Transumbilical catheterization of cerebral arteries.
OBJECTIVE
For neonates requiring cerebral endovascular procedures, an alternative route of arterial access, the umbilical artery, is described. Transfemoral catheterization, with its attendant risks, can thus be avoided.


METHODS
Six neonates with severe cardiac failure secondary to aneurysmal malformations of the vein of Galen underwent transarterial embolization in an effort to reduce flow through the intracranial arteriovenous malformations and therefore improve control of the high output cardiac failure.


METHODS
The transumbilical route was used in each case, with successful devascularization of some of the malformations in all patients. The femoral arteries were preserved for future staged embolizations. No complications related to the umbilical artery catheterization were encountered.


CONCLUSIONS
Femoral artery cannulation in neonates is technically challenging and may result in stenosis or thrombosis of the vessel. The umbilical artery provides an alternative route of vascular access for cerebral artery catheterization and embolization in these patients, preserving the femoral arteries for future interventions.
Berenstein
A
A
Institute for Neurology and Neurosurgery, Beth-Israel Medical Center North Division, New York, New York, USA.
Masters
L T
LT
Nelson
P K
PK
Setton
A
A
Verma
R
R
D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000002:abnormalities / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D016896:Treatment Outcome; D014469:Umbilical Arteries / Q000000981:diagnostic imaging