On Wednesday 13 November 2024, P.M. Janssen will defend the doctoral thesis titled Optimizing Workflow of Endovascular Thrombectomy for Acute Ischemic Stroke
- Promotor
- Promotor
- Date
- Wednesday 13 Nov 2024, 15:30 - 17:00
- Type
- PhD defence
- Space
- Professor Andries Querido room
- Building
- Education Center
- Location
- Erasmus MC
- More information
The public defence will start exactly at 15.30pm. The doors will be closed once the public defence starts, latecomers can access the hall via the fourth floor. Given the solemn nature of the meeting, we advise not to bring children under the age of 6 to the first part of the ceremony.
A livestream link has been provided to candidate.
Below is a brief summary of the dissertation:
In 2015, treatment with endovascular thrombectomy was proven effective in patients with acute ischemic stroke. Endovascular thrombectomy is aimed at the removal of a blood clot that occludes a blood vessel in the brain. Since 2015, acute stroke care had been reorganized, not only to make this treatment available to all stroke patients, but also to offer this treatment as fast as possible. The overall aim of this thesis was to contribute to the improvement of outcome of patients with ischemic stroke by analyzing the workflow of endovascular thrombectomy.
We identified multiple targets for workflow improvement, for example aimed at optimization of prehospital management, reduction of in-hospital patient transfers, anesthetic management, improvement of teamwork, and provision of feedback on achieved time intervals to the team. We showed that implementation of these workflow improvements led to a significant reduction in time to treatment, especially when multiple interventions were combined. Furthermore, we showed that the type and number of implemented workflow improvements varied largely between centers in the Netherlands. Moreover, we showed that functional outcome of patients after endovascular thrombectomy differed substantially between centers and this variation could be largely explained by potentially modifiable center characteristics, such as time to reperfusion.
In conclusion, stroke teams should make a continuous effort to critically evaluate prehospital and in-
hospital workflow, and thereby identifying opportunities for improvement. For workflow evaluation, treatment times should be monitored and regularly evaluated with the stroke team, both per center and per region.
