An article published in the Journal of NeuroInterventional Surgery references a new device, worn like a visor, that can pick up emergent large-vessel occlusion in patients with suspected stroke: with up to 92 percent accuracy.
Clinical investigators at the Medical University of South Carolina (MUSC), Mount Sinai, and the University of Tennessee Health Sciences Center report that patients with large-vessel occlusions can be routed to a Comprehensive Stroke Center with endovascular capabilities. Until recently, a standard physical examination achieved between 40 to 89 percent accuracy in identifying patients with large-vessel occlusion, all of whom could benefit from endovascular therapy.
Endovascular therapy (EVT) is the standard of care for ELVO within 24 hours, yet positive outcomes are more likely the earlier a patient is treated. Because approximately only 10 percent of stroke centers are capable of performing EVT, it is crucial to accurately and quickly triage patients with severe strokes, writes lead author Christopher P. Kellner, MD, and colleagues in the Journal of NeuroInterventional Surgery.
According to researchers, the volumetric impedance phase shift spectroscopy (VIPS) device (Cerebrotech Visor™, Cerebrotech Medical Systems, Pleasanton, CA) works by sending low-energy radio waves through the brain, which change frequency when passing through fluids. Such waves are reflected back through the brain, and then detected by the device. When a patient has a sever stroke, the brain’s fluids change, which produces an asymmetry in the radio waves detected by the VIPS device. The greater the asymmetry, the more severe the stroke.
The device is anticipated to save valuable time in critical situations, when utilized with emergency medical personnel in the field. The accuracy of the device simplifies the decision surrounding where to first take patients, according to Raymond D. Turner, M.D., professor of neurosurgery and chief of the Neuroscience Integrated Center of Clinical Excellence at MUSC. Turner served as principal investigator for MUSC in the VIPS for the Non-Invasive Detection of Hemispheric Bioimpedance Asymmetry in Severe Brain Pathology (VITAL) study reported in the article.
“Transfer between hospitals takes a lot of time,” says Turner. “If we can give the information to emergency personnel out in the field that this is a large-vessel occlusion, that should change their thought processes in triage, as to which hospital they go to.”
Kellner and colleagues compared the device to portable ECGs for heart attacks: both could be easily transported in ambulances, and used to triage patients in emergency cases. “Future testing is necessary to validate this device as a diagnostic tool in specific patient populations and settings,” the researchers wrote. “With such a high diagnostic accuracy for severe stroke, other potential settings where triage is necessary might include locations with people at a higher than usual risk for stroke, such as nursing homes, in operations with increased stroke risk such as cardiothoracic surgery or carotid endarterectomy, and settings removed from standard medical care, such as cruise ships, flights, and third world settings where neuroimaging is not readily available.”