Review articles and clinical analyses in Stroke
Four randomized trials appeared to close the door on distal vessel thrombectomy — but their negative results reflected patient selection failures, not biological limits. ORIENTAL MEVO and DISTALS demonstrate what…
For decades, the 4.5-hour window defined who could receive IV thrombolysis. Now, imaging-guided selection is extending that window to 24 hours — transforming acute stroke care by replacing the wall…
GLP-1 receptor agonists are widely recognized as excellent drugs for diabetic patients with cardiovascular risk factors. But when it comes to stroke prevention specifically, there are two schools of thought.…
Two NEJM trials published weeks apart in March 2026 gave opposite answers to the same question: when does left atrial appendage closure genuinely rival lifelong anticoagulation? CHAMPION-AF said yes for…
A device that promises to restore swallowing in 30 minutes over 3 days sounds extraordinary — but the largest randomized trial was negative, the positive trial was stopped early with…
After decades of stagnation in non-cardioembolic stroke prevention, we finally have a new antithrombotic class that works. OCEANIC-STROKE showed that asundexian reduced recurrent stroke by 26% with no increase in…
Meta-analyses show a 16% stroke reduction. The 2024 AHA/ASA guidelines give GLP-1 RAs a Class I recommendation for stroke prevention. But in most individual trials, the stroke component wasn't significant.…
For two decades, we've watched LDL targets in secondary stroke prevention steadily decline. What started as a cardiologist's target of <100 mg/dL has moved to <70, and now <55 for…
Two decades of research have progressively extended the thrombolysis window from 3 to 4.5 to potentially 24 hours. But the path hasn't been linear—early trials targeting large vessel occlusions showed…
