{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T18:04:05Z","timestamp":1789322645000,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Vein of Galen malformation is associated with significant perinatal morbidity and mortality. Postnatal management typically relies on transarterial embolization of the feeding arteries. To date, fetal therapeutic efforts focused on the transvenous approach. This study aimed to preclinically evaluate the feasibility and safety of a prenatal transarterial approach: Fetal Embolization via Transcardiac Transarterial Ultrasound\u2010 and fluoroscopy\u2010guided Surgery (FETTUS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>MR\u2010angiography was initially performed in neonatal lambs to identify a target artery for embolization. FETTUS was then standardized in fetal lambs at varying gestational ages. Under maternal\u2013fetal anesthesia, laparotomy\u2010assisted fetal left ventricular access was obtained under ultrasound guidance, a microcatheter was advanced to the target artery under fluoroscopy, and embolization was performed with N\u2010butyl cyanoacrylate. The primary outcome was fetal survival \u2265\u00a030\u00a0minutes after confirmed embolization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The internal maxillary artery was chosen as the target artery for embolization. Three fetal lambs underwent successful embolization (100%) at 130\u00a0days of gestation (term\u00a0=\u00a0145\u00a0days; 2.8\u00a0\u00b1\u00a00.6\u00a0kg), two out of six (33%) at 100\u00a0days of gestation (0.9\u00a0\u00b1\u00a00.3\u00a0kg) and finally 6 out of 7 (86%) at 120\u00a0days of gestation (2.3\u00a0\u00b1\u00a00.4\u00a0kg). No non\u2010target embolization, ischemia, or hemorrhage was observed on postmortem examination within the limitations of the observations obtained at 30\u00a0minutes after the procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FETTUS is feasible and safe in fetal lambs at a gestational age equivalent to 30\u00a0weeks in humans.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70157","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T02:36:58Z","timestamp":1776998218000},"page":"1607-1616","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Novel Fetal Embolization Technique via Transcardiac Transarterial Ultrasound\u2010 and Fluoroscopy\u2010Guided Endovascular Surgery for Vein of Galen Malformation: Preclinical Study in the Fetal Lamb"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8252-2483","authenticated-orcid":false,"given":"Emma","family":"Van den Eede","sequence":"first","affiliation":[{"name":"My FetUZ Fetal Research Center Department of Development and Regeneration Biomedical Sciences Catholic University of Leuven (KU Leuven)  Leuven Belgium"},{"name":"Department of Obstetrics and Gynecology University Hospitals Leuven  Leuven Belgium"},{"name":"Department of Obstetrics and Gynecology University Hospital Antwerp  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5034-3867","authenticated-orcid":false,"given":"Karen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Texas Children's Fetal Center, Pavilion for Women Texas Children's Hospital (TCH) and Baylor College of Medicine (BCM)  Houston Texas USA"},{"name":"Department of Obstetrics and Gynecology Texas Children's Center for Translational Fetal Research TCH and BCM  Houston Texas USA"},{"name":"Edward B. Singleton Department of Radiology Division of Interventional Radiology TCH and BCM  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Altman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Texas Children's Fetal Center, Pavilion for Women Texas Children's Hospital (TCH) and Baylor College of Medicine (BCM)  Houston Texas USA"},{"name":"Department of Cardiology TCH and BCM  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8326-7864","authenticated-orcid":false,"given":"Tomohiro","family":"Arai","sequence":"additional","affiliation":[{"name":"My FetUZ Fetal Research Center Department of Development and Regeneration Biomedical Sciences Catholic University of Leuven (KU Leuven)  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasinee","family":"Tianthong","sequence":"additional","affiliation":[{"name":"My FetUZ Fetal Research Center Department of Development and Regeneration Biomedical Sciences Catholic University of Leuven (KU Leuven)  Leuven Belgium"},{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Coudyzer","sequence":"additional","affiliation":[{"name":"Department of Radiology University Hospital Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greetje","family":"Vande Velde","sequence":"additional","affiliation":[{"name":"Department of Imaging and Pathology Biomedical MRI\/Molecular Small Imaging Center (MoSAIC) KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Aertsen","sequence":"additional","affiliation":[{"name":"My FetUZ Fetal Research Center Department of Development and Regeneration Biomedical Sciences Catholic University of Leuven (KU Leuven)  Leuven Belgium"},{"name":"Department of Radiology University Hospital Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Krings","sequence":"additional","affiliation":[{"name":"Division of Neurointerventional Radiology UMass\u2010Chan Lahey Department of Radiology Lahey Hospital &amp; Medical Center \u2010 Beth Israel Lahey Health. TH Chan School of Medicine, UMass Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Sutton","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Texas Children's Fetal Center, Pavilion for Women Texas Children's Hospital (TCH) and Baylor College of Medicine (BCM)  Houston Texas USA"},{"name":"Department of Obstetrics and Gynecology Texas Children's Center for Translational Fetal Research TCH and BCM  Houston Texas USA"},{"name":"Department of Anesthesiology TCH and BCM  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"McCluggage","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Texas Children's Fetal Center, Pavilion for Women Texas Children's Hospital (TCH) and Baylor College of Medicine (BCM)  Houston Texas USA"},{"name":"Department of Neurosurgery TCH and BCM  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Whitehead","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Texas Children's Fetal Center, Pavilion for Women Texas Children's Hospital (TCH) and Baylor College of Medicine (BCM)  Houston Texas USA"},{"name":"Department of Obstetrics and Gynecology Texas Children's Center for Translational Fetal Research TCH and BCM  Houston Texas USA"},{"name":"Department of Neurosurgery TCH and BCM  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Sanz Cortes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Texas Children's Fetal Center, Pavilion for Women Texas Children's Hospital (TCH) and Baylor College of Medicine (BCM)  Houston Texas USA"},{"name":"Department of Obstetrics and Gynecology Texas Children's Center for Translational Fetal Research TCH and BCM  Houston Texas USA"},{"name":"Department of Obstetrics &amp; Gynecology, Maternal\u2010Fetal Medicine Division TCH and BCM  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9810-9578","authenticated-orcid":false,"given":"Larry H.","family":"Hollier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Texas Children's Fetal Center, Pavilion for Women Texas Children's Hospital (TCH) and Baylor College of Medicine (BCM)  Houston Texas USA"},{"name":"Department of Obstetrics and Gynecology Texas Children's Center for Translational Fetal Research TCH and BCM  Houston Texas USA"},{"name":"Michael E. DeBakey Department of Surgery Division of Pediatric Surgery TCH and BCM  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5287-9673","authenticated-orcid":false,"given":"Luc","family":"De Catte","sequence":"additional","affiliation":[{"name":"My FetUZ Fetal Research Center Department of Development and Regeneration Biomedical Sciences Catholic University of Leuven (KU Leuven)  Leuven Belgium"},{"name":"Department of Obstetrics and Gynecology University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry A. G. M.","family":"Huisman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Texas Children's Fetal Center, Pavilion for Women Texas Children's Hospital (TCH) and Baylor College of Medicine (BCM)  Houston Texas USA"},{"name":"Department of Obstetrics and Gynecology Texas Children's Center for Translational Fetal Research TCH and BCM  Houston Texas USA"},{"name":"Edward B. 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