Training surgeons to treat aneurysms safely

St. Michael’s teaches endovascular doctors from around the world how to reduce hemorrhagic stroke risk during brain surgery.

An international class of endovascular doctors completes St. Michael’s Hospital’s inaugural training program in advanced neurointervention for hemorrhagic conditions, in November 2023.

An international class of endovascular doctors completes St. Michael’s Hospital’s inaugural training program in advanced neurointervention for hemorrhagic conditions, in November 2023.

St. Michael’s is a national leader in medical education. The hospital is now training the trainers–showing top endovascular doctors from around the world the latest methods in treating brain aneurysms.

This past year, the hospital’s RADIS lab, which stands for Robotics, Artificial Intelligence, Dynamic Flow, (Advanced) Imaging and Simulation, launched an international training program in advanced neurointervention for hemorrhagic conditions. The RADIS team is training interventional surgeons, from countries as far away as China, Korea and Brazil, on the new, 64-wire, intracranial, flow-diverting stents (FDDs) that the lab helped to develop. These devices simplify the treatment for complex brain aneurysms and reduce the risk of hemorrhagic stroke, or uncontrollable bleeding in the brain. They do this by reconstructing arteries from the inside out and redirecting blood away from aneurysms, decreasing their size and preventing their rupture.

Back in May 2021, the St. Michael’s team led by Dr. Vitor Pereira, the head of the neurovascular program, and Dr. Julian Spears, the head of neurosurgery, performed North America’s first brain surgery using one of the new 64-wire FDDs.

“With previous generations of the stent, which only had 48 wires, we sometimes needed multiple devices to treat the same case, and that increased the complexity and risk of the procedure,” says Dr. Pereira, who holds the Schroeder Chair in Advanced Neurovascular Interventions at The Schroeder BRAIN&HEART Centre. “That’s why we want to train physicians on how to use this new technology, so we can prevent the life-threatening complications of hemorrhagic stroke treatment and improve the success rate of the procedure."

Training surgeons to treat aneurysms safely

St. Michael’s is renowned for teaching health practitioners how to teach others. It has the world’s only hospital-based Faculty Development program, in partnership with the University of Toronto, and the world’s most advanced safety simulation program, in the Allan Waters Family Simulation Centre.

Nicole Cancelliere, the neurovascular research program manager, radiographer and co-lead of the RADIS lab, says that this new program is a further testament to St. Michael’s reputation in medical education. Participants are mentored by global experts, including Dr. Pereira and Dr. Tom Marotta, the fellowship director of the neurovascular program. They also have access to a state-of-the-art, bi-plane angiography system and silicon-based models that perfectly replicate cerebral aneurysms.

In-person simulations lower the learning curve of new FDD placements and set up clinicians to be more successful with the device more quickly, according to Cancelliere.

“It’s one thing to learn all about this healthcare innovation and why it's better than previous interventions. But it's another thing to learn how to use it in a low-risk scenario, with no impact on patients whatsoever,” 

Cancelliere says. “It’s also quite significant to gather together global leaders in the neurovascular field in one place, at the same time. They’ve been very excited to train with these new 64-wire FDDs and then supervise this training in their home countries.”

Next, the RADIS team wants to expand its experimental educational program. It is all part of revolutionizing St. Michael’s BRAIN&HEART care through research in preventing complications of treatment, such as those around complex brain aneurysms, and education that furthers the technical skills of experts, such as those in the neurovascular field.

Currently, the team is carrying out foundational research to perform these procedures and training remotely. That way, patients in rural communities can have equal access to highly specialized endovascular treatments.

The pioneering work of the RADIS lab is all thanks to the generosity of donors. If you’re interested in learning more about what’s happening at The Schroeder BRAIN&HEART Centre, contact Ashley Downey at

Donate to St. Michael's Foundation.

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