PhD defence Faysal Benali

Keywords: Stroke, Pre-stroke functioning, Brain resilience, Heparin in flush fluids during EVT

"Brain resilience and heparin flush in endovascular thrombectomy for acute ischemic stroke, challenging current literature"

Endovascular thrombectomy (EVT) has become standard practice for large vessel occlusions in acute ischemic stroke. Nonetheless, up to 50% of patients do not recover fully despite successful recanalization. In addition, comprehensive prediction models as well as baseline stroke severity scores lack sufficient specificity to optimally predict outcome. Especially in the elderly population, variability in outcome is large. Even among patients with similar occlusion and perfusion metrics.

This thesis explores established dogmas that may contribute to this variability. Firstly, it covers the importance of brain resilience (by evaluating brain atrophy and the burden of small vessel disease). Secondly, it examines the value of pre-stroke dependency as an established exclusion criterium in current guidelines. Thirdly, it investigates the importance of the use of a blood thinner (heparin), specifically administered through flush fluids during EVT. 

Addressing these variables may equip stroke physicians with additional tools to individualize care, inform about prognosis and improve outcomes across diverse patient populations.

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