PhD defence R.A. (Robert) van de Graaf

A large proportion of patients suffering from an acute ischemic stroke caused by a large vessel occlusion in the anterior circulation (most commonly originating from the heart) die or become functionally dependent in daily life when treatment is not offered in time.
In case the right treatment (endovascular treatment) is offered fast and the thrombus can be removed reperfusion can recover and the outcomes are less dramatic (resulting in less patients being functionally dependent or death). Despite the large success of the endovascular treatment (which has only been introduced since 2015) still a large proportion of patients (±50%) does not recover, even when treatment is successful and thrombus has been removed. In my thesis I evaluated whether outcomes after endovascular treatment - for ischemic stroke due to a large vessel occlusion – can be improved further by better reperfusion through administration of antithrombotics, anesthesia type and blood pressure. I concluded that antithrombotics and in particular unfractionated heparin and aspirin are associated with an increased intracranial hemorrhage risk and this did not improve outcomes. Furthermore, I found that patients being treated under local anesthesia alone had better functional outcomes when compared to patients treated under conscious sedation. Finally, I concluded that maintaining blood pressure as stable as possible during and after the endovascular treatment was associated with better outcomes when compared to patients in whom this was not the case.

The public defence will take place at the Prof. Andries Queridoroom, 3rd floor Education Center, location Erasmus MC. The ceremony will begin exactly at 10.30 AM. In light of the solemn nature of the ceremony, we recommend that you do not take children under the age of 6 to the first part of the ceremony.