Transcatheter occlusion of the patent ductus arteriosus with Cook detachable coils.
OBJECTIVE
To report initial experience with a new occlusion device for native and residual patent ductus arteriosus.


METHODS
Descriptive study of consecutive non-randomised patients undergoing a new method of patent ductus arteriosus closure with detachable coils.


METHODS
Tertiary centres for paediatric cardiology.


METHODS
71 consecutive patients, aged 1.2-22 years, with a patent ductus arteriosus (PDA) underwent elective transcatheter closure. 45 had native PDAs (group A) with a minimum diameter of 1.0 mm-5.0 mm (median 2.0 mm). A further 26 had undergone one or more previous occlusion attempts (group B).


METHODS
A total of 133 detachable (Cook) spring coils were successfully implanted in 70 patients. The procedure was performed transvenously in 51 patients, retrograde arterially in 13, and by both routes in a further 6 patients. One 5 mm coil migrated but was successfully retrieved.


METHODS
In group A colour flow Doppler echocardiography showed that complete occlusion was achieved in 40/45 (89%) at 24 hours, 41/45 (91%) at 1 month, and 44/45 (98%) by 6 months post procedure. Occlusion rates in residual PDAs were 22/25 (88%) occluded at 24 hours, 23/25 (92%) at 1 month, and 24/25 (96%) at 6 months follow up.


CONCLUSIONS
Transcatheter occlusion using detachable (Cook) spring coils is a safe and effective alternative to presently available devices. The delivery system allows full retrieval of the coil until a satisfactory position is obtained.
Tometzki
A J
AJ
Royal Liverpool Children's Hospital.
Arnold
R
R
Peart
I
I
Sreeram
N
N
Abdulhamed
J M
JM
Godman
M J
MJ
Patel
R G
RG
Kitchiner
D J
DJ
Bu'Lock
F A
FA
Walsh
K P
KP
D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000628:therapy*; D018618:Echocardiography, Doppler, Color; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male