Abstract
PURPOSE OF REVIEW: Tenecteplase has been studied and recommended as an alternative thrombolytic agent in patients with acute stroke. A brief review of clinical trials and guidelines pertinent to our clinical decision algorithm is described. This is followed by operational steps that were made to create and implement a clinical pathway based on available evidence in which tenecteplase is used in select patients with stroke at our comprehensive stroke center. RECENT FINDINGS: A number of patients have been treated at our center with IV tenecteplase. A case is presented to illustrate the successful implementation of this new process. SUMMARY: Development of our protocol is discussed in detail to enable other centers to create their own clinical pathways for thrombolytic treatment of acute ischemic stroke using tenecteplase.