The American Heart Association's (AHA) 2026 International Stroke Conference (ISC) recently wrapped up in New Orleans, Louisiana. From February 4 through February 6, the three-day conference was the annual gathering of the global stroke community. Attendees met up for networking, hundreds of research presentations, and educational sessions that featured the latest in brain health.

Today, we’re looking at a curated selection of abstracts presented at the conference. Some descriptions and conclusions were edited for brevity and clarity. For a complete look at the abstracts presented during the conference, visit the 2026 abstracts archive on the AHA’s website.

2026 International Stroke Conference Abstracts

Safety and Efficacy of Intra-Arterial Thrombolysis After Endovascular Thrombectomy for Large-Vessel Occlusion: A Dose-Wise Network Meta-Analysis of Randomized Trials

  • Description: The benefit of adjunct intra-arterial (IA) thrombolysis post endovascular thrombectomy (EVT) for acute ischemic stroke remains unclear. [The researchers aimed] to compare the efficacy and safety of IA thrombolytic agents used in post-EVT, with particular attention to dose variation.
  • Conclusion: Adjunctive IA Alteplase and Tenecteplase after EVT improved functional recovery with no increase in intracerebral hemorrhage or mortality, and higher dose Tenecteplase appeared to yield a superior outcome compared to lower dose, underscoring the need for larger trials to refine optimal regimens.

Acute Myocardial Infarction-Related Mortality Trends in Stroke Patients in the U.S. from 1999-2023: Insights from CDC WONDER

  • Description: In this study, [researchers analyzed] long-term national trends in acute myocardial infarction-related mortality among stroke patients in the U.S. aged ≥ 25 years from 1999 to 2023.
  • Conclusion: The age-adjusted mortality rates have decreased significantly, possibly due to better prevention of risk factors, increased acute care and improvements in public health policy. An increased sharp rise in the total number of deaths after 2020 highlights the continuous burden and the necessity for focused prevention and reestablishment of care post-pandemic. Higher rates in older adults, men, non-Hispanic Black Americans, and those in southern, metropolitan areas reflect ongoing health disparities and systemic inequities.

Complex Aortic Plaque on Computed Tomography Angiography in Embolic Stroke of Undetermined Source: Association with Multiple Strokes

  • Description: Complex aortic plaque (CAP), an underrecognized source of embolic stroke, lacks standardized CT criteria. [Researchers] evaluated the prevalence of CAP on routine CTA at different thresholds of maximal plaque thickness and additionally capturing low attenuation plaque and ulceration in patients with embolic stroke of undetermined source (ESUS). [Researchers] assessed the association between CAP and history of prior strokes before the index ESUS.
  • Conclusion: CTA-detected CAP was present in 6-16% of embolic stroke of undetermined source patients. Plaque ≥4 mm and broader high-risk definition (≥4 mm, ≤80 HU, or ulceration) was significantly associated with multiple strokes. Aortic arch assessment on routine neck CTA may enhance detection of potential aortic embolic sources.

Early vs. Later Anticoagulation for Acute Ischemic Stroke in Patients with Atrial Fibrillation: A Systematic Review and Meta-Analysis

  • Description: The optimal timing for initiating oral anticoagulation in patients with atrial fibrillation after acute ischemic stroke remains uncertain. This systematic review and meta-analysis aims to compare early versus later initiation of oral anticoagulants in this patient population.
  • Conclusion: Early initiation of anticoagulants appears to be comparable to later initiation in terms of stroke recurrence, bleeding risks, and mortality in patients with atrial fibrillation. These findings support a more individualized approach to anticoagulation timing, balancing ischemic and hemorrhagic risks based on patient characteristics. Further high-quality trials are needed to refine clinical guidelines and optimize anticoagulation strategies in this population.

Impact of Time on Thrombectomy Utilization in Patients with Acute Stroke Due to Large Vessel Occlusion

Description: Randomized controlled trials have established the benefit of thrombectomy within 24 hours of time last known normal. Studies supporting the role of thrombectomy in the 6- to 24-hour window selected patients based on favorable penumbral imaging, and it is unclear how thrombectomy eligibility and utilization change over time. [The researchers] aimed to characterize changes in thrombectomy utilization within the 24-hour time window.

Conclusion: Thrombectomy utilization declines linearly over the 24-hour window, which may reflect a corresponding reduction in salvageable penumbra. All efforts should be made to identify and assess stroke patients as quickly as possible to increase the likelihood of receiving treatment.

Vascular Calcification Burden and Outcome of Endovascular Therapy in Acute Ischemic Stroke

  • Description: Vascular calcification has been linked to poor outcomes in ischemic stroke, but most prior studies have focused on intracranial arteries alone. The prognostic impact of combined calcification burden across multiple vessel beds in patients undergoing endovascular therapy (EVT) remains unclear.
  • Conclusion: High calcification burden in the cervical internal carotid artery and aortic arch is associated with worse unadjusted functional outcomes after EVT, but National Institute of Health stroke scale and modified Rankin Scale remain independent factors. Higher cervical internal carotid artery calcification is associated with longer procedural time but does not affect the outcome.

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