Guideline Evolution: Are We Ready for Living Stroke Guidelines in the U.S.?

The American Heart Association has recently published the 2026 Guideline for the Early Management of Patients with Acute Ischemic Stroke which updates the 2018/2019 Guidelines. Stroke management over the previous 5-10 years has been dynamic and stroke clinicians depend on evidence based practice incorporated into guidelines. In contrast to static guidelines updated at regular intervals, the Australian/New Zealand Clinic Guidelines for Stroke Management are living guidelines and updated continuously as evidence emerges to reduce the translational gap between research and guideline development. This presents a provocative alternative to static guidelines. Whether the United States is ready to consider the transition to living guidelines remains to be debated and resolved.