title: Evaluation of Gianturco coils for closure of large (> or = 3.5 mm) patent ductus arteriosus.
abstract: OBJECTIVE
  This report evaluates the use of Gianturco coils to close large patent ductus arteriosus (PDAs) (> or = 3.5 mm) and describes transvenous delivery of 0.052-in. (0.132-cm) Gianturco coils.
  
  
  BACKGROUND
  Coil closure of PDAs has become increasingly popular. However, the technique has significant limitations when used to close large PDAs. This report evaluates patient characteristics, PDA anatomy, hemodynamic variables, delivery technique and coil geometry to determine predictors of success.
  
  
  METHODS
  Between January 1995 and January 1997, 16 of 118 patients undergoing catheterization for PDA closure were found to have large PDAs. Their median age and weight were 14 months (range 3 months to 43 years) and 8.5 kg (range 3.5 to 73), respectively. The mean PDA diameter was 4.3 mm (range 3.5 to 5.9). Closure of PDAs was attempted using transcatheter delivery of 0.038-in. (0.096-cm) and 0.052-in. coils. Differences in clinical, anatomic, hemodynamic and technical variables between successes and failures were compared.
  
  
  RESULTS
  Eleven (69%) of 16 patients had successful closure of their PDA. Failures occurred only in patients < 8 months of age with an indexed PDA diameter > 7 mm/m and a pulmonary/systemic flow ratio > or = 2.8:1. Use of 0.052-in. coils tended to reduce the incidence of embolization and the number of coils needed for closure.
  
  
  CONCLUSIONS
  Patients > 8 months of age can have successful closure of large PDAs with currently available Gianturco coils. The 0.052-in. Gianturco coils can be used safely to close large PDAs in infants as small as 6 kg. Increased experience and improved coil design may improve closure rates of large PDAs in infants.
authors.affiliation: Division of Pediatric Cardiology, University of California San Francisco 94143, USA. Carl_Owada@pedcardgateway.ucsf.edu
authors.forename: C Y
authors.initials: CY
authors.lastname: Owada
authors.forename: D F
authors.initials: DF
authors.lastname: Teitel
authors.forename: P
authors.initials: P
authors.lastname: Moore
mesh_terms: D006328:Cardiac Catheterization; D016022:Case-Control Studies; D004374:Ductus Arteriosus, Patent / Q000503:physiopathology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D006801:Humans; D007223:Infant; D016896:Treatment Outcome