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Red Deer was first hospital in Alberta to administer newly approved stroke medication

New clot-busting treatment available at rural primary stroke centres
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The clot-busting medication Tenecteplase was approved in Alberta as of Nov. 1 for strokes related to blood clots. (Contributed)

Red Deer Regional Hospital Centre was recently the first site in Alberta to administer a newly approved treatment to an acute stroke patient.

Alberta Health Services said that on Nov. 1, the health-care team at the emergency department administered an injection of Tenecteplase to a patient in his eighties who had suffered a stroke.

Tenecteplase is a clot-busting medication clinically approved as of Nov. 1 for strokes related to blood clots, called acute ischemic stroke.

Until now, the only proven clot-busting medication for these patients was Alteplase, an agent that works similarly but is more expensive and not as simple to administer.

Elaine Shand, stroke co-ordinator for Alberta Health Services Central Zone, said every minute counts for these patients and they can be treated very quickly with Tenecteplase.

“Time is brain. We’re losing 2 million neurons every minute that we don’t open up that circulation to the brain,” Shand said.

The quicker treatment also allows health care staff to assist the patient in other ways, as well as simplify the process to transfer patients to Calgary or Edmonton who require a specialized clot removal procedure, she said.

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AHS said investigators in Alberta, including at Red Deer hospital, led a major national clinical trial comparing Tenecteplase to Alteplase proving that Tenecteplase was just as good.

That study was published in the medical journal The Lancet (June 29, 2022).

AHS said Alberta is now transitioning over to Tenecteplase which can be delivered in one dose – as opposed to Alteplase, which requires an injection, followed by an hour-long infusion — making Tenecteplase simpler, faster and safer for healthcare teams and patients.

Members of Red Deer’s neurology team were instrumental in the home-grown, Alberta-led, University of Calgary landmark trial, testing the safety and efficacy of Tenecteplase, ultimately clearing the way for its use.

Dr. Oje Imoukhuede, AHS Central Zone chief of neurology, said about 85 per cent of strokes are related to blood clots, and besides being equally effective, Tenecteplase slightly lowers bleeding risk in the brain.

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Red Deer hospital is a Primary Stroke Centre whereby local stroke neurologists work with the emergency and radiology departments to assess and treat Red Deer and Central Zone stroke patients.

So far this year, about 45 Red Deer hospital patients were treated with clot-busting rapid drugs.

Shand said the decision was made provincially for the rural primary stroke centres to provide patients with Tenecteplase before other hospitals. Stock of Alteplase, which is close to $3,000 a dose, can’t be wasted and is being rerouted to hospitals in Calgary and Edmonton because they see more stroke patients and will use up the remaining stock much faster.

“We were looking forward to transitioning to the Tenecteplase as soon as possible. We were fortunate we were the first rural hospital an eligible patient presented to and were familiar with the treatment because we were involved in the trial.”

All sites in Alberta are expected to be transitioned to Tenecteplase by the New Year.



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