Gianturco coil embolization of vein of Galen aneurysms: technical aspects

Galenic A-V fistulas typically result in hydrocephalus and increased cerebral venous pressure, with symptoms of progressive seizure activity, chronic cardiac failure and failure to thrive. Surgery and arterial embolization have been only partially successful in reducing flow through these shunts. The authors present technical details of a procedure for embolizing such lesions via a transtorcular venous approach. Early results in 15 patients are reported: Twelve patients appear to have had significant symptomatic improvement; two have died of persistent heart failure, and one died of a subdural hematoma associated with ventriculostomy.