Rural patients with acute ischemic stroke face a critical challenge: limited access to stroke-ready hospitals. The logistics of alteplase administration, which require a continuous infusion and close monitoring, have historically restricted its use in community hospitals.1 This has left many patients without timely thrombolytic therapy.
Tenecteplase presents a practical solution to this problem. Its single bolus administration simplifies stroke treatment in resource-limited settings, allowing rural emergency departments to deliver thrombolysis without requiring intensive post-infusion monitoring.2This streamlined approach can significantly reduce the time-to-treatment gap, a crucial factor in improving functional outcomes.
Studies have shown that TNK is non-inferior to alteplase in efficacy, with potential benefits in clot dissolution and early recanalization.3,4 The ongoing TIMELESS trial is further investigating its role in an extended time window, which could expand eligibility for thrombolytic therapy in rural populations.5 Additionally, integrating TNK into telestroke programs can empower rural clinicians to administer thrombolysis with remote neurologist support, mitigating disparities in care.
By removing logistical barriers associated with alteplase, TNK has the potential to revolutionize stroke care in rural settings.1 Expanding its implementation in non-thrombectomy-capable hospitals, coupled with increased funding for telemedicine initiatives, represents a crucial step in addressing stroke care inequities and improving outcomes for underserved populations.
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