Linking To And Excerpting From “2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association” With Links To Three Video Summaries From EM Note

Posted on January 30, 2026 by Tom Wade MD

In addition to today’s resource, please review EM Note‘s excellent summaries of the 2026 Guideline.

Today, I review, link to, and excerpt from “2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association“. [PubMed Abstract] [Full-Text HTML] [Full-Text PDF]. Stroke. 2026 Jan 26. doi: 10.1161/STR.0000000000000513. Online ahead of print.

All that follows is from the above resource.

Abstract

Aim: The “2026 Guideline for the Early Management of Patients With AIS” replaces the “2018 Guidelines for the Early Management of Patients With AIS” and the 2019 update to reflect recent advances in evidence. This updated guideline is intended to provide a comprehensive, up-to-date, evidence-based set of recommendations, advising management from prehospital evaluation through acute treatment and early in-hospital management of complications and initiation of early secondary prevention measures. The intended audience includes prehospital care professionals, physicians, allied health professionals, and hospital administrators.

Methods: A search for literature derived from research principally involving human subjects, published in English since the last AIS guideline in 2018 and the 2019 update, and indexed in MEDLINE, PubMed, Cochrane Library, and other selected databases relevant to this guideline, was conducted between September and December 2024. Additional high impact studies and articles published through March 2025 were added later, where appropriate.

Structure: This guideline represents the most current and comprehensive evidence available in AIS care. Key updates include the incorporation of new evidence related to thrombolytic choice and eligibility, determination of eligibility for endovascular thrombectomy, and management of hyperglycemia and dysphagia; a focused consideration of the pediatric population; and modification of the approach to thrombolysis contraindications. Although this guideline reflects significant advances, it also highlights gaps in knowledge and underscores the urgent need for continued research to further refine and improve treatment strategies.

Keywords: AHA Scientific Statements; endovascular procedures; guideline; ischemic stroke; stroke; thrombolytic therapy.

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