International Stroke Conference 2026: Miller School of Medicine Neurologists Highlight New Stroke Guidelines and Data-Driven Innovations
Summary
- Neurologists from the University of Miami Miller School of Medicine contributed high-impact presentations and a broad slate of abstracts spanning acute treatment, imaging-informed outcomes, systems of care and community stroke recognition at this year’s International Stroke Conference.
- Dr. Jose Romano led sessions on major scientific statements published in the last year and how guidelines are commissioned and completed.
- A central theme across the Miller School presentations was how the Florida Stroke Registry translates data and guidelines into measurable improvements in care.
Neurologists and neuroscientists at the University of Miami Miller School of Medicine contributed meaningfully at this year’s International Stroke Conference through national leadership roles, high-impact presentations and a broad slate of abstracts spanning acute treatment, imaging-informed outcomes, systems of care and community stroke recognition.
The three-day conference in New Orleans, hosted by the American Heart Association/American Stroke Association (AHA/ASA), brought together thousands of stroke clinicians and researchers from around the world to share findings, debate evolving clinical questions and review new practice guidance. This year’s meeting placed particular emphasis on how rapidly evolving evidence, reflected in newly updated acute ischemic stroke guidelines and scientific statements, can be translated into real-world care.
Guidelines and Best Practices
Jose Romano, M.D., professor and chair of the Department of Neurology at the Miller School and executive director of the Florida Stroke Registry, played a key role in sessions that highlighted new scientific statements and the development of stroke guidelines.
As the immediate past chair of the AHA/ASA’s Scientific Statement Oversight Committee, Dr. Romano helped lead sessions on the major scientific statements published in the last year and how guidelines are commissioned and completed.
“The impact of these two sessions is that we disseminate to the professional community the best clinical practice guidelines and opinions published in the last year, used by not only all practitioners in the U.S. but internationally to provide acute stroke care,” Dr. Romano said. “Stroke is the second leading cause of death in adults worldwide, and the most important cause of permanent disability, so providing acute treatment is of paramount importance to preserve brain health and improve outcomes, making sure patients can reintegrate with their community, family and work.”
Florida Stroke Registry Takes Center Stage
A central theme across the Miller School presentations was how the Florida Stroke Registry, started by the University of Miami and later incorporated into Florida statute and under the auspices of the Florida Department of Health, translates data and guidelines into measurable improvements in care. The registry has grown to aggregate data from 192 hospitals across the state, as well as EMS agencies and other administrative data sets from the Florida Agency for Health Care Administration, to benchmark performance at hospital and regional levels and drive quality improvement.
Over roughly the last dozen years, Florida has cut the time from hospital arrival to treatment by about half, Dr. Romano said. This progress is meaningful because with stroke, every minute of delay in care can translate into additional brain injury.
This year, the Florida Stroke Registry team presented multiple abstracts that reflect an expansion beyond in-hospital metrics. By linking data sources, the registry can evaluate stroke care before arrival to the hospital, in-hospital treatment timelines and what happens after discharge. The data can identify delays in care, gaps in education or unequal access to therapies.
“We’re excited to share with the rest of the world that the statewide effort coordinated by us here at the University of Miami and in partnership with the state’s Department of Health is critically important to improve the quality of stroke care and improve the outcomes of certain patients,” Dr. Romano said. “By demonstrating our best practices and our findings, it provides not only a greater exposure to the efforts that the State of Florida and the University of Miami are doing in stroke but also demonstrating how a multi-stakeholder partnership has coalesced to work together and improve lives and affect policy.
Linking Registry Data with Imaging
Negar Asdaghi, M.D., associate professor in the Stroke Division at the Miller School and director of the research and outcomes core for the Florida Stroke Registry, presented work focused on linking Florida Stroke Registry data with an external imaging-derived dataset to add imaging details that are often missing from large registries.
The work outlines pitfalls, strengths and methodological steps involved in doing this kind of linkage at scale while preserving patient privacy.
“The very diagnosis of stroke is predicated on imaging, and imaging profiles have very strong predictive capabilities to determine outcomes,” Dr. Asdaghi said. “Linking anonymized registry data with imaging-derived datasets lets us ask questions we couldn’t answer before.”
Dr. Asdaghi emphasized that the platforms don’t perfectly overlap. Not every patient who undergoes advanced imaging had a stroke, and not every stroke patient appears in both datasets. Ensuring accurate linkage while maintaining privacy was a major undertaking supported by the advanced computer resources and expertise at UM’s Frost Institute for Data Science and Computing.
The linkage is already enabling real-world analyses of timely clinical questions, including the expanding role of endovascular thrombectomy for patients with large ischemic core stroke. Miller School neurology resident Aaron Rodriguez Calienes, M.D., examined outcomes for endovascular thrombectomy in these patients.
“What’s reassuring is that, even though this is an observational study, we’re seeing very similar mortality benefits from this therapy in routine care to what was shown in clinical trials of thrombectomy for large core,” Dr. Asdaghi said. “That suggests the new evidence is being adopted and is working in real practice.”
Treatment for Mild Stroke With Vessel Occlusion
Dr. Asdaghi also gave an invited talk on ongoing controversies and current treatment in medium and distal vessel occlusions. Drawing on a Miller School-led international collaboration, she highlighted findings from the TRIMIS study, which included about 5,800 patients across 43 centers in 18 countries on four continents.
Findings from this type of collaboration can help guide decisions in complex cases, particularly when symptoms are mild and clinicians must weigh potential benefits against procedural risks.
Stroke Education Outreach Through Targeted Social Media
Carolina Marinovic Gutierrez, Ph.D., assistant research professor in the Stroke Division at the Miller School and associate director of the Florida Stroke Registry, leads the registry’s health literacy work. She presented on the impact of targeted social media outreach to deliver stroke symptom education to populations most at risk and those least likely to recognize symptoms or activate emergency medical services.
“A huge problem across the state and nationally is the community’s ability to recognize a stroke, resulting in delayed care and potentially terrible stroke outcomes,” Dr. Gutierrez said. “Many people, if they’re experiencing a stroke symptom, will just lay down, believing it will go away.”
By misinterpreting stroke symptoms like dizziness, vision changes and slurred speech as something that will pass, people delay care and miss the window for the most effective treatments. To address this gap, Dr. Gutierrez piloted story-based, animated ads aimed at non-Hispanic Black women, a population at higher risk of stroke in part due to disproportionate rates of hypertension. The campaign focused on Broward and Orange counties, selected because they had higher rates of stroke patients not arriving at the hospital by emergency medical services.
The messaging centered on BEFAST: Balance, Eyes, Face droop, Arm weakness, Speech changes and Time (call 911).
“We are using social media algorithms to identify the target population and make the message specific and attractive to that particular group, which is very unique,” Dr Gutierrez said.
Over three months, the program reached 207,000 non-Hispanic Black women. They viewed the ads an average of 13 to 17 times, repeated exposure designed to help the message stick. Dr. Gutierrez plans to expand beyond English to Spanish and Haitian Creole.
Post-Stroke Care, Readmissions and Comorbidities
Florida Stroke Registry abstracts from the Miller School also addressed practical questions across stroke care and outcomes, including predictors of 30-day readmission after stroke, sleep apnea and risk of in-hospital pneumonia and guideline-based antihypertensive prescribing after stroke. One oral presentation, delivered by Karlon Johnson, Ph.D., a postdoctoral research associate at the Miller School, examined whether adults living with acute stroke and diabetes receive sufficient discharge education on next steps.
“What we are finding is that education is not sufficient when stroke patients with diabetes leave the hospital. Solutions to improve this finding may include addressing language barriers, patient/caregiver worry and nervousness causing inability to capture the large amounts of information provided at discharge, or even a need for enhanced clinician education on discharge communications,” Dr. Gutierrez said. “This is a great example of the work we do at the Florida Stroke Registry, and how we transform valuable data we collect into actionable results.”
Tags: Department of Neurology, Dr. Carolina Gutierrez, Dr. Gillian Gordon Perue, Dr. Jose Romano, Dr. Negar Asdaghi, International Stroke Conference, neurology, stroke, stroke outcomes, stroke prevention, thrombectomy