Eficácia do uso de Tenecteplase em pacientes com Acidente Vascular Cerebral Isquêmico

Abstract

Introduction: Stroke is a serious clinical condition that occurs due to the obstruction (ischemic stroke) or rupture (hemorrhagic stroke) of blood vessels in the brain, which can cause severe neurological deficits and even death. Ischemic stroke, which accounts for 80% of cases, is treated with thrombolytics, such as alteplase. However, tenecteplase, a genetically modified variant of alteplase, has been studied as an alternative because it presents advantages such as greater specificity to fibrin, longer half-life and lower risk of hemorrhage. Methodology: This research consists of a systematic review of the literature, with the objective of synthesizing the results of studies on a specific topic. The search was carried out in the PubMed and Virtual Health Library (VHL) databases, using descriptors such as "Cerebrovascular Accident", "Tissue Plasminogen Activator", "adverse effects", "efficacy" and their English translations. A total of 507 articles were found, 428 after duplicates were removed. Of these, 67 were assessed for eligibility, resulting in the selection of 14 articles for the final sample. Results: tenecteplase showed greater efficacy in early vessel recanalization, especially at a dose of 0.25 mg/kg, with a lower risk of hemorrhagic complications. Studies have also shown that tenecteplase has similar mortality rates and functional outcomes to alteplase, being a viable alternative, especially in specific contexts, such as large vessel occlusions and mechanical thrombectomy. Conclusions: tenecteplase has advantages in terms of recanalization and cost-effectiveness compared to alteplase, but further studies are needed to validate its use in different populations and clinical contexts.