关键词: 急性缺血性卒中; 血管内治疗; 大血管闭塞; 前循环卒中; 后循环卒中; 儿童卒中

Abstract: Acute ischemic stroke (AIS) is a major global cause of death and disability, with reperfusion therapy being crucial for improving outcomes in the acute phase. In January 2026, the 2026 Guideline for the Early Management of Patients with Acute Ischemic Stroke: A Guideline from the American Heart Association/American Stroke Association was officially released, updating relevant recommendations. This article provides an interpretation focused on the endovascular therapy (EVT) section. Building on existing evidence for patients with proximal anterior circulation large vessel occlusion, the 2026 guideline further clarifies imaging eligibility criteria of EVT within the extended time window and delineates more explicit selection criteria of EVT for AIS patients with large ischemic cores and pre-stroke functional impairment. In addition, for posterior circulation stroke, particularly basilar artery occlusion, the 2026 guideline stratifies decision-making basis according to clinical severity and the extent of imaging-defined injury. Notably, the 2026 guideline systematically includes EVT recommendations in pediatric AIS for the first time, providing a reference framework for clinical decision-making in pediatric patients across different age groups and time windows.

Key words: Acute ischemic stroke; Endovascular therapy; Large vessel occlusion; Anterior circulation stroke; Posterior circulation stroke; Pediatric stroke