(705) 728-9090 x46320 | 201 Georgian Drive. Barrie, ON L4M 6M2

Central East Stroke Network
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Endovascular Therapy

Endovascular Thrombectomy (EVT) is a standard of care for clinical management of ischemic stroke patients.  Highly selected patients with large ischemic stroke and large artery occlusion may benefit from EVT up to 24 hours from the time they were last known well, including patients with stroke on awakening.  

For additional information on acute stroke management refer to the Canadian Stroke Best Practice Recommendations #5 Acute Ischemic Stroke Treatment 2022 Update.    


4-24hr EVT Toolkit for Non-thrombolytic Sites

The EVT Toolkit has been developed to help Central East Stroke Network organizations with the implementation of a Large Vessel Occlusion Stroke Screening Tool (ACT-FAST) and guide the decision making in the eligibility for EVT.  The screen has high specificity and reliability for recognizing large vessel occlusions in severe anterior circulation stroke (Zhao et al., 2018).  


The toolkit is for community non-thrombolytic hospitals and is intended for use by organizations’ clinicians including, educators, managers, resource nurses, coordinators, nurses and physicians. Each tab contains resources that can be modified for your site as well as district-specific resources.

EVT is a highly specialized procedure involving the mechanical removal of a clot in the brain.  The procedure is performed  by specialists with neurointerventional expertise at EVT Centres. The procedure is for patients with large vessel occlusions. Using advanced imaging, a guide wire is introduced into the femoral artery and guided up to and through the clot.  The guide wire is removed, and a stent is inserted and deployed. The clot is encapsulated by the stent and then is mechanically removed. 

Medtronic Innovation Helps Yoga Mom Survive a Stroke – Click Here to view video clip

Dr. Timo Krings on why he loves helping patients – Krembil Brain Institute – Click Here to view video clip

Time and Teamwork in Stroke Care – Click Here to view video clip

Mechanical Thrombectomy at the Cleveland Clinic – Click Here to view a short video clip that demonstrates how the procedure is done

When should my stroke patient be sent for EVT? What Emergency Doctors Need to Know!

This video (18 min) was developed by Dr. Blair Bigham in collaboration with the Central East Stroke Network. It provides information for emergency doctors who work in hospitals without comprehensive stroke teams, on-call stroke neurologists or neurointerventional programs. The video discusses indications for EVT, various large vessel stroke syndromes, and the steps needed to refer to a neurointerventionalist.

Created by Dr. Blair Bigham MD MSc DTMH FRCPC an Emergency Physician in the Durham Region, Ontario

Screen – Scan – Send: A Primer on Recognizing Large Vessel Occlusion Strokes that may Benefit from Endovascular Therapy

This 18-minute video provides an overview of the initial assessment of someone presenting with stroke-like symptoms (SCREEN), the importance of STAT imaging (SCAN) and contacting CritiCall to speak with the Stroke Endovascular Team and if patient accepted, arrangements to transfer the patient to an EVT centre (SEND).

The video was created in collaboration with Dr. Blair Bigham MD MSc DTMH FRCPC an Emergency Physician in the Durham Region, Ontario. A very special thank-you to all the individuals who participated in the video and to the Videographer at Lakeridge Health for filming.  

Additional Resources as outlined in the video include:

TPA Evidence Review (42 min, free online, U. Ottawa “A stroke of luck” Jul 2021):  Thrombolytics – A Stroke of Luck

EVT Evidence Review

EVT +/- Lysis:  The future of Stroke? Blog on SGEM and ACEPNow:   

Bedside Neurological Assessment of the Stroke Patient

This 13 min video was developed and filmed by the Stroke Network of Southeastern Ontario. Dr. Jin, a stroke neurologist, explains and demonstrates the key elements of a neurological assessment which can be done at the bedside.  CLICK HERE to view

National Institutes of Health Stroke Scale (NIHSS) – Training for ED Physicians (no cost)


Additional Training Videos:


Scoring Tools/apps:

  • Lexicomp – subscription required.  Some organizations may have subscription to this resource and can access the NIHSS scoring tool
  • Apple Store – NIHSS Stroke Scale – Inneva Pharma SL (there is an associated cost to purchase app)

Do not delay calling CritiCall to await local interpretation of imaging. 

Medical Escort

Guidance for Medical Escort Requirements for AIS Patients being Transferred for EVT – this is a new document as of June 14th, 2023. The document was developed in collaboration with the Hyperacute Stroke Steering Committee, the Ontario Base Hospital MAC and the Ontario Association of Paramedic Chiefs.  

Simcoe Audit Tool 

Note:  The measurements in red on the audit tool identify what indicator is being measured. You do not need to do anything with them when you are completing the form. 

Muskoka Audit Tool
HKPR Audit Tool
York Audit Tool
Process Reporting Form

Regional Director:  Donelda Sooley

T:    705-928-9090 ext. 46300         Email: sooleyd@rvh.on.ca

Regional Education Coordinator:  Dorothy Burridge

Email: burridged@rvh.on.ca

Medical Director:  Dr. Alex Jahangirvand


District Stroke Coordinator: Amy Gargal

T: 705-789-2311  ext. 2510    Email:  amy.gargal@mahc.ca

Stroke Nurse Specialist: Julia Crump

Email:  julia.crump@mahc.ca

Haliburton Kawartha Pine Ridge (HKPR)

District Stroke Coordinator:  position vacant (Nov 2023)

T: 705 743 2121  ext. 3946            Email: 

Advance Practice Stroke Nurse:  Shannon Bacon

T:  705-743-2121  ext. 4144      Email:  sbacon@prhc.on.ca

Medical Director:  Dr. Kirk Dillon

Lakeridge Health

District Stroke Coordinator: Amy Maebrae-Waller 

Email: AWaller@lh.ca

Clinical Nurse Specialist: Julia Deck

Email: jdeck@lh.ca

Medical Director:  Dr. Lancy Wang


District Stroke Coordinator:  Anna Sewell

T:  (905) 883-1212 ext. 6215           Email:  anna.sewell@mackenziehealth.ca

Clinical Nurse Specialist:  Paul Corteza

T:  905-883-1212 ext. 7109/3839        Email:  paul.corteza@mackenziehealth.ca

Looking for local community resources? Please visit the links below for more information:

Central East Line
Central Health Line
NSM Health Line