PhD defence Robrecht Robertus Martinus Maria Knapen

Keywords: Stroke, Endovascular treatment, Recanalization, Thrombolysis

"Optimizing recanalization in acute ischemic stroke patients: Encompassing intravenous thrombolysis and endovascular treatment"

This thesis gives an accessible overview of modern stroke treatment, focusing on two main approaches: medicines that dissolve blood clots (intravenous thrombolysis, or IVT) and procedures that physically remove the clot (mechanical thrombectomy). Using data from several large national and international studies, it explores how these treatments work in different situations.

First, the research looks at strokes in the back part of the brain and shows that IVT can be helpful on its own, but adds little when combined with thrombectomy. Next, it compares ways to treat more complex blockages and examines which thrombectomy techniques work best in different patient groups. Another part of the thesis studies a tool called a balloon guide catheter, showing that its benefits depend on how and when it is used. Finally, the thesis identifies factors that may predict natural reopening of blocked vessels and compares older and newer devices, highlighting that better tools do not always lead to better recovery, underscoring the importance of selecting the right patients for each treatment.

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