Safety and efficacy of interventional occlusion of patent ductus arteriosus with detachable coils: a multicentre experience.
In order to define the safety and efficacy of Cook detachable coils for interventional closure of patent ductus arteriosus, we performed a retrospective analysis of all patients who underwent cardiac catheterization in seven centres for intended interventional occlusion of patent arterial duct. From January 1995 until March 1998, cardiac catheterization for intended interventional occlusion of patent arterial duct was performed in 317 consecutive children. Successful placement of at least one coil was achieved in 282 children (89%). The mean diameter of the ductus in children treated with Cook detachable coils was 1.65 mm, mean fluoroscopy time was 10.7 min. Occlusion rates were 62% 10 min after the procedure, 82% at the time of discharge, 91% at 4 months and 95% at late follow-up (2 years). In children with a ductus diameter of < or = 2.5 mm the rate of successful coil deployment was 94% with a 98% occlusion rate at late follow-up. Complications occurred in 11 procedures (3.5%) including haemolysis (3 patients), embolization of a coil to the pulmonary artery (7 patients, 2.3%) and inability to release a coil (1 patient).


CONCLUSIONS
In our opinion, Cook detachable coils are safe and effective especially in the treatment of persistent ductus arteriosus with a diameter < or = 2.5 mm. Due to the low costs these coils appear to be superior to other devices in this subgroup of patients.
Hofbeck
M
M
Department of Paediatric Cardiology, University Childrens Hospital, Erlangen, Germany. michael.hofbeck@kinder.med.uni-erlangen.de
Bartolomaeus
G
G
Buheitel
G
G
Esser
R
R
Grävinghoff
L
L
Hoffmann
W
W
Kienast
W
W
Michel-Behnke
I
I
Scharabrine
E G
EG
Schranz
D
D
Schmaltz
A A
AA
Shakhov
B E
BE
Singer
H
H
Lindinger
A
A
D000293:Adolescent; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D007223:Infant; D015641:Radiography, Interventional; D012189:Retrospective Studies