Actualización anual de la evidencia sobre accidentes cerebrovasculares de la ESO 2025
Diana Aguiar de Sousa1,2,3, Aristeidis H Katsanos4, Linxin Li5
1Stroke Center, Department of Neurosciences, ULS São José, Lisbon, Portugal.
European stroke journal
|February 18, 2026
Resumen
En 2025, la trombectomía endovascular no mostró beneficio para los accidentes cerebrovasculares por MeVO. La tenecteplasa mejoró los resultados para los accidentes cerebrovasculares por LVO y la reducción temprana de la presión arterial ayudó a la recuperación de la HIC. Se necesita más investigación para tipos específicos de accidentes cerebrovasculares y tratamientos.
Área de la Ciencia:
- Neurología
- Medicina Cardiovascular
- Medicina de Accidentes Cerebrovasculares
Sus antecedentes:
- La medicina de los accidentes cerebrovasculares está en rápida evolución con nueva evidencia.
- La European Stroke Organisation (ESO) proporciona actualizaciones para cerrar las brechas en las revisiones de las guías.
- Estas actualizaciones sintetizan los avances recientes para informar la atención de los accidentes cerebrovasculares.
Objetivo del estudio:
- Sintetizar la nueva evidencia publicada en 2025 en dominios clave de accidentes cerebrovasculares.
- Identificar avances en tratamiento agudo, prevención, rehabilitación, imagenología, sistemas de atención y resultados.
- Proporcionar una descripción general curada de los desarrollos recientes en el manejo de accidentes cerebrovasculares.
Principales métodos:
- Se buscaron las principales revistas de accidentes cerebrovasculares y medicina interna.
- Se revisaron los resúmenes de conferencias internacionales sobre accidentes cerebrovasculares.
- Se seleccionaron estudios basados en la calidad metodológica, la relevancia clínica y el impacto potencial.
Principales resultados:
- La trombectomía endovascular no mostró beneficio para los accidentes cerebrovasculares por enfermedad de Moyamoya (MeVO).
- La tenecteplasa antes de la trombectomía mejoró los resultados para los accidentes cerebrovasculares por oclusión de grandes vasos (LVO).
- La reducción intensiva temprana de la presión arterial en la hemorragia intracerebral (HIC) aguda mejoró la recuperación funcional.
- La terapia triple de pastillas y la iniciación temprana de DOAC redujeron los accidentes cerebrovasculares recurrentes.
- El inhibidor del Factor XIa asundexian redujo el riesgo de accidente cerebrovascular isquémico.
- Las unidades móviles de accidentes cerebrovasculares son rentables en sistemas de alto volumen.
- La estimulación y el entrenamiento cerebral muestran promesa para el deterioro cognitivo post-accidente cerebrovascular.
Conclusiones:
- No hay un papel rutinario para la TEV en MeVO.
- Se refuerza la tenecteplasa para la trombólisis de puente en LVO.
- Se fortalece la reducción intensiva temprana de la presión arterial para la HIC aguda.
- Se necesita más investigación sobre subgrupos de TEV, trombólisis intraarterial y vías de selección de imágenes.
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