Coil embolization to occlude aortopulmonary collateral vessels and shunts in patients with congenital heart disease.
Gianturco coils were used to embolize 77 vessels in 54 patients: 58 aortopulmonary collateral vessels, 14 Blalock-Taussig shunts, 3 arteries involved in pulmonary sequestrations and 2 venae cavae. Embolization resulted in total occlusion in 53 (69%), subtotal occlusion in 19 (25%) and partial occlusion in 3 (1 intentional). Two embolizations failed to reduce flow. Thus, 72 (95%) of 76 embolizations in which complete occlusion was the intended result resulted in total or subtotal occlusion. Analysis of the results demonstrates that completely occluded collateral vessels were longer and had a smaller diameter than did incompletely occluded vessels. Complications included six cases of inadvertent embolization to the pulmonary arteries (n = 5) or the aorta (n = 1); three were retrieved and three were left without symptoms. In addition, there was a case of severe hemolysis after intentional partial occlusion of a Blalock-Taussig shunt. The results demonstrate that coil embolization can be an effective procedure for managing a wide variety of aorto-pulmonary collateral vessels and shunts in children with congenital heart disease.
Perry
S B
SB
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Radtke
W
W
Fellows
K E
KE
Keane
J F
JF
Lock
J E
JE
D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000503:physiopathology*; D001027:Aortography; D002648:Child; D002675:Child, Preschool; D002932:Cineangiography; D003097:Collateral Circulation; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004868:Equipment Failure; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011652:Pulmonary Circulation