Catheter closure of moderate to large sized patent ductus arteriosus using the simultaneous double or triple coil technique.
BACKGROUND
Although the clinical experience with transcatheter closure of the patent ductus arteriosus using the coils has grown rapidly, one important complication of this procedure using the conventional Gianturco coil was the migration of coils into peripheral vessels. This is especially for patients with a relatively larger size ductus and the risk for such complications could be increased. In this situation, the detachable coil may have some technical benefits to perform coil occlusion and reduce the incidence of complications.


METHODS
We describe the clinical efficacy of a simultaneous double or triple coil occlusion technique using the Cook detachable coil or bioptome delivered 0.052 inch Gianturco coil to close the ductus arteriosus. This was performed in patients whose ductus diameter was greater than 3.0 mm.


RESULTS
From February 1995 to December 2000, 118 patients with patent ductus arteriosus were treated by coil occlusion using Cook detachable coils, of whom 58 patients whose minimum diameter of ductus > or = 3.0 mm were reviewed. All patients had successful placement of coils. According to the evaluation by color flow mapping, a trivial shunt was observed in 17 patients (29%) within 24 h after the procedure. In 11 out of 17 patients, a residual shunt was not detected 1 month after the procedure. At 6 months after the procedure, the residual shunt was detected only in three patients.


CONCLUSIONS
Although this study did not calculate the statistical significance between detachable and non-detachable coils in term of occlusion rate, our institutional experience suggests that the simultaneous double or triple coil technique using the detachable or 0.052 inch Gianturco coils can reduce the prevalence of coil migration or complications.
Akagi
T
T
Department of Pediatrics, Kurume University School of Medicine, Kurume, Japan. akagi@med.kirumr-u.ac.jp
Mizumoto
Y
Y
Iemura
M
M
Tananari
Y
Y
Ishii
M
M
Maeno
Y
Y
Kato
H
H
D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D004867:Equipment Design; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D011859:Radiography; D014463:Ultrasonography