Dual Therapy Boosts Stroke Recovery: Clot Removal Plus Medication Shows Promise

In a groundbreaking development for stroke treatment, new research presented at the American Stroke Association’s International Stroke Conference 2026 suggests that combining two therapies significantly improves recovery outcomes for patients suffering from large-artery ischemic (clot-caused) strokes. The CHOICE2 trial, conducted across 14 stroke centers in Spain and involving over 400 adults, found that administering the clot-busting medication alteplase directly into the affected brain artery immediately after mechanical thrombectomy—a minimally invasive procedure to physically remove the clot—led to dramatically better results. Patients who received this dual approach were 15 percentage points more likely to achieve excellent functional recovery at 90 days (57.5% vs. 42.5%), reported higher quality of life in mobility and self-care, and showed a 22-percentage-point reduction in inadequate blood flow in the brain's smallest vessels, all without a significant increase in brain bleeds or mortality.

The study, led by Professor Ángel Chamorro of the University of Barcelona, addresses a critical gap in stroke care: even after successful thrombectomy to reopen blocked large arteries, more than half of survivors do not fully recover, often due to persistent blockages in the microcirculation that standard imaging can miss. This research builds on earlier findings from the CHOICE trial and aligns with similar studies like the ANGEL-TNK trial, which used tenecteplase, reinforcing the potential of adjunctive clot-dissolving therapies. While the results are practice-informing and highlight the importance of getting the right care quickly, the authors caution that broader adoption requires confirmation in additional studies and careful patient selection, as this approach is not a one-size-fits-all solution but may eventually reduce reliance on advanced imaging techniques.

Key players in this news include the American Stroke Association, which hosted the conference, and the research team from Spain, with the core message emphasizing that stroke treatment continues to evolve, offering hope for improved recovery and reduced disability. The products and services involved are the medical procedures thrombectomy and intra-arterial alteplase infusion, detailed in the context of the 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke. Hyperlinks such as those to the American Stroke Association’s International Stroke Conference 2026 and resources like the 2026 Acute Ischemic Stroke Guideline Resources underscore the collaborative effort in advancing brain health, with the study's limitations noted, including its focus on non-contrast CT scanning and its generalizability across diverse populations.