Abstract
OBJECTIVE: To assess the outcome of arterial duct occlusion with coils chosen according to the duct morphology. DESIGN: Retrospective study. SETTING: Paediatric cardiology centre. PATIENTS: Coil occlusion was attempted in 57 patients aged 0.5 to 15 (median 3.7) years and weighing 5-59 (median 14) kg between January 1991 and December 1995. A residual leak was present in 8 patients after umbrella closure and in 4 patients after duct ligation. METHODS: Coils of 4 different types were implanted through 4 or 5 F femoral artery catheters. Platinum or Interlocking Detachable 0.018 inch coils were deployed completely inside tubular ducts. Gianturco or PDA controlled release 0.038 inch coils were implanted to straddle short, post ligation and post umbrella ducts. RESULTS: Coil implantation was successful in 54/57 patients. At 1 year the cumulative occlusion rate was 53/57 ducts (93%) on an intention to treat analysis. A single coil was implanted in 37 (69%), 2 coils in 10 (19%), 3 coils in 3 (5%) and 4 coils in 4 (7%) of the 54 successful procedures. Duct occlusion was documented at the end of the procedure in 31%, by the following day in 83%, by 6 weeks in 87%, by 6 months in 96%, and by 1 year in 98%. Coil embolisation occurred in 6/58 procedures (10%), with a 50% rate in the first year of implantation (1/2 patients) falling to 7% in the last year (3/42 patients). All embolised coils were easily retrieved. CONCLUSIONS: Occlusion of small to moderate size arterial ducts, including residual post umbrella or post ligation ducts, was readily accomplished by coils selected according to the duct anatomy. This has both cost and practical benefits.
Full text
PDF





Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Benson L. N., Freedom R. M. Balloon dilatation of the very small patent ductus arteriosus in preparation for transcatheter occlusion. Cathet Cardiovasc Diagn. 1989 Sep;18(1):48–49. doi: 10.1002/ccd.1810180112. [DOI] [PubMed] [Google Scholar]
- Chen S. A., Chiang C. E., Tsang W. P., Hsia C. P., Wang D. C., Yeh H. I., Ting C. T., Chuen W. C., Yang C. J., Cheng C. C. Selective radiofrequency catheter ablation of fast and slow pathways in 100 patients with atrioventricular nodal reentrant tachycardia. Am Heart J. 1993 Jan;125(1):1–10. doi: 10.1016/0002-8703(93)90050-j. [DOI] [PubMed] [Google Scholar]
- Fadley F., al-Halees Z., Galal O., Kumar N., Wilson N. Left pulmonary artery stenosis after transcatheter occlusion of persistent arterial duct. Lancet. 1993 Feb 27;341(8844):559–560. doi: 10.1016/0140-6736(93)90321-7. [DOI] [PubMed] [Google Scholar]
- Gray D. T., Fyler D. C., Walker A. M., Weinstein M. C., Chalmers T. C. Clinical outcomes and costs of transcatheter as compared with surgical closure of patent ductus arteriosus. The Patient Ductus Arteriosus Closure Comparative Study Group. N Engl J Med. 1993 Nov 18;329(21):1517–1523. doi: 10.1056/NEJM199311183292101. [DOI] [PubMed] [Google Scholar]
- Hijazi Z. M., Geggel R. L. Results of anterograde transcatheter closure of patent ductus arteriosus using single or multiple Gianturco coils. Am J Cardiol. 1994 Nov 1;74(9):925–929. doi: 10.1016/0002-9149(94)90588-6. [DOI] [PubMed] [Google Scholar]
- Hosking M. C., Benson L. N., Musewe N., Dyck J. D., Freedom R. M. Transcatheter occlusion of the persistently patent ductus arteriosus. Forty-month follow-up and prevalence of residual shunting. Circulation. 1991 Dec;84(6):2313–2317. doi: 10.1161/01.cir.84.6.2313. [DOI] [PubMed] [Google Scholar]
- Huggon I. C., Tabatabaei A. H., Qureshi S. A., Baker E. J., Tynan M. Use of a second transcatheter Rashkind arterial duct occluder for persistent flow after implantation of the first device: indications and results. Br Heart J. 1993 Jun;69(6):544–550. doi: 10.1136/hrt.69.6.544. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Latson L. A. Residual shunts after transcatheter closure of patent ductus arteriosus. A major concern or benign "techno-malady"? Circulation. 1991 Dec;84(6):2591–2593. doi: 10.1161/01.cir.84.6.2591. [DOI] [PubMed] [Google Scholar]
- Lloyd T. R., Fedderly R., Mendelsohn A. M., Sandhu S. K., Beekman R. H., 3rd Transcatheter occlusion of patent ductus arteriosus with Gianturco coils. Circulation. 1993 Oct;88(4 Pt 1):1412–1420. doi: 10.1161/01.cir.88.4.1412. [DOI] [PubMed] [Google Scholar]
- Moore J. W., George L., Kirkpatrick S. E., Mathewson J. W., Spicer R. L., Uzark K., Rothman A., Cambier P. A., Slack M. C., Kirby W. C. Percutaneous closure of the small patent ductus arteriosus using occluding spring coils. J Am Coll Cardiol. 1994 Mar 1;23(3):759–765. doi: 10.1016/0735-1097(94)90765-x. [DOI] [PubMed] [Google Scholar]
- Ottenkamp J., Hess J., Talsma M. D., Buis-Liem T. N. Protrusion of the device: a complication of catheter closure of patent ductus arteriosus. Br Heart J. 1992 Sep;68(3):301–303. doi: 10.1136/hrt.68.9.301. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Perry S. B., Lock J. E. Front-loading of double-umbrella devices, a new technique for umbrella delivery for closing cardiovascular defects. Am J Cardiol. 1992 Oct 1;70(9):917–920. doi: 10.1016/0002-9149(92)90738-k. [DOI] [PubMed] [Google Scholar]
- Porstmann W., Wierny L. Percutaneous transfemoral closure of the patent ductus arteriosus -- an alternative to surgery. Semin Roentgenol. 1981 Apr;16(2):95–102. doi: 10.1016/0037-198x(81)90045-6. [DOI] [PubMed] [Google Scholar]
- Rashkind W. J., Mullins C. E., Hellenbrand W. E., Tait M. A. Nonsurgical closure of patent ductus arteriosus: clinical application of the Rashkind PDA Occluder System. Circulation. 1987 Mar;75(3):583–592. doi: 10.1161/01.cir.75.3.583. [DOI] [PubMed] [Google Scholar]
- Reidy J. F., Jones O. D., Tynan M. J., Baker E. J., Joseph M. C. Embolisation procedures in congenital heart disease. Br Heart J. 1985 Aug;54(2):184–192. doi: 10.1136/hrt.54.2.184. [DOI] [PMC free article] [PubMed] [Google Scholar]




