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. 2023 Aug 18;13(16):2704.
doi: 10.3390/diagnostics13162704.

Long-Term Outcomes of Endovascular Embolization in a Vein of Galen Aneurysmal Malformation: A Single-Center Experience

Chingiz Nurimanov  1 , Yerbol Makhambetov  1 , Karashash Menlibayeva  2 , Nurtay Nurakay  1 , Nursultan Makhambetov  1 , Elena Zholdybayeva  3 , Serik Akshulakov  1
Affiliations

Long-Term Outcomes of Endovascular Embolization in a Vein of Galen Aneurysmal Malformation: A Single-Center Experience

Chingiz Nurimanov et al. Diagnostics (Basel). .

Abstract

Background: A vein of Galen aneurysmal malformation (VGAM) is a rare congenital cerebral vascular condition with a high mortality rate if left untreated. This study describes the long-term outcomes of patients with VGAM, who were treated with endovascular embolization.

Methods: This retrospective analysis focused on VGAM patients who underwent one or more endovascular embolization sessions between January 2008 and December 2022. The study included newborns and children under 18 years. Data encompassed clinical and demographic characteristics, types of endovascular embolization, treatment complications, mortality rates, and long-term outcomes.

Results: Out of 22 VGAM cases, the majority were boys (86.36%), and the average age of the participants was 38 months, ranging from 25 days to 17 years. Endovascular embolization using liquid embolizing agents was the most common intervention (50%), and around 73% of patients underwent multiple sessions. Some patients underwent ventriculoperitoneal shunting (VPS) due to persistent hydrocephalus. In long-term outcomes, four patients (18.2%) showed developmental delays, and 16 patients (72.7%) had a positive outcome.

Conclusions: Combining endovascular therapy with a comprehensive management strategy significantly reduces mortality rates and improves the possibility of normal neurological development in patients.

Keywords: AV malformation of the vein of Galen; Bicêtre score; endovascular embolization; hydrocephalus; neonates; the vein of Galen aneurysmal malformation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Brain magnetic resonance axial and sagittal images showing a dilated vein of Galen and enlarged ventricles (A,C). Cerebral angiography (B,D) reveals multiple direct fistulae from the thalamoperforating artery and posterior cerebral artery to the vein of Galen.
Figure 2
Figure 2
Follow-up images after 12 months. Brain magnetic resonance axial and sagittal imaging (A,C) indicates a reduction in the size of the vein of Galen and ventricles. Cerebral angiography (B,D) shows subtotal occlusion of the lesion. There is no evidence of any remaining issues.
Figure 3
Figure 3
Brain magnetic resonance axial and sagittal images showing a dilated vein of Galen (red arrows) and enlarged ventricles and periventricular edema (green arrows) (A,C). Cerebral angiography (B,D) reveals multiple direct fistulae from the thalamoperforating artery and posterior cerebral artery to the vein of Galen.
Figure 4
Figure 4
Follow-up images after 18 months. Brain magnetic resonance axial and sagittal imaging (A,C) revealed a significant reduction in the size of the vein of Galen (red arrows) and ventricles, with the periventricular edema resolved (green arrows). Additionally, cerebral angiography (B,D) demonstrated the complete occlusion of the lesion. There is no evidence of any remaining issues.
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