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Improving Outcomes for Stroke Patients
With over 800,000 cases occurring in North America every year, strokes are a huge health problem, which is why Dr. Mayank Goyal is dedicated to discovering new and innovative ways to treat stroke victims. Two of his latest innovations are the multiphase computed tomography angiogram (mCTA) and the Brisk Recanalization Ischemic Stroke Kit (BRISK).
These medical breakthroughs vastly improve the efficiency of stroke treatment, potentially saving thousands of lives every year. “When treating strokes, time is absolutely critical and every minute we save greatly improves our outcome,” says Goyal, who is a professor at the University of Calgary.
It’s with this in mind that Goyal set out to create his medical innovations and completely change the way strokes are treated around the world.
Improving Imaging to Improve Lives
Goyal’s invention of the mCTA has put Calgary at the top of the list for stroke imaging. Producing images of the brain during a stroke is critical as it is the first step in treating the patient, and the resulting images tell the doctors exactly how to treat the stroke. Without the mCTA many organizations are taking up to 25 to 30 minutes of imaging, whereas now that time has been successfully shortened to 5 to 6 minutes.
This time is extremely valuable as it can save many neurons, which are responsible for transporting information all throughout the body. “There is data that suggests that approximately two million neurons per minute die during a stroke, so if we are able to save 20 minutes then that’s 40 million neurons that we’ve just saved,” explains Goyal.
In addition to improved diagnosis time, the mCTA also solved several issues with one of the previous imaging techniques of CT perfusion, which required a highly trained and experienced operator to process the data. Even with expert technicians, the results were often deceptive. These problems created difficulties in the treatment of stroke patients, and were detrimental to the health of the victims.
Goyal says the mCTA addresses all of these issues. “We have very solid data that the results of mCTA are not only faster than CT perfusion and Magnetic Resonance Imaging (MRI), but that in many ways, it’s also superior.”
Plan for the Worst
Once a stroke patient is diagnosed using an imaging technique, they are then transferred to the catheterization laboratory for surgery. It is here that Goyal’s second innovation is used to once again save valuable time in the treatment of strokes.
The idea for BRISK came to Goyal when he realized that a bit of planning and preparation for surgery could be the difference in saving someone’s life.
“What I realized one day was that for each surgery there was 57 packets of medical supplies that needed to be opened. Five of these were expensive equipment, but the other 52 were inexpensive objects like syringes and needles. So I created a kit where those 52 packets were already opened and ready to go and organized in a way that they are available to the surgical team based on when they are needed, and the remaining five were still wrapped underneath the surgical station,” says Goyal.
This new prepared set-up allowed the surgical team to begin surgery much faster, creating a much better outcome for the patient. “On average by using BRISK we are saving 18 minutes during each daytime surgery and up to 45 minutes during after-hours surgeries,” explains Goyal.
Other Canadian stroke teams soon recognized this preparation can mean the difference between life and death for stroke patients, and BRISK is now being implemented all across the country. Goyal also has his sights set on international markets and he is currently working with partners to commercialize the product internationally.
Looking Towards the Future
Even with the success of his two innovations, Goyal isn’t slowing down. He is currently undergoing a second series of trials where his team is working to make endovascular stroke treatment more widely available and better with the use of a new neuroprotective agent discovered in Toronto.
Goyal says it’s an important part of his career to continually innovate stroke treatment. “We are always thinking about how we will improve the lives of stroke patients, because that is our main focus,” he says.