Work package information

The CONTRAST 2.0 Consortium will address the main items of the research agenda of the Dutch Heart
Foundation and Dutch Brain Foundation with an integrated research program focusing on acute
treatment of ischemic and hemorrhagic stroke. Therefore, the main scope of all research described
below is on improving outcome for patients with stroke.
Focus of the current proposal will be on three main themes: a) earlier prehospital diagnosis of the
(subtype of) stroke and improving the organization of acute stroke care; b) rapid, (cost-)effective, and
personalized treatment of acute stroke with innovative treatment options; c) optimized personalized
rehabilitation for stroke survivors after the acute phase.

The underlying hypotheses driving the key objectives are:

Preclinical and experimental studies (WP1)

1) Basic experimental studies can unravel the cascade of secondary events after recanalization, identify
new mechanism-based biomarkers of futile recanalization and reveal the effects of combination
treatment with neuroprotective agents.

Prehospital phase: improving triage for faster treatment (WP2, WP9)

2) Time to treatment is crucial and better prehospital triage is possible, which will shorten time to
treatment and improve treatment allocation.
3) Optimal implementation of new treatment modalities depends on regional organization and requires
modelling of routing of patients and (pre-) selection of patients.

Hospital phase: extending the indications for EVT, improving EVT procedures and treatment outcomes
(WP3a, WP3b, WP3c, WP5, WP7, WP9)

4) Treatment of medium vessel occlusion with EVT improves clinical outcome.
5) Carotid artery stenting during EVT for patients with ipsilateral high-grade extracranial carotid artery
stenosis is non-inferior and cost-effective compared to routine deferred treatment (endarterectomy,
6) Modulating key elements in the pathophysiological cascade towards cell death before or directly after
mechanical treatment of ischemic or hemorrhagic stroke results in better clinical outcome.
7) Large stroke registries with consecutive inclusion and sufficient treatment variation with high
resolution data can inform us on characteristics and outcomes of patients treated with EVT in clinical
practice, safety of EVT and on best practices in stroke care.
8) Procedural success of EVT is based on optimal interaction between vascular anatomy (extracranial
and intracranial), and thrombus characteristics on the one hand and endovascular approach (devices,
technique) on the other hand and can be predicted to guide clinical decision making.

Hospital phase: Improving outcome of patients with ICH and SAH (WP4, WP6, WP9)

9) Minimally invasive endoscopy-guided surgery in the acute phase improves the outcome of patients
with intracerebral hemorrhage (ICH).
10) Procedural success of treatment of subarachnoid hemorrhages (SAH) is based on optimal
interaction between vascular anatomy and endovascular approach (devices, technique).

Rehabilitation phase: improving the outcome and organization of post-stroke rehabilitation (WP8, WP9)

11) Long-term outcome can be predicted with baseline (clinical), treatment (imaging) and short-term
(clinical and imaging) characteristics and such predictions can be used to optimize allocation of
rehabilitation resulting in improved outcome.

Research Infrastructure (WP10, WP11,WP12)

1) To facilitate a smooth transition from the CONTRAST 1.0 consortium, ensuring that collected clinical
data, imaging, and bio samples (blood, thrombus) generated in the context of CONTRAST 1.0 are
available for further use in and outside of the consortium.
2) To expand the infrastructure for basic neurovascular studies and clinical registries and trials.
3) To foster the development of young talents in basic and clinical neurovascular research.
4) To foster public – private collaboration with medium and large enterprises resulting in additional
funding for preclinical and clinical research projects.
5) To increase cohesion between the young members of the consortium and help them in their scientific and personal development.