PhD defence Esmee Venema

The effect of endovascular treatment (EVT) for ischemic stroke due to an intracranial large vessel occlusion varies between individual patients. Treatment benefit is affected by differences in clinical characteristics at baseline and early initiation of EVT is associated with improved chances of good recovery. A possibility to reduce delay is to directly transport patients with suspected large vessel occlusion stroke to an intervention center capable of performing EVT. However, this strategy might be harmful for stroke patients without large vessel occlusion, who only benefit from rapid intravenous thrombolysis in the nearest hospital. The optimal triage strategy requires a tradeoff between the harm of delaying intravenous thrombolysis versus the potential benefit of rapid EVT. 

The overall aim of this thesis was to increase the benefit of EVT by optimizing prediction of outcome and treatment effect, reducing treatment delay, and improving prehospital triage strategies.