Stroke remains one of the most significant health threats facing older Australians, striking around 113 people across the country every single day. Now, Australian researchers have developed a groundbreaking new technology that could dramatically improve how accurately doctors predict who is actually at risk of a stroke, rather than relying on the broad, sometimes misleading risk categories used today.

Just how common is stroke in older Australians?

The numbers make clear why this research matters so much. According to the Australian Institute of Health and Welfare, an estimated 425,000 Australians have experienced a stroke at some point in their lives, with around 41,100 stroke events recorded in 2023 alone. Hospitalisations rise sharply with age: half of all stroke hospitalisations in Australia occur in people aged 75 and over, and more than 85 per cent of ischaemic stroke hospitalisations involve people aged 60 and older. Stroke was the underlying cause of 7,900 deaths in 2024. The encouraging news is that the age-standardised rate of stroke has actually fallen by 30 per cent since 2001, thanks to better prevention and treatment – but with Australia’s population continuing to age, the total number of stroke survivors is still projected to keep climbing in the years ahead.

The problem researchers set out to solve

Despite decades of research, predicting an individual’s risk of ischemic stroke — the most common type, caused by a blood clot blocking blood flow to the brain — remains genuinely difficult. That’s because the process behind it, where a clot forms and then breaks free to lodge in another blood vessel, depends on factors unique to each person’s own body.

“We know that even patients at ‘low risk’ can suffer from severe or fatal strokes,” said Lining Arnold Ju from the University of Sydney, one of the researchers behind the new study, published in the journal Cell Biomaterials. “We wanted to find a better way to predict this risk.”

A “physical twin” of your own artery

The team’s solution is a genuinely novel one: an “artery-on-a-chip” platform that recreates a patient’s own specific carotid artery structure and blood flow patterns — essentially building a physical, working replica of that person’s own blood vessel, rather than relying on generic risk calculators.

“Our work recreates precise, patient-specific carotid artery geometries,” Ju explained. The model also uses cells designed to closely mimic how blood actually behaves as it moves through those exact structures.

Testing the approach on reconstructed arteries from six patients with varying degrees of disease, the researchers used computational fluid dynamics to map how blood flowed through each one. The results were revealing: even patients with similar levels of artery narrowing showed substantially different blood flow patterns. After creating a small, controlled injury in each model to observe clotting behaviour, the team found strikingly different clotting responses depending on the artery’s individual shape.

“Our findings suggested that three-dimensional vascular shape and local flow disturbances matter far more than simple narrowing,” said first author Yunduo Charles Zhao, from the Heart Research Institute in Newtown. Zhao has a personal connection to the research, having shifted his focus toward predictive stroke diagnosis during his PhD after losing his grandmother to stroke.

What this could mean for the future

The hope is that this technology will eventually allow doctors to test how individual patients might respond to particular stroke-prevention medications, and to develop genuinely personalised treatment plans based on a person’s own unique artery shape, rather than a one-size-fits-all risk category. The research team is now recruiting stroke patients for a clinical trial to test how the technology could directly benefit patients who are currently underserved by existing risk prediction methods.

The researchers also believe the same approach could eventually be applied to other vascular conditions common in older adults, including peripheral artery disease, deep-vein thrombosis and aneurysms.

Why this research matters, even before it reaches patients

While this technology is still in the research and trial phase, its significance lies in directly addressing a problem many older Australians and their families may have witnessed firsthand: a “low risk” classification that didn’t prevent a serious or fatal stroke. If this kind of personalised, shape-based risk assessment eventually makes its way into everyday clinical practice, it could mean considerably more accurate warnings for the patients who need them most, rather than broad statistical categories that don’t always reflect an individual’s true risk.

In the meantime, the fundamentals of stroke prevention remain unchanged: managing blood pressure, cholesterol and diabetes, not smoking, staying physically active, and knowing the FAST warning signs of stroke (Face drooping, Arm weakness, Speech difficulty, Time to call 000) remain the best tools available to reduce risk and ensure fast treatment if a stroke does occur.

This article reports on published research findings and is general in nature. It isn’t medical advice — if you have concerns about your stroke risk, speak with your GP.