Embolization for vein of Galen aneurysmal malformation via the brachial artery in an infant: illustrative case

• DOI: 10.3171/case24861
• Publication Date: 2025-03-25T20:21:12Z
• Authors: Taisuke Akimoto; Yu Iida; Yasuhiro Ichikawa; Kaori Mori; Yuki Minamisawa; Satoshi Hori; Jun Suenaga; Yasunobu Nakai; Kastumi Sakata; Tetsuya Yamamoto
• Keywords: Brachial artery

BACKGROUND A vein of Galen aneurysmal malformation (VGAM) is a rare vascular lesion that often requires treatment in the neonatal period or infancy. Neonates and infants have limited catheter access, VGAM multiple procedures. When standard access routes are unavailable, alternative becomes essential. OBSERVATIONS female infant born at 35 weeks 6 days gestation with prenatal diagnosis developed severe heart failure anuria after birth. Urgent transarterial glue embolization was performed on 0 1. Three months later, follow-up MRI showed shunt worsening venous congestion. With no remaining available, brachial artery utilized as an alternative, both femoral arteries were occluded direct internal carotid puncture unsafe due to short neck enlarged jugular vein. After this approach, improved congestion reduced without complications, preserving blood flow artery. LESSONS In neonates, maintaining umbilical crucial for future use. However, if these lost procedures, can serve effective access. https://thejns.org/doi/10.3171/CASE24861