Vein of galen aneurysmal malformation in a neonate complicated by disseminated intravascular coagulation: A case report

Abstract

Vein of Galen Aneurysmal Malformations (VGAM) are complex arteriovenous malformations of the pediatric age group characterized by shunting of blood from the arterial to the vnous system resulting in high-output cardiac failure, hydrocephalus, PHTN and irreversible neurological damage if not detected and treated promptly. Here, we report the case of a true choroidal type VGAM detected antenatally that was complicated by disseminated intravascular coagulation. We will be discussing the diagnostic approach, the in-hospital course and the treatment modalities implied to manage the associated complications along with the treatment plan tailored for our patient.

Rapid ventricular overdrive pacing and other advanced flow-control techniques for the endovascular embolization of vein of galen malformations

“…This approach can be technically challenging because the sub-occlusive coils may be unstable in the turbulent, high-flow environment of the arterialized vein pouch, and unintended thrombosis of the vein pouch may be precipitated by subsequent transarterial embolization. Additionally, some authors have reported that the interaction of high-flow jets with the intravascular “strainer effect” of the non-occlusive coil matrix can promote hemolysis and disseminated intravascular coagulation ( 22 , 23 ).To enhance the safety and efficacy of embolization, two transvenous techniques have been developed. These are the “ Brassel kissing microcatheter technique ” ( 3 , 9 , 11 ) and the “ Adapted Chapot pressure cooker technique ” ( 9 , 13 ).…”