Systematic Review of Blood Biomarkers for Diagnosing Large Vessel Occlusions

Background Large vessel occlusions (LVOs), which account for approximately 25% of ischemic strokes, pose a significant challenge due to their severe impact and need for rapid diagnosis and treatment. Current diagnostic approaches—primarily based on clinical scales and imaging— often lack specificity or delay treatment, severely impacting patient outcomes. This review aims to evaluate the potential of blood biomarkers in improving the accuracy and efficiency of LVO diagnosis. Methods A systematic review adhering to PRISMA guidelines was conducted with specific inclusion/exclusion criteria and multi‐person screening. PubMed, Google Scholar, and Embase were searched using targeted queries related to LVO and biomarkers. Studies reporting the diagnostic accuracy, sensitivity, and specificity of blood biomarkers for LVO were included. Data was extracted and synthesized to categorize biomarkers and assess their diagnostic utility. Results Sixteen studies were included, categorizing biomarkers into five groups: coagulation and hemostasis, acute brain injury, inflammatory, angiogenic growth factors, and metabolic and structural markers. Conclusions The review highlights the critical role of biomarker blood testing to enhance LVO diagnosis, especially in acute clinical settings. Coagulation and hemostasis markers such as D‐ dimer offer rapid thrombus detection, while acute brain injury and angiogenic biomarkers provide insight into the extent of injury, localization, and vascular response. A combination of biomarkers from multiple categories is needed to provide an accurate clinical picture of LVO in patients. Despite promising results for multiple biomarkers, including GFAP, UCHL1, and D‐ dimer, further research is needed to validate these biomarkers in diverse populations and integrate them into clinical practice effectively.