Like a heart attack, a stroke is a “brain attack.” It happens
when there is a sudden loss of blood to an area of the brain. This could
be due to a blood clot, or clogged arteries, and it starves the brain
of the oxygen and nutrients it needs. This is called an “Acute Ischemic
Stroke.” The center of the starved area in the brain
may die quickly, and the area around it may die more slowly.
Tenecteplase, also known as “TNKase”, is a medication that breaks up blood clots.
TNKase can sometimes break up the clot that is blocking the blood vessel causing the stroke. If it can dissolve the clot, the blocked blood vessel re-opens, allowing the starved brain to get blood flow, with oxygen and nutrients. If the clot is dissolved soon enough, some of the brain may be rescued. Rescuing the brain may decrease the amount of disability someone has from a stroke.
No. There are specific rules for who gets TNKase, and who does not. These rules help the doctors choose who it might benefit, and to avoid serious side effects. If the stroke patient does not meet these guidelines, it is more risky to give the medication. TNKase has to be givenwithin a specific range of time, and the patient must first have a CT scan to make sure there is no bleeding in the brain.
A key benefit is an increased chance of having a good outcome and the patient returning to normal, or near-normal, functioning. The goal is always to minimize brain injury and maximize patient recovery. Treatment with TNKase doubles the odds of being normal or near-normal at hospital discharge, or even 3 months later. In a simulated group of 100 patients - 32 patients benefit, and 3 are harmed.
The chances of a good outcome are improved with TNKase. However, a good outcome is not guaranteed.
While small, the most serious risk with the use of TNKase is bleeding into the brain, or other bleeding, leading to a worsening condition or death. The risk of serious bleeding is less than 1% in patients not treated with TNKase, versus about 3% in those treated with TNKase. Other less common side effects are minor bleeding, or bleeding into other parts of the body, and allergic reactions.
When a patient is given TNKase, nurses monitor them as frequently as every 15 minutes and visit the patient’s room often for observation. Our nurses are trained to look out for side effects and react swiftly if anything concerning occurs.