What question did this study set out to answer?

The research aims to assess if lateral flow biomarker tests can accurately detect large vessel occlusion strokes eligible for thrombectomy in pre-hospital settings.

May 8, 2026Open Access

Abstract Number: Esoc2026ot17 Prehospital Biomarker and Phone Call-Based Detection for Ischaemic Stroke Thrombectomy (Pronto): Work in Progress

Key Points

The research aims to assess if lateral flow biomarker tests can accurately detect large vessel occlusion strokes eligible for thrombectomy in pre-hospital settings.
Prospective observational cohort study involving adults with FAST symptoms presenting to ambulance services within 6 hours of onset.
Two portable lateral flow assays for detecting D-dimer and Glial Fibrillary Acidic Protein using fingerprick capillary blood.
Ambulance practitioners relay test results and clinical information via pre-alert calls to stroke teams.
The study includes 496 participants with evaluations of sensitivity, specificity, and predictive values for identifying LVO stroke.
Reference standards for LVO diagnosis include CT brain imaging with expert clinician opinion.
Suitability for direct comprehensive center admission is based on specific clinical criteria including NIHSS and mRS assessments.

Abstract

Abstract Background and aims Large vessel occlusion (LVO) stroke is effectively treated by time-critical thrombectomy but procedures are only available at regional comprehensive stroke centres. Many eligible patients need interhospital transfer which creates delays. Direct admission to comprehensive centres may improve outcomes but no accurate triage tool exists. Methods This pre-hospital project is evaluating whether lateral flow biomarker tests combined with specific clinical information communicated from ambulance practitioners to stroke teams can detect LVO stroke and those LVO patients which are potentially suitable for thrombectomy. Results Study design: Prospective observational cohort study. Study setting: Ambulance services and hospital stroke units. Study population: Adults with at least one FAST symptom presenting to an ambulance service within 6 hours of onset. Study processes: Two portable lateral flow assays use fingerprick capillary blood to detect D-dimer and Glial Fibrillary Acidic Protein (Upfront diagnostics). Ambulance practitioners communicate the lateral flow result and specific clinical information during a routine pre-alert call to the nearest stroke team. Standard rules assign outcomes of LVO/non-LVO and suitable/not suitable for direct comprehensive centre admission. Reference standards: Independently adjudicated standard CT brain +/- CT/MR angiography plus expert clinician opinion establishes the presence of LVO or non-LVO condition. Suitability for direct comprehensive centre admission is pre-specified as: confirmed LVO stroke, NIHSS ≥ 6, pre-stroke mRS scale 0-2 and no pre-existing brain tumour, dementia or advanced cancer diagnosis. Main analyses: Sensitivity, specificity, negative and positive predictive values for identification of LVO stroke and suitable for direct comprehensive centre admission. Sample size: 496 participants. Conflict of interest

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