For patients with ischemic stroke, early reperfusion of the brain tissue by removing the occluding thrombus is essential to limit or even reverse neurological deficits. To improve clinical and safety outcomes of patients with ischemic stroke, new interventions should be designed and evaluated in clinical trials.The overall aim of the research described in this thesis is to evaluate and improveclinical research methods and outcomes in patients treated with reperfusiontherapy for ischemic stroke.Based on the research in this thesis, we recommend use of the modified Rankin Scale score as primary outcome measure with assessment performed by central assessors in phase III trials. For phase II(b) trials of acute treatment for ischemic stroke, the NIHSS within 1 week can be used as a primary outcome measure. Presence of any ICH on MRI can be reliably used as (safety) outcome measure. For trials with subjective outcome and PROBE design, the methods and effectiveness of blinding should be assessed and reported. Whether dual thrombolytic treatment with small bolus alteplase followedby mutant pro-urokinase improves outcomes in patients with ischemic stroke needsto be assessed in larger trials in patients with larger ischemic strokes.<br/
