving After 4.5 Hours (Room 243-245) -  Dec 21, 2021 - Abstract #ISC2022ISC_55;    
    Introduction: Many patients arrive beyond the guideline-recommended time window for treatment with IV alteplase... Results show the importance of timely hospital arrival, as well as a need to address racial disparities in arrival times, reduce costs, and develop new treatment options for patients with AIS arriving after 4.5 hours from last known well time.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim
    Tenecteplase Is Safe And Efficacious In Telestroke Patients With Confirmed Large Vessel Occlusions (Room 208-210) -  Dec 21, 2021 - Abstract #ISC2022ISC_44;    
    There were no differences reported between thrombolysis groups and DIO, p = 0.63. Conclusion Telestroke patients presenting with confirmed LVO and treated with IV tenecteplase were found to have better 90 day outcomes compared to patients treated with IV alteplase, without increased complication rates.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Population Access To Acute Stroke Expertise In The United States (Room 208-210) -  Dec 21, 2021 - Abstract #ISC2022ISC_42;    
    Backgound In 2011, nearly 20% of Americans lacked timely access to alteplase-capable hospitals...Conclusion Relative to previous reports, an increasing proportion of the US population has access to acute stroke expertise. While geographic disparities in access remain, telestroke plays an important role in filling this gap.