Reviewed by Dr Reza Lankarani, General Surgeon

Founder | Surgical Pioneering Newsletter and Podcast Series

Editorial Board Member | Genesis Journal of Surgery and Medicine

This review is provided as a courtesy of Professor Alireza A. Shamshirsaz (Professor of Obstetrics and Gynecology and Reproductive Biology, Harvard Medical School Chief, Division of Maternal-Fetal Medicine and Surgery | Director, Fetal Care and Surgery Center | Director, Perinatal Surgery Fellowship), whose contributions to fetal surgery and maternal-fetal medicine were instrumental in this groundbreaking work. For full details, refer to the original publication [JAMA, August 2025].

DOI: 10.1001/jama.2025.12363

Introduction

Vein of Galen malformation (VOGM) is a rare, life-threatening

congenital cerebral arteriovenous shunt most commonly diagnosed

in late gestation or the neonatal period. The advent of prenatal

imaging has enabled earlier diagnosis, and recent developments

in interventional radiology and fetal therapy have introduced in

utero embolization as a potential option for high-risk cases. This

report provides an in-depth, paragraph-driven narrative and visual

analysis of the in utero embolization procedure for fetal VOGM,

detailing the relevant cerebrovascular anatomy, imaging modalities,

procedural workflow, medical equipment, anesthesia protocol, and

multidisciplinary care. Special attention is given to educational

strategies and visual representation, aiming to facilitate a deep

understanding of this pioneering prenatal intervention.

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https://Surgicalpioneer.codeadx.me

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