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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2020; 39(03): 213-216
DOI: 10.1055/s-0040-1710311
Technical Note | Nota Técnica

Prenatal Diagnosis of Vein of Galen Aneurysmal Malformation Allows Early Transumbilical Endovascular Treatment

Diagnóstico pré-natal de malformação aneurismática da veia de Galeno possibilita tratamento endovascular precoce por acesso transumbilical
Zeferino Demartini  Jr
1   Department of Neurosurgery, Hospital de Clínicas da Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
2   Department of Neurosurgery, Hospital Pequeno Príncipe, Curitiba, PR, Brazil
,
Gelson Luis Koppe 
2   Department of Neurosurgery, Hospital Pequeno Príncipe, Curitiba, PR, Brazil
3   Department of Neurosurgery, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil
,
Luana A.M. Gatto 
3   Department of Neurosurgery, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil
,
Ana Lucia Sarquis 
4   Department of Pediatrics, Hospital de Clínicas da Universidade Federal do Paraná(UFPR), Curitiba, PR, Brazil
,
Alexandre N. Francisco 
3   Department of Neurosurgery, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil
,
Adriane Cardoso-Demartini 
4   Department of Pediatrics, Hospital de Clínicas da Universidade Federal do Paraná(UFPR), Curitiba, PR, Brazil
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Abstract

Neonates with vein of Galen aneurysmal malformation (VGAM) presenting with severe cardiac failure and pulmonary hypertension represent a challenge for endovascular therapy. When early treatment is required, the small femoral arteries in this population are usually difficult to cannulate. Alternatively, the umbilical vessels offer a natural pathway to reach the lesion. Therefore, prenatal diagnosis of VGAM allows for delivery planning, perinatal management, and embolization through umbilical approach, thus leading to better outcomes.

Resumo

Neonatos com malformação aneurismática da veia de Galeno (MAVG) apresentando insuficiência cardíaca severa e hipertensão pulmonar representam um desafio terapêutico. Quando o tratamento precoce é necessário, o pequeno diâmetro dos vasos femorais nessa faixa etária dificulta a punção e canulação. Como alternativa, os vasos umbilicais oferecem um acesso natural para alcançar a lesão. Assim, o diagnóstico pré-natal da MAVG proporciona planejamento adequado do parto em local com a estrutura necessária e cateterização dos vasos umbilicais ao nascer, o que permite tratamento precoce e melhor evolução desses pacientes.

Keywords

vein of Galen malformations - arteriovenous malformations - prenatal diagnosis - umbilical arteries - newborn infant - endovascular procedures.

Palavras-chave

malformações da veia de Galeno - malformaçõesarteriovenosas - diagnóstico pré-natal - cordão umbilical - recém-nascido - embolização terapêutica


Publication History

Received: 28 February 2020

Accepted: 24 March 2020

Article published online:
31 July 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Lasjaunias PL, Chng SM, Sachet M, Alvarez H, Rodesch G, Garcia-Monaco R. The management of vein of Galen aneurysmal malformations. Neurosurgery 2006; 59 (05) (Suppl. 03) S184-S194 , discussion S3–S13
    PubMedGoogle Scholar
  • 2 Paladini D, Deloison B, Rossi A. , et al. Vein of Galen aneurysmal malformation (VGAM) in the fetus: retrospective analysis of perinatal prognostic indicators in a two-center series of 49 cases. Ultrasound Obstet Gynecol 2017; 50 (02) 192-199 . Doi: 10.1002/uog.17224
    CrossrefPubMedGoogle Scholar
  • 3 Demartini Jr Z, Dos Santos ML, Koppe GL, Cardoso-Demartini AA. Sinus thrombosis after endovascular treatment of vein of Galen aneurysmal malformation. Pediatr Neurosurg 2017; 52 (02) 136-139 . Doi: 10.1159/000452806
    CrossrefPubMedGoogle Scholar
  • 4 Marques RM, Lobão CA, Sassaki VS, Aguiar LR. Vein of Galen aneurysm in an adult: case report. Arq Neuropsiquiatr 2006; 64 (3B): 862-864
    CrossrefPubMedGoogle Scholar
  • 5 Yan J, Gopaul R, Wen J, Li XS, Tang JF. The natural progression of VGAMs and the need for urgent medical attention: a systematic review and meta-analysis. J Neurointerv Surg 2017; 9 (06) 564-570 . Doi: 10.1136/neurintsurg-2015-012212
    CrossrefPubMedGoogle Scholar
  • 6 Meila D, Schmidt C, Melber K. , et al. Delayed and incomplete treatment may result in dural fistula development in children with Vein of Galen malformation. Interv Neuroradiol 2018; 24 (01) 82-87 . Doi: 10.1177/1591019917741755
    CrossrefPubMedGoogle Scholar
  • 7 De Rosa G, De Carolis MP, Tempera A. , et al. Outcome of neonates with vein of Galen malformation presenting with severe heart failure: a case series. Am J Perinatol 2019; 36 (02) 169-175 . Doi: 10.1055/s-0038-1666813
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Komiyama M, Terada A, Ishiguro T. Neuro-interventions for the neonates with brain arteriovenous fistulas: with special reference to access routes. Neurol Med Chir (Tokyo) 2016; 56 (03) 132-140 . Doi: 10.2176/nmc.oa.2015-0336
    CrossrefPubMedGoogle Scholar