How to approach reversal of TNK in hemorrhagic conversion of ischemic stroke?

Considering the short half-life, at what point would it be deemed too late to administer any reversal agent, and to consider withholding it?

Answer from: at Academic Institution

There is no specific "reversal agent" for tenecteplase. Once administered, the thrombolytic effect will persist until the drug is fully metabolized and any residual plasmin has been cleared by alpha-2-antiplasmin. So, perhaps the first question is what can you do if there is an acute bleeding event ...

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at University of Minnesota
Intracranial bleeding is the feared complication a...

Answer from: at Community Practice

To summarize (in addition to such a thorough answer above) we follow the same reversal protocol for TNK that is outlined in the AHA/ASA acute ischemic stroke guidelines (most recent 2018, rev 2019) for tPA. The mechanism of action of both are similar. TNK has a longer half-life and greater fibrin sp...

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at University of Minnesota
Agree.

at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
As Dr. @Hill has mentioned, fibrinogen level remai...

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How to approach reversal of TNK in hemorrhagic conversion of ischemic stroke?

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