Related Experiment Video
Updated: Mar 16, 2026
Murine Model of Central Venous Stenosis using Aortocaval Fistula with an Outflow Stenosis
Published on: July 11, 2019
Fistulous-type vein of Galen malformation phantom model for endovascular training and research
Dan Meila1,2, Katharina Melber1, Dominik Grieb1
1Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany.
Insights
A new phantom model accurately simulates Vein of Galen malformation (VGM) for endovascular treatment training and research. This model aids in understanding hemodynamics and angioarchitecture, improving pediatric neurovascular disease management.
Area of Science:
- Pediatric Neurosurgery
- Interventional Neuroradiology
- Medical Device Development
Background:
- Vein of Galen malformation (VGM) is a severe pediatric neurovascular disease with high mortality and disability rates.
- Endovascular embolization is the primary treatment for VGM, necessitating effective training and research tools.
Purpose of the Study:
- To create a simplified, in vitro pulsatile phantom model of a fistulous-type VGM.
- To facilitate teaching and training for various endovascular treatment techniques.
- To enable investigation of novel treatment strategies and devices for VGM.
Main Methods:
- Development of an experimental in vitro pulsatile phantom mimicking a high-flow fistulous-type VGM.
- Performance of pressure measurements at arterial sites before and after VGM closure.
- Utilized a 'kissing microcatheter technique' for VGM embolization via combined transvenous and transarterial approaches.
Main Results:
- The phantom model demonstrated in vitro behavior closely resembling in vivo conditions in children.
- Statistically significant changes in intra-arterial pressures were observed post-embolization, consistent with human arteriovenous malformations.
- Antegrade and retrograde microcatheter injections provided complementary visualizations of hemodynamics and angioarchitecture.
Conclusions:
- The developed phantom model accurately replicates fistulous-type VGM characteristics.
- The model is suitable for in vitro teaching, training, and further research in VGM management.
- It enhances understanding of hemodynamics and angioarchitecture crucial for endovascular treatment of VGM.
Introduction:
Vein of Galen malformation (VGM), a high-flow intracranial arteriovenous shunt, is among the most severe neurovascular diseases in childhood. In many cases untreated children die or survive only severely disabled. Endovascular embolization is the preferred treatment.
Objective:
To develop a simple fistulous-type VGM phantom model for teaching and training of different endovascular treatment methods and to investigate new treatment options and devices.
Methods:
An experimental in vitro pulsatile phantom model was developed imitating a high-flow fistulous-type VGM, which is typical, especially in the neonatal phase. Pressure measurements at different arterial sites were performed before and after closure of the VGM. Closure of the VGM was achieved by coiling using a combined microcatheter-based transvenous and transarterial approach called 'kissing microcatheter technique'.
Results:
The behaviour of the phantom model in vitro under fluoroscopy and under angiographic runs was extremely similar to that in in vivo conditions in children. The results showed that intra-arterial pressures changed and increased statistically significantly at all measurement sites after embolization, as in human arteriovenous malformation. We also demonstrated different and complementary visualizations of hemodynamics and angioarchitecture by antegrade and retrograde microcatheter injections.
Conclusions:
Our phantom model behaves like a typical fistulous-type VGM and can be used in vitro for teaching and training and for further research. It offers a new and better understanding of hemodynamics and angioarchitecture in the endovascular management of VGM.
