The 5-Year Horizon: Evolving Paradigms in Ischemic Stroke Management

In this forward-looking finale, the panel discusses the transformative shifts expected in stroke management over the next five years.

While the introduction of Factor XIa inhibitors like asundexian marks a milestone in prevention, the experts look beyond pharmacology to the systems and technologies that will define care in the near-term future. The discussion addresses the following guiding question:

Besides the potential introduction of factor XIa inhibitors into clinical practice, how do you envision ischemic stroke care changing over the next 5 years?

The expert Neurology Experts highlight the impact of the 2026 Acute Ischemic Stroke Guidelines, which have already begun expanding eligibility for mechanical thrombectomy and intravenous thrombolysis. The panel envisions a future where Mobile Stroke Units (MSUs) and AI-driven imaging analytics become the standard, significantly reducing "door-to-needle" times and expanding access for rural and pediatric populations. Additionally, the experts discuss the "comeback" of neuroprotection, with agents like loberamisal showing promise in phase 3 trials to preserve brain tissue during the hyperacute phase. From robotic-assisted surgical platforms to streamlined regional "hub-and-spoke" networks, the conversation outlines a vision of stroke care that is faster, more precise, and increasingly accessible.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

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