The 2026 AHA/ASA Guideline Updates to Management of Patients with Acute Ischemic Stroke: A Guide for Radiologists

The 2026 guideline for early management of acute ischemic stroke (AIS) retains many foundational recommendations while introducing clinically meaningful updates spanning imaging, broader inpatient management, and reperfusion strategies including intravenous thrombolysis (IVT) and endovascular therapy (EVT). Notably, it provides expanded guidance for medium vessel occlusions and introduces pediatric recommendations that were largely absent from prior iterations. Given their impact on imaging workflows in AIS, the authors present a focused review of the updated guidelines for the radiologist.