EVT – Improving Stroke Outcomes in Northwestern Ontario

Submitted by the Northwestern Ontario Regional Stroke Network


Endovascular thrombectomy (EVT) is a treatment for acute ischemic stroke. EVT uses a small tube, a guide wire and stent to remove large stroke-causing clots from the brain. Across Ontario, there are 11 EVT centres able to provide this life-changing stroke treatment.  

Since 2017, Thunder Bay Regional Health Sciences Centre (TBRHSC) has been offering this treatment, and in 2022 the service was expanded to two providers.

Dr. Graeme Marchuk, Neurosurgeon and EVT provider states, “I’m pleased to welcome our newest provider, Interventional Neurologist Dr. Razmik Bebedjian, who has helped us to obtain 80 per cent coverage for access to EVT treatment in Northwestern Ontario.”

With the addition of a second provider, the Hospital has more then doubled the number of patients receiving EVT treatment. Brian Bragnalo received EVT treatment in October of 2022.

“I was sitting at home and I guess I wasn’t making sense,” Bragnalo recalls. “My wife immediately recognized what was happening and called 911. It was incredible how fast they got there. Everyone was incredible; it was like a miracle how quickly everything worked. I walked out of the Hospital a few days later.”

While not every stroke patient is eligible for EVT, this procedure addresses patients with the most severe type of stroke caused by a large clot (ischemic stroke). Patients are evaluated with advanced neuroimaging which includes TBRHSC’s latest technology, computed tomography perfusion (CTP). CTP is a colour coded brain imaging that supports physicians to identify brain tissue that can potentially be saved by EVT treatment. This advancement in imaging was launched in Thunder Bay in October 2021 and in Kenora, Lake of the Woods District Hospital in June 2022, and most recently in Fort Frances in June of this year at La Verendrye Hospital – Riverside Health Care. This technology supports getting the appropriate patients to EVT centres.

“As one of only 11 Hospitals in Ontario providing EVT treatment, we are fortunate to be able to offer this service for the people of Northwestern Ontario,” says Adam Vinet, Vice President, Patient Experience, Chief Nursing Executive and RVP, Regional Cancer Care.

For more information, visit www.nwostroke.ca or email nwostroke@tbh.net.

Donations towards supporting stroke care and EVT initiatives can be directed to the STROKE FUND through Thunder Bay Regional Health Sciences Foundation at https://www.healthsciencesfoundation.ca/.

(L-R) Dr. Razmik Bebedjian, Interventional Neurologist, TBRHSC, Brian Bragnalo, stroke survivor and recipient of EVT, Dr. Graeme Marchuk, Neurosurgeon, TBRHSC

Active Commute Challenge Wrap Up

Just because the challenge is coming to an end does not mean an end to your active commuting! We still have the entire summer ahead! So set a personal goal to continue actively commuting throughout the year. You will continue to reap all the health, environmental, and economic benefits! 

Prizes will be drawn next week so stay tuned.  Winners will be contacted by the Thunder Bay District Health Unit via email.

Therapy Dogs for Staff – TODAY

Do you need to paws and relax?

Prevention and Screening Services and Volunteers Services have partnered with St. John’s Ambulance Therapy Dogs to offer an Open House for staff on Wednesday, June 28, 2023 at 12:00pm-1:00pm in the Cafeteria Courtyard.

When: Wednesday, June 28, 2023
Time: 12:00pm-1:00pm
Where: Cafeteria Courtyard
Who: All staff, learners and volunteers are welcome to attend

For more information, please contact Haley.Shipston@tbh.net

Code Grey – Air Exclusion Policy Refresher

Shared on behalf of Ryan Sears, Director, Capital and Facility Services


The Hospital acknowledges that Environment Canada has issued a special air quality statement noting that smoke plumes from active forest fires in the Northwest are putting particles and gases into the air that can be harmful to human health. People may experience symptoms such as increased coughing, throat irritation, headaches, or shortness of breath. Leadership will continue to monitor the air quality situation and adjust our Hospital’s response as required.

Recommended Actions:

  • Review the Code Grey – Air Exclusion (Button Down) policy and associated refresher Safety Huddle (see attached).
  • Directors/Managers, post/circulate and discuss the attached Safety Huddle contents with your teams.
  • Visit www.airhealth.ca for information on how to reduce your health risk along with current and forecasted Air Quality Health Index (AQHI) values.

EVT – Advancements in Stroke Care in Northwestern Ontario

EVT - Advancements in Stroke Care in Northwestern Ontario

In Canada, there is one stroke approximately every five minutes. For the best patient outcomes, Emergency Medical Services (EMS) and hospitals need to be ready to ensure patients receive the right care in a timely way. In Northwestern Ontario, EMS and Emergency Departments have enhanced stroke assessment by using screening tools to identify severe stroke. These tools identify patients who may benefit from endovascular thrombectomy (EVT).

EVT is a treatment for acute ischemic stroke that uses a small tube, a guide wire and stent to remove large stroke-causing clots from the brain. The EVT procedure requires specialized equipment and a coordinated team approach to ensure success. Thunder Bay Regional Health Sciences Centre (TBRHSC), one of 11 EVT centers, strives to continuously optimize stroke care by improving and upgrading equipment. In September 2022, an aspiration (suction) system was upgraded at TBRHSC to assist when removing a clot from the brain.

The next goal is to purchase an anesthesia machine and monitoring equipment for the EVT suite.

“Stroke is the most feared complication after cardiac surgery,” remarks Dr. Bebedjian, Interventional Neurologist and EVT provider at TBRHSC. “And as our cardiac care grows at TBRHSC, preparing for the opening of the cardiovascular program, it is vital to continue with our progress in stroke care.”

“The additional equipment we have received and the upgrades we hope to obtain in the future mean faster and more efficient treatment for patients, ultimately giving the patient the best opportunity for recovery,” adds Dr. A. Hassan, Neurologist and Medical Lead, Northwestern Ontario Regional Stroke Network.

While more strokes are happening, with advancements in stroke care, more people are surviving. The need for stroke treatment, prevention and recovery systems is crucial.

Donations supporting stroke care and EVT initiatives can be directed to the STROKE FUND through the Thunder Bay Regional Health Sciences Foundation at healthsciencesfoundation.ca/donate or by calling 807-345-4673.

For more information on stroke care in Northwestern Ontario, visit www.nwostroke.ca or email nwostroke@tbh.net.

Transplant Ambassador Program Webinar (TODAY)

For those individuals who are interested in kidney transplant or kidney donation, join this free Transplant Ambassador Program (TAP) webinar entitled “Kidney Transplant in Your 60’s or 70’s?  Getting a New Lease on Life in Your Golden Years” on Wednesday June 21, 2023 6:30 p.m. to 8:00 p.m. 

Please register at www.transplantambassadors.ca/tap-webinar-series/ to join.

Hear from our TAP panel of kidney transplant recipients and donors who share their lived experience.  These individuals wouldn’t let age be their obstacle in receiving or donating a kidney.

Staff Appreciation BBQ: TODAY!

All Hospital staff, professional staff and volunteers are invited to join us for food, free giveaways and camaraderie as we celebrate the work that has been accomplished in the first year of our Strategic Plan 2026.

Staff who complete the Wake the Giant Training module will receive a 15% promotional code towards the purchase of Wake the Giant Music Fest tickets and qualify for a chance to win free tickets at the Staff Appreciation BBQ.

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