Table 2

Characteristics of studies reporting the incidence of LVO in patients presenting with acute ischemic stroke

Number of patients with AISJournalLOEPresentation time following onset of symptomsDefinition of LVONumber of patients with LVO (%)Diagnostic modalityNotes
Studies included in qualitative synthesis
Demeestere et al
381 Journal of Stroke and Cerebrovascular DiseasesIV<4.5 hoursICA, M1136 (35.7%)CTA only551 consecutive patients with suspected AIS, 381 (69.1%) of whom had a final diagnosis of AIS
Beumer et al
338 Neurovascular ImagingIV<6 hoursICA, A1, M1, M2, VA, BA, P1, P2106 (31%)CTA onlyTransfers excluded
Vanacker et al
1645 in derivation cohort;
2023 in validation cohort
Critical Care MedicineIIIImaging performed <12 hoursICA, M1, BA346 (21%) derivation
566 (28%) validation
CTA only in derivation cohort
CTA or MRA in validation cohort
Acute STroke Registry and Analysis of Lausanne (ASTRAL) used for derivation.
Bernese Stroke Registry for validation; includes transfers from outside facilities
Heldner et al
1085 Journal of NeurologyIII<6 hoursICA, M1, M2657 (60.6%)CTA or MRABernese Stroke Registry. Includes outside transfers. Comatose patients and those with posterior circulation strokes were excluded. 17.1% presented with TIA, 97.3% of which would be classified as stroke as per tissue-based definitions
Turc et al
1004 StrokeIV<6 hoursICA, M1, BA328 (32.7%)CTA or MRATransfers excluded.
Lima et al
727 StrokeIII<24 hoursICA, M1, M2, BA240 (33%)CTA onlyPatients enrolled in a prospective cohort study at two academic medical centers
Moore et al
191 Journal of Neurointerventional SurgeryIVEvaluated <12 hoursICA, M1, M2, VA, BA87 (45.5%)CTA onlyOf 522 patients presenting to the emergency department, 191 (36.6%) were diagnosed with AIS
Kummer et al
664 Journal of Stroke and Cerebrovascular DiseasesIIIICA, M1, M2, BA80 (14.2%)CTA or MRA or DSA
Rai et al (2016)17 1157 Journal of Neurointerventional SurgeryIVICA, M1, BA129 (11.1%)CTA or MRA
Hansen et al
637 International Journal of StrokeIII<6 hoursICA, ACA, M1, M2, PCA, VA, BA183 (28.7%)CTA onlyConsecutive unselected series. 162 (25.4%) of patients had final diagnosis of TIA
Zhu et al
175 Journal of Stroke and Cerebrovascular DiseasesIII<4.5 hoursICA, A1, M1, M2, VA, BA, P170 (40%)CTA onlyOf the 175 AIS patients included in the analysis, 112 had severe strokes (54.5% LVO) and 63 had mild strokes (14.3% LVO)
de la Ossa et al
240 StrokeIII<6 hoursICA, M1, BA76 (31.7%)Transcranial duplex or CTA or MRAOnly the 357/880 (40%) patients who had a completed RACE evaluation were included in the analysis. Of these, 240 (67.2%) were diagnosed with ischemic stroke. LVO was diagnosed with transcranial duplex in half of the patients
Olavarria et al
463 NeurologyIII-ICA, M134 (7.3%)CTA or MRAValue only includes large vessels of anterior circulation (ICA, M1). 104 (22.5%) patients had an occlusion, and posterior circulation was not stratified into large vs small vessel
Smith et al
578 StrokeIII<24 hoursICA, A1, A2, M1, M2, VA, BA, P1, P2267 (46%)CTA onlyProspectively collected series. Transfers excluded
Cipriano et al
250 American Journal of NeuroradiologyIIIICA, M1, M2, BA86 (34.4%)CTA or MRAThese data are derived from the authors’ 2005 series. The authors present an additional analysis of data collected in 2000, which represents the same population analyzed by Torres-Mozqueda et al
Torres-Mozqueda et al
205 American Journal of NeuroradiologyIIIICA, M1, M2, BA56 (27.3%)CTA or MRAOf the 230 patients in the series, 205 underwent CTA or MRA
  • A1, first division of the anterior cerebral artery; A2, second division of the anterior cerebral artery; ACA, anterior cerebral artery; AIS, acute ischemic stroke; BA, basilar artery; CTA, CT angiography; DSA, digital subtraction angiography; LOE, level of evidence; LVO, large vessel occlusion; M1, first division of the middle cerebral artery; M2, second division of the middle cerebral artery; MRA, magnetic resonance angiography; P1, first division of posterior cerebral artery; P2, second division of posterior cerebral artery; VA, vertebral artery.