Abstract WMP30: Real World Experience With Tenecteplase on a Mobile Stroke Unit

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Background: Tenecteplase (TNK) administered on a mobile stroke unit (MSU) has demonstrated superior rates of early reperfusion compared to alteplase. Current guidelines include TNK as a second-tier option for large vessel occlusions as TNK has many benefits, including rapid IV administration and ease of dosing. The objective of this study was to describe real world utilization of TNK on a MSU. Methods: This was a retrospective observational study of patients receiving TNK as compared to alteplase between February 2021 and April 2023 at a large academic comprehensive stroke center. Baseline demographics, GCS, NIHSS, as well as time of initial imaging were collected. Primary endpoint was time from MSU door to thrombolytic administration. Secondary endpoints included: MSU door to imaging interpretation, dispatch to thrombolytic administration, and provider decision time to thrombolytic administration. Safety endpoints included symptomatic ICH within 24 hours. Results: During the studied time period 40 patients received alteplase and 32 patients received TNK on the MSU. The median age was 65.7 years and median NIHSS score was 9. There was no difference in time from MSU door to thrombolytic administration (15 vs 17.5, p=0.30). There was also no difference in time from MSU door to imaging interpretation, dispatch to thrombolytic administration, or provider decision time to thrombolytic administration. No hemorrhagic conversion occurred. Conclusion: This is the largest series to date describing real-world utilization of TNK administration in a MSU. There were no significant differences in time to therapy in any of the time points evaluated. This data is promising for the treatment of ischemic stroke in which time to administration of thrombolytic therapy is paramount and TNK is administered as a rapid IV injection as compared to alteplase infusion.

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