Solvemed at ISC 2026: Quantitative Pupillometry for a New Era of Stroke Care

AI-Driven Pupillometry at ISC 2026

Solvemed was on the ground at the International Stroke Conference (ISC) 2026 in New Orleans, where the conference delivered some of the most consequential stroke science in recent memory. Held February 4–6 at the Ernest N. Morial Convention Center, ISC 2026 featured late-breaking trial results that drew standing ovations, a first-ever Brain Health Symposium that broadened the field's view of neurological care beyond the acute event, and expanded global collaboration with twice the number of joint international sessions compared to last year.

Our team spent the conference in conversation with neurologists, neurocritical care physicians, stroke coordinators, and nurse leaders who are navigating an inflection point in the field. What became clear across every interaction is that the stroke community is grappling with an expanding mandate. Clinicians are being asked to act faster, treat within wider time windows, monitor more precisely after intervention, and do all of it with tools that produce standardized, objective data. That mandate aligns directly with what the PuRe Pupillometer was built to do.

ISC 2026 in Context: Why This Year Matters

The conference arrived at a pivotal moment for the stroke community. Two weeks before the event, the American Heart Association published its 2026 Heart Disease and Stroke Statistics Update in Circulation, confirming that stroke has risen to the fourth leading cause of death in the United States. In 2023, stroke was the underlying cause of 162,639 deaths nationwide. One American dies of stroke roughly every three minutes. And while overall stroke mortality declined slightly from the prior year, the trend among younger adults moved in the opposite direction: the crude stroke death rate among adults aged 25–34 increased approximately 8% over the past decade.

Against that backdrop, ISC 2026 arrived with a program designed for broader reach and deeper engagement. The conference introduced 22 new abstract categories, five Digital Oral Poster Theaters for real-time discussion, an expanded Simulation Zone, and new Fireside Chat sessions that replaced formal lectures with direct expert dialogue. All sessions were organized into 15 distinct Communities, making it easier for clinicians to find programming tailored to their specialty.

The collective message from the conference floor was unmistakable. The field is moving toward earlier detection, wider treatment windows, and more rigorous post-intervention monitoring. Every one of those shifts raises the bar for bedside neurodiagnostic tools.

Late-Breaking Science That Reinforces the Need for Monitoring

Several late-breaking trials presented at ISC 2026 will shape clinical practice in the months ahead, and each one reinforces why objective neurological monitoring matters more than ever in stroke care.

The CHOICE2 trial, presented by Ángel Chamorro, MD, PhD, of the University of Barcelona, demonstrated that adjunctive intra-arterial alteplase following successful endovascular thrombectomy produced significantly better functional outcomes at 90 days. Among 440 patients with acute ischemic stroke and successful reperfusion, 57.5% of those who received adjunctive intra-arterial alteplase achieved excellent functional status at 90 days compared to 42.9% in the thrombectomy-alone group. That 15-point difference in functional outcomes will prompt stroke centers to re-examine post-thrombectomy protocols, and the clinicians we spoke with at ISC 2026 were quick to note that tracking neurological status after these interventions requires reliable, repeatable assessment tools.

The OCEANIC-STROKE trial drew the largest reaction of the conference. In a room that erupted in applause, Mike Sharma, MD, of McMaster University, reported that the Factor XIa inhibitor asundexian reduced recurrent ischemic stroke by 26% compared to placebo in over 12,000 patients across 37 countries. The cumulative incidence curves diverged early and continued to separate throughout the follow-up period, all without a significant increase in major bleeding. This opens a new frontier in secondary stroke prevention, one that will require sustained neuromonitoring of at-risk patients to detect early signs of recurrence.

Meanwhile, extended thrombolysis time window data from trials using CT perfusion to identify candidates beyond the traditional window generated substantial discussion. As Dr. Ava Liberman of Weill Cornell Medicine noted in her post-conference commentary, the field should feel more confident about the extended treatment window for thrombolysis in patients without large vessel occlusion. Broader treatment windows demand more precise assessments of evolving neurological status to guide clinical decisions in real time.

Where PuRe Pupillometry Fits

Each of these advances places greater weight on what happens at the bedside after the acute intervention. Post-thrombectomy monitoring. Secondary prevention surveillance. Extended-window treatment decisions. None of it works without tools that produce objective, repeatable, and clinically interpretable neurological data.

The PuRe Pupillometer addresses that need directly. By pairing high-resolution smartphone imaging with AI trained to evaluate the full dynamics of the Pupillary Light Reflex, the PuRe Pupillometer brings millisecond timing precision and submillimeter measurement accuracy to any clinical setting. The device eliminates inter-observer variability and transforms pupillary reactivity into structured data that care teams can track over time and use to detect early neurological changes.

In the conversations our team had at ISC 2026, a consistent theme emerged. Clinicians understand that pupil diameter alone provides limited diagnostic value. What matters is the dynamic response: constriction velocity, latency, dilation velocity, and the Neurological Pupil index. These parameters have been shown to correlate with intracranial pathology in ways that static measurements do not. Osman and colleagues demonstrated in 2019 that constriction velocity correlated with the degree of midline shift in acute stroke, while pupil diameter alone showed no such relationship. Giamarino et al. (2021) reinforced this by linking the Pupillary Light Reflex and anisocoria to midline shift at both the septum pellucidum and the pineal gland.

As Zanier et al. described in 2024, continuous neuromonitoring techniques, including pupillometry, contribute to more individualized management by identifying deviation from expected neurological trajectories before clinical deterioration becomes apparent. In a field that increasingly recognizes stroke outcomes as time-dependent and monitoring-dependent, this capability is no longer optional.

Brain Health, Equity, and the Broader ISC 2026 Agenda

ISC 2026 also expanded the conversation beyond the acute event. The inaugural Brain Health Symposium, a full-day pre-conference session, reflected the field's growing recognition that stroke and brain health are inseparable. Topics ranged from cognitive outcomes after intervention to vagus nerve stimulation for motor recovery and transcranial stimulation for post-stroke aphasia.

The CREST-2 substudy, which found no cognitive benefit from carotid revascularization compared to intensive medical management, added nuance to the secondary prevention discussion. It underscored a broader truth: neurological outcomes depend on careful, ongoing monitoring and management, not just the intervention itself.

Meanwhile, the HEADS-UP pre-conference symposium focused on Health Equity and Actionable Disparities in Stroke. Race and age-stratified data continue to reveal persistent disparities in stroke mortality and care access. Smartphone-based neurodiagnostic tools that integrate into existing workflows without requiring specialized hardware have a role to play in addressing those gaps, particularly in community hospitals and lower-resourced settings where dedicated pupillometry devices may not be available.

What Comes Next

The trajectory set by ISC 2026 is clear. Expanded treatment windows, new secondary prevention agents, and the growing role of AI in stroke triage all point toward a model of care that demands more from bedside assessment tools. The PuRe Pupillometer was designed for exactly this moment: to deliver precise, objective neurodiagnostic data where clinicians need it most, without adding complexity to workflows already under pressure.

We left New Orleans more convinced than ever that quantitative pupillometry is becoming essential infrastructure for modern stroke care, and that the clinical community is ready for it.

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