ABSTRACT NUMBER: ESOC2026A1187 EVALUATION OF TENECTEPLASE USE IN ACUTE ISCHAEMIC STROKE: A QUALITY AUDIT FROM A HYPERACUTE STROKE UNIT

Abstract Background and aims Tenecteplase is increasingly utilised for intravenous thrombolysis in acute ischaemic stroke (AIS), offering practical advantages over alteplase. Ensuring timely administration, safety compliance and robust documentation is essential for safe implementation. The audit aimed to evaluate local use of Tenecteplase against agreed standards. Methods We performed a retrospective observational audit of consecutive adult patients with AIS thrombolysed with intravenous Tenecteplase at a hyperacute stroke centre between 9 January and 9 May 2025. Data were extracted from routinely collected clinical records and stroke databases, including safety checklist completion, Tenecteplase administration and documentation, stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS),treatment timelines and complications. Descriptive statistics were used to summarise findings. Results Forty-nine patients received treatment with Tenecteplase within the study period. Safety checklist completion was documented in 82% of patients; 14.0% were incomplete or missing and 4% unavailable. Tenecteplase administration was fully documented in 62%, incomplete or undocumented in 34.0% and unavailable in 4%. Post-Tenecteplase monitoring was completed in 86%, missed in 8.0% and unavailable in 4%. Stroke severity with NIHSS <4 in 22.4%, 5–15 in 59.1% and >15 in 18.3%. Door-to-needle time ≤60 minutes was achieved in 63.8% of patients. All patients were scanned within 60 minutes, with 94.0% scanned within 20 minutes. Complications, including haemorrhage transformation occurred in 6.1%. Conclusions Although imaging and treatment timelines met international standards, gaps in documentation and safety checklist compliance were suboptimal. Embedding standardised Tenecteplase workflows and mandatory checklists within electronic patient records may improve safety, data completeness and quality ongoing assurance. Conflict of interest Nothing to disclose