Hendrix P, et al. -Given that predicting an acute ischemic stroke (AIS) due to anterior large vessel occlusion (LVO) that is amendable to mechanical thrombectomy accurately is a challenge, utilizing medical history components present on admission and neurological examination, researchers developed and validated a prediction model for anterior circulation LVO stroke. AIS patients admitted to three hospitals within a large healthcare system in the US between 2009 and 2017 were retrospectively reviewed. A total of 1,654 AIS, including 248 (15%) with proximal anterior circulation LVO AIS, were studied. Apart from the severity of the stroke, anterior circulation LVO AIS was related to smoking, diabetes mellitus, extracranial carotid, and intracranial atherosclerotic stenosis. A history of smoking and diabetes mellitus can be easily obtained in the field and represent important elements of the prehospital score complementing the National Institutes of Health Stroke Scale, even if atherosclerotic stenosis isn’t known until imaging is obtained.