To observe the clinical effect of endovascular therapy for vein of Galen aneurysmal malformation (VGAM) in children.

The clinical data of 10 children with VGAM (aged≤3 years) treated with endovascular therapy in the Department of Pediatric Neurosurgery, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2005 to November 2021 were retrospectively analyzed. The VGAM of single supplying artery was treated with coil combined with Onyx glue embolization. For VGAM with multiple fistulas and multiple supplying arteries, staging embolization was performed. Routine outpatient follow-up was performed at 3, 6, and 12 months after operation. Follow-up contents included assessment of clinical symptoms and Denver developmental screening test, head CT or MRI, and DSA to assess the occlusion situation of VGAM. Complete embolization was defined as complete occlusion of all fistulas without blood flow entry.

DSA results of the 10 children showed that there were 2 cases with single blood supply and 8 cases with multiple blood supply. Endovascular embolization was performed for 1-3 times (1 time in 2 cases, 2 times in 3 cases and 3 times in 5 cases). VGAM was completely embolized in all patients. There were no complications such as intracranial hemorrhage, infection and thrombosis. The median follow-up time of the 10 patients was 34.5 months (2-116 months). The time of DSA review was at 3-12 months post surgery. Ten children had hydrocephalus before surgery, among whom 7 had obvious hydrocephalus relief within 2 months after surgery, and 3 had hydrocephalus relief after ventriculoperitoneal shunt. By the last follow-up, the clinical symptoms of 10 children were relieved. Imaging examination showed that the median maximum diameter of VGAM was 0.3 cm (0-2.3 cm), which was reduced in size (5 cases) or disappeared (5 cases). DSA showed that the fistulas were completely occluded. The Denver developmental screening test results were normal in 8 cases and suspiciously abnormal in 2 cases.

Primary observation has shown that endovascular therapy can completely embolize VGAM, improve the clinical symptoms and growth and development of the children, which has a good effect.

Vein of galen malformations; Endovascular procedures; Treatment outcome; Child