🧠PEARL RCT co-authored by Raul G Nogueira, MD, FAHA, FSVIN: IA alteplase after thrombectomy → better recovery (mRS 0-1: 45% vs 30%) w/o ↑ bleeding. 🔗tinyurl.com/5hczvc4r ✅ Matches our pooled analysis on IAT post-EVT. 🔗 tinyurl.com/mususm69 Mohamed F Doheim, MD UPittStroke #NeuroTwitter

#WSC2025 #IAT_TOP 🌐 Multicenter RCT 🇨🇳n=246 💉 IA-tPA 0.225 mg/kg vs standard care after eTICI ≥ 2b50 in posterior AIS 🎯 mRS 0–2 at 90d: 🟡41.9% vs 46.7% (NS) ⚠️ sICH ≈ 2.5%, no excess risk ➡️ No functional benefit of adjunct IA-tPA after EVT in PC stroke Raul G Nogueira, MD, FAHA, FSVIN

Our Raul G Nogueira, MD, FAHA, FSVIN in Opening & Closing Plenaries! 🧠 1️⃣ #ANGEL_COAST: BAO<24h → ↑CA, ↑FPE, ↓complete recan, no clinical difference. 2️⃣ #IAT_TOP: mRS 0–2 @90d 41.9% vs 46.7% (NS) but safe. 3️⃣ HEMERA-1: #PP_007 shows promise vs matched UPittStroke Mohamed F Doheim, MD Pitt Neurology

🚨 New from the VERITAS collaboration: Bridging IVT→EVT in basilar artery occlusion is safe but shows no added benefit vs EVT alone which establish equipoise. Findings from pooled 4 RCTs support tailored decision-making in VBAO strokes. UPittStroke 🔗 link.springer.com/article/10.100…

Contact aspiration’s first-pass benefits seemingly “offset” by inferior final recanalisation versus stent retrievers in basilar occlusion stroke 🔗 neuronewsinternational.com/contact-aspira… Raul G Nogueira, MD, FAHA, FSVIN UPittStroke Pitt Neurology

Happy to share two new co-authored multicenter publications on tenecteplase vs alteplase in BAO patients undergoing EVT, with contributions from UPittStroke and NeuroPrecision Lab 🔗 onlinelibrary.wiley.com/doi/10.1002/an… 🔗 onlinelibrary.wiley.com/doi/10.1002/ac…

From “Does EVT work for DMVO?”❌ to "WHICH patients benefit most?" ✅, we used explainable counterfactual model to move beyond "one-size-fits-all".🧐 🔗 onlinelibrary.wiley.com/doi/10.1002/an… 🔗 dusktool.streamlit.app ANA Journals NeuroPrecision Lab UPittStroke Pitt Neurology Raul G Nogueira, MD, FAHA, FSVIN

Happy to present our DUSK tool to individualize treatment for distal medium vessel occlusion! Time to move beyond “one-size-fits-all”UPittStroke Pitt Neurology NeuroPrecision Lab

Pleased to present our work on multidimensional clot characterization and the need for real time assessment and dynamic evaluation for optimizing first line technique and procedural outcomes! UPittStroke Pitt Neurology NeuroPrecision Lab

A great win for our field with the presentation of ORIENTAL MeVO — the first trial on moderate to severe MeVO (median NIHSS=10). The study opens the door for future adaptive research. Presented by our own Raul G Nogueira, MD, FAHA, FSVIN at #ISC26. UPittStroke

“Hospitals treat efficiently once patients arrive, yet many patients lose critical hours before they reach them” Please read our editorial on ICH reversal and system of care fragmentation 🔗 ahajournals.org/doi/10.1161/JA… Thanks for the invitation عُمَرْ ألجَنْابِي Omar Al-Janabi MD, MS, PhD Mohammad AlMajali