Cerebral arteriovenous malformation: Approach to Care

The University of Florida offers highly specialized treatment for AVM. Approximately 100 patients with AVM are seen each year at the University of Florida.

Neurovascular Surgery

The University of Florida Neurovascular Center is one of the leading comprehensive cerebrovascular/endovascular neurosurgery services in the United States. All aspects of cerebrovascular neurosurgery are performed routinely, including aneurysm clipping, carotid endarterectomy, resection of intracranial arteriovenous malformations, resection of spinal arteriovenous malformations, EC-IC bypass procedures, and combination open cerebrovascular/endovascular procedures. Common Neuroendovascular procedures include coiling of aneurysms, embolization of arteriovenous malformations, endovascular treatment of acute strokes,embolization of tumors, intracranial and extracranial angioplasty and stent placement, obliteration of arteriovenous fistulae including carotid cavernous fistulae, embolization of vein of Galen malformations and other pediatric cerebrovascular disease, and vertebroplasty or kyphoplasty for spinal compression fractures.

Team

Our team includes  Dr. Brian Hoh and Dr. J Mocco. Pediatric patients are treated by Dr. David Pincus.

Clinical Trials

The University of Florida is an active participating site for many cerebrovascular/endovascular clinical trials. The latest high technology devices are constantly being evaluated and perfected for improved patient care. We have an active research laboratory focused on prevention and treatment of stroke, intracranial aneurysms, and arteriovenous malformations. Our team performs more than 300 cerebrovascular/endovascular procedures every year.


Radiosurgery

Candidates for radiosurgery include patients with arteriovenous malformations, acoustic schwannomas, meningiomas, pituitary tumors, metastatic tumors, gliomas, and other brain lesions. This one-time outpatient radiosurgery treatment is often an excellent alternative to complex surgical procedures requiring lengthy hospitalization.

For more information about Radiosurgery at The University of Florida please contact Dr. Friedman's secretary at (352) 273-9000 or e-mail fanderso@neurosurgery.ufl.edu.

The UF Radiosurgery Team

The UF radiosurgery team currently includes two neurosurgeons, a radiation physicist, a biomedical engineer, a computer programmer, a dedicated patient secretary, two radiation oncologists, as well as doctoral students, residents and medical students performing research projects.

In 1985, the UF team decided to implement radiosurgical capability at the University of Florida Shands Teaching Hospital. After reviewing the technology available for radiosurgery planning and radiosurgery treatment, the UF team decided to develop an entirely new approach to radiosurgery, using the linear accelerator as the source of radiation. A new mechanical system to improve accurate delivery of radiosurgery treatment, as well as the first true dedicated computer dosimetry program dedicated to radiosurgery optimization, were created. The University of Florida subsequently patented this new approach to radiosurgery planning and radiosurgery delivery, which has become one of the most popular commercial radiosurgery systems worldwide, known as the Linac Scalpel. This system is now marketed by Varian Systems.

UF Radiosurgery Patient Tracking

The UF Radiosurgery team has developed a customized computer database which enables them to carefully track each of the over 2000 patients treated clinically with radiosurgery at the University of Florida. A full time database coordinator insures that appropriate follow-up information is available on each radiosurgery patient. This database has facilitated the continuous improvement of radiosurgical treatment at UF and has served as the substrate for over 100 published articles, chapters, and books on stereotactic radiosurgery.

UF Continuous Improvement in the Radiosurgery Process

Recent research projects include the following:

  • The implementation of a micromultileaf collimator device for producing non-circular beam shapes in stereotactic radiotherapy
  • The development of new tools for automatic multiple isocenter radiosurgery.
  • The development of a standardized "index" for judging the quality of radiosurgery plans. 
  • The development of systems for using radiosurgical technology to treat extracranial tumors (i.e. spine, liver, prostate). the development of a highly conformal intensity modulated radiosurgery.

The UFBI Radiosurgery/Radiobiology Laboratory includes a dedicated research linear accelerator. 


Publications