Intervention for Critically-Ill Patients

Intervention for Critically-Ill Patients
From the Radiology Department Newsletter, Editor: Mary McAllister

With a combination of specialized expertise and breakthrough technology, the largest neurointerventional group on the East Coast based at Johns Hopkins Hospital is successfully treating critically-ill patients.

Dr. Philippe Gailloud, Associate Professor of Radiology, heads this team that treats everything that involves the blood vessels of the brain and spine. This includes stroke, vascular malformations and tumors, as well as various bone disorders. The team, which includes four attending interventional neuroradiologists, three clinical fellows, a nurse practitioner, a medical illustrator, a research coordinator, a research assistant, and an office manager, offers full-time services to adult and pediatric patients at Hopkins’ Baltimore and Bayview campuses.

Dr. Gailloud says that his team, which includes a dedicated spine neurointerventionalist, is rapidly expanding its spine service. With close ties to neurology, neurosurgery, and pediatrics, this group is the most intensively clinical division in the department, and will continue to expand in the future, as the clinical volume grows.

The group is expanding not only in personnel but also in new equipment. “We are now working on three biplane angiography suites, a new 40-slice interventional CT is ready to be installed to complement our 64- slice Multi-Detector Computed Tomography (MDCT), and we use, in collaboration with Cardiology, a state-of-the- art 320 CT for clinical research on CT angiography and perfusion,” he said. In addition to its heavy clinical load, the group is also developing a diverse research program, and is actively involved in several major national and international studies.

This unique combination of expertise and the latest technology is often put to the test when the team faces challenging cerebrovascular diseases. Recently, for example, a patient with a massive brain hemorrhage was referred to the group for treatment.

“Mrs. Claudia Leichling came to us because all her other treatment options had been exhausted,” explained Dr. Gailloud. “She had complicating health issues, including severe cardiac problems and a collapsed lung, which made her prognosis extremely poor. Her condition was essentially considered inoperable, and, quite frankly, hopeless, but we had to try to help her.”

She had a ruptured cerebral aneurysm that was successfully treated with detachable coils. “In total, she spent 18 days at Hopkins before we felt she was well enough to go home.”

“Thank you to everybody for saving my life,” says the grateful patient, who is now in good health and continues to follow up with her Hopkins physicians.

Dr. Gailloud reiterated the goal of his group to offer the latest in patient care, saying: “We will continue to treat all brain vascular disorders, expand our pediatric and spine coverage, and explore new and better ways to diagnose and treat these challenging and often critically ill patients.”

Internationally-renowned Dr. Jeff Geschwind has collaborated with Dr. Michael Soulen, professor of Radiology, at the University of Pennsylvania Health System on the first book to be published about interventional oncology (treatment of liver cancer). Dr. Geschwind is an associate professor of radiology, surgery and oncology at the Johns Hopkins University School of Medicine and Director of vascular and interventional radiology, and director of interventional radiology research at The Johns Hopkins Hospital in Baltimore. Dr. Geschwind has authored or co-authored more than 160 published manuscripts and abstracts mostly on magnetic resonance imaging and interventional oncology.

Dr. Dan Haller, editor in chief of the Journal of Clinical Oncology, said: “I was very excited to see the table of contents of this new book, which I believe should be mandatory reading for all interventional radiologists and oncologists. All of the authors are internationally known experts in their respective field of oncology. Drs. Geschwind and Soulen have done an admirable job of addressing a real need, frequently overlooked in existing standard textbooks."