Key takeaways:
- Rapid, reliable detection in a pre-hospital setting is critical ahead of treating large vessel occlusion stroke.
- The Open-Motion device will undergo a future validation study to further determine its viability.
Large vessel occlusion-type strokes are urgent enough that a single
clinical scale utilized for detection in a pre-hospital setting may lead
to misdiagnosis that endangers the patient, according to new research.
Open-Motion 3.0, a mobile evaluation device manufactured by
Openwater, quickly and easily detected large vessel occlusions in a
study published in the Journal of Stroke and Cerebrovascular Diseases.
The device correctly identified 79% of patients who had large vessel occlusions
(LVO) while correctly excluding 84% of those patients who did not,
outperforming stroke scales used prior to arrival at the hospital.
Healio spoke to Christopher G. Favilla, MD, assistant
professor of neurology at the Hospital of the University of Pennsylvania
and lead author of the study, to learn more about OpenMotion and its
application in rapid stroke detection.
Healio: What is the Open-Motion 3.0 device, how does it detect LVOs, and how is that better than current detection techniques?
Favilla: Open-Motion is a diagnostic device and platform
that uses low intensity near-infrared light to non-invasively measure
blood flow and volume in tissue. Changes in the absorption and
scattering of this light can identify abnormalities in anterior
circulation of the brain. Current clinical examination-based assessments
are not sufficiently sensitive for LVO. Too often, patients are brought
to hospitals that are not equipped to perform the endovascular
procedure used to most effectively treat LVO stroke. Open-Motion is a
portable device that could be used in the field to improve prehospital
stroke triage to ensure patients are taken to the hospital that can best
treat them.
Healio: What makes LVO strokes more urgent than other types of stroke?
Favilla: If untreated, LVO result in the largest and
most disabling strokes for patients. A large vessel occlusion refers to a
blockage in a major artery in the base of the brain which cuts off
critical blood flow and leads to extensive brain injury if not treated
quickly. Fortunately, endovascular thrombectomy
(EVT) is a revolutionary treatment opportunity for this patient
population that dramatically increases the likelihood of a favorable
outcome.
However, approximately 2 million neurons die every minute as the
stroke evolves, and the benefits of EVT are time dependent. Rapid
identification and triage are critical in ensuring that patients can
reduce treatment times and thereby maximize the benefit of EVT.
Healio: How does the OpenMotion device cut down on diagnostic times and head off the possibility of false negatives?
Favilla: Only about 10 percent of hospitals can perform
endovascular thrombectomy. This leads to the majority of patients with
an LVO presenting to the emergency department of a hospital that is
unable to provide the care they need. After the occlusion is identified
on a scan, the patients require transfer to an endovascular-capable
hospital, which unfortunately can take hours and further delay
treatment.
OpenMotion device provides the opportunity to quickly and easily detect an LVO. If EMS providers could harness this technology in the back of the ambulance,
they could reduce stroke treatment times by bypassing the nearest
hospital and driving directly to an endovascular-capable hospital.
Minimizing false negatives is key to maximizing the impact of this
diagnostic approach and ensuring patients receive the appropriate care.
It is also important to consider the impact of false positives, given
the implications for EMS workflow and emergency department patient
volumes. Minimizing these false positives ensures that critical
resources are allocated to the patients most in need. The OpenMotion
device provides the opportunity to titrate the threshold, such that the
balance of false negatives and false positives can be optimized.
Christopher Favilla
Healio: Based on existing study data, what form would an independent validation take?
Favilla: We are preparing for a multicenter validation
study in which patients with suspected stroke will complete an
OpenMotion scan during the clinical stroke alert workflow. By enrolling a
broad population of patients from multiple centers, we will not only
provide an opportunity to validate the device performance by comparing
the OpenMotion results with gold standard clinical neurovascular
imaging.
We expect enrollment to begin before the end of 2025 and complete enrollment before the end of 2027.
Healio: Would the device solely be used for EMS personnel, or would it have applications in the home or the clinic?
Favilla: Our current approach focuses on EMS
utilization. One could imagine potential use in the home setting, but
that would require an entirely different scientific approach. Other
environments, such as nursing homes or long-term care facilities, could
similarly be a consideration in future work.
Healio: Could OpenMotion be applied to other forms of stroke that would or would not be addressed by EVT?
Favilla: The current algorithm is designed to
differentiate LVO, but ongoing work is evaluating the potential to
differentiate hemorrhagic and ischemic stroke. It is too early to know,
but we will certainly report findings in that space as soon as they
become available. There are several potential future applications,
including a range of neurologic and cardiac disease states in which
optimizing brain perfusion is a pillar of clinical care.
Reference:
Favilla CG, et al. J NeuroInterventional Surg. 2025;doi:10.1136/jnis-2024-021536.
Favilla CG, et al. J Stroke Cerebrovasc Dis. 2025;doi:10.1016/j.jstrokecerebrovasdis.2025.108323.
Researchers using Openwater monitor report accurate detection of large vessel occlusion in suspected stroke. https://www.einpresswire.com/article/810706727/researchers-using-openwater-monitor-report-accurate-detection-of-large-vessel-occlusion-in-suspected-stroke. Published May 8, 2025. Accessed May 22, 2025.
For more information:
Christopher Favilla, MD, can be reached at neurology@healio.com.
