{
  "abstract": "Vein of Galen aneurysmal malformations (VOGMs) are rare congenital cerebrovascular malformations associated with an almost 100% morbidity and mortality rate if untreated. Open surgical case reports had reported intraoperative neonatal mortality rates close to 100%, rendering the disease untreatable. The development of endovascular techniques subsequently provided a viable treatment option for these complex cases, with a staged transarterial approach currently being the preferred mainstay treatment.We report on a technique that involves direct exposure of the transverse sinus under image-guided mini-craniotomy in a vascular hybrid intraoperative theater, followed by direct puncture of the transverse sinus with venous access to embolize the VOGM via a transvenous route. This was performed in a 3-year-old patient in whom further transarterial embolization was not feasible and who had bilateral occlusion of the internal jugular veins. The procedure was successful, with elimination of the high-flow arteriovenous shunt and no procedure-related complications.",
  "authors": [
    {
      "affiliations": [
        "Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK",
        "Neuroradiology, Alder Hey Children's Hospital Trust, Liverpool, UK",
        "School of Pharmacy and Bioengineering, Keele University, Stoke on Trent, UK"
      ],
      "name": "Gilbert Gravino"
    },
    {
      "affiliations": [
        "Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK",
        "Neuroradiology, Alder Hey Children's Hospital Trust, Liverpool, UK"
      ],
      "name": "Saad Aamir"
    },
    {
      "affiliations": [
        "Neurosurgery, Alder Hey Children’s Hospital Trust, Liverpool, UK"
      ],
      "name": "Sofie Dietvorst"
    },
    {
      "affiliations": [
        "Neurosurgery, Alder Hey Children’s Hospital Trust, Liverpool, UK"
      ],
      "name": "Kush Bhatt"
    },
    {
      "affiliations": [
        "Neuroradiology, University College London, London, UK",
        "Interventional Radiology, Great Ormond Street Hospital for Children NHS Trust, London, UK"
      ],
      "name": "Fergus Robertson"
    },
    {
      "affiliations": [
        "Neurosurgery, Alder Hey Children’s Hospital Trust, Liverpool, UK"
      ],
      "name": "Chris Parks"
    },
    {
      "affiliations": [
        "Anaesthesia, Alder Hey Children's Hospital Trust, Liverpool, UK"
      ],
      "name": "Richard Craig"
    },
    {
      "affiliations": [
        "Neuroradiology, Alder Hey Children's Hospital Trust, Liverpool, UK"
      ],
      "name": "Andrew Healey"
    },
    {
      "affiliations": [
        "Neurosurgery, Alder Hey Children’s Hospital Trust, Liverpool, UK"
      ],
      "name": "Dawn Henningan"
    },
    {
      "affiliations": [
        "Neurosurgery, Alder Hey Children’s Hospital Trust, Liverpool, UK"
      ],
      "name": "Conor Mallucci"
    },
    {
      "affiliations": [
        "Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK",
        "Neuroradiology, Alder Hey Children's Hospital Trust, Liverpool, UK"
      ],
      "name": "Arun Chandran"
    },
    {
      "affiliations": [
        "Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK",
        "Neuroradiology, Alder Hey Children's Hospital Trust, Liverpool, UK"
      ],
      "name": "Mani Puthuran"
    }
  ],
  "title": "Vein of Galen aneurysmal malformation treatment with direct open surgical access of the transverse sinus and transvenous selective endovascular embolization: a hybrid approach",
  "uid": "9e623bce-d089-5c91-a1c0-92719199042b"
}