Abstract:
Introduction: Current guidelines for acute ischemic stroke recommend timely administration of intravascular thrombolytic therapy to promote functional and neurologic outcomes. Tenecteplase is an emerging off-label therapy for this indication and being utilized by various institutions due to its simpler administration strategy. In emergent situations in which intravenous access cannot be obtained, intraosseous access is a viable option for medication administration.
However, there has been minimal published cases to support the efficacy and safety of intraosseous administration of tenecteplase for acute ischemic stroke.Case: We describe the case of a 51-year-old woman who developed acute ischemic stroke within our institution. Due to difficulty achieving intravenous access and time-dependent efficacy of thrombolytic therapy, the decision was made to administer tenecteplase by the intraosseous route. Stroke symptoms improved within 48 hours following administration without complication.
Conclusion: Intraosseous administration of tenecteplase may be considered for treatment of acute ischemic stroke if intravenous access is unattainable.
Reference:Chung J, Bundy J, Khan S, Hunt A, Carroll S, Ali A, Shafi N, Tesoro E. “Intraosseous Administration of Tenecteplase for Thrombolysis of an Acute Ischemic Stroke”. J Stroke Cerebrovasc Dis. 2024 Jul 4:107850. doi: 10.1016/j.jstrokecerebrovasdis.2024.107850. Epub ahead of print. PMID: 38971481.