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Abstract

Transfemoral venous embolization of vein of Galen malformations.

C F Dowd, V V Halbach, S L Barnwell, R T Higashida, M S Edwards and G B Hieshima
American Journal of Neuroradiology July 1990, 11 (4) 643-648;
C F Dowd
Department of Radiology, University of California, San Francisco 94143.
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V V Halbach
Department of Radiology, University of California, San Francisco 94143.
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S L Barnwell
Department of Radiology, University of California, San Francisco 94143.
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R T Higashida
Department of Radiology, University of California, San Francisco 94143.
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M S Edwards
Department of Radiology, University of California, San Francisco 94143.
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G B Hieshima
Department of Radiology, University of California, San Francisco 94143.
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Abstract

Three infants with vein of Galen malformations, all presenting with congestive heart failure, underwent a total of five embolization procedures that employed a percutaneous transfemoral venous approach to catheterize the vein of Galen. In one instance, direct retrograde catheterization of feeding arterial pedicles to the vein of Galen and embolization of the fistulous connections was achieved via this route. The indications for transfemoral venous treatment included persistent symptoms despite transarterial and transtorcular embolization in one patient, an unsuccessful transarterial embolization attempt (complicated by catheter fracture) in another, and the inadvisability of transarterial embolization because of an excessive number of feeding arteries in a third. Complete obliteration of the malformation was achieved in one patient and significant flow reduction in the other two. Vein of Galen perforation with the catheter tip complicated one procedure. All three patients were stable after clinical follow-ups (9-12 months). The transvenous route to the vein of Galen can be undertaken from a transfemoral approach, obviating surgical exposure of the torcular Herophili. In addition, we introduce the concept of direct retrograde catheterization of the feeding arteries to the vein of Galen malformation by a transfemoral venous approach, a procedure that has not been reported previously.

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American Journal of Neuroradiology
Vol. 11, Issue 4
1 Jul 1990
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Transfemoral venous embolization of vein of Galen malformations.
C F Dowd, V V Halbach, S L Barnwell, R T Higashida, M S Edwards, G B Hieshima
American Journal of Neuroradiology Jul 1990, 11 (4) 643-648;

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Transfemoral venous embolization of vein of Galen malformations.
C F Dowd, V V Halbach, S L Barnwell, R T Higashida, M S Edwards, G B Hieshima
American Journal of Neuroradiology Jul 1990, 11 (4) 643-648;
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