Roxana Carare, MD, PhD, University of Southampton, Southampton, UK, discusses recent investigations into ways to improve waste clearance from the brain through manipulation of the intramural periarterial drainage (IPAD) system. One line of research involves using chaperones for efficient transport of amyloid beta along the IPAD pathways. Clusterin is thought to chaperone solubilized proteins along the transport system and thus, may aid in prevention or delay of symptoms of cerebral amyloid angiopathy and Alzheimer’s disease. Another approach targets the vascular smooth muscle cells, through agents that harness cholinergic or adrenergic innervation of cerebral arteries. This interview took place at European Stroke Organisation Conference 2022 in Lyon, France.