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2018 has been very exciting year for stroke. There have been a number of trials that have pushed the envelope with regards to thrombectomy, and many other exciting developments such as studies extending the TPA window in addition to investigating tenecteplase as an alternate to alteplase.

As the world was watching, in April 2018, the American Heart Association released the stroke guidelines for the United States. Subsequently several important portions of this guideline where removed temporarily which is an unprecedented event.

In the June addition of Neurology Today, Gina Shaw, interviews Dr. William Powers, who is the chair of the writing group, and discusses the challenges that the group has faced with regards to the withdrawal and the rewriting process. The correction published in April/May, states that based on feedback from the clinical stroke community the AHA guidelines had to be revised. In the interview with Dr. Powers, it seems that due to the summer break, the latest we can expect these guidelines to be resubmitted is in September 2018.

Of note the revisions are not going to be limited to just the sections that were withdrawn, but the entire document is going to be re-reviewed. It seems like the writing committee has its work cut out for them, and they are going to be very careful with this revision given the high steaks.

Myself and others in the stroke community look forward to the revised document in the meantime this article in Neurology Today provides a glimpse into the complex world of guideline writing and its implications.

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