TRANSUMBILICAL CATHETERIZATION OF CEREBRAL-ARTERIES

OBJECTIVE AND IMPORTANCE: For neonates requiring cerebral endovascular procedures, an alternative route of arterial access, the umbilical ar tery, is described. Transfemoral catheterization, with its attendant r isks, can thus be avoided. CLINICAL PRESENTATION: Six neonates with se vere cardiac failure secondary to aneurysmal malformations of the vein of Galen underwent transarterial embolization in an effort to reduce flow through the intracranial arteriovenous malformations and therefor e improve control of the high output cardiac failure. TECHNIQUE: The t ransumbilical route was used in each case, with successful devasculari zation of some of the malformations in all patients. The femoral arter ies were preserved for future staged embolizations. No complications r elated to the umbilical artery catheterization were encountered. CONCL USION: Femoral artery cannulation in neonates is technically challengi ng and may result in stenosis or thrombosis of the vessel. The umbilic al artery provides an alternative route of vascular access for cerebra l artery catheterization and embolization in these patients, preservin g the femoral arteries for future interventions.