Characteristics of studies reporting the incidence of LVO in patients presenting with acute ischemic stroke
| Author (year) | Number of patients with AIS | Journal | LOE | Presentation time following onset of symptoms | Definition of LVO | Number of patients with LVO (%) | Diagnostic modality | Notes |
| Studies included in qualitative synthesis | ||||||||
| Demeestere et al (2017)20 | 381 | Journal of Stroke and Cerebrovascular Diseases | IV | <4.5 hours | ICA, M1 | 136 (35.7%) | CTA only | 551 consecutive patients with suspected AIS, 381 (69.1%) of whom had a final diagnosis of AIS |
| Beumer et al (2016)21 | 338 | Neurovascular Imaging | IV | <6 hours | ICA, A1, M1, M2, VA, BA, P1, P2 | 106 (31%) | CTA only | Transfers excluded |
| Vanacker et al (2016)22 | 1645 in derivation cohort; 2023 in validation cohort | Critical Care Medicine | III | Imaging performed <12 hours | ICA, M1, BA | 346 (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 (2016)23 | 1085 | Journal of Neurology | III | <6 hours | ICA, M1, M2 | 657 (60.6%) | CTA or MRA | Bernese 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 (2016)24 | 1004 | Stroke | IV | <6 hours | ICA, M1, BA | 328 (32.7%) | CTA or MRA | Transfers excluded. |
| Lima et al (2016)25 | 727 | Stroke | III | <24 hours | ICA, M1, M2, BA | 240 (33%) | CTA only | Patients enrolled in a prospective cohort study at two academic medical centers |
| Moore et al (2016)26 | 191 | Journal of Neurointerventional Surgery | IV | Evaluated <12 hours | ICA, M1, M2, VA, BA | 87 (45.5%) | CTA only | Of 522 patients presenting to the emergency department, 191 (36.6%) were diagnosed with AIS |
| Kummer et al (2016)27 | 664 | Journal of Stroke and Cerebrovascular Diseases | III | – | ICA, M1, M2, BA | 80 (14.2%) | CTA or MRA or DSA | – |
| Rai et al (2016)17 | 1157 | Journal of Neurointerventional Surgery | IV | – | ICA, M1, BA | 129 (11.1%) | CTA or MRA | – |
| Hansen et al (2015)28 | 637 | International Journal of Stroke | III | <6 hours | ICA, ACA, M1, M2, PCA, VA, BA | 183 (28.7%) | CTA only | Consecutive unselected series. 162 (25.4%) of patients had final diagnosis of TIA |
| Zhu et al (2014)5 | 175 | Journal of Stroke and Cerebrovascular Diseases | III | <4.5 hours | ICA, A1, M1, M2, VA, BA, P1 | 70 (40%) | CTA only | Of 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 (2014)29 | 240 | Stroke | III | <6 hours | ICA, M1, BA | 76 (31.7%) | Transcranial duplex or CTA or MRA | Only 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 (2011)30 | 463 | Neurology | III | - | ICA, M1 | 34 (7.3%) | CTA or MRA | Value 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 (2009)31 | 578 | Stroke | III | <24 hours | ICA, A1, A2, M1, M2, VA, BA, P1, P2 | 267 (46%) | CTA only | Prospectively collected series. Transfers excluded |
| Cipriano et al (2009)32 | 250 | American Journal of Neuroradiology | III | – | ICA, M1, M2, BA | 86 (34.4%) | CTA or MRA | These 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 (2008)33 | 205 | American Journal of Neuroradiology | III | – | ICA, M1, M2, BA | 56 (27.3%) | CTA or MRA | Of 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.