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<meta name="DC.Title" content="Endovascular Treatment of Vein of Galen Malformations: A Systematic Review and Meta-Analysis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5403" />
<meta name="DC.Date" content="2017-12-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND: Outcomes after endovascular embolization of vein of Galen malformations remain relatively poorly described.

PURPOSE: We performed a systematic review of the literature to determine outcomes and predictors of good outcomes following endovascular treatment of vein of Galen malformations.

DATA SOURCES: We used Ovid MEDLINE, Ovid Embase, and the Web of Science.

STUDY SELECTION: Our study consisted of all case series with ≥4 patients receiving endovascular treatment of vein of Galen malformations published through January 2017.

DATA ANALYSIS: We studied the following outcomes: complete/near-complete occlusion rates, technical complications, perioperative stroke, perioperative hemorrhage, technical mortality, all-cause mortality, poor neurologic outcomes, and good neurologic outcomes. Outcomes were stratified by age-group (neonate, infant, child). A random-effects meta-analysis was performed.

DATA SYNTHESIS: A total of 27 series with 578 patients were included; 41.9% of patients were neonates, 45.0% of patients were infants, and 13.1% of patients were children. All-cause mortality was 14.0% (95% CI, 8.0%–22.0%). Overall good neurologic outcome rates were 62.0% (95% CI, 57.0%–67.0%). Overall poor neurologic outcome rates were 21.0% (95% CI, 17.0%–26.0%). Neonates were significantly less likely to have good neurologic outcomes than infants (48.0%; 95% CI, 35.0%–62.0% versus 77.0%; 95% CI, 70.0%–84.0%; P &lt; .01). Treatment indications following the Bicêtre neonatal evaluation score resulted in significantly higher rates of good neurologic outcome ( P = .04). Patients with congestive heart failure had significantly lower rates of good neurologic outcome (OR, 0.50; 95% CI, 0.28–0.88; P = .01).

LIMITATIONS: Limitations were selection and publication biases.

CONCLUSIONS: Patients receiving endovascular embolization of vein of Galen malformations experienced good long-term clinical outcomes in &gt;60% of cases. Appropriate patient selection is key as treatment guided by the Bicêtre neonatal evaluation score was associated with improved neurologic outcomes.

BNES
:   Bicêtre neonatal evaluation score
CHF
:   congestive heart failure
PRISMA
:   Preferred Reporting Items for Systematic Reviews and Meta-Analyses
VOGM
:   vein of Galen arteriovenous malformation" />
<meta name="DC.Contributor" content="W. Brinjikji" />
<meta name="DC.Contributor" content="T. Krings" />
<meta name="DC.Contributor" content="M.H. Murad" />
<meta name="DC.Contributor" content="A. Rouchaud" />
<meta name="DC.Contributor" content="D. Meila" />
<meta name="article:published_time" content="2017-12-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Endovascular Treatment of Vein of Galen Malformations: A Systematic Review and Meta-Analysis" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND:&lt;/h3&gt;
&lt;p&gt;Outcomes after endovascular embolization of vein of Galen malformations remain relatively poorly described.&lt;/p&gt;&lt;h3&gt;PURPOSE:&lt;/h3&gt;
&lt;p&gt;We performed a systematic review of the literature to determine outcomes and predictors of good outcomes following endovascular treatment of vein of Galen malformations.&lt;/p&gt;&lt;h3&gt;DATA SOURCES:&lt;/h3&gt;
&lt;p&gt;We used Ovid MEDLINE, Ovid Embase, and the Web of Science.&lt;/p&gt;&lt;h3&gt;STUDY SELECTION:&lt;/h3&gt;
&lt;p&gt;Our study consisted of all case series with ≥4 patients receiving endovascular treatment of vein of Galen malformations published through January 2017.&lt;/p&gt;&lt;h3&gt;DATA ANALYSIS:&lt;/h3&gt;
&lt;p&gt;We studied the following outcomes: complete/near-complete occlusion rates, technical complications, perioperative stroke, perioperative hemorrhage, technical mortality, all-cause mortality, poor neurologic outcomes, and good neurologic outcomes. Outcomes were stratified by age-group (neonate, infant, child). A random-effects meta-analysis was performed.&lt;/p&gt;&lt;h3&gt;DATA SYNTHESIS:&lt;/h3&gt;
&lt;p&gt;A total of 27 series with 578 patients were included; 41.9% of patients were neonates, 45.0% of patients were infants, and 13.1% of patients were children. All-cause mortality was 14.0% (95% CI, 8.0%–22.0%). Overall good neurologic outcome rates were 62.0% (95% CI, 57.0%–67.0%). Overall poor neurologic outcome rates were 21.0% (95% CI, 17.0%–26.0%). Neonates were significantly less likely to have good neurologic outcomes than infants (48.0%; 95% CI, 35.0%–62.0% versus 77.0%; 95% CI, 70.0%–84.0%; &lt;i&gt;P&lt;/i&gt; &amp;lt; .01). Treatment indications following the Bicêtre neonatal evaluation score resulted in significantly higher rates of good neurologic outcome (&lt;i&gt;P&lt;/i&gt; = .04). Patients with congestive heart failure had significantly lower rates of good neurologic outcome (OR, 0.50; 95% CI, 0.28–0.88; &lt;i&gt;P&lt;/i&gt; = .01).&lt;/p&gt;&lt;h3&gt;LIMITATIONS:&lt;/h3&gt;
&lt;p&gt;Limitations were selection and publication biases.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Patients receiving endovascular embolization of vein of Galen malformations experienced good long-term clinical outcomes in &amp;gt;60% of cases. Appropriate patient selection is key as treatment guided by the Bicêtre neonatal evaluation score was associated with improved neurologic outcomes.&lt;/p&gt;" />
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<meta name="citation_author" content="W. Brinjikji" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiology (W.B.)" />
<meta name="citation_author_institution" content="bNeurosurgery, (W.B.)" />
<meta name="citation_author_institution" content="dDivision of Neuroradiology and Neurosurgery (W.B., T.K.), University of Toronto, Toronto Western Hospital and University Health Network, Toronto, Ontario, Canada" />
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<meta name="twitter:title" content="Endovascular Treatment of Vein of Galen Malformations: A Systematic Review and Meta-Analysis" />
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<meta name="twitter:description" content="BACKGROUND: Outcomes after endovascular embolization of vein of Galen malformations remain relatively poorly described.

PURPOSE: We performed a systematic review of the literature to determine outcomes and predictors of good outcomes following endovascular treatment of vein of Galen malformations.

DATA SOURCES: We used Ovid MEDLINE, Ovid Embase, and the Web of Science.

STUDY SELECTION: Our study consisted of all case series with ≥4 patients receiving endovascular treatment of vein of Galen malformations published through January 2017.

DATA ANALYSIS: We studied the following outcomes: complete/near-complete occlusion rates, technical complications, perioperative stroke, perioperative hemorrhage, technical mortality, all-cause mortality, poor neurologic outcomes, and good neurologic outcomes. Outcomes were stratified by age-group (neonate, infant, child). A random-effects meta-analysis was performed.

DATA SYNTHESIS: A total of 27 series with 578 patients were included; 41.9% of patients were neonates, 45.0% of patients were infants, and 13.1% of patients were children. All-cause mortality was 14.0% (95% CI, 8.0%–22.0%). Overall good neurologic outcome rates were 62.0% (95% CI, 57.0%–67.0%). Overall poor neurologic outcome rates were 21.0% (95% CI, 17.0%–26.0%). Neonates were significantly less likely to have good neurologic outcomes than infants (48.0%; 95% CI, 35.0%–62.0% versus 77.0%; 95% CI, 70.0%–84.0%; P &lt; .01). Treatment indications following the Bicêtre neonatal evaluation score resulted in significantly higher rates of good neurologic outcome ( P = .04). Patients with congestive heart failure had significantly lower rates of good neurologic outcome (OR, 0.50; 95% CI, 0.28–0.88; P = .01).

LIMITATIONS: Limitations were selection and publication biases.

CONCLUSIONS: Patients receiving endovascular embolization of vein of Galen malformations experienced good long-term clinical outcomes in &gt;60% of cases. Appropriate patient selection is key as treatment guided by the Bicêtre neonatal evaluation score was associated with improved neurologic outcomes.

BNES
:   Bicêtre neonatal evaluation score
CHF
:   congestive heart failure
PRISMA
:   Preferred Reporting Items for Systematic Reviews and Meta-Analyses
VOGM
:   vein of Galen arteriovenous malformation" />
<meta name="og-title" property="og:title" content="Endovascular Treatment of Vein of Galen Malformations: A Systematic Review and Meta-Analysis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/38/12/2308" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND: Outcomes after endovascular embolization of vein of Galen malformations remain relatively poorly described.

PURPOSE: We performed a systematic review of the literature to determine outcomes and predictors of good outcomes following endovascular treatment of vein of Galen malformations.

DATA SOURCES: We used Ovid MEDLINE, Ovid Embase, and the Web of Science.

STUDY SELECTION: Our study consisted of all case series with ≥4 patients receiving endovascular treatment of vein of Galen malformations published through January 2017.

DATA ANALYSIS: We studied the following outcomes: complete/near-complete occlusion rates, technical complications, perioperative stroke, perioperative hemorrhage, technical mortality, all-cause mortality, poor neurologic outcomes, and good neurologic outcomes. Outcomes were stratified by age-group (neonate, infant, child). A random-effects meta-analysis was performed.

DATA SYNTHESIS: A total of 27 series with 578 patients were included; 41.9% of patients were neonates, 45.0% of patients were infants, and 13.1% of patients were children. All-cause mortality was 14.0% (95% CI, 8.0%–22.0%). Overall good neurologic outcome rates were 62.0% (95% CI, 57.0%–67.0%). Overall poor neurologic outcome rates were 21.0% (95% CI, 17.0%–26.0%). Neonates were significantly less likely to have good neurologic outcomes than infants (48.0%; 95% CI, 35.0%–62.0% versus 77.0%; 95% CI, 70.0%–84.0%; P &lt; .01). Treatment indications following the Bicêtre neonatal evaluation score resulted in significantly higher rates of good neurologic outcome ( P = .04). Patients with congestive heart failure had significantly lower rates of good neurologic outcome (OR, 0.50; 95% CI, 0.28–0.88; P = .01).

LIMITATIONS: Limitations were selection and publication biases.

CONCLUSIONS: Patients receiving endovascular embolization of vein of Galen malformations experienced good long-term clinical outcomes in &gt;60% of cases. Appropriate patient selection is key as treatment guided by the Bicêtre neonatal evaluation score was associated with improved neurologic outcomes.

BNES
:   Bicêtre neonatal evaluation score
CHF
:   congestive heart failure
PRISMA
:   Preferred Reporting Items for Systematic Reviews and Meta-Analyses
VOGM
:   vein of Galen arteriovenous malformation" />
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      <h1 class="highwire-cite-title" id="page-title">Endovascular Treatment of Vein of Galen Malformations: A Systematic Review and Meta-Analysis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">W. Brinjikji</span>, <span class="highwire-citation-author" data-delta="1">T. Krings</span>, <span class="highwire-citation-author" data-delta="2">M.H. Murad</span>, <span class="highwire-citation-author" data-delta="3">A. Rouchaud</span> and <span class="highwire-citation-author" data-delta="4">D. Meila</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">December 2017,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2308-2314; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5403 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-57333--6531956118" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">W. Brinjikji </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (W.B.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery, (W.B.)</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Division of Neuroradiology and Neurosurgery (W.B., T.K.), University of Toronto, Toronto Western Hospital and University Health Network, Toronto, Ontario, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W.%2BBrinjikji%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Brinjikji%20W&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AW.%2BBrinjikji%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5271-5524" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for W. Brinjikji</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">T. Krings </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Division of Neuroradiology and Neurosurgery (W.B., T.K.), University of Toronto, Toronto Western Hospital and University Health Network, Toronto, Ontario, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.%2BKrings%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Krings%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.%2BKrings%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-6321-5787" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T. Krings</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">M.H. Murad </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Center for the Science of Healthcare Delivery (M.H.M.), Mayo Clinic, Rochester, Minnesota</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.H.%2BMurad%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Murad%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.H.%2BMurad%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5502-5975" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.H. Murad</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">A. Rouchaud </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Neuroradiology Service (A.R.), Centre Hospitalier Universitaire Bicêtre, Le Kremlin Bicêtre, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BRouchaud%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rouchaud%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BRouchaud%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-0902-3375" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Rouchaud</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">D. Meila </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Radiology and Neuroradiology (D.M.), Klinikum Duisburg, Duisburg, Germany</div><div class='author-affiliation'><span class='nlm-sup'>g</span>Department of Diagnostic and Interventional Neuroradiology (D.M.), Medical School Hannover, Hannover, Germany.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BMeila%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Meila%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.%2BMeila%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-4077-0208" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D. 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 38</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 12 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Dec 2017 </div></div>
      
      
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      <div class="highwire-cite-title">Endovascular Treatment of Vein of Galen Malformations: A Systematic Review and Meta-Analysis</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">W.</span> <span class="nlm-surname">Brinjikji</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Krings</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.H.</span> <span class="nlm-surname">Murad</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Rouchaud</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Meila</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Dec 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2308-2314; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5403 </span></div>
  
  
  
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      <div class="highwire-cite-title">Endovascular Treatment of Vein of Galen Malformations: A Systematic Review and Meta-Analysis</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">W.</span> <span class="nlm-surname">Brinjikji</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Krings</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.H.</span> <span class="nlm-surname">Murad</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Rouchaud</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Meila</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Dec 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2308-2314; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5403 </span></div>
  
  
  
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