Treating stroke faster than ever

Dr. Timo Krings is Head, Division of Neuroradiology; Site Chief, Medical Imaging, Toronto Western Hospital; David Braley and Nancy Gordon Chair in Interventional Neuroradiology. He leads a team of neuroradiology experts who are finding new ways to treat brain injuries such as stroke.

Q: You are a leader in stroke care. What are some of the latest advances?
A: Our team were the only Canadians to participate in a recent study published in the “New England Journal of Medicine” – one of the most impactful medical journals – that demonstrated we can treat an acute stroke in certain patients as far out as 24 hours after onset. Before now, it was only within 4.5 hours. This is a major advancement. Just yesterday, a patient I treated came in eight hours after her initial stroke. She wasn’t able to speak or move her hand but after treatment she was back to her baseline, that is, normal, and she will be able to go home tomorrow.

Q. What are some other advances you are working on?
A. We are looking at new techniques to remove clots. We are working with a so-called clot aspiration device – with which you suck the clot out rather than extracting it. In an international study for which we are doing the core imaging, the technique is safer and has increased our success rates from 80 to 90%. Yesterday, we removed a clot within four minutes – a new record. In stroke care, every second counts and the faster we can help patients, the greater the odds of them recovering completely.

Q: What role does imaging play in stroke care?
A: Imaging can tell if the brain is still alive and if there is tissue that is at risk of being harmed by the stroke. Time is of the essence in stroke care: For every minute delay the brain loses approximately 1.9 million neurons. In most centers, patients have to go through multiple “pit stops” before they reach the angiography suite where we extract the clot: they have to go from the Emergency Department, to the CT, back to the ER, and then to the angiography. We have developed a technique where the imaging can be done right in the angiography suite, where the treatment is done. This saves easily ten minutes – or 19 million neurons!

Q: Is donor support important to the work you do?
A: Donor funding is vital to our work. It allows us to continue our cutting-edge research and continue to be independent. People come from across Canada and around the world to learn about stroke care from us and that is, in large part, thanks to donor support, which allows us to develop new techniques and retain significant talent. We have so many bright people on our research team and that is why we can achieve such high-level impacts on patient care.

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