Transcatheter occlusion of the patent ductus arteriosus with Cook detachable coils

• Published in: Heart (British Cardiac Society) Vol. 76; no. 6; pp. 531 - 535
• Main Authors: Tometzki, A. J., Arnold, R., Peart, I., Sreeram, N., Abdulhamed, J. M., Godman, M. J., Patel, R. G., Kitchiner, D. J., Bu'Lock, F. A., Walsh, K. P.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.12.1996; BMJ; BMJ Publishing Group LTD
• Subjects: Adolescent; Adult; Biological and medical sciences; Cardiac Catheterization; Cardiology. Vascular system; Child; Child, Preschool; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Ductus Arteriosus, Patent - diagnostic imaging; Ductus Arteriosus, Patent - therapy; Echocardiography, Doppler, Color; Embolization, Therapeutic - instrumentation; Embolization, Therapeutic - methods; Female; Follow-Up Studies; Heart; Humans; Infant; Male; Medical sciences; Human; Closure; Instrumentation therapy; Catheter; Cardiovascular disease; Ductus arteriosus; Congenital disease; Result; Percutaneous route; Coil; Treatment; Malformation; Heart disease; Complication; Technique; Child
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.76.6.531

OBJECTIVE: To report initial experience with a new occlusion device for native and residual patent ductus arteriosus. DESIGN: Descriptive study of consecutive non-randomised patients undergoing a new method of patent ductus arteriosus closure with detachable coils. SETTING: Tertiary centres for paediatric cardiology. PATIENTS: 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). INTERVENTIONS: 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. MAIN OUTCOME MEASURES: 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.