ESO annual stroke evidence update 2025 - PubMed

4 days ago

The ESO Annual Stroke Evidence Update 2025 provides a curated synthesis of recent advances in stroke care.
Three randomised trials found no benefit for endovascular thrombectomy (EVT) over best medical therapy in stroke due to medium vessel occlusion (MeVO).
Intravenous tenecteplase before thrombectomy improved functional independence at 90 days compared to thrombectomy alone in large vessel occlusion (LVO) stroke.
Intensive blood pressure lowering in acute intracerebral hemorrhage (ICH) was safe and improved functional recovery, especially when started within 3 hours.
Triple-pill combination therapy achieved blood pressure control and reduced recurrent stroke after ICH.
Early initiation of direct oral anticoagulants within 4 days reduced recurrent ischemic stroke in atrial fibrillation-associated stroke without increasing symptomatic ICH.
Asundexian, a novel factor XIa inhibitor, reduced ischemic stroke risk in non-cardioembolic stroke and high-risk TIA without increasing major bleeding.
Mobile stroke units were shown to be cost-effective in high-volume systems.
Promising therapeutic strategies for post-stroke cognitive impairment include brain stimulation, computerized cognitive training, and cardiorespiratory training.
Priority research questions include identifying subgroups benefiting from EVT in MeVO and defining the role of adjunct intra-arterial thrombolysis post-EVT.

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