Vascular Medicine Team Contributes to Unique Approach of Jefferson Vascular Center

Patients who need vascular care enjoy “one-stop shopping” at the Jefferson Vascular Center (JVC), which offers appointments with medical and surgical experts, as well as access to a vascular diagnostic lab and endovascular suites for routine and complex interventional procedures. The JVC is co-led by surgeon Paul J. DiMuzio, MD, MBA, and internist Geno J. Merli, MD. Dr. Merli’s Vascular Medicine team consists of Luis H. Eraso, MD, Taki Galanis MD, Walter K. Kraft, MD, and Geoffrey O. Ouma, DO, as well as Lynda Thompson, Pharm D, nurse practitioners Dina Orapallo and Heather Yenser, and support staff Julia Spross and Veronika Dubrovina. In addition to offering care in Center City and at Jefferson Methodist Hospital in South Philadelphia, Dr. Merli and his team provide 24/7 consultative services for vascularrelated disorders in patients at Jefferson, Methodist and Jefferson Hospital for Neuroscience. The Vascular Medicine team also offers specialty services. For example, Thompson, the Center’s pharmacist, supports the Jefferson Anti- Thrombotic Service for managing patients on blood-thinning medications, while Dr. Galanis and Orapallo run a special program for patients with peripheral artery disease. Dr. Merli’s team is also at the forefront of research in vascular medicine. Jefferson is a founding member of the Pulmonary Embolism Response Team Consortium (PERT), a national organization that advocates a team approach to caring for patients who come into hospitals with blood clots in their lungs. When such a patient is admitted, an alert goes out to PERT members, who use secure messaging to assemble a team with representation from pulmonary critical care, vascular medicine and interventional radiology. “We then get on the phone to discuss the patient or visit the patient in person. By following the PERT procedures, we’ve reduced length of stay in the ICU and in the hospital,” Dr. Merli explains, adding that PERT treated their 100th patient earlier this year. Another benefit of PERT Consortium membership is the participation in the National PERT database which analyzes performance across the 120 PERT hospitals in the U.S. Recently the Division completed the ADIOS Study, evaluating 130 patients who take blood thinners for atrial fibrillation and had to stop taking them prior to surgery. The study found that the anticoagulants are cleared from the system within 72 hours and thus safe to proceed with surgery. Another noteworthy endeavor is Jefferson’s Facilitated Anti- Coagulation for Safe Transitions (FAST) study, which developed a model for prescribing blood thinners to treat and release patients who come to the ER with a blood clot. FAST is now a national effort with involvement by the Society of Hospital Medicine, and plans are underway to extend the FAST study to eight hospitals across the U.S. “I’m proud of the way the Division has evolved over time,” Dr. Merli says. “We have faculty appointments in the Department of Medicine and Surgery. We are a unique model that demonstrates that integration and collaboration are the way we have to go. It’s wonderful to work this way.