Welcome to the website of the CONTRAST consortium.

Between 2023 and 2028, the CONTRAST 2.0 Consortium will increase the likelihood of a good recovery in a large group of patients with cerebral infarction or cerebral haemorrhage by developing new treatments in the laboratory, by research on improvement of treatment logistics, and by initiating six large clinical trials. Each of these studies test one or more new treatments or answers important research questions. All studies will be supported by a central assessment of brain-CT and -MRI scans, statistically analysed and collected in a central database.

The ambition of CONTRAST 2.0 is to improve outcome after stroke and increase the number of patients
who are eligible for acute treatment. CONTRAST 2.0 addresses the aims of the DHF with an integrated
research program to develop and evaluate new treatment strategies for AIS, ICH and SAH in preclinical
studies, a series of complementary RCTs and registries. To establish an optimal setting for long-term
preclinical studies on brain damage caused by ischemia-reperfusion or hemorrhage and the effects of
neuroprotection, we will develop a platform for assorted translational studies in the most appropriate
animal models with clinically relevant output parameters. As such, the consortium will find new
opportunities for further clinical evaluation of new treatment modalities.

The clinical trials and registries will not only be aimed at prompt and accurate treatment in the hospital,
but also before admission (in the ambulance) and after admission of stroke patients. Their design allows
that results can be readily implemented in clinical practice. Studies will demonstrate: a) how to improve
prehospital triage by evaluating prediction rules and devices for diagnosis of the type of stroke and the
presences of intracranial vessel occlusion, b) how to improve the outcome of ischemic stroke by
treatment of medium vessel occlusions, by treatment of occlusive and stenotic carotid bifurcation
disease, by neuroprotective drugs and by achieving better technical procedural outcome with a
personalized technical approach based on thrombus and vessel characteristics, c) how to improve the
outcome of hemorrhagic stroke with minimally invasive interventions, and d) how to improve post-stroke
rehabilitation by better prediction of long-term outcome and the prediction of effects of intervention.
Large clinical datasets will be used to develop models for care organization and individualized treatment
strategies, considering individual prognosis based on personal characteristics (sex, age, stroke type,
severity), and imaging findings (thrombus and vessel characteristics). The proposed research program
will make use of the national stroke research infrastructure established within CONTRAST 1.0 and aims
to attract additional public and private funding for fully execution of the research plans.

The overarching aim of CONTRAST 2.0 remains to improve outcome of stroke patients by blending
mechanistic, basic scientific projects with pragmatic randomized clinical trials and registries.
Specifically, CONTRAST 2.0 will aim to advance treatment through earlier diagnosis of stroke, rapid and
more effective personalized treatment of acute stroke, and lastly optimized personalized rehabilitation of
stroke survivors in the acute and subacute phase. At the end of the project, it is our ambition to have:

1. evaluated and implemented the best prehospital triage strategy in the Netherlands resulting in earlier
   treatment of more patient with stroke.
2. expanded the indications of EVT to patients with MeVO.
3. implemented evidence-based guidelines for the optimal treatment timing of carotid occlusive disease.
4. a preclinical platform for identification of new therapeutic targets and testing of promising therapies,
   and we have performed the first preclinical trials with neuroprotective agents.
5. developed personalized EVT approach (technique and device choice) based on thrombus and vessel
   characteristics.
6. proven that minimally invasive endoscopy-guided surgery for ICH results in better outcome and we
   can offer this treatment to all patients in the Netherlands.
7. assessed the treatment outcomes of advanced endovascular devices for a recently ruptured
   intracranial aneurysms in the Netherlands and to have initiated an RCT to support evidence-based
   decision making.
8. improved prediction of medium-term outcome (defined on multiple domains) of stroke patients to
   guide the individualized treatment decision of patients 1) in the chain of care and 2) for additional
   interventions resulting in improved functioning and quality of life.

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