Doctors have successfully inserted wire coils into the veins of 3-year-old conjoined twins to give them independent blood flow to their brains as part of what will be a months-long, high-risk procedure to separate them, a doctor said Thursday.
"Based on recent events, we are enthusiastic and hopeful," said Dr. Nathan Levitan, chief medical officer at University Hospitals Case Medical Center and the leader to the team that intends to separate Tatiana and Anastasia Dogaru, born in Rome to Romanian parents.
Doctors are confident the procedure can work, he said.
The top of Tatiana's head is attached to the back of Anastasia's. A team of up to 50 doctors and nurses will separate the girls in four stages over several weeks at Rainbow Babies & Children's Hospital in Cleveland.
The twins arrived in Cleveland on April 6 after 2 1/2 years in Dallas. Without separation, they run the risk of dying in early childhood.
In the weeks to come, the twins will face other tests on blood flow and heart function. Anastasia, the larger twin, also requires a kidney transplant; she has no kidney function and relies on Tatiana's kidneys.
Twins born joined at the head - called craniopagus twins - are extremely rare, occurring in about 1 in 2.5 million births.
Recent tests on the twins found that their brains are against each other, and it is not clear how much brain tissue might be shared, Levitan said.
Wire coils made of platinum are used to block blood vessels to redirect blood flow in a variety of medical treatments. In the case of the conjoined twins, it is "a step towards creating an independent circulation" for each child, Levitan said.
The medical team said they think the coil procedure has not been tried in a comparable case.
Scans have produced images of the girls' skulls and brains to help doctors better prepare.