ISC 2026 Data Showcase New Horizons for Stroke Prevention, Recovery

Trials on novel anticoagulants, neuroprotection, and thrombectomy optimization presented at the International Stroke Conference.

Published on Feb. 12, 2026

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The 2026 International Stroke Conference (ISC) in New Orleans featured potentially practice-shifting clinical trial results that could reshape approaches to acute stroke management and secondary prevention. Key highlights included the OCEANIC-STROKE trial evaluating the factor XIa inhibitor asundexian for recurrent stroke prevention, the CHOICE2 trial on adjunctive intra-arterial alteplase after thrombectomy, and the LAIS trial testing the neuroprotective agent loberamisal.

Why it matters

These findings represent major advancements in stroke care, offering new options for preventing recurrent strokes, optimizing recovery after mechanical thrombectomy, and potentially reviving neuroprotective strategies that have long struggled to demonstrate clinical benefit. If confirmed in further studies, these innovations could significantly improve outcomes for stroke patients.

The details

The OCEANIC-STROKE trial showed that the factor XIa inhibitor asundexian reduced the relative risk of recurrent ischemic stroke by 26% compared to standard antiplatelet therapy, without increasing major bleeding risk. The CHOICE2 trial found that adjunctive intra-arterial alteplase after successful thrombectomy improved functional outcomes at 90 days, potentially by treating residual distal vessel microthrombi. Meanwhile, the LAIS trial demonstrated that the neuroprotective agent loberamisal, when initiated within 48 hours, increased the proportion of patients achieving excellent functional recovery by 13 percentage points.

  • The 2026 International Stroke Conference (ISC) was held February 4-6 in New Orleans, Louisiana.
  • The OCEANIC-STROKE trial ( NCT05686070 ) results were presented at ISC 2026.
  • The CHOICE2 trial ( NCT05797792 ) data was presented at ISC 2026.
  • The LAIS trial ( NCT06517173 ) findings were presented at ISC 2026.

The players

Mike Sharma

The Michael G. DeGroote Chair in Stroke Prevention and professor of medicine at McMaster University in Ontario, Canada, who was the principal investigator of the OCEANIC-STROKE trial.

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What they’re saying

“Asundexian holds the potential to reduce the risk of a recurrent stroke over the long term without an increased safety risk. This is a major advance in our ability to prevent strokes in people at risk of stroke recurrence.”

— Mike Sharma, Principal OCEANIC-STROKE investigator (American Stroke Association)

What’s next

As factor XIa inhibition moves toward regulatory review, neuroprotection is reconsidered, and intervention strategies potentially expanding to smaller vessels, the stroke care landscape appears poised for continued evolution.

The takeaway

The 2026 International Stroke Conference highlighted promising new approaches to stroke prevention, acute management, and recovery that could significantly improve outcomes for stroke patients if confirmed in further research and clinical practice.