title: Endovascular management of a vein of Galen aneurysmal malformation in an infant with challenging femoral arterial access.
abstract: A 5-month-old infant was to be treated with elective transarterial embolization for a vein of Galen aneurysmal malformation (VGAM). A team of endovascular surgical neuroradiologists, pediatric interventional radiologists, and pediatric cardiologists attempted conventional femoral arterial access, which was unsuccessful given the small caliber of the femoral arteries and superimposed severe vasospasm. Thereafter, eventual arterial access was achieved by navigating from the venous to the arterial system across the patent foramen ovale following a right femoral venous access. Embolization was then successfully performed. At a later date, the child underwent successful transvenous balloon-assisted embolization and eventual arterial embolization with cure of the VGAM.
authors.affiliation: Departments of 1 Radiology.|Neurosurgery, and.|Neurology, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Bharathi D
authors.initials: BD
authors.lastname: Jagadeesan
authors.affiliation: Neurology, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Haralabos
authors.initials: H
authors.lastname: Zacharatos
authors.affiliation: Departments of 1 Radiology.
authors.forename: David R
authors.initials: DR
authors.lastname: Nascene
authors.affiliation: Departments of 1 Radiology.|Neurosurgery, and.|Neurology, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Grande
authors.affiliation: Neurosurgery, and.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Guillaume
authors.affiliation: Departments of 1 Radiology.|Neurosurgery, and.|Neurology, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Ramachandra P
authors.initials: RP
authors.lastname: Tummala
mesh_terms: D019468:Disease Management; D057510:Endovascular Procedures / Q000379:methods*; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D054080:Vein of Galen Malformations / Q000000981:diagnostic imaging* / Q000601:surgery
keywords: DS = digital subtraction; PAPVR = partial anomalous pulmonary venous return; PFO = patent foramen ovale; VGAM = vein of Galen malformation; patent foramen ovale; transvenous embolization; vascular disorders; vein of Galen malformation