Transcatheter closure of patent ductus arteriosus and aorto-pulmonary vessels using non-ferromagnetic Inconel MReye embolization coils.
OBJECTIVE
We report the use of non-ferromagnetic embolization coils for transcatheter PDA closure.


BACKGROUND
Transcatheter patent ductus arteriosus (PDA) closure has been performed for 40 years. A number of devices have been used with varying degrees of success. Gianturco embolization coils have been used frequently since 1992 with excellent results. These coils are a stainless steel alloy, and create an artifact when subsequent MRI imaging is performed.


METHODS
Eight patients underwent right and left heart catheterization and transcatheter PDA closure. Angiography displayed a PDA with left to right shunting. The minimum PDA diameter was measured. An Inconel MReye coil was implanted using standard retrograde technique. A postimplant angiogram was performed. Evaluations were performed the following morning and after 2 months.


RESULTS
The median age was 5.5 years, median weight was 24 kg. The PDA minimum diameter was 1.7 mm (range 1.4-2.4 mm), with a median Qp:Qs=1.33:1. In all patients, the PDA was completely immediately closed using one Inconel coil. Two patients also had a small aorto-pulmonary collateral vessel that was occluded using a separate Inconel coil. All patients had follow-up evaluation the following day; the PDA remained completely occluded and there was no obstruction of the pulmonary artery branches or descending aorta. Seven patients had subsequent follow-up and echocardiograms; the PDA remained completely occluded. There were no complications.


CONCLUSIONS
The Inconel MReye coil is safe and effective for coil occlusion of small PDA and aorto-pulmonary vessels. Additional studies are needed to define the maximum vessel diameter for Inconel coil occlusion.
Grifka
Ronald G
RG
Department of Cardiology, Helen DeVos Children's Hospital, Grand Rapids, Michigan 49503, USA. ronald.grifka@devoschildrens.org
Fenrich
Arnold L
AL
Tapio
Jason B
JB
D000293:Adolescent; D000497:Alloys; D001011:Aorta / Q000473:pathology / Q000503:physiopathology; D001027:Aortography; D016477:Artifacts; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D002932:Cineangiography; D003097:Collateral Circulation; D017023:Coronary Angiography; D004374:Ductus Arteriosus, Patent / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D011651:Pulmonary Artery / Q000473:pathology / Q000503:physiopathology; D011652:Pulmonary Circulation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000497:Alloys