Consultant Interventional Neuroradiologist

About Dr Levansri Makalanda

More than 3,000 brain procedures and 4,500 spinal procedures, a 24-hour stroke thrombectomy service built from a single-operator unit and a practice that treats the brain and the spine without open surgery.

Dr Levansri Makalanda
Dr Levansri Makalanda
Consultant Interventional Neuroradiologist

Education

Dr Makalanda qualified in medicine from Guy’s and St Thomas’ (UMDS) in 1999. He is a Member of the Royal College of Surgeons (MRCS, 2004) and a Fellow of the Royal College of Radiologists (FRCR, 2008), and trained in cardiothoracic surgery and intensive care before specialising in radiology and neuroradiology. He is a Fellow of the European Board of Neurointervention and holds the three European Diplomas in neuroradiology, all awarded in 2012: diagnostic, interventional endovascular and interventional spinal. Together they cover the full range from diagnosis to treatment of the brain and the spine.

Experience

Appointed Consultant at Barts Health NHS Trust in 2012, he led the interventional neuroradiology service at The Royal London Hospital until 2025, growing it from a single-operator unit into a team of eight running a 24-hour stroke thrombectomy service for North East London. He has personally performed more than 3,000 brain procedures and 4,500 spinal procedures. He chairs NHS England committees on neurointervention, co-founded the BRAIN Conference and teaches interventional techniques to consultants in the UK and abroad.

Specialisation

He treats brain and spinal vascular conditions without open surgery: aneurysms (coiling, stent-assisted coiling and flow diversion), arteriovenous malformations and dural fistulas, acute stroke (thrombectomy and carotid stenting), pulsatile tinnitus and venous sinus disease, CSF leaks, and image-guided spinal procedures. As a Consultant Stereotactic Radiosurgeon he also offers Gamma Knife radiosurgery for selected AVMs. He sees patients in clinic at 30 Devonshire Street, London W1G 6PU, and performs procedures at The Wellington Hospital (brain and neurovascular) and The London Clinic (spine).

Research

He is Principal Investigator on multi-centre stroke and aneurysm trials, including ESCAPE-MeVO, published in the New England Journal of Medicine in 2025, and the SEALANT, TOPSAT-2, CALM-2 and CALM-DIEM trials. He has more than 60 peer-reviewed publications and lectures internationally on aneurysm treatment, stroke thrombectomy and minimally invasive spinal intervention. His publications are listed on Google Scholar.

What sets the practice apart

Four things patients and referrers notice, and the reasons behind them.

  1. Wrist access instead of the groin

    Most brain procedures are still done through the groin. Dr Makalanda pioneered the routine use of wrist (transradial) access for neurointervention in the UK, and has since helped establish it across Europe.

    Going in through the arm rather than the groin means fewer problems at the puncture site, no lying flat for hours afterwards and usually a quicker discharge. Patients who have had both nearly always prefer the arm.

    Sources

    • Bhogal P, Chan N, Makalanda H, Wong K, Noblet J. Transradial Woven EndoBridge device to treat a ruptured basilar tip aneurysm under conscious sedation. Interventional Neuroradiology 2020;26(6):779–784. doi.org/10.1177/1591019920927243

  2. Research that changes practice

    Research is part of the job, not an addition to it. The aim is to find the technique that gives a patient a safer procedure and a better result, test it properly, and then make it routine.

    Several of these started in his practice. The UK’s first embolisation of a CSF venous fistula, for spinal fluid leaks that were previously missed or unfixable. One of the first in the UK to carry out flow diversion with the patient awake, treating a brain aneurysm without a general anaesthetic. The world’s first Flow-T stent configuration, a demanding technique he has gone on to use for selected aneurysms at an artery branch point that no single stent can treat. What works is published, taught and shared, so that it reaches patients beyond one unit.

    Sources

    • Makalanda H, Wong K, Bhogal P. Flow-T stenting with the Silk Vista Baby and Baby Leo stents for bifurcation aneurysms: a novel endovascular technique. Interventional Neuroradiology 2020;26(1):68–73. doi.org/10.1177/1591019919870618
    • Early UK experience of CSF venous fistula embolisation. Presented at the Brain Interventional Group meeting, March 2023.

  3. Awake and day case wherever it is safe

    A general anaesthetic and a night in hospital are not always necessary. Where the procedure allows, Dr Makalanda works awake, under local anaesthetic and light sedation, through a vein or artery in the arm.

    For pulsatile tinnitus and venous sinus disease that means measuring the pressures and, if they confirm the cause, placing the stent in the same sitting, with the patient able to say whether the noise has gone before the stent is finally released. Most go home the same evening. The same approach applies to spinal injections, lumbar puncture and myelography, done as day cases under CT guidance.

  4. A decision, not a sales pitch

    Not every aneurysm, AVM or narrowing needs treating, and the consultation is where that is worked out. Dr Makalanda reviews the scans himself, quotes the risks for the individual patient rather than the textbook figure, and says plainly when watching is the better option.

    Complex cases are discussed with neurosurgical, ENT and spinal colleagues before any decision, and he refers on when surgery or radiosurgery is the right answer. Patients who want an independent view of a diagnosis made elsewhere can come for a second opinion without any commitment to treatment.

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