Every year in the United States, >600,000 individuals have a first ischemic stroke and approximately 200,000 more have a recurrent stroke. More than 9 million Americans age 20 years and older self-report having had a stroke, with an overall prevalence estimated at 3.3%.
The prevalence of stroke in the United States continues to increase with the aging population. It is estimated that by 2030 an additional 3.4 million US adults (3.9% of the adult population) will have had a stroke, representing an increase of >20% from 2012.
This guideline updates the 2018 Acute Ischemic Stroke Guideline and its 2019 update. Key changes include endorsement of mobile stroke units, refined EMS triage, expanded use of tenecteplase within 4.5 hours, broader eligibility for endovascular thrombectomy, and the first recommendations for pediatric acute ischemic stroke.
Figure 1. Journey of a patient with AIS. The phases of care and key management steps and treatments are highlighted to ensure the most optimal functional outcome. AIS indicates acute ischemic stroke; EMS, emergency medical services; EVT, endovascular thrombectomy; MSU, mobile stroke unit; and TNK, tenecteplase.
2026 Acute Ischemic Stroke Guideline Series: New Guidance for Healthcare Professionals
In a new four-part video series, authors of the 2026 American Heart Association Acute Ischemic Stroke Guideline review major updates with direct relevance to frontline clinicians and stroke systems of care. Each video is tailored to a specific professional audience—emergency medicine, neurointervention and imaging, nursing and stroke coordination, and pediatric stroke—providing clear takeaways to support guideline implementation in real-world practice.
