Thrombectomy
Oedema reduction mediates thrombectomy benefit in large core stroke: secondary analysis of the TENSION trial
A selected CT-based secondary analysis of TENSION links EVT with less 24-hour net water uptake and estimates an oedema-mediated pathway to 90-day outcome, but the mediation is hypothesis-generating.
Transauricular Vagus Nerve Stimulation in Acute Ischaemic Stroke Requiring Mechanical Thrombectomy: Sham-Controlled, Randomised Device Trial — a neutral primary endpoint
In a 36-person sham-controlled thrombectomy pilot, auricular vagus stimulation was feasible and showed no serious device-related harm, but did not reduce 24-hour systolic blood-pressure variability.
Defining the Therapeutic Ceiling of Endovascular Thrombectomy in Large-Core Stroke — Beyond the Limits of ASPECTS
Quantitative infarct volumetry — not NCCT-ASPECTS — sets the true ceiling for endovascular thrombectomy in large-core stroke: benefit holds up to a DWI core of roughly 110 mL, then collapses.
Tenecteplase in Large-Vessel Occlusion — Bridging, Extended-Window, and the 4.5-Hour Wall
Meta-analysis of five RCTs (n=2,054) finds IV tenecteplase improves mRS outcomes in LVO versus no thrombolysis; bridging within 4.5 h before EVT and extended-window use without EVT show benefit, but bridging 4.5–24 h does not.
Effect of Proximal Blood Flow Arrest During Endovascular Thrombectomy (ProFATE): A Multicenter, Blinded-End Point, Randomized Clinical Trial
ProFATE: temporary proximal blood flow arrest via balloon guide catheter during anterior-circulation thrombectomy did not significantly improve eTICI 2c/3 (74.4% vs 70.8%; aOR 1.07, P=0.88) but reduced distal embolization (1.5% vs 12.3%) and tripled first-pass complete recanalization (33% vs 15.3%) in 131 patients across four UK centers.
Intra-Arterial Tenecteplase After Successful Reperfusion in Large Vessel Occlusion Stroke
DATE: adjunctive intra-arterial tenecteplase at 0.0313 or 0.0625 mg/kg after successful reperfusion is safe to advance to a phase 3 trial, with a numerically higher but non-significant 90-day no-disability rate (43.5% vs 33.8% control).