NeurologyLive® Year in Review 2023: Top Stories in Stroke and Cerebrovascular Disease

In 2023, the NeurologyLive^® staff was a busy bunch, covering clinical news and data readouts from around the world across a number of key neurology subspecialty areas. From major study publications and FDA decisions to societal conference sessions and expert interviews, the team spent all year bringing the latest information to the website's front page.

Among our key focus areas is stroke and cerebrovascular disease, a field that has reported massive progress over the past several years, as well as in 2023. Although major news items often appear among the top pieces our team produces, sometimes smaller stories reach those heights for other reasons—clinical impact and interest, or concerns about the small- or big-picture parts of care, for example. Whatever the reason for the attention these stories got, their place here helps provide an understanding of the themes in this field over the course of 2023.

Here, we'll highlight some of the most-read content on NeurologyLive^® this year. Click the buttons to read further into these stories.

1. Significant Stroke Risk Disparities Reduced Following Intensive Medical Intervention

Published in Stroke, findings from a retrospective analysis showed that significant stroke risk disparities between Black and nonBlack stroke survivors were reduced after 1 year of intensive medical intervention. These findings suggest that that intensive risk factor management may have an important role in ameliorating disparities in these risk factors between Black and nonBlack patients.

2. Study Identifies Significant Link Between Hypertensive Disorders of Pregnancy and Stroke in Black Women

Findings from the Black Women’s Health study (BWHS), a prospective cohort of US Black women who enrolled in 1995, showed that a history of hypertensive disorders of pregnancy (HDOP) was associated with an estimated 66% increased long-term risk of stroke. Investigators concluded that this association may contribute to the disproportionately higher stroke incidence in Black women given the higher prevalence of HDOP in this population.

3. Thrombolytic Agent Recombinant Human Prourokinase Noninferior to Alteplase in Stroke Treatment

A published, randomized, open-label, phase 3 trial (NCT03541668) found that use of recombinant human prourokinase (rhPro-UK) within 4.5 hours of symptom onset in patients with acute ischemic stroke (AIS) was noninferior in terms of efficacy to traditionally used alteplase. The rhPro-UK group showed a similar rate of symptomatic intracranial hemorrhage (ICH) but fewer cases of systemic bleeding than the alteplase group.

4. CDC and FDA Announce Stroke Safety Concern Related to Pfizer-BioNTech Bivalent COVID-19 Vaccine

The FDA and Centers for Disease Control and Prevention (CDC) issued a joint statement claiming that the agencies were assessing data regarding Pfizer-BioNTech's COVID-19 vaccine bivalent increases the risk of ischemic stroke in elders.

5. FDA Clears First Stroke-Specific Radial Access Platform for Mechanical Thrombectomy

The FDA granted 510(k) clearance to Imperative Care’s Zoom RDL Access System, making it the first radial access platform developed specifically for treating patients with ischemic stroke. Additionally, the company also announced the successful completion of the first-in-human case using Zoom RDL.

6. 3-Year Follow-Up of STROKE-AF Demonstrates Stroke Risk Increase With Atrial Fibrillation

Findings from the STROKE-AF trial (NCT02700945) showed that after 3 years of observation, approximately 1 in 5 patients with ischemic stroke had atrial fibrillation (AF) observed by an insertable cardiac monitor (ICM), a 10-fold increase versus standard of care (SOC). These findings suggest undetected AF may increase risk for cardioembolic stroke for a patient population not considered normally for AF management.

7. Phase 3 Study of GTX-104 in Subarachnoid Hemorrhage Expected to Proceed Following FDA Feedback

After receiving a type C written meeting response and clarifying feedback from the FDA, Acasti Pharma planned to submit final clinical protocol that will ultimately allow it to move forward with a phase 3 clinical trial assessing its investigational agent GTX-104 in patients with subarachnoid hemorrhage (aSAH).

8. FDA Grants Breakthrough Device Designation to Reach Neuro’s Chronic Stroke Platform

The FDA granted breakthrough device designation for Reach Neuro’s Avantis, a platform that delivers small electrical impulses to the spinal cord to restore shoulder, arm, and hand movement to post chronic stoke patients.

9. FDA Grants Fast Track Designation for Atrial Fibrillation Therapy Asundexian

An observational study conducted by Eric E. Smith, MD, et al, and published in JAMA Neurology showed that the addition of alteplase to endovascular therapy improves in-hospital mortality and functional outcomes in patients with acute ischemic stroke; however, there was an increased association with symptomatic intracranial hemorrhage.

10. Imperative’s Complete Stroke Solution Expands With FDA-Cleared Large Distal Platform

The FDA granted 510(k) clearance to Imperative Care’s Zoom 88 Large Distal Platform (LDP) Support, a catheter-based approach to improving reperfusion in poststroke patients, further expanding the company’s complete stroke system.