Fetal Intervention for Vein of Galen Malformations | Overview
A vein of Galen malformation (VOGM) is a rare blood vessel abnormality that causes blood to flow directly into a large vein deep in the base of the brain instead of reaching the surrounding brain tissue. This abnormal and excess flow puts strain on the heart and lungs, leading to complications such as high blood pressure or heart failure. VOGM is often diagnosed before birth through prenatal imaging, which allows doctors to monitor the condition and plan treatment. Despite early detection, however, many affected infants develop severe symptoms within days of delivery and are at high risk of serious illness or death, even with expert care. Currently, a multidisciplinary team at Boston Children’s and Brigham and Women’s Hospital is studying a new approach to treat VOGM in the womb to help these high-risk patients.
In March 2023, the team performed the first successful fetal intervention for VOGM in North America. In 2025, outcomes from the first seven patients enrolled in the trial were published in JAMA. Of the seven, five underwent successful fetal treatment, reducing the expected neonatal mortality rate from 90 percent to 43 percent. Among the five treated, three are thriving with no signs of neurodevelopmental delay. These findings suggest the procedure is safe and effective. The study is ongoing.
What is fetal embolization?
Fetal embolization is a procedure designed to slow the abnormal blood flow in the brain before birth using a catheter to place coils into the abnormal blood vessels. This helps reduce blood flow without blocking the vein.
What does the study involve?
This intervention is performed in an obstetric OR by a team of physicians. Darren Orbach, MD, PhD, chief of Neurointerventional Radiology and co-director of the Cerebrovascular Surgery and Interventions Center, will perform the brain embolization; the Brigham and Women’s team is led by Dr. Louise Wilkins-Haug (division director of Maternal Fetal Medicine and Reproductive Genetics).
Who is eligible?
Below: Watch and learn more about vein of Galen malformations and the pioneering treatment approaches available.
Candidates for this intervention must have an in utero diagnosis of VOGM. Patients will be assessed at Boston Children’s Fetal Care and Surgery Center (FCSC) for trial eligibility.
Interested patients should contact the FCSC at 617-355-6512 or email FCSCreferrals@childrens.harvard.edu. More information about the research intervention and the potential risks and benefits will be provided at that time.