Doctors Edward Smith (left) and Darren Orbach (right), co-directors of the Cerebrovascular Surgery and Interventions Center.
Whether you’re a parent of a child with cerebrovascular disease, a young adult seeking a second opinion, or a physician seeking a consultation and possible referral, we hope you’ll consider Boston Children’s. We treat more children with cerebrovascular disease (CVD) than any other center in the world, including rare childhood vascular disorders virtually never seen elsewhere.
Because we have the capability to provide the entire spectrum of cerebrovascular disease treatment options—surgery, radiation, embolization—we are able to provide the best care plan for each child, minimizing invasive procedures and radiation exposure wherever possible. Most importantly, we are not adult-oriented physicians who also treat children: Our entire Center and its practice are focused exclusively on children and young adults with CVD.
Multidisciplinary, team approach
Patients receive care from a collaborative, highly experienced team, including a pediatric neurosurgeon, a dedicated neurointerventional radiologist, and clinicians with expertise in childhood neurology, neurocritical care, neuroanesthesia, diagnostic neuroradiology, stroke, vascular anomalies and blood disorders. Our goal is to provide a seamless, team-based, patient-focused approach. We also offer centralized scheduling for visits to other departments and clinics at Boston Children’s during the child’s hospital stay.
Many of the interventions used at Boston Children’s, such as pial synangiosis for moyamoya disease, were first developed and tested here. In many cases, we have modified devices and techniques used to treat cerebrovascular conditions in adults, to ensure their effectiveness and safety in children.
Advances in care
Our physicians have authored and contributed to professional guidelines for stroke and other CVDs, informing the entire field. In our own practice, our evolving understanding of the risks entailed in different procedures has led to innovations to dramatically improve safety, and has greatly improved our selection of treatment options. The result is better outcomes: our patients with pediatric moyamoya disease, for example, only have a 4 percent stroke risk over five years after treatment, one of the best rates in the field.
Physicians in the Cerebrovascular Surgery and Interventions Center are among the most published in the world (see our selected publications). The consistent goal of our research is to improve diagnostic and therapeutic approaches to CVD in children. Through it, we have built an extensive database that guides and informs our practice and helps us innovate.
Research has allowed us, for example, to reduce radiation doses for children undergoing image-guided interventions, and to explore simple, noninvasive urine testing as a way to monitor cerebrovascular conditions like moyamoya disease and arteriovenous malformations (AVMs), reducing the need for imaging studies. We also collaborate actively with scientists around the world to better understand rare types of CVD and identify genetic causes of cerebrovascular conditions. Our research efforts span the entire range from new technical approaches in the hospital to benchtop laboratory science in our Vascular Biology Program, the largest pediatric vascular research institute in the United States.
Read more on our Innovation and Research page.