Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

Introduction: Acute ischemic stroke is a neurologic emergency, requiring rapid recognition and treatment with intravenous thrombolysis. Since the publication of the 2019 American Heart Association/American Stroke Association Guidelines that recommend tenecteplase as an alternative agent, several centers across the United States are transitioning from alteplase to tenecteplase as the agent of choice for thrombolysis in acute ischemic stroke.

Methods: Our health system transitioned to tenecteplase for the treatment of acute ischemic stroke in 2021 due to increasing evidence for efficacy and potential for improved door-to-needle time. Herein we describe our experience and provide guidance for other institutions to implement this change.

Conclusion: Emergency nurses are vital to the care of acute ischemic stroke patients. There are several pharmacologic and logistical differences between alteplase and tenecteplase for this indication. This paper outlines these key differences.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jen.2023.11.004DOI Listing

Publication Analysis

Top Keywords

acute ischemic
20
ischemic stroke
16
alteplase tenecteplase
8
acute
5
ischemic
5
stroke
5
implementation tenecteplase
4
tenecteplase acute
4
stroke treatment
4
treatment introduction
4

Similar Publications

Ambient temperature and coronary plaque rupture risk in STEMI: Insights from OCT analysis.

Atherosclerosis

September 2025

Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China; State Key Laboratory of Frigid Zone Cardiovascular Diseases, Harbin Medical University, Harbin, China. Electronic address

Background And Aims: Cold weather is associated with an increased risk of cardiovascular events, but its impact on culprit plaque characteristics in ST-segment elevation myocardial infarction (STEMI) remains unclear.

Methods: This study included 647 STEMI patients who underwent optical coherence tomography (OCT) to assess untreated culprit lesions. Participants were grouped based on ambient temperature on the day of admission or mean ambient temperatures over the preceding 7-, 14-, 21-, and 28-day periods.

View Article and Find Full Text PDF

Background And Purpose: Cervicocephalic artery dissection (CCAD) is a well-recognized cause of ischemic stroke. However, complex forms of CCAD, characterized by a wide intimal inlet without a visible intramural hematoma, pose diagnostic challenges and complicate endovascular access to the true lumen when recanalization is required. We aimed to analyze the clinical presentation, outcomes, and feasibility of endovascular treatment of complex CCAD and to propose a novel morphological classification.

View Article and Find Full Text PDF

Effect of ECMO Flow Variations on Pulmonary Capillary Wedge Pressure in Patients With Cardiogenic Shock.

J Am Coll Cardiol

September 2025

Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France; Sorbonne Université, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France.

Background: The hemodynamic effects of femoro-femoral venoarterial (VA) extracorporeal membrane oxygenation (ECMO) on pulmonary capillary wedge pressure (PCWP) remain poorly defined. High ECMO flow is believed to increase PCWP and the risk of pulmonary edema; yet, supporting in vivo physiological data are lacking.

Objectives: The purpose of this study was to evaluate the impact of incremental femoro-femoral VA-ECMO flow variations on PCWP, hemodynamic, and echocardiographic parameters in patients with cardiogenic shock during the early phase of VA-ECMO support, after stabilization.

View Article and Find Full Text PDF

Introduction: Intracranial atherosclerosis is the main cause of stroke globally, with acute large vessel occlusive (LVO) stroke being a predominant contributor to stroke-related mortality. In recent years, aspiration thrombectomy (AT) has emerged as a novel therapeutic method for treating acute LVO stroke. The purpose of this study aims to investigate the safety and efficacy of AT alone or combined with stent retriever thrombectomy (SRT) in the treatment of acute LVO stroke METHODS AND ANALYSIS: This is a multicentre and observational real-world study involving patients diagnosed with acute LVO stroke.

View Article and Find Full Text PDF

Objectives: This study aimed to analyse the number of myocardial infarction (MI) admissions during the COVID-19 lockdown periods of 2020 and 2021 (March 15th to June 15th) and compare them with corresponding pre-pandemic period in 2019. The study also evaluated changes in critical treatment intervals: onset to door (O2D), door to balloon (D2B) and door to needle (D2N) and assessed 30-day clinical outcomes. This study examined MI care trends in India during the COVID-19 lockdown period, irrespective of patients' COVID-19 infection status.

View Article and Find Full Text PDF