Treatment Programs

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Brain Aneurysm and Arteriovenous Malformations Program

The Brain Aneurysm and Arteriovenous Malformations Program at the Massachusetts General Hospital Fireman Vascular Center offers sophisticated diagnosis and innovative treatments for patients with intracranial (brain) aneurysms and rare conditions such as arteriovenous malformations (AVMs) of both the brain and spinal cord.

Our Approach The Massachusetts General Hospital Fireman Vascular Center is one of the few places in the U.S. to offer expert diagnosis and treatment of arteriovenous malformations (AVMs), a rare condition in which tangles of abnormal blood vessels form in the arteries and veins of a person’s brain, body or limbs.

We also offer patients comprehensive care that includes a full range of medical, surgical and minimally invasive endovascular treatment options for intracranial (brain) aneurysms, abnormal bulges in the arterial wall of the brain.

A Multidisciplinary Approach to Neurovascular Care

The Mass General Fireman Vascular Center is one of the only vascular centers in the country with specialists in every area of vascular disease. Our Brain Aneurysm and Arteriovenous Malformations Program brings together a team of clinicians from multiple disciplines to provide care from many perspectives, including:

  • Neurology
  • Diagnostic neuroradiology
  • Neurointerventional imaging
  • Neurosurgery
  • Vascular medicine

We work together with the patient and referring physician to coordinate a personalized treatment plan for all patients.

Specialists Dedicated to Neurovascular Imaging

To accurately diagnose brain aneurysms and AVMs, our team includes full-time neurovascular radiologists who are specially trained to detect abnormalities in the vascular system and whose practice focuses specifically on neurovascular disease. These intracranial imaging specialists are board certified in general radiology and fellowship trained with additional specialization in neurovascular procedures.

At the Fireman Vascular Center, we also offer computed tomography angiography (CTA), a technique that produces detailed 3D images of the blood vessels. CTA is considered less invasive, and our neurovascular specialists are skilled in interpreting its results. Depending on the patient, we may use other diagnostic techniques such as:

  • Ultrasound
  • CT scan
  • Magnetic resonance imaging (MRI)
  • Magnetic resonance angiography (MRA)
  • Venograms
  • Arteriograms

These tests are also available at our convenient Waltham location.

 

Leading-Edge Treatment Options for Brain Aneurysms

Our main goal is to evaluate the patient and design an individualized treatment plan that blocks off the aneurysm to prevent rupture. Treatment is determined according to the patient’s age and the size and location of the brain aneurysm. Treatment options available include:

  • Minimally invasive endovascular techniques. These include stents (metal-mesh tubes that hold open the aneurysm and keep it from bulging) and surgical glue, which blocks blood flow when injected into the aneurysm. Our physicians are recognized leaders in using liquid surgical glue and are continuing to refine this and other emerging technologies
  • Coiling. During this minimally invasive endovascular procedure, a catheter (thin, flexible tube) is used to insert a metal coil into the aneurysm. This blocks blood flow to the aneurysm and helps prevent rupture
  • Clipping. This surgical procedure involves placing a metal clip across the “neck” of the aneurysm, which prevents it from bleeding

Expertise in Treating AVMs and Other Rare Conditions

Our clinicians are recognized nationally and internationally for their expertise and innovations in treating AVMs, a rare condition that occurs in the brain, body or limbs. Treatment options include:

  • Embolization. This minimally invasive endovascular procedure involves the injection of a material or chemical into the AVM to block its blood supply, causing it to shrink. At the Fireman Vascular Center, we successfully use a variety of materials including alcohol, coils and liquid surgical adhesive
  • Radiosurgery. This approach uses radiation to shrink the size of the AVM
  • Surgical removal. Depending on the location of the AVM, our experienced cerebrovascular surgeons may remove it surgically

We are at the forefront of genetics and genomics and offer testing for hereditary hemorrhagic telangiectasia (HHT), a disorder that causes abnormalities of blood vessels, including AVMs. Our physicians discuss the possibility of developing HHT or AVMs based on these test results.

About This Program

Neurovascular specialists at Mass General have a long tradition of excellence in clinical care, and have been national leaders in the diagnosis and treatment of brain aneurysms and AVMs. All of our physicians are at the forefront of new research and serve on national and international professional societies. Joshua Hirsch, MD, has taken an ongoing leadership role at the Society of NeuroInterventional Surgery and is a founding editor of its professional journal.

Mass General is also home to one of the largest neurological intensive care units in the nation, and our stroke specialists offer state-of-the-art acute vascular management. For the treatment of AVMs, our clinicians are among the few in Massachusetts who have expertise in this condition within any region of the body.

Clinical Trials and Research

Our specialists participate in major clinical studies evaluating new technologies and devices to treat brain aneurysms. This allows us to bring our patients promising new treatments as quickly as possible. Some of these studies include:

  • International Study of Unruptured Intracranial Aneurysms (ISUIA) compares surgical and endovascular approaches in the treatment of unruptured brain aneurysms
  • Matrix And Platinum Science (MAPS) compares the use of coated versus uncoated coils in the treatment of aneurysms
  • AXIUM Coiling Experience and Recanalization (RACER) tests platinum coils in aneurysms
  • Conscious 2 examines at the management of vasospasm, a complication of ruptured brain aneurysms

Patients interested in participating in clinical trials can browse online for open trials.

One Call Coordinates Care

Our dedicated nurse coordinator is available Monday through Friday from 8:00 am to 5:00 pm to take relevant information about your condition and symptoms and to make a timely appointment with the most appropriate specialist.

Time is critical when treating brain aneurysms and AVMs. We strive to see patients as soon as possible and assign every patient one clinician to organize care between members of our multidisciplinary team. From diagnosis to treatment and follow up, this physician guides patients through the treatment process.

Beyond the Realm of Clinical Care

Our team goes beyond the realm of clinical care to provide patients with more than just treatment. We offer a variety of options for ongoing support, including:

Conditions and Diseases

Mass General is dedicated to ensuring that people understand their health care choices and have the necessary information to make decisions affecting their health and well being. The related support and wellness information listed below can play a role in treatment options.

Cerebral Aneurysm

A cerebral aneurysm (also called an intracranial aneurysm or brain aneurysm) is a bulging, weakened area in the wall of an artery in the brain, resulting in an abnormal widening or ballooning. Because there is a weakened spot in the artery wall, there is a risk for rupture (bursting) of the aneurysm.

Support and Wellness

Mass General is dedicated to ensuring that people understand their health care choices and have the necessary information to make decisions affecting their health and well being. The related support and wellness information listed below can play a role in treatment options.

Designing an Exercise Program

When you exercise, you'll breathe faster and more deeply. This maximizes the amount of oxygen in your blood.

Healthy Eating

Many vascular conditions can be improved by changing certain lifestyle factors. Maintaining a healthy weight is one of many factors. If you are trying to make heart-healthy changes to your diet, it is helpful to know some basics about nutrition, starting with the components of food.

Determining Your Body Mass Index

A good indicator of how much fat you carry is the Body Mass Index (BMI). Although it is not a perfect measure, it gives a fairly accurate assessment of how much of your body is composed of fat.

The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.

09/28/2010: Brain Aneurysm Symposium
Our Fireman Vascular Center clinicians invite you to join us for a Brain Aneurysm Symposium, sponsored by Massachusetts General Hospital and the Brain Aneurysm Foundation. Learn who is at risk for developing brain aneurysms, and about treatment options and ongoing research to help patients with this difficult condition.

Nurse recognized for outstanding work with brain aneurysm patients

The Boston Globe recently recognized Deidre Buckley, RN, NP, in its honorary feature, Salute to Nurses. Selected from nurses nominated from across New England, including 23 from Mass General, Buckley stands out as continually going above and beyond the call of duty.

Arteriovenous malformation triggers a patient's near-fatal hemorrhage

Software engineer Lori Corbani was never sick. Yet one day, she was rushed to Massachusetts General Hospital after suffering a near-fatal brain hemorrhage triggered by a congenital condition.

09/28/2010: Brain Aneurysm Symposium
Our Fireman Vascular Center clinicians invite you to join us for a Brain Aneurysm Symposium, sponsored by Massachusetts General Hospital and the Brain Aneurysm Foundation. Learn who is at risk for developing brain aneurysms, and about treatment options and ongoing research to help patients with this difficult condition.

Access to new treatments

Fireman Vascular Center physicians and scientists participate in international research and lead more than 70 clinical trials that evaluate current therapies and investigate new devices to treat vascular disease. These research efforts have led to a number of groundbreaking firsts, bringing innovative new treatments to the patient’s bedside.

Designing an Exercise Program

When you exercise, you'll breathe faster and more deeply. This maximizes the amount of oxygen in your blood.

Healthy Eating

Many vascular conditions can be improved by changing certain lifestyle factors. Maintaining a healthy weight is one of many factors. If you are trying to make heart-healthy changes to your diet, it is helpful to know some basics about nutrition, starting with the components of food.

Determining Your Body Mass Index

A good indicator of how much fat you carry is the Body Mass Index (BMI). Although it is not a perfect measure, it gives a fairly accurate assessment of how much of your body is composed of fat.

Vascular Center

55 Fruit Street
Boston, MA 02114

Phone: 877-644-8346
Hours: 9:00 am to 5:00 pm


Vascular Center at Waltham52 Second Avenue, Suite 2100
Waltham, MA 02451
Phone: 
877-644-8346
Hours:
8:00 am to 5:00 pm
Learn about our convenient Waltham location

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