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Blood Biomarkers for Large Vessel Occlusions: A Systematic Review.

Tanaisha Italia1, Ilayda Kayir2, Ganesh Chilukuri3

  • 1Department of Neurosurgery Hospital of the University of Pennsylvania Philadelphia PA.

Stroke (Hoboken, N.J.)
|January 29, 2026
PubMed
Summary

Blood biomarkers show promise for diagnosing large vessel occlusions (LVOs) in ischemic stroke patients. Combining markers like D-dimer and those for brain injury may improve diagnostic accuracy and speed up treatment.

Keywords:
biomarkersischemic strokelarge vessel occlusion

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Area of Science:

  • Neurology
  • Biomarker Research
  • Stroke Medicine

Background:

  • Large vessel occlusions (LVOs) are a major cause of ischemic stroke, necessitating rapid diagnosis and treatment.
  • Current diagnostic methods often lack specificity or cause treatment delays, negatively impacting patient outcomes.
  • Blood biomarkers offer a potential avenue to improve LVO diagnosis accuracy and efficiency.

Purpose of the Study:

  • To systematically review and evaluate the diagnostic utility of blood biomarkers for large vessel occlusions (LVOs).
  • To assess the potential of various biomarker categories in enhancing LVO diagnosis.

Main Methods:

  • A systematic review was conducted following PRISMA guidelines.
  • Searches were performed across PubMed, Google Scholar, and Embase for studies on LVO biomarkers.
  • Included studies reported diagnostic accuracy, sensitivity, and specificity of blood biomarkers for LVO.

Main Results:

  • Sixteen studies were included, classifying biomarkers into five groups: coagulation/hemostasis, acute brain injury, inflammatory, angiogenic, and metabolic/structural.
  • Coagulation markers (e.g., D-dimer) aid in rapid thrombus detection.
  • Brain injury and angiogenic markers provide insights into injury extent and vascular response.

Conclusions:

  • Blood biomarker testing is crucial for improving LVO diagnosis, particularly in acute settings.
  • A combination of biomarkers from different categories is necessary for a comprehensive diagnostic picture.
  • Further research is needed to validate biomarkers like GFAP, UCH-L1, and D-dimer in diverse populations and integrate them into clinical practice.