Zhao Siqi,Ying Jianbin,Chen Xuanjie,et al.Analysis of prognostic risk factors for aneurysmal malformation of the great vein of Galen in children treated with interventional embolization[J].Journal of Clinical Pediatric Surgery,2025,(02):125-130.[doi:10.3760/cma.j.cn101785-202411026-005]
Analysis of prognostic risk factors for aneurysmal malformation of the great vein of Galen in children treated with interventional embolization
- Keywords:
- Vein of Galen Aneurysmal Malformation; Endovascular Therapy; Embolization; Therapeutic; Treatment Outcome; Root Cause Analysis; Child
- Abstract:
- Objective To summarize the relevant clinical data to identify risk factors for the prognosis of pediatric aneurysmal malformation of great vein of Galen Galen aneurysmal malformation (VGAM) children undergoing interventional embolization. Methods From September 2021 to March 2023,we recruited 3 VGAM children receiving interventional treatment at our department and screened for the relevant literature items published in the electronic databases of PubMed,MEDLINE and EMBASE from January 2010 to October 2024.The relevant clinical data included age,gender,clinical symptoms,vascular structure,number of embolization events,initial embolization route,degree of embolization occlusion and prognosis.Statistical analysis was performed for identifying the risk factors associated with prognosis. Results According to the inclusion and exclusion criteria,a total of 67 cases from 7 articles were eligible along with 3 children at our department for analysis.Among a total of 70 cases,65.7%(46/70) had a good prognosis after interventional embolization while 34.3%(24/70) a poor prognosi.The ratio of boy-to-girl was 48:22.There were prenatal cases (n=14),neonates (n=23) and infants & toddlers (n=33).The pre-existing conditions included heart failure (58.6%,41/70) and hydrocephalus (47.1%,33/70).The clinical types of pathological vascular structure were choroid plexus (65.7%,46/70) and wall (34.3%,24/70).The frequency of embolization was once (41.4%,29/70) and ≥ twice (58.6%,41/70).Initial embolization route was arterial (72.9%,51/70) and venous or dual (27.1%,19/70).Postoperative occlusion was complete (38.6%,27/70) and incomplete (61.4%,43/70).Univariate analysis revealed that degree of occlusion might be a predictive factor for prognosis (P=0.046).Multivariate analysis indicated that structure of diseased blood vessels (P=0.013) and degree of occlusion (P=0.046) were both related risk factors for predicting prognosis.The probability of good prognosis for choroidal type was 0.175 fold that of wall type.And the probability of good prognosis for completely occluded type was 3.370 folds that of incomplete occluded type. Conclusions Interventional embolization is a preferred treatment for VGAM.And the presence of wall-like vascular structures and complete postoperative occlusion are related risk factors for good prognosis.
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Memo
收稿日期:2024-11-11。
基金项目:福建省省级临床重点专科建设项目-福建省儿童医院小儿神经外科[闽卫医政(2023)1163号]
通讯作者:荆俊杰,Email:jjj0709@sina.com