Direct Transfer to an Endovascular Center Compared to Transfer to the Closest Stroke Center in Acute Stroke Patients With Suspected Large Vessel Occlusion

Inclusion Criteria: * Suspected LVO acute stroke patients identified by a RACE scale score \>4 at the pre-hospital setting, that is evaluated by EMS professionals when attending patients, in non-stroke ready centers or primary health centers, previous to the transfer to a stroke center. * Patients located in geographical areas in which the reference stroke center is a hospital not capable to offer endovascular treatment (Primary stroke Center or Telestroke Center). * Estimated arrival time at an EVT-SC \<7 hours from symptom onset. Symptom onset is defined as point in time the patient was last seen well (at baseline). * No significant pre-stroke functional disability (modified Rankin scale 0 - 2) * Age ≥18 * Deferred informed consent obtained from patient or acceptable patient surrogate (after the acute phase, as permission to use clinical data within a clinical registry) Exclusion Criteria: * Patients in a coma (NIHSS item of consciousness \>1) * Patients with unstable clinical status who require emergent life support care * Serious, advanced, or terminal illness with anticipated life expectancy of less than 6 month. * Suspected LVO acute stroke patients identified at the Emergency Department of a stroke center * Subject participating in a study involving an investigational drug or device that would impact this study. * Patients with a pre-existing neurological or psychiatric disease that would confound the neurological or functional evaluations. This excludes patients who are severely demented, require constant assistance in a nursing home type setting or who live at home but are not fully independent in activities of daily living (toileting, dressing, eating, cooking and preparing meals, etc.) * Unlikely to be available for 90-day follow-up (e.g. no fixed home address, visitor from overseas).