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Ahmed Koriesh on The Novel Approach in Use of Tenecteplase
Ahmed Koriesh/LinkedIn
Oct 27, 2025, 05:47

Ahmed Koriesh on The Novel Approach in Use of Tenecteplase

Ahmed Koriesh, Director Hospital Neurology Service at Cleveland Clinic Florida, shared on LinkedIn:

”Beyond 24 Hours: Tenecteplase Pushes the Clock Further

Last month, we asked: “Are we there yet?”

Now — with the 2025 TNK 4.5–24h Meta-Analysis, the answer may be even closer.

1,278 patients from 4 RCTs (TNK 0.25 mg/kg vs standard care/placebo)
Imaging-based selection (DWI–FLAIR mismatch or CT/MR perfusion)

Results:

  • Excellent outcome (mRS 0–1 at 90 days): 35.1% vs 28.9% (OR 1.34, p = 0.02)
  • Recanalization: 46.6% vs 28.4% (OR 3.30, p = 0.001)
  • No increase in sICH or mortality
  • Greater benefit in patients without EVT access

Interpretation:
IV tenecteplase up to 24 hours after onset appears to be beneficial and safe when guided by advanced imaging.

Clinical Pearl:

  • From 3 → 4.5 → 9 → 24 hours — thrombolysis is no longer just about time, but about tissue.
  • The line continues to blur — and that’s a good thing for stroke patients.”

Ahmed Koriesh on The Novel Approach in Use of Tenecteplase

Stay updated with Hemostasis Today.

Ahmed Koriesh Cleveland Clinic Florida DWI–FLAIR mismatch Health Hematology Hemostasis Hemostasis Today Medicine stroke Tenecteplase thrombosis TNK
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