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Vein of Galen Aneurysmal Malformation : Endovascular Management of 6 Cases in a Single Institute

  • Moon, Jung-Hyeon (Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Cho, Won-Sang (Department of Neurosurgery, Kangwon National University Hospital, School of Medicine, Kangwon National University) ;
  • Kang, Hyun-Seung (Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Kim, Jeong-Eun (Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Lee, Seung-Jin (Departmentof Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Han, Moon-Hee (Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital)
  • Received : 2011.03.03
  • Accepted : 2011.09.14
  • Published : 2011.09.28

Abstract

Objective : The aim of this study was to analyze the treatment outcome of patients with vein of Galen aneurysmal malformations (VGM). Methods : Clinical and angiographic data of six consecutive patients with VGM were retrospectively reviewed. VGMs were angiographically classified by Yasargil's method. Treatment outcomes were evaluated. Results : Mean age at initial treatment was $4.4{\pm}5.7$ months. Angiographic types of VGMs were type II in two patients and type III in four. Three patients had cardiac symptoms and the others were asymptomatic. Two patients were treated with transvenous embolization, three with transarterial embolization, and one was managed conservatively. Two patients died due to venous hypertension few days after transvenous approach. Of three patients who were transarterially embolized, one was completely occluded with Onyx and two were incompletely occluded. During the follow-up period (range, one to six years) two of three patients treated with transarterial approach were asymptomatic and the other showed mild symptoms. One patient who was managed conservatively showed normal performance. Conclusion : Transarterial embolization of VGMs may be better than transvenous approach in terms of the treatment outcome and complication. Further studies are needed because of the rarity of the disease and rapid advancement of endovascular techniques.

Keywords

References

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  3. The natural progression of VGAMs and the need for urgent medical attention: a systematic review and meta-analysis vol.9, pp.6, 2011, https://doi.org/10.1136/neurintsurg-2015-012212
  4. Endovascular Treatment of Vein of Galen Malformations: A Systematic Review and Meta-Analysis vol.38, pp.12, 2017, https://doi.org/10.3174/ajnr.a5403
  5. Adjuvant Coil Assisted Glue Embolization of Vein of Galen Aneurysmal Malformation in Pediatric Patients vol.13, pp.1, 2011, https://doi.org/10.5469/neuroint.2018.13.1.41