Rationale u2013 The emergence of Intraarterial Thrombectomy (IAT) has challenged acute stroke care organization both at a national and regional level. Important parameters include distances to primary and comprehensive stroke centers, and effectiveness of interventions as a function of time and availability of ambulance services. Further dissemination of IAT may increase treatment rates, yet, could affect efficient use of scarce resources and effectiveness. Aim u2013 To study the organizational model and logistics of IAT for ischemic stroke patients in the Netherlands.Design u2013 Using a simulation modeling approach current performance of hospitals offering IAT in the Netherlands will be quantified. Patient data concerning pathway logistics both pre- and intrahospital will be collected and used to build and validate the simulation models. Results from previous studies will be expanded with results and data of trials performed later in the consortium to represent current patient logistics, time delays and outcomes. Simulation experiments will be performed to assess effectiveness and efficiency of alternative network typologies, i.e. primary and comprehensive stroke services (hybrid system) versus a service delivery based on comprehensive and centralized care. The model will be expanded with cost-data to prepare for elaborate budget impact and cost-effectiveness analyses.Study outcomes u2013 Primary outcomes include IAT treatment rates and patient disability according to the modified Rankin Scale. As secondary outcomes the onset-to-treatment time and resource use will be collected. Discussion u2013 This research fulfills an important clinical and policy need for evaluating the organizational model for IAT treatment in the Netherlands.