scholarly journals Hemodynamic disturbances associated with endovascular embolization in newborn infants with vein of Galen malformation

2006 ◽  
Vol 26 (5) ◽  
pp. 273-278 ◽  
Author(s):  
F Y Wong ◽  
P J Mitchell ◽  
B M Tress ◽  
P A Dargaville ◽  
P M Loughnan
Keyword(s):  
Newborn Infants ◽  
Endovascular Embolization ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation

Fistulous-type vein of Galen malformation phantom model for endovascular training and research

2016 ◽  
Vol 9 (9) ◽  
pp. 880-886
Author(s):  
Dan Meila ◽  
Katharina Melber ◽  
Dominik Grieb ◽  
Collin Jacobs ◽  
Heinrich Lanfermann ◽  
...  
Keyword(s):  
Treatment Options ◽  
Endovascular Embolization ◽  
High Flow ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Phantom Model ◽  
Before And After ◽  
And Training

IntroductionVein of Galen malformation (VGM), a high-flow intracranial arteriovenous shunt, is among the most severe neurovascular diseases in childhood. In many cases untreated children die or survive only severely disabled. Endovascular embolization is the preferred treatment.ObjectiveTo develop a simple fistulous-type VGM phantom model for teaching and training of different endovascular treatment methods and to investigate new treatment options and devices.MethodsAn experimental in vitro pulsatile phantom model was developed imitating a high-flow fistulous-type VGM, which is typical, especially in the neonatal phase. Pressure measurements at different arterial sites were performed before and after closure of the VGM. Closure of the VGM was achieved by coiling using a combined microcatheter-based transvenous and transarterial approach called ‘kissing microcatheter technique’.ResultsThe behaviour of the phantom model in vitro under fluoroscopy and under angiographic runs was extremely similar to that in in vivo conditions in children. The results showed that intra-arterial pressures changed and increased statistically significantly at all measurement sites after embolization, as in human arteriovenous malformation. We also demonstrated different and complementary visualizations of hemodynamics and angioarchitecture by antegrade and retrograde microcatheter injections.ConclusionsOur phantom model behaves like a typical fistulous-type VGM and can be used in vitro for teaching and training and for further research. It offers a new and better understanding of hemodynamics and angioarchitecture in the endovascular management of VGM.

scholarly journals Pulmonary Hypertension in Newborn Infants with Vein of Galen Malformation

Perinatology ◽  
2019 ◽  
Vol 30 (2) ◽  
pp. 99
Author(s):  
Woo Sun Song ◽  
Moon Yeon Oh ◽  
Jae Young Cho ◽  
Chae Young Kim ◽  
Dae Chul Suh ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Newborn Infants ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation

scholarly journals Vein of Galen malformation

2009 ◽  
Vol 27 (5) ◽  
pp. E8 ◽  
Author(s):  
Stanley Hoang ◽  
Omar Choudhri ◽  
Michael Edwards ◽  
Raphael Guzman
Keyword(s):  
Poor Prognosis ◽  
Pediatric Population ◽  
Vascular Lesion ◽  
Endovascular Embolization ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Developmental Mechanisms

A vein of Galen malformation is a rare intracranial vascular lesion affecting the pediatric population. Its poor prognosis has been significantly improved with the development of endovascular embolization. In this paper the authors review the developmental mechanisms, clinical pathophysiology, and the available data on the management and outcome of the disease.

scholarly journals Targeted Neonatal Echocardiography-Guided Therapy in Vein of Galen Aneurysmal Malformation: A Report of Two Cases with a Review of Physiology and Approach to Management

2019 ◽  
Vol 09 (02) ◽  
pp. e172-e176 ◽  
Author(s):  
R. E. Giesinger ◽  
Y. N. Elsayed ◽  
M. P. Castaldo ◽  
P. J. McNamara
Keyword(s):  
Ductus Arteriosus ◽  
Endovascular Embolization ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Systemic Blood ◽  
Systemic Blood Flow ◽  
Ventricular Performance ◽  
Right Ventricular Performance ◽  
Neonatal Echocardiography ◽  
Guided Therapy

AbstractVein of Galen malformation results in predictable changes in physiology which exist on a continuum. Severe pulmonary hypertension may present as hypoxemia; however, excessive reduction in pulmonary vascular resistance may precipitate progressive pulmonary overcirculation and impaired systemic blood flow. Right ventricular performance and the patency and direction of the ductus arteriosus may play a crucial role in postductal organ perfusion. Physiological stabilization may be complex and variable over time. The utilization of targeted neonatal echocardiography to guide treatment decisions may improve the ability to provide therapy tailored to the specific disease pathophysiology and monitor serially as conditions change. An enhanced approach to physiological stabilization may reduce the risk of unexpected decompensation and allow for thoughtful, controlled endovascular embolization in appropriate candidates.

scholarly journals Neurocognitive improvements following endovascular repair of vein of Galen malformation in a child

2015 ◽  
Vol 15 (2) ◽  
pp. 197-202 ◽  
Author(s):  
Robyn A. Howarth ◽  
Andrew Reisner ◽  
Joshua J. Chern ◽  
Laura L. Hayes ◽  
Thomas G. Burns ◽  
...  
Keyword(s):  
Successful Treatment ◽  
Endovascular Repair ◽  
Endovascular Embolization ◽  
Initial Presentation ◽  
Cognitive Deterioration ◽  
Vein Of Galen ◽  
Neurocognitive Deficits ◽  
Vein Of Galen Malformation ◽  
Neurocognitive Profile

Cognitive regression is a well-described presentation of vein of Galen aneurysmal malformations (VGAMs) in childhood. However, it remains unclear whether successful treatment of the malformation can reverse cognitive regression. Here, the authors present the case of a 5-year-old girl with a VGAM that was treated with staged endovascular embolization procedures. Comprehensive neurocognitive assessments were completed before intervention and approximately 6 years after initial presentation. There were significant age-matched improvements in this child's neurocognitive profile over this period. The authors believe that timely and successful treatment of VGAM in children may not only stabilize the associated cognitive deterioration but, in some cases, may ameliorate these deficits. Details of this case and a discussion of neurocognitive deficits related to VGAM are presented.

Vein of Galen Malformation

2018 ◽  
Author(s):  
Elizabeth C. Eastburn ◽  
Mary Landrigan-Ossar
Keyword(s):  
Vascular Lesion ◽  
Endovascular Embolization ◽  
Neurological Dysfunction ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Initial Symptoms ◽  
History Of ◽  
Flow Through ◽  
Intracranial Vascular Malformation ◽  
Selection Of

Vein of Galen malformation (VGM) is a high-flow intracranial vascular malformation, presenting in utero or after birth with a range of initial symptoms. The natural history of untreated VGM is grave, with progressive permanent neurological dysfunction, developmental delay, seizures, intracranial hemorrhage, and death. Presentation varies with age, with more severe manifestations resulting in earlier presentation and poorer outcome. The mainstay of treatment is medical stabilization followed by endovascular embolization. The goal is to reduce flow through the malformation such that normal development can proceed without neurological deficit. The past 20 years have seen great advances both in the technical treatment of the vascular lesion and in the overall prognosis of patients treated for this condition. Key to a good outcome is appropriate selection of patients and treatment by physicians familiar with this pathophysiology.

Scepter mini assisted angiographic cure of a Vein of Galen Malformation with n-butyl cyanoacrylate

2021 ◽  
pp. 159101992199336
Author(s):  
Timothy G White ◽  
Amir R Dehdashti ◽  
Henry H Woo
Keyword(s):  
Clinical Presentation ◽  
Balloon Catheter ◽  
Standard Of Care ◽  
Endovascular Embolization ◽  
Easy Access ◽  
The Novel ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Multiple Treatment ◽  
Staged Approach

Background Even in the modern endovascular era, the treatment of Vein of Galen Malformations (VOGM) is extremely challenging. While their natural history is very poor, endovascular embolization has emerged as the standard of care. These lesions often require multiple treatment sessions to decrease shunting, with each treatment including multiple pedicles. Here we present the first reported use of the Scepter Mini (Microvention, Aliso Viejo, CA) in the treatment of vein of Galen malformations. Clinical presentation A 7 month old female presented with an enlarging VOGM that was initially identified on prenatal ultrasound. Given the enlarging size of the lesion and failure to meet developmental milestones, the patient underwent planned endovascular embolization of the VOGM. The novel Scepter Mini balloon catheter was used for treatment of this lesion affording easy access to the target pedicle and immediate flow arrest which allowed for immediate cure of the lesion. Conclusion The novel Scepter Mini Balloon (Microvention, Aliso Viejo, CA) afforded excellent distal access with subsequent immediate flow arrest therefore facilitating endovascular cure. Initially, a staged approach was favored for the treatment of the lesion, but the flow arrest achieved by the Scepter mini facilitated immediate occlusion from a single pedicle.

A cardiopulmonary bypass strategy to support a patient with vein of Galen malformation

Perfusion ◽  
2021 ◽  
pp. 026765912110015
Author(s):  
Alex Robertson ◽  
Nagarajan Muthialu ◽  
Mike Broadhead
Keyword(s):  
Cardiopulmonary Bypass ◽  
Surgical Repair ◽  
Circulatory Arrest ◽  
Ductus Arteriosus ◽  
Venous Drainage ◽  
Deep Hypothermic Circulatory Arrest ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Neurological Sequelae ◽  
Ph Stat

We present a dissection of the patent ductus arteriosus and pulmonary artery for surgical repair utilising cardiopulmonary bypass in the setting of vein of Galen malformation. Several strategies were employed to attenuate the cerebral shunt including pH-stat, high cardiac index, restrictive venous drainage, continuous ventilation and deep hypothermic circulatory arrest. The patient recovered from surgery with no apparent neurological sequelae.

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