Radiologist Dr. William Siu and his team at Royal Columbian Hospital implemented the Endovascular Therapy (EVT) Program, a multi-agency approach to stroke care, which transformed how strokes are treated in Fraser Health and across B.C. at an administrative level.

For patients experiencing a stroke, every minute matters. Every minute can mean a life saved or long-term disabilities avoided. Recognizing this, Dr. William Siu developed and implemented the Endovascular Therapy (EVT) Program in Fraser Health to ensure stroke patients receive lifesaving treatment in a timely manner, starting from the first minutes of a call to 911 for help.

Dr. Siu obtained his medical degree and Radiology Residency Specialty training at the University of British Columbia. He spent the first year of his five-year radiology residency as an intern at Royal Columbian Hospital. Through his fellowship in neuroradiology at Vancouver General Hospital, he gained his stroke imaging and interventional skills. Since 2000, Dr. Siu has worked as a radiologist at Royal Columbian Hospital.

The Endovascular Therapy (EVT) Program is a multi-agency approach to stroke care. It begins as soon as 911 is called. Special stroke triaging frameworks ensure patients get to the hospital that can treat them most appropriately. For people experiencing acute ischemic strokes and requiring EVT, they will be triaged to Royal Columbian Hospital.

When they are alerted of a stroke patient on the way, Royal Columbian Hospital's Neurology and Emergency Departments quickly arrange diagnostic imaging and the dedicated stroke nurse provides around-the-clock patient care. If deemed appropriate, endovascular therapy is performed to extract blood clots affecting the brain's blood supply.

Endovascular therapy involves treating patients using microcatheters and retrieval devices inserted into the brain's arteries to remove blood clots that are blocking the blood supply to the brain, which Dr. Siu and his team must perform.

"It is not only the treatment that he has implemented in Fraser Health, but he has looked at the entire patient pathway," says Dr. Kenneth Wong, a colleague of Dr. Siu and the local department head of Medical Imaging at Royal Columbian Hospital. "He has been able to save patients on an individual basis, and also helped transform how stroke is treated in Fraser Health and across B.C. at an administrative level."

"Not one individual can do this — you need to build a team and have team efforts," says Dr. Siu. He trained colleagues and worked with provincial agencies to implement standards and policies for practitioners to create a streamlined process. The EVT is now available at several sites in the province.

When asked what motivates him, Dr. Siu says, "When patients wake up and realize they have recovered their speech and they can say thank you to the team and me — those moments are very touching."

Dr. Siu recalls one of his early patients, "She had a major stroke during Christmas time, and her granddaughter called it in. We were able to get her back home within a few weeks. She continued to update us every year. She would come to meet us, bring us a box of chocolates. She lived a full life and watched her granddaughter grow up — this would not have been possible if she didn't receive EVT."

Dr. Siu's colleague, Dr. Kenneth Wong, explains, "Dr. Siu's efforts go above and beyond the normal duties of a physician. He encourages and trains his colleagues. Through the years, he's made himself more available as more patients presented at Royal Columbian Hospital. This is worthy of recognition."

Dr. William Siu is a recipient of this year's Above and Beyond Fraser Health Hero Award.

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