What are suitable topics for a narrative literature review on ischemic stroke?

From the Guidelines

A suitable topic for a narrative literature review on ischemic stroke is the evolving landscape of endovascular thrombectomy (EVT) for large vessel occlusion strokes, as it has seen significant advancements in recent years and offers rich material for review. This topic is particularly relevant given the updates in guidelines and recommendations for the management of acute ischemic stroke, as outlined in the 2018 guidelines for the early management of patients with acute ischemic stroke 1. The review could examine the expansion of treatment windows from the traditional 6-hour limit to 24 hours in selected patients based on perfusion imaging, as demonstrated in the DAWN and DEFUSE-3 trials.

Some key areas to explore in this review include:

• The technical evolution of thrombectomy devices from early generation retrievers to modern stent retrievers and aspiration systems, and how these have improved recanalization rates and patient outcomes
• Ongoing controversies such as whether to perform direct thrombectomy versus combined intravenous thrombolysis plus thrombectomy
• The role of advanced imaging in patient selection
• Emerging approaches for distal vessel occlusions

This area is particularly suitable because it encompasses clinical practice changes, technological innovation, patient selection criteria, and has demonstrated significant impact on reducing disability from stroke, making it both clinically relevant and academically rich for comprehensive narrative review, as supported by recent updates in nursing care for patients with acute ischemic stroke 1. The American Heart Association/American Stroke Association has also provided guidelines for the prevention of stroke in patients with stroke or transient ischemic attack, which could be explored in the context of EVT 1. However, the most recent and highest quality study on this topic is the 2018 guidelines for the early management of patients with acute ischemic stroke 1, which should be prioritized in the review.

From the Research

Suitable Topics for a Narrative Literature Review on Ischemic Stroke

Some potential topics for a narrative literature review on ischemic stroke include:

• The efficacy and safety of anticoagulant therapies in preventing recurrent ischemic strokes in patients with atrial fibrillation 2, 3, 4, 5
• The optimal timing of initiation of oral anticoagulation after acute ischemic stroke in patients with atrial fibrillation 4, 5
• The role of antiplatelet and anticoagulant therapies in secondary stroke prevention 3
• The pathophysiology of thrombogenesis that links atrial fibrillation and ischemic stroke 6
• The diagnosis and management of atrial fibrillation in stroke patients 6
• The use of imaging in stroke prevention and the evaluation of stroke mechanisms 3
• The identification of risk factors and mechanisms of stroke despite anticoagulation in patients with atrial fibrillation 2
• The development of strategies for secondary prevention of ischemic stroke in patients with atrial fibrillation, including the use of left atrial appendage occlusion plus anticoagulation 2

Key Areas of Focus

Key areas of focus for a narrative literature review on ischemic stroke may include:

• The current state of knowledge on the prevention and treatment of ischemic stroke in patients with atrial fibrillation
• The efficacy and safety of different anticoagulant and antiplatelet therapies in preventing recurrent ischemic strokes
• The optimal timing and choice of anticoagulation for secondary stroke prevention in patients with atrial fibrillation
• The role of imaging and other diagnostic tools in evaluating stroke mechanisms and guiding treatment decisions
• The development of personalized treatment strategies for patients with atrial fibrillation and ischemic stroke

Relevant Studies

Relevant studies that may be included in a narrative literature review on ischemic stroke include:

• Studies examining the efficacy and safety of anticoagulant and antiplatelet therapies in preventing recurrent ischemic strokes 2, 3, 4, 5
• Studies investigating the optimal timing and choice of anticoagulation for secondary stroke prevention in patients with atrial fibrillation 4, 5
• Studies exploring the pathophysiology of thrombogenesis that links atrial fibrillation and ischemic stroke 6
• Studies evaluating the diagnosis and management of atrial fibrillation in stroke patients 6