PhD defence A.S.A. (Anouchska) Autar

Summary:

An arterial intervention is generally regarded as a safe and effective therapy for acute ischemic events such as acute myocardial infarction (AMI) and acute ischemic stroke (AIS). Nevertheless, problems such as no-reflow (incomplete microvascular reperfusion), in-stent restenosis, and in-stent-/re-thrombosis still exist. In case of Percutaneous Coronary Interventions (PCI), incidences of stent thrombosis and restenosis have been dramatically reduced by dual antiplatelet therapy and the newer generations of drug eluting stents.1 Regardless, they remain the biggest hurdles in PCI, with an emphasis on no-reflow. In case of mechanical thrombectomy as a treatment for AIS, we are rapidly gaining more experience Currently, stenting of cerebral arteries for AIS is also being considered.2 AIS is undergoing in-depth investigations in which the relationship between outcome and intervention-related parameters is studied, such as duration of ischemia, the timing of thrombectomy, intervention-related drug therapy, presence of residual thrombus, and reperfusion efficacy.3-8 The complexity of problems regarding arterial interventions and factors determining treatment outcome lie in their multifactorial nature and can be patient, procedure as well as device related.9 The aim of this thesis was to further study the role of such parameters related to outcome after arterial interventions for AMI and AIS interventions, including procedural parameters, plasma and arterial thrombi.