IZZET OKCESIZ, HALİL DONMEZ
Turkish Neurosurgery - 2021;31(4):661-664
AIM: To present an alternative endovascular treatment option for the vein of Galen aneurysmal malformation by ethylene vinyl alcohol copolymer embolization via a double lumen balloon microcatheter. MATERIAL and METHODS: A female patient was suspected with the vein of Galen aneurysmal malformation in the prenatal period and diagnosed choroidal type vein of Galen aneurysmal malformation. Once the patient was symptomatic with severe cardiac failure, an endovascular treatment decision was made. In the first step, a mixture of N butyl cyanoacrylate lipiodol was used for embolization. In the second session of the treatment, ethylene vinyl alcohol copolymer was administered through a double lumen balloon microcatheter. RESULTS: Complete cure of the aneurysmal malformation was obtained by no filling was observed in arterial feeders, collapsed appearance of the vein of Galen, and arterial venous shunts at the end of the five year follow up period with magnetic resonance imaging and angiography. CONCLUSION: Ethylene vinyl alcohol copolymer embolization via double lumen balloon microcatheter provides an alternative and effective endovascular treatment option for the vein of Galen aneurysmal malformations using less contrast agent in less procedural time. Also, the possibility of spontaneous regression of residual aneurysmal malformations with small feeders should be considered.
