PhD defence S. (Selina) Vlieger

Below is a brief summary of the dissertation:

Although the treatment of heart and blood vessel diseases has improved greatly, diseases affecting the heart’s arteries remain a major cause of illness and death worldwide. This thesis explores how the treatment of patients with narrowed heart arteries can be improved. It focuses on three main areas: better identifying patients at risk, evaluating new treatment tools, and improving treatment methods.

The first part of the research examines how patients can be better identified as having a higher or lower chance of developing future heart problems. By combining different imaging techniques, it became possible to identify patients with a lower risk of complications more accurately. A blood marker called lipoprotein(a) was linked to more buildup in the artery walls but provided limited additional information for predicting future problems.

The second part focuses on new devices used to treat narrowed arteries. Newer stents, small tubes placed to keep arteries open, showed better results than older designs. Other devices, such as self-expanding stents and special balloons, also showed promising results for patients with more complex artery problems.

The final part investigates how stent treatment can be improved. A structured approach, including careful preparation of the artery and accurate placement of the stent, resulted in better stent expansion compared with placing the stent directly.

Overall, the findings support a more personalized approach to heart care, where treatment decisions are tailored to each patient. Combining better risk assessment, improved devices, and optimized treatment techniques may help improve long-term outcomes for people with heart artery disease.