Table 3.

Stroke Prognostic POCT Devices Summary.

POCT Device	Description	Application	Clinical Value	Reference
Mobile Stroke Unit (MSU)	Imaging and a variety of Blood-tests. Integration of CT scanners and POCTs in ambulances, IV-tPA treatment can be started on-site	Consists of a registered nurse, paramedic, emergency medical technician, and a CT technologist, in addition, POCT are used, which includes coagulation profile, complete blood count, and blood chemistry	Pre-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission	[79,86,87,88,89,90,91]
CoaguChek® (Roche)	Test strips with electro-chemical detection. Based on amperometric (electrochemical) determination of the PT time after activation of the coagulation with human recombinant thromboplastin, results are obtained within 1 min	Convenient, portable and user-friendly device for monitoring oral anticoagulation therapy which can determine the INR value from a drop of capillary whole blood	Pre/In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission	[91,92,93,94,95]
Hemochron® Junior (ITC)	Optical detection. Micro-coagulation system, results within minutes	POCTs monitoring of: (1) ACT-LR, (2) ACT, (3) PT, (4) Citrate PT, (5) APTT and (6) Citrate APTT	Pre/In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission	[96]
PocH-100i hematology analyzer (Sysmex)	Micro-fluidics. WBCs, RBCs and PLTs are counted using the direct current detection method with hydrodynamic focusing technology. Hemoglobin analysis is conducted using a non-cyanide method	Provides a full blood count and a 3-part differential leukocyte count	Pre/In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission	[91,96,97]
i-STAT (Abbott)	Micro-fluidics. Based on advanced microfluidic and deliver fast, reliable lab accurate results within 2 min	Bedside care tests such as blood gases, electrolytes, metabolites and coagulation	Pre/In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission	[91,98,99,100]
Reflotron® plus analyzer (Roche, Cobas series)	Test strips with optical detection (Reflectance photometry). Single-test clinical chemistry system which is able to measure whole blood, plasma or serum for: liver and pancreas enzymes, metabolites and blood lipids. Results within 2–3 mins	Used for blood clinical-chemistry parameters measurement, such as c-glutamyltransferase, p-amylase, and glucose	Pre/In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission	[96]
Abbott AxSYM® BNP/Alere Triage® BNP/i-STAT BNP	Optical Detection (AxSYM)/Fluorescent detection (Triage)/Electro-chemical sensor on a silicon chip (i-STAT). BNP POCT.	BNP elevated serum levels in stroke patients show (1) correlation with CEI stroke, (2) increased mortality and (3) indication on second stroke recurrence	In/Post-hospital: Improves stroke prognostic (correlation to CEI) and stroke recovery (indication on second stroke reoccurrence)	[88,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126]
Cornell University, State University of New York and the New York Presbyterian Hospital	Luminescent detection. NSE POCT based on enzymes tethered to nanoparticles	NSE elevated serum levels in stroke patients assist in distinguishing stroke from mimics, an important first step in expediting the diagnostic process	In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission	[127,128,129,130,131,132,133]
Prediction Sciences LLC	Lateral flow POCT for the proteomic marker cellular fibronectin (c-Fn)	Fibronectin (c-Fn) elevated serum levels in stroke patients at IV-tPA admission can identify if the patient is at high or low risk for a subsequent hemorrhage	In-hospital: Reduces time-to-IV-tPA admission	[124]
ReST™ (Valtari Bio™ Inc.)	Rapid evaluation stroke triage POCT for the measurement of blood brain-specific biomarkers associated with immune responses, results within 10 min	Following stroke, the immune system is activated. The degree and direction of the immune system activation allow the accurate identification of acute stroke from non-stroke	In-hospital: Initial stroke versus no stroke diagnosis	[134,135,136]
SMARTChip (Sarissa Biomedical)	Micro-electrode POCT device for stroke diagnosis that measures purines from a drop of whole blood and give the reading within minutes	Can be used by paramedics, which will allow faster identification of stoke victims at the point of injury	In-hospital: Stroke diagnosis	[137]
PFA-100®, Platelet Function Analyzer (Dade Behring)	High-shear force dynamic flow system POCT that assesses platelet aggregation under high shear, mimicking platelet-rich thrombus formation after injury to a small vessel wall under flow conditions	Rapid and reliable identification of aspirin non-responsive patients, without the requirement of a specialized laboratory	Post-hospital: Prevention of second stroke recurrence	[138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155]
Ultegra-RPFA VerifyNow Aspirin® test (Accumetrics)	Optical detection. POCT based on turbidimetric optical detection of platelet aggregation in whole blood. As aggregation occurs, the system converts luminosity transmittance results into ‘Aspirin Reaction Units’	Rapid and reliable identification of aspirin non-responsive patients, without the requirement of a specialized laboratory	Post-hospital: Prevention of second stroke recurrence	[138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154]