Radiologist brings expertise to Libin Cardiovascular Institute

Cardiovascular disease and strokes are closely connected. In fact, strokes increase the risk of heart attacks, heart failure, atrial fibrillation and other cardiovascular conditions. Conversely, patients with heart disease are more likely to have a stroke. 

Dr. Johanna Ospel, MD, PhD, is bringing her expertise in stroke care and research to the Libin Cardiovascular Institute as its newest member.  

A Clinical Associate Professor in the Department of Diagnostic Imaging at the University of Calgary, Ospel is a radiologist who specializes in diagnostic and interventional neuroradiology. 

Clinically, Ospel specializes in endovascular neuro treatment of cerebrovascular disease – a minimally invasive treatment for stroke patients that involves using a catheter to clear blood clots (occlusions) from the brain vessels following a stroke.

According to Ospel, the procedure was first proven to be beneficial in 2015 and vastly improves patient outcomes for stroke patients.   

“Calgary held one of the landmark trials and is a leader in this intervention,” says Ospel. “Prior to development of the endovascular procedure, there really wasn’t an effective treatment for stroke, and between 20-30 per cent of patients died within three months following a large stroke. Many more ended up severely disabled.”  

With the endovascular procedure, the mortality rate of large vessel stroke is lowered to 15 per cent at three months, and the number of patients who can live their lives independently almost doubles, from around 25 to almost 50 per cent. 

Ospel interest in medicine began in her youth. 

“My mom is a family doctor in a small town in Germany, and in my teens I spent time at her clinic,” says Ospel. “She absolutely loved her job, and still finds it very fulfilling. That inspired me to pursue medicine.” 

Ospel’s fascination with endovascular stroke treatment began while she was introduced to the then cutting-edge stroke treatment while completing a radiology rotation in medical school at the Friedrich-Schiller-Universität Jena in Germany. 

“It was amazing,” says Ospel. “Patients go into the procedure paralyzed on one side of their body, and they can suddenly start moving it again. “You can see the difference immediately.” 

Inspired by these minimally invasive procedures that can suddenly completely turn around a patient’s prognosis, Ospel went on to complete her radiology residency at the University Hospital Basel in Switzerland and her fellowship in diagnostic and interventional radiology at the University of Calgary. 

On the research side, she earned her PhD at the University of Amsterdam and worked as a postdoctoral research associate in the Department of Clinical Neurosciences at the University of Calgary before taking on her current role. 

Ospel’s research mainly focuses on endovascular treatment for strokes and finding more effective treatments for stroke patients in general. 

“One of my biggest research projects has been looking at expanding indications for treatment,” says Ospel. “So far, the procedure is only done in a selected group of patients with occlusions in the large vessels of their brain. We are looking at expanding that to patients with medium sized occlusions.” 

Working with these patients isn’t easy, says Ospel. Because the affected vessels are quite small, it can be hard to spot these blockages, and their location in small, delicate vessels makes their removal tricky.  

Ospel’s research in this area has been published in the New England Journal of Medicine (https://www.nejm.org/doi/full/10.1056/NEJMoa2411668).

Ospel is also interested in studying the structure and underlying causes of brain blockages.  

She explains that these clots tell a story about the health of the patient and the source of the stroke. For example, researchers can link the clots to the heart, which can impact care pathways, or look for inflammation or cancer cells in blood clots. They can also examine why some individuals respond better to clot busting drugs, with the aim of finding the optimal treatment for each individual patient. 

 “Endovascular stroke treatment offers a lot of opportunities because these interventions are novel,” says Ospel. “There are so many things to discover.”  

Ospel joined the instate because she is interested in building a multi-disciplinary network comprised of clinicians and researchers, such as neurologists, stroke physicians, radiologists, cardiologists, imaging specialists, engineers and data scientists. She can be reached at johanna.ospel@ucalgary.ca