ICH is common in large-core stroke, particularly after MT, but is often asymptomatic and not independently linked to poor outcome. PH may reduce the benefit of MT, but overall, MT remains associated with improved functional outcomes. Distinguishing hemorrhage types is crucial in assessing posttreatment risk in this vulnerable population.

In response to these deficits, a hydrophilic polymer ... platelet adhesion, and supported endothelial progenitor cell adhesion and proliferation [127].

Surmodics emphasizes that hemocompatible coating selection requires strategic early-stage engagement rather than treating it as a final specification step. Companies must evaluate multiple pathways—heparin versus non-heparin formulations, dwell duration, and material sources—each with distinct clinical, regulatory, and manufacturing consequences. By assessing clinical profiles, device substrate properties, and regulatory requirements during feasibility phases, organizations can ensure coating choices are defensible in submissions and durable long-term. This structured approach during development fundamentally shapes validation possibilities and regulatory success, ultimately delivering optimal hemocompatibility outcomes.

Mechanical thrombectomy has emerged as a critical intervention for acute ischaemic stroke management. This research examines functional outcomes in patients who underwent mechanical thrombectomy beyond the traditional six-hour treatment window. The study evaluates whether extending the intervention timeframe yields clinically meaningful benefits for stroke patients presenting outside standard acute care protocols. By analyzing functional recovery metrics and patient outcomes in this extended timeframe, the research contributes valuable insights into the efficacy and safety profile of late mechanical thrombectomy. These findings have significant implications for clinical practice guidelines and patient management strategies in acute stroke care, potentially expanding treatment opportunities for individuals initially considered ineligible for intervention.

Even under extreme mechanical stress known to delay endothelial recovery, the CD31-coated stent preserved lumen geometry and flow comparable to a DES while achieving complete endothelial coverage without drug release. Higher minimum stent and mean lumen areas suggest maintained expansion and limited neointimal growth despite the absence of antiproliferative drug. These findings indicate that the CD31 coating preserves mechanical integrity and vascular compatibility even in a stringent injury model, warranting further evaluation under standard implantation (BAR ≈ 1.05) and high-bleeding-risk conditions. By promoting rapid vascular healing without an antiproliferative agent, this biomimetic approach may represent a path toward safer DAPT de-escalation in interventional cardiology.

In this paper, we have developed and computationally evaluated an AI-augmented Digital Twin framework designed to correlate the modeled degradation process with new bone formation. Based on a stochastic approach, it was demonstrated that the major risks associated with Mg-based alloy degradation, such as hydrogen emission and the cytotoxicity of Mg2+ ions at certain concentrations, could be theoretically managed within the modeled bounds. It was concluded that the Mg-Zn alloy exhibited favorable simulated behavior, with a computed protection efficiency of 92.97%, indicating a high probability of suppression of hydrogen gas evolution under the selected boundary assumptions. In addition, a synchronization index greater than 1, as within the model’s logic, indicates that bone regeneration replaces implant degradation.

This medical case report examines an unusually positioned aneurysm located at an extremely proximal posterior communicating artery, presenting a rare anatomical variant with significant clinical implications. The study documents the diagnostic findings, imaging characteristics, and clinical presentation of this atypical cerebral aneurysm location. Such proximal posterior communicating artery aneurysms represent a challenging subset of intracranial vascular pathology, requiring specialized diagnostic and therapeutic approaches. The research contributes valuable insights into the anatomical diversity of cerebral aneurysms and informs clinical decision-making regarding treatment planning and patient management strategies for this uncommon but clinically important vascular abnormality.

This Bayesian network meta-analysis of seven randomized controlled trials involving 2,131 patients examined adjunctive intra-arterial thrombolysis (IAT) strategies following successful endovascular thrombectomy for acute ischemic stroke caused by large-vessel occlusion. Results demonstrate that EVT combined with 0.225 mg/kg alteplase or 0.125 mg/kg tenecteplase significantly improved excellent functional outcomes compared to EVT alone. However, the lower dose of tenecteplase (0.0625 mg/kg) was associated with increased intracranial hemorrhage risk. While no significant differences emerged in functional independence, symptomatic hemorrhage, or mortality, surface under the cumulative ranking curve analysis revealed optimal safety and efficacy profiles varied by dosage regimen, providing clinicians with evidence-based guidance for selecting appropriate adjunctive thrombolytic strategies.

In the recent OPTION trial, IVT with TNK in the extended time window improved the rate of an excellent outcome for patients without large vessel occlusion who ...

Intracranial aneurysms, particularly wide-neck bifurcation lesions, present significant endovascular treatment challenges. Traditional coil embolization suffers from instability and high recurrence rates, while adjunctive techniques like balloon remodeling and stent-assisted coiling increase procedural complexity and require prolonged dual antiplatelet therapy, problematic in ruptured cases. Flow diversion, though effective for sidewall aneurysms, has limitations at bifurcation sites due to branch incorporation concerns and ongoing antiplatelet dependencies. Intrasaccular flow disruptors, exemplified by the Woven EndoBridge device, emerged to address these gaps by promoting aneurysm thrombosis while preserving parent vessel circulation without long-term antiplatelet requirements. Following FDA approval in 2018, the WEB-IT trial and subsequent prospective investigational device exemption trials established rigorous evidentiary standards through standardized endpoints and independent imaging review, advancing treatment options for this challenging patient population.

The surface of oxygenator membranes activate coagulation posing serious risks of thrombosis and stroke. These and many more examples have in common that the ...

Ischemic stroke represents a neurological emergency caused by focal brain infarction resulting from arterial thrombosis, embolization, or severe hypoperfusion. Defined clinically by rapid-onset neurological deficits accompanied by imaging or pathologic evidence of central nervous system infarction, ischemic stroke ranks as the second leading cause of global mortality and third for combined death and disability among non-communicable diseases. Risk factors closely align with atherosclerosis contributors, including advanced age, smoking, hypertension, hypercholesterolemia, and diabetes mellitus. Symptom presentation varies depending on affected vascular territory, including anterior circulation, posterior circulation, and lacunar infarcts, with clinical manifestations evolving over hours as the ischemic penumbra's fate determines outcome severity.

This research article examines the clinical application of intra-arterial recombinant human TNK tissue-type plasminogen activator, a thrombolytic agent designed to dissolve blood clots through direct arterial administration. The study investigates the efficacy and safety profile of this treatment approach, which represents an advance in interventional thrombotic therapy. Published as a medRxiv preprint in June 2026, the work contributes to the growing body of evidence regarding novel drug delivery mechanisms for acute vascular conditions. The research is available in the public domain, allowing broad access for medical professionals and researchers interested in thrombolytic treatment innovations and their clinical outcomes.

By limiting protein adsorption, these coatings reduce platelet adhesion, leukocyte recruitment, and downstream thrombo-inflammatory activation [30,31].

The high incidence of in-stent restenosis (ISR) associated with bare-metal stents (BMS) undermines the viability of endovascular treatment as a treatment option for patients with severe symptomatic intracranial atherosclerotic stenosis (ICAS). The study aimed to evaluate whether durable fluoropolymer drug-eluting stents (DES) reduce the incidence of ISR compared with BMS in the treatment of severe ICAS.

This study shows preliminary evidence that there is significant variation in reported preferences for endovascular aneurysm occlusion. Some of this variation occurs between specialty types, but overall, there is a wide range of preferences when considering difficult-to-treat aneurysms. The findings underscore the dynamic nature of the field, where interventionalists demonstrate a willingness to incorporate new technologies into their practice regardless of when they received their training. Moreover, the study highlights ongoing debates surrounding the management of ruptured aneurysms. Importantly, respondents showed preferences for endovascular treatment modalities for clinical situations not yet studied in the literature, highlighting several areas meriting further investigation. Further studies are needed to see true variations in trends in clinical practice.

Despite major advances in intravenous thrombolysis and endovascular thrombectomy, nearly half of patients with acute ischemic stroke fail to achieve functional recovery even after technically successful recanalization. The recanalization-reperfusion gap—the discordance between angiographic vessel opening and tissue-level perfusion recovery—has brought thromboinflammation, the pathological interplay of coagulation and innate immunity, to the forefront of stroke biology. Neutrophil extracellular traps, platelet-leukocyte aggregates, complement activation, and vessel wall inflammation render clots resistant to lysis, promote microvascular obstruction and the no-reflow phenomenon, and amplify ischemia-reperfusion injury.

Integrating human factors into post-market surveillance represents a critical evolution in medical device safety management. While premarket usability studies establish baseline performance, real-world use generates insights that traditional surveillance mechanisms often miss. Both EU MDR and FDA regulations increasingly emphasize continuous demonstration of device usability and safety throughout product lifecycles. By incorporating human factors methodology into post-market surveillance activities, manufacturers can identify user interaction issues, understand root causes of problems, and proactively address safety risks. This integration strengthens regulatory compliance, reduces costly recalls and corrective actions, and ultimately delivers safer, more user-friendly devices that better serve clinical needs in practice.  

The LATE-MT randomized controlled trial demonstrates that mechanical thrombectomy can improve 90-day functional outcomes in anterior-circulation large vessel occlusion stroke patients presenting 24 to 72 hours after symptom onset, compared to standard medical care. However, the procedure carries significant risks, including increased mortality rates and symptomatic intracranial hemorrhage. While thrombectomy's benefits within earlier time windows have been well established, extending treatment beyond 24 hours shows promise for patients with slower disease progression. Despite functional improvements, clinicians must carefully weigh the therapeutic advantages against elevated adverse event rates when considering late thrombectomy interventions. These findings from the prospective, multicenter trial were presented at the 2026 European Stroke Organisation Conference, providing critical evidence for decision-making in extended-window stroke treatment protocols.

Ischemic stroke remains a significant cause of mortality and disability worldwide, with conventional interventions constrained by limited therapeutic windows and blood-brain barrier penetration challenges. This comprehensive review examines nanotechnology's potential across four critical stroke management stages: prevention, neuroprotection, revascularization, and adjunctive therapy. The authors emphasize the value of staged nanomedicine interventions, from controlled drug delivery during prevention to extending acute treatment windows and enhancing therapeutic efficacy. By systematically addressing challenges at each management stage, nanotherapeutics offer promising solutions to overcome limitations of traditional thrombolysis and mechanical thrombectomy approaches, potentially improving patient outcomes and reducing long-term disability associated with ischemic stroke.