gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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The “kissing microcatheter technique”: A new endovascular treatment method in vein of galen malformation

Meeting Abstract

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  • Friedhelm Brassel - Klinik für Radiologie und Neuroradiologie, Klinikum Duisburg - Sana Kliniken
  • Raphaela Hannak - Klinik für Radiologie und Neuroradiologie, Klinikum Duisburg - Sana Kliniken
  • Axel Feldkamp - Klinik für Kinder- und Jugendmedizin, Klinikum Duisburg - Sana Kliniken
  • Martin Schlunz-Hendann - Klinik für Radiologie und Neuroradiologie, Klinikum Duisburg - Sana Kliniken
  • Collin Jacobs - Poliklinik für Kieferorthopädie, Universitätsmedizin Mainz
  • Dan Meila - Klinik für Radiologie und Neuroradiologie, Klinikum Duisburg - Sana Kliniken

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMI.15.01

doi: 10.3205/13dgnc406, urn:nbn:de:0183-13dgnc4060

Published: May 21, 2013

© 2013 Brassel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Vein of Galen Malformation (VGM) is a severe pediatric neurovascular disease with a fatal prognosis untreated. Endovascular embolization is the treatment of choice. We want to present our results with a new method called “kissing microcatheter technique”. This method allows closure of the arteriovenous shunt with its in- and outflow zone using a combined transarterial and transvenous approach.

Method: 40 children with VGM presented in our department between 1992 and 2012. Since the year 2000 a consecutive series of 21 children (11 neonates and 10 infants) were treated with the new method. We reviewed and analyzed the data records, the angiographic results, the clinical symptoms and the outcome.

Results: Complete or > 90% angiographically confirmed closure of the VGM was documented in 16 of 21 (76%) patients. Three children are still under treatment. Good outcome was achieved in 16 of 20 (80%) surviving children. One child died due to a non-procedural complication in another hospital two years after the last treatment. Control of heart failure was achieved in all patients.

Conclusions: Endovascular treatment of VGM using the “kissing microcatheter technique” is a safe procedure with a low complication rate. The overall outcome can be improved, even in the high-risk neonatal group with congestive heart failure.