Two-and-a-half years ago, Dr Sonu Bhaskar had an idea. Standing before him, however, were what many would describe as insurmountable challenges, one of which included a lack of resources. Faced with such challenges, most people would simply have shelved the idea and got on with life. But Dr Bhaskar is not like most people.
His drive and passion to learn as much as about the human brain, coupled with his unwavering commitment to help patients, saw him work relentlessly, pulling countless all-nighters and all-weekenders to turn his ideas into reality.
The idea? To develop a Brain Clot Bank which he hopes will, one day, become an important resource, not only in cardiovascular/stroke research, but also in assisting clinicians with their decisions on how to best treat different types of stroke.
In this venture, Dr Bhaskar joined with A/Professor Murray Killingworth from NSW Health Pathology, Ingham Institute and the University of New South Wales, a specialist in correlative microscopy and nanopathology. Together they began with the premise that the clots removed during a relatively new procedure, known as endovascular thrombectomy (EVT), should be analysed utilising the microscopy infrastructure available at Liverpool Hospital.
Previously, clots were only examined pathologically if there was a suspicion of infection. This lack of investigation, Dr Bhaskar explains, means that doctors are potentially missing valuable information about clot aetiology and the underlying mechanisms of a patient’s stroke.
“The NSW Brain Clot bank will be a useful resource in identifying the source of the clot blockage which can then assist doctors in advising stroke survivors of their ongoing risk factors and allow precision targeted therapy to prevent disease recurrence.”
This, Dr Bhaskar believes, will be particularly useful in cryptogenic stroke cases where the underlying cause of the stroke is unknown.
“When there is ambiguity around the cause of the stroke or the origin of the clot, there is an ambiguity about what the best treatment options are. This then impacts on the clinical care of the patient. These patients have poorer outcomes with a five times higher risk of mortality,” says Dr Bhaskar.
“Clots that we retrieve will, at the very least, throw some insights into this particular group of stroke patients.”
Dr Bhaskar’s idea for the development of the NSW Brain Clot Bank has become a reality with the awarding of four-years funding from the NSW Ministry of Health. This grant will enable the collection of thrombectomy samples and other biospecimens (including blood, stool, etc.) to be housed at the NSW State-wide Biobank Facility. Major NSW comprehensive stroke centres including Liverpool Hospital and Royal Prince Alfred Hospital have committed their support to contribute samples to the biobank. It is envisaged this will then extend to other major stroke centres across the country and internationally.
Creating the framework for the Brain Clot Bank, Dr Bhaskar explains, involved substantial work at a policy level. Before this, there were no standardised pathways for storing and analysing clots and no standardised reporting mechanisms.
“At the policy level, we are standardising the assessment, storage, workflow and the entire chain of clot diagnostics,” Dr Bhaskar explains.
Dr Bhaskar and Professor Killingworth’s work has been recognised by the Ministry of Health who are implementing their policy framework across other NSW biobanks. This framework is currently being considered for use at a national level.
Dr Bhaskar is steadfast in recognising the contribution and support from the Ingham Institute for Applied Medical Research, NSW Health Pathology, Liverpool Hospital and South West Sydney Local Health District (SWSLHD).
“This is a Liverpool story. A story which shows that despite challenges and a lack of resources, we can still persevere and deliver if we have the passion for improving the quality of life for our patients and an unflinching commitment to research,” says Dr Bhaskar.
Indeed, the establishment of the NSW Brain Clot bank is testament to Dr Bhaskar’s perseverance, passion, and commitment to turning his idea into a reality.