Emilio Sacristan is the Chief Scientific Officer of Vacere, a company working to eliminate brain damage and death caused by ischemic stroke and vasospasm. Its CEREFAST™ medical device proved successful in initial human trials, and the team is now conducting multicenter testing in the US via a National Institutes of Health (NIH) grant.
CEREFAST™ significantly improves blood flow to the brain at the earliest interventional opportunity by stimulating facial nerves during a two-minute, noninvasive procedure. “Time is brain,” explains Emilio. In addition to almost immediate treatment for stroke, the product has been shown effective for treating vasospasm (a potentially fatal result of post-aneurysm treatment) and migraines.
Emilio and Wendy connected at the Redefining Early Stage of Investment (RESI) Conference in Boston, hosted by Life Science Nation. (Wendy recently interviewed Dennis Ford, founder and CEO of Life Science Nation, which specializes in fundraising for life sciences companies.)
From “Crazy Idea” to Modern Medical Device
Emilio is also a Professor of Biomedical Engineering at Universidad Autónoma Metropolitana-Iztapalapa (UAM-Iztapalapa) in Mexico City. He holds dual Spanish citizenship, speaks four languages (Spanish, English, French, and German), and has a Ph.D. in Biomedical Engineering from Worcester Polytechnic Institute (WPI). Yet even with such a storied background, Emilio was initially skeptical of the whole concept. When his partner first floated the idea, Emilio said, “It’s never going to work.”
But we did; we worked on it for several years, doing animal experiments and trying to figure out how to make it work. We've known for a long time that facial nerves control many things. It's our cheeks, it's our palate, our smile, but it also has a branch that controls the arteries of the brain. [I]f you expose the nerve and give it electrical impulses, you can actually open up the arteries. But that never had a clinical application because when you're having a stroke, nobody is going to start cutting open your cheek….
Stroke is the leading cause of disability and the second leading cause of death worldwide. In the US, at least 800,000 people suffer a stroke each year, resulting in over 140,000 deaths. Worldwide, those numbers reach 15 million and 7 million, respectively. And these numbers ignore the lifelong disabilities affecting the survivors.
As such, the global implications of CEREFAST™ are profound. It represents more than just a medical innovation; it signals a potential paradigm shift in emergency neurological care. In many regions, especially those with limited medical infrastructure, stroke patients often receive minimal treatment at the time of the incident, and as Emilio repeats, “time is brain.”
Navigating Global Markets with Linguistic and Cultural Expertise
And just as Emilio and his partner had to jump through interdisciplinary regulatory and engineering hoops to secure approval for human trials, the company’s go-to-market strategy was built upon a deeply nuanced cross-cultural understanding and attention to linguistic details. Emilio’s linguistic arsenal lends him a significant competitive advantage, allowing him to navigate complex international negotiations, build relationships, and understand subtle communication cues.
Except in China, one of Vacere’s primary target markets, where even English-speaking colleagues can be unreliable in their written translation and spoken interpreting. Emilio admits that he works with a professional language services company for dealings in China, adding that he more than occasionally finds himself translating or reviewing documents in one of his three fluent languages.
“Of course we’re going to do this worldwide," Emilio says, starting with expansion into Europe and the start of a migraine study in Latin America next year. When approaching new markets and potential investors, he adds, follow a deliberate and thoughtful cultural playbook, strategically avoiding potentially divisive topics like politics and history, and instead focusing on universally engaging subjects that foster positive dialogue.
"Innovation is a topic that everybody likes," he notes. "Everybody has their own definition, but everybody wants to talk about it."
The Multilingual Entrepreneur's Toolkit
For any entrepreneur looking to expand globally, Emilio suggests keeping these skills at the ready:
- Strong multilingual communication skills
- Cultural intelligence and adaptability
- A repository of positive, forward-looking conversation topics
- Networking
- An open mind for unconventional, innovative ideas
- Diverse, international teams
Listen to the full episode for more practical advice on securing international funding, and the language and cultural requirements for successful global expansion and marketing.
Links:
LinkedIn: https://www.linkedin.com/in/emiliosacristan/
Connect with Wendy: https://www.linkedin.com/in/wendypease/
Music: Fiddle-De-Dee by Shane Ivers - https://www.silvermansound.com
ATTENTION: Below is a machine-generated transcription of the podcast. Yes, here at Rapport International we talk a lot about how machine translation lacks quality. Here you see an example of what a machine can do in your own language. This transcription is provided as a gist and to give time indicators to find a topic of interest.
Wendy: Welcome to The Global Marketing Show. Listen, I'm so excited for our guest today. And I just want to remind you before I introduce him that we're brought to you by Rapport International and today's tidbit is a peaceful greeting. Selamat is a typical greeting in Indonesia that means peace.
So can you imagine saying selamat to everybody you see wishing them peace? I think that's so nice. So today's guest is Emilio Sacristan. He's from Vacere Medical. And he must be brilliant, because he has been visiting professor at Stanford, Yale, and multiple other places. He hails from Mexico.
Emilio: Mexico City.
Wendy: So Emilio, welcome!
And tell me a little bit about yourself.
Emilio: I'm from Mexico, grew up in Mexico, although I'm actually a Spanish citizen also because my father was Spanish. And I [00:01:00] came to school around here in England. And lived here in. In MIT, right? Sometime at MIT and at WPI.
Wendy: I knew it.
Emilio: So, I lived in this area for a long time. So I feel very much at home in New England. You mentioned some of the universities, but I'm a professor of biomedical engineering at the Metropolitan University of Mexico City.
Wendy: Okay. I lived in Mexico City when I was a little girl. Really? Yes. So I just said that I lived in Mexico City when I was young, first and second grade. So I love Mexico City. I have wonderful memories of going to first and second grade there. So tell me about Vacere Medical.
Emilio: So this is a project I've been working on for a little over 10 years now.
We started with the crazy idea that my then partner, a neurologist thought that [00:02:00] maybe if we could stimulate the facial nerves, we could actually open up the arteries in the brain, and we could do this non invasively. And it was a crazy idea. When he first told me about it, I said, it's never gonna work.
It's just not gonna work. But we did, we worked on it for several years, doing animal experiments, trying to figure out how to make it work. We've known for a long time, that the facial nerve controls many things. It's our cheeks, it's our palate, our smile, but it also has a branch that controls the arteries of the brain.
Our central nervous system has a fast control mechanism that will allow us to stand on our head and do a flip without passing out. So the central nervous system can quickly open and close the arteries to the brain. This has been known for a long time that if you actually [00:03:00] give electrical impulses, expose the nerve and give it electrical impulses, you can actually open up the arteries.
But that never had a clinical application because you're having a stroke or something, nobody is going to start cutting open your cheek to expose a nerve to give it a little electrical shock.
Wendy: Yeah, that seems a little unusual.
Emilio: So the idea here is maybe we could trigger the nerve magnetically with magnetic pulses.
And it was a harebrained idea at the time. But we started testing it and it works really well. We found out exactly how to do it and what it took and we finally developed a human system. And when we first started this project, it was relatively easy to get funding to do animal experiments and to test the idea.
But we've pretty much done everything we could think of. We needed to step it up and go human.
Wendy: Yeah.
Emilio: And we need to build a human system, which required some very [00:04:00] expensive engineering to develop the system. And we needed to get approval to actually start testing humans. And then we hit a brick wall.
I mean, everybody's like, are you sure there's going to be safe and effective in humans? And we're like, well, no, that's what we need to build it and test it. You know, everybody was like,
Wendy: standard.
Emilio: Well, we finally convinced the authorities, we did our first human trials, healthy humans, we did clinical trials and it worked.
It was incredible. It works so well. And so then the FDA gave us humanitarian device designation and the NIH gave us a big grant to do a multicenter trial in the US,
and so we're up and running again and we're getting that done and we want to get this to market and save some lives.
Wendy: Excellent. Okay, so now we understand a little bit about what it is. Let's switch it over to the, the business side and the [00:05:00] global marketing. So where are you and are you based in Mexico or US?
Emilio: Yeah, I live in Mexico City.
Wendy: Okay.
Emilio: I didn't move to Cleveland, Ohio for a while.
Because that's where we're running the trials.
But I'm back in Mexico City. After COVID, everybody went to Zoom for everything. And then I realized that why am I traveling so much? I could just live at home and take Zoom meetings from Mexico. I still travel a lot. But,
Wendy: Well, you're here at the RESI conference. Yeah, and I was just in Cleveland,
Emilio: but not as much, and I don't have to live in Cleveland. I can supervise things.
We have an international group. Our team has an international group. We have a European investors and one of our board members is French and so it's widespread team.
Wendy: So how did you get the European investors? [00:06:00] How did you connect with them?
Emilio: Networking.
Wendy: Networking?
Emilio: Yep.
Wendy: Online? RESI conferences?
Emilio: Oh yeah, conferences and things like that.
I went to a conference like this, pitched the project. This guy was on the panel. He really liked it. He opened up and made introductions.
Wendy: Okay. So going to international conferences is what opened it up. Okay. And where are they? You said European investors or?
Emilio: Netherlands.
Wendy: They're in the Netherlands. Okay. And now what's your plan for go to market?
Emilio: Well, we want to do three. It's the same technology, but we want to use it for three clinical applications. First application is most interesting, it's stroke. We want to treat patients in the emergency room, or even in the ambulance on the way to the emergency room, [00:07:00] as a first emergency treatment to be used within the first 12 hours.
So as soon as a physician can make the decision that they can be treated. And hopefully this could be a treatment that can be offered even in non-stroke centers. Right now you can only get treated for stroke in a stroke center. So a lot of patients go to the wrong hospital and they have to get transferred
Wendy: and they lose that time.
Emilio: So, and time is brain. So the longer you take to get some treatment, the more of your brain is going to die.
Wendy: So this would be a therapeutic
Emilio: Therapeutic.
Wendy: That you could teach
Emilio: Responders to use, right? This would be like a defibrillator but for the brain,
Wendy: okay and so I understand that in the US system. How are you thinking about global launch or what countries are you going into?
Emilio: Yes. Well, the biggest markets are the US, Europe, and [00:08:00] China. Most of the world, I mean, stroke affects everywhere, but most of the world does not have stroke centers. They have very, very few stroke centers. So, basically people that get a stroke either die or get disabled or recover.
Some of them recover fully, but they don't really get treated within that first time window. So, the only treatment they receive is really rehabilitation after the fact if they survive, in most places. It's incredibly expensive, to have stroke centers that will receive patients, and quickly treat them, within that first time window.
Some hospitals have even recurred to having these really expensive ambulances that actually have a CT scanner inside the ambulance so that they can be diagnosed on the way to the hospital.
Wendy: Wow.
Emilio: And a lot of patients go to the wrong hospital and they have to [00:09:00] get referred. And by the time they get to the right hospital, it's too late.
So that's a big problem. And it's incredibly expensive. Stroke is very expensive in the impact it causes. The associated cause of rehabilitation, and it's, the second leading cause of death worldwide. So it's a big problem, big unresolved problem.
Wendy: If I think back to cell phones, there were some parts of the world that skipped landlines because they didn't have the technology to put them in and they went straight to cell phones.
I mean, treating stroke, this is kind of making me think of that.
Emilio: Yeah, this might open this up for people that don't have access, to be able to offer some therapy. And it doesn't compete against other therapies. This will be in conjunction. You can still get a thrombolytic, which is a clot busting drug or something else, but this can be applied earlier because it's safe and it's easier.
[00:10:00] And you don't need to have a differential diagnosis. So we hope eventually to prove that you could treat patients before you even determine whether they have ischemic stroke or hemorrhagic stroke.
Wendy: Right, because there's no damage that's caused. Okay.
Emilio: So that would be the first application.
The second application is a stroke-like condition that is the nightmare of the neurosurgeon. It's called vasospasm. So a patient has a burst aneurysm, gets rushed into the operating room, they get brain surgery, they put a clip on it. They're recovering in the ICU. They're doing well.
They even start to walk. Met with a family. Then suddenly, four to seven days later, they get something that's called vasospasm, which is, the arteries in the brain get irritated and then they just clamp down and close off. And it's like a stroke. And it's deadly. More than [00:11:00] fifty percent of patients die or have a permanent disability.
And there's no standard treatment that's really effective. We tried it in our group, a hundred percent of our patients fully recovered, resolved their vasoplasm, or didn't need any further treatment. When the FDA saw that data, they said, we're going to give you the Humanitarian Device Exemption.
So that would be the second application. That's a smaller market, but it's a big need. And the third, we have a strategic partner that is funding trials to use this as a prophylactic treatment for migraine.
Wendy: For?
Emilio: Migraine. Oh, migraine. Ooh. Yeah. Yeah. Migraine is also related to vascular changes.
Wendy: Yes.
Emilio: You have a long period of this vasoconstriction that constricts the arteries.
And then suddenly you get like a bounce and it vasodilates and that's when you get the pain.
Wendy: Yeah. [00:12:00] Yes.
Emilio: And so we're going to try it and see if we can vasodilate and do it periodically.
Wendy: So it's almost a direct to consumer product
Emilio: then?
No, it would be sold to the neurologist and the neurologist would be able to treat their patients in the office.
Wendy: Wow. Okay. I mean, this is fantastic stuff. It could change the world with how people treat stroke. So you know your hot markets are in the US, Europe, and China.
Emilio: Yeah.
Wendy: How?
Emilio: Of course we're going to do this worldwide.
Wendy: Right.
Emilio: Well, right now our clinical trials are in the US,
We want to do a separate arm for stroke in Europe starting next year. Next year we're starting our migraine study in Latin America.
Wendy: Okay. I mean it's The Global Marketing Show so we have to talk about language and culture and how you're [00:13:00] handling that. How are you handling the different languages across countries?
Emilio: Well, we're a very multilingual team. The only part where we really struggle is China.
China is difficult because none of us speak Chinese.
Wendy: Yeah.
Emilio: It's very difficult. But Europe is not a big deal. We're all very bilingual, trilingual. I speak four languages.
Wendy: English, Spanish,
Emilio: French, German,
Wendy: and German. Oh, Okay. I wouldn't have guessed that. All right. And so you can have all the business dealings and negotiations.
You can switch the languages. And then what about when you're doing contracts or you're doing your marketing materials or authorization?
Emilio: Well, Europe is not hard to find people that speak English. Europe is very easy. You know, you hire lawyers or advisors that will speak both languages and will help you do all that.
That's not that hard.
Wendy: Okay.
Emilio: You can of course do that in China too, but the [00:14:00] problem is you can't double check. It's harder. And I've had the issue of having documents translated into Chinese and then translated back. And the way you get back is, it's kind of nonsense. It's very hard.
Wendy: It's very hard. Yeah. We've had people ask us at Rapport International for back translations. And we say you're better off getting another person that's fully bilingual, a professional translator, to review it and make any edits to things that don't make sense.
And then you can see the number of edits and what kind of edits are on there. Oh, yeah. Because the back translation can leave a lot open.
Emilio: Of course, in China, a lot of people speak English too, in a professional setting, but even then, you wonder what it is you're missing.
Wendy: Yes.
Emilio: Yeah, so that's the experience I [00:15:00] have with that.
I've lived and worked in the US for a big chunk of my life, so I have no problem dealing with the US.
Wendy: So you got the US and Mexico down pat.
Yeah. And then have you ever worked with a professional translation company or you've been able to lean on your internal folks and attorney?
Emilio: Yeah, I have at times when I don't have time to translate stuff, but I usually review whatever's being done as much as I can.
Wendy: Yeah.
Emilio: I don't have one that I work with particularly.
Wendy: I wondered what your experience was and I'm surprised with what you're managing, you're still doing the translations.
Emilio: Yeah. Well, yeah. If I have time.
And my German is not good. But I feel very comfortable doing English and French, no doubt.
Wendy: No, it takes a lot of time. We've had people [00:16:00] talking about what they could have been doing with that time by using a professional translator, but you're driving a good point home is that how do I trust that they're doing a good job?
Yeah, and you knowing the languages really helps.
Emilio: Yeah.
Wendy: If you find the right professional translation agency they can help you work through a lot of that. That's what you can depend on. But I also want to talk about culture.
Emilio: Yes.
Wendy: Like you are definitely multicultural.
Emilio: Yes.
Wendy: And so what's your advice for people who are thinking maybe I could do fundraising or maybe when I want to launch in other countries, like how do you work across cultures so that you feel like you're being productive or what are some of the challenges you've had and how have you worked through them?
Emilio: Well, I grew up very multicultural, my mother is actually Hungarian.
My father is French. My wife is American, but she was born in [00:17:00] Canada from Finnish and English. And I have such a multicultural and I've always traveled a lot, lived in different cultures. So I think I have a big sense of different cultures.
Wendy: So you do it kind of seamlessly. You've been exposed to so many cultures, you know how to land. Yeah. What are some topics that you would say you don't talk about if you're going into a new culture? Is there anything off limits?
Emilio: Oh, yeah, I avoid politics.
Wendy: Okay.
Emilio: I don't try to talk politics. The politics is off the table.
Yeah, and sometimes they want to talk politics and I'm like, all right, but I'll try not to talk about it. Yeah.
Wendy: I'm not going to ask you about American politics at all. Yeah.
Emilio: Yeah.
Wendy: Are there any other topics that are off limits?
Emilio: Well, there's some [00:18:00] historical things like if your country went to war with the other country and stuff like that, I want to kind of not really get into that too much because you probably have two very different takes on history.
Wendy: Okay.
Emilio: So yeah, I try to avoid that too. Keep it always forward looking.
Wendy: Forward looking. Okay. So what topics would you tend to bring up if you're socializing?
Emilio: Curing disease, where the future could go, innovation in general. It's a topic that everybody likes, everybody has their own definition, but everybody wants to talk about innovation. So that makes it easier.
Wendy: Those are great ideas. And ones I hadn't heard before, but everybody can engage in them. How do you define innovation? What's innovation? What are you excited about? Right. Great, great idea. Yeah. [00:19:00] Okay. So, you know, I have to ask this question because I ask everybody, what's your favorite foreign word?
Emilio: What's my favorite foreign word?
Wendy: Yes.
Emilio: Oh, and it works in every language.
Wendy: Every language. That's why I like asking it.
Emilio: I'll say it in French, merde. .
Wendy: All right. Now you have to define it and say why it's your favorite word.
Emilio: But in English or in Germany is just dissatisfied or in Spanish.
Wendy: All of them. All of them. Like give, tell me how to say all the languages.
Emilio: Yeah. So anyway, merde.
Wendy: Yeah.
Emilio: Merde. Shit.
Wendy: What's it in German?
Emilio: Scheiße.
Wendy: Scheiße, of course, yeah.
Emilio: So that would be my favorite one.
Wendy: Oh yeah? Why is that your favorite one?
Emilio: I don't know, it's just satisfying.
Wendy: It is satisfying in so many ways. [00:20:00] All right. What are you hoping to get out of the RESI conference today?
Emilio: Well, we're here to raise money for our next launch and next step, next phase. So we're trying to wrap up our fundraising drive.
Wendy: Excellent. Well, thank you so much. We will share the episode so you can use it to help you with fundraising. And I'd also like to present you with a copy of The Language of Global Marketing.
Thank you. Thank you very much. Yes, and I wish you the best of luck and if there's anything that we can ever do to help you with your international expansion, please let me know.
Emilio: very much. It's been a pleasure.
Wendy: Okay. And thank you listeners of The Global Marketing Show. I hope you enjoyed this episode with Emilio, who is certainly a cross cultural person with all the places he's lived and the exposures he's had. And, I love his idea about [00:21:00] speaking about innovation. So I hope you use that in any of your international discussions, rate us with the five, share the episode, come back and check out another episode. Thanks so much for tuning in.
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