The past year in stroke: thrombolysis, thrombectomy, neuroprotection, secondary prevention and recovery, each summarised in the MedShorts 360 format with its date and source.
NeurologyIV loberamisal within 48 hours of ischaemic stroke led to excellent outcomes in 69.7% vs 56.3% with placebo.
NeurologyIn 2,850 matched patients, GLP-1 RA use was associated with less dementia (3.4% vs 7.0%) and lower mortality over five years.
NeurologyPooling three RCTs with 14,239 patients, adding a FXIa inhibitor to antiplatelets reduced any stroke (RR 0.75) and cardiovascular events.
NeurologyThe French trial stopped for futility: good outcomes were 62% with thrombectomy vs 68% with medical care alone.
NeurologyIn 1,803 Korean patients with CHA2DS2-VASc 1 (men) or 2 (women), anticoagulation cut the primary endpoint to 0.5% from 1.5% over 2 years.
NeurologyIn 14,118 matched pairs, tirzepatide was associated with a 2.1-point lower stroke risk at one year than established GLP-1 RAs.
NeurologyAmong 209,180 first-time stroke patients, prior GLP-1 RA use was associated with lower NIHSS, fewer severe strokes and lower mortality.
NeurologyIn 1,380 patients with anterior large-vessel occlusion, tirofiban after reperfusion raised independence at 90 days to 49% from 43%.
NeurologyAdding IV tirofiban after an inadequate response to tenecteplase raised excellent outcomes to 63.8% from 52.2%, with very little bleeding.
NeurologyAdjunctive intra-arterial alteplase raised excellent outcomes to 57.5% from 42.5%, but 90-day mortality was higher.
NeurologyFor proximal MCA occlusion 4.5–24 hours after onset at thrombectomy-capable centres, bridging tenecteplase did not improve independence.
NeurologyEarly dual antiplatelet therapy after IV thrombolysis for moderate stroke raised excellent outcomes to 68.7% from 62.0% without a clear rise in bleeding.
NeurologyIn 154 patients, TXA within 24 hours lowered 180-day mortality to 25.6% from 38.2% and reduced the need for surgery.
NeurologyIn 1,670 patients after intracerebral haemorrhage, the triple pill lowered recurrent stroke to 4.6% from 7.4%.
NeurologyIn 12,327 patients after noncardioembolic stroke or high-risk TIA, the factor XIa inhibitor added to antiplatelets lowered ischaemic stroke to 6.2% from 8.4%.
NeurologyIn 566 patients selected by perfusion imaging, late tenecteplase raised excellent recovery to 43.6% from 34.2%, with a 2.8% risk of symptomatic bleeding.
NeurologyAcross 77 hospitals and 21,603 patients, an AI-assisted clinical decision support system improved care quality and lowered vascular events at 12 months.
NeurologyRobotic exoskeleton training gave a 22-point greater gain in Fugl-Meyer arm score, with 68% vs 32% reaching meaningful improvement.
NeurologyNine RCTs with 3,124 patients show TXA reduces haematoma volume but not mortality or disability after ICH.
NeurologyPooled data from six trials with 3,740 patients show PFO closure prevents more strokes than the extra AF it causes in ‘probable’ and ‘possible’ PASCAL groups.
NeurologyIn 1,724 patients, minocycline raised excellent recovery to 52.6% from 47.4% at 90 days, with no safety concerns.
NeurologyAmong 1,360 thrombectomy patients, functional independence was 55.0% with the neuroprotectant vs 49.6% with placebo (P=0.05).
NeurologyIn 636 patients with type 2 diabetes and minor stroke or high-risk TIA, liraglutide lowered 90-day stroke recurrence to 7.9% from 13.8%.
NeurologyAcross 5,459 patients, switching to another antithrombotic after a stroke on aspirin did not significantly cut recurrence (RR 0.88).
NeurologyA review of 35 studies found strong preclinical neuroprotection but no clear clinical benefit yet in people without diabetes.