Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! By
Diagnostic Value of Non-Invasive Large Vessel Occlusion Detection Methods: A Systematic Review and Meta-Analysis Publisher



Sb Jazayeri Seyed BEHNAM ; Mmm Nejad Mohammad Mehdi MEHRABI ; Sa Ghozy Sherief A ; N Hamouda NOHA ; B Ahmad BARIA ; Rd Kadirvel Ramanathan D ; Df Kallmes David F
Authors

Source: Interventional Neuroradiology Published:2025


Abstract

Background: Accurate and timely prehospital detection of large vessel occlusion (LVO) is critical for optimizing patient triage and initiating appropriate reperfusion therapies. Recent advances in portable stroke detection technologies, such as electroencephalography (EEG) and transcranial Doppler (TCD) ultrasound, offer potential solutions but their diagnostic performance remains unclear. Methods: We searched PubMed, Scopus, Embase, and Web of Science, following the PRISMA guidelines. Studies were included if they assessed the diagnostic performance of non-invasive prehospital LVO detection tools compared to CT or MR angiography. Risk of bias was assessed using the QUADAS-2 tool. Results: A total of 13 studies were included, examining various portable detection tools including EEG or neurophysiological monitoring, ultrasound-based techniques including TCD or TCCD, portable Openwater optical blood flow monitor and cranial accelerometry. The pooled diagnostic odds ratio (DOR) was 52.7 (95% CI: 28.3–97.8), indicating strong diagnostic performance, with significant heterogeneity among studies (I2 = 67.3%, P < 0.001). Subgroup analysis revealed that TCD-based methods had the highest DOR (120.4, 95% CI: 76.9–188.7), followed by other tools (26.8, 95% CI: 13.7–52.6), and EEG (18.2, 95% CI: 9.1–36.3). The pooled sensitivity was 87.4% (95% CI: 82.5–91.0) and specificity was 89.39% (95% CI: 83.0–93.5) across all methods. TCD-based methods showed the highest specificity (95.0%, 95% CI: 91.8–97.0). Conclusion: Non-invasive prehospital LVO detection tools show promising diagnostic performance, particularly TCD-based methods. Future studies should focus on validating these tools in larger, diverse populations to enhance prehospital stroke triage and improve patient outcomes. © 2025 Elsevier B.V., All rights reserved.
Related Docs
View other Related Docs
1. A Nomogram-Based Clinical Tool for Acute Ischemic Stroke Screening in Prehospital Setting, Current Journal of Neurology (2023)
2. The Rapid Arterial Occlusion Evaluation (Race) Scale Accuracy for Diagnosis of Acute Ischemic Stroke in Emergency Department – a Multicenter Study, BMC Emergency Medicine (2023)
3. Anterior Ischemic Stroke: Analysis of the Multivariable Ct-Based Models for Prediction of Clinical Outcome, Journal of Stroke and Cerebrovascular Diseases (2023)
Experts (# of related papers)
View all Related Experts
Alireza Baratloo (8)
Somayeh Karimi (7)
Other Related Docs
4. Outcomes of Mechanical Thrombectomy for Acute Ischemic Stroke Following Cardiac Interventions: A Systematic Review and Meta-Analysis, CardioVascular and Interventional Radiology (2025)
5. Safety and Efficacy of Intravenous Thrombolytic Therapy in the Extended Window up to 24 Hours: A Systematic Review and Meta-Analysis, Annals of Clinical and Translational Neurology (2024)
6. Full Head-To-Head Comparison of Ultrasonography and Ct Scan in Volumetric Quantification of Pleural Effusion: A Systematic Review and Meta-Analysis, Emergency Radiology (2024)
7. Diagnostic Accuracy of Two-Dimensional Coronary Angiographic-Derived Fractional Flow Reserve—Preliminary Results, Catheterization and Cardiovascular Interventions (2021)
8. The Value of Predictive Instruments in the Screening of Acute Stroke: An Umbrella Review on Previous Systematic Reviews, Frontiers in Emergency Medicine (2022)
9. Relative Cerebral Blood Flow As an Indirect Imaging Surrogate in Patients With Anterior Circulation Large Vessel Occlusion and Association of Baseline Characteristics With Poor Collateral Status, Journal of the American Heart Association (2024)
10. Two-Stage Clinical Model for Screening the Suspected Cases of Acute Ischemic Stroke in Need of Imaging in Emergency Department; a Cross-Sectional Study, Archives of Academic Emergency Medicine (2023)
11. Safety of Intravenous Thrombolysis Among Stroke Patients Taking New Oral Anticoagulants - Case Series and Systematic Review of Reported Cases, Journal of Stroke and Cerebrovascular Diseases (2015)
12. Accuracy of Prehospital Ambulance Stroke Test in Terms of Diagnosis of Patients With Acute Ischemic Stroke: A Multi-Center Study, Current Journal of Neurology (2020)
13. A Multicenter Diagnostic Accuracy Study on Prehospital Stroke Screening Scales, Archives of Iranian Medicine (2021)
14. New Insights on the Predictive Value of Hypoperfusion Intensity Ratio in Thrombectomy: An Updated Systematic Review and Meta-Analysis With Multiple Cut-Offs, Journal of NeuroInterventional Surgery (2025)
15. Dosimetric Comparison of Three Different Cardiac Ct Angiography Techniques in a Dual-Source Scanner Using Size-Specific Dose Estimation (Ssde), Radiation Physics and Chemistry (2025)
16. Comparison of Doppler Ultrasound and Digital Subtraction Angiography in Extracranial Stenosis, Annals of Medicine and Surgery (2022)
17. The Validity of Recognition of Stroke in the Emergency Room (Rosier) Scale in the Diagnosis of Iranian Patients With Acute Ischemic Stroke in the Emergency Department, Turkish Journal of Emergency Medicine (2021)
18. Direct Mechanical Thrombectomy Versus Prior Bridging Intravenous Thrombolysis in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis, Life (2023)
19. The Prehospital Ambulance Stroke Test Vs. the Cincinnati Prehospital Stroke Scale: A Diagnostic Accuracy Study, Australasian Journal of Paramedicine (2020)
20. Comparative Diagnostic Accuracy of Pre-Test Clinical Probability Scores for the Risk Stratification of Patients With Suspected Pulmonary Embolism: A Systematic Review and Bayesian Network Meta-Analysis, BMC Pulmonary Medicine (2025)