What is the treatment window for administering Tenecteplase (TNK) in ischemic stroke?

What is the treatment window for administering Tenecteplase (TNK) in ischemic stroke?

• A. Up to 3 hours from Last Known Well
• B. Up to 4 ½ hours from Last Known Well
• C. Up to 6 hours from Last Known Well
• D. Up to 12 hours from Last Known Well

Answer: (B)

Ischemic stroke treatment with a thrombolytic is time-sensitive—the sooner, the better. Tenecteplase is given within a 4.5-hour window from the Last Known Well time. Giving it within this period maximizes the chance of dissolving the clot and improving functional outcomes while keeping the risk of hemorrhagic transformation lower. Beyond 4.5 hours, the evidence does not support benefit and the risk rises, so TNK is not routinely used. (For context, in selected cases, mechanical thrombectomy may be considered up to later times, but thrombolysis with TNK itself is not used past 4.5 hours.)

Ischemic stroke treatment with a thrombolytic is time-sensitive—the sooner, the better. Tenecteplase is given within a 4.5-hour window from the Last Known Well time. Giving it within this period maximizes the chance of dissolving the clot and improving functional outcomes while keeping the risk of hemorrhagic transformation lower. Beyond 4.5 hours, the evidence does not support benefit and the risk rises, so TNK is not routinely used. (For context, in selected cases, mechanical thrombectomy may be considered up to later times, but thrombolysis with TNK itself is not used past 4.5 hours.)