Follow-up of coil occlusion of patent ductus arteriosus

Shim, David; Fedderly, Raymond T.; Beekman, Robert H.; Ludomirsky, Achi; Young, Mary Lynn; Schork, M. Anthony; Lloyd, Thomas R.

doi:10.1016/0735-1097(96)00107-6

Cited by 93 publications

(79 citation statements)

References 11 publications

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“…40,41,238 -243 It provides effective therapy for the large majority (more than 90%) of restrictive PDAs when the minimum angiographic diameter is less than 4 mm. 243 Coil embolization has also been described for the larger but still restrictive PDA with a minimum diameter of 4 to 7 mm. 241 The coil occlusion technique is not appropriate for the nonrestrictive PDA, and its use in the clinically silent PDA has also been questioned.…”

Section: Patent Ductus Arteriosusmentioning

confidence: 99%

“…240 Follow-up data have shown that tiny residual shunts noted immediately after coil implantation often resolve spontaneously. 243 A recent retrospective study has found that hospital charges are substantially lower for coil occlusion than surgical ligation even when charges associated with surgery for residual PDA after coil occlusion are taken into account. 245 Complications related to PDA coil occlusion include a persistent residual shunt in 5% to 10% of cases, embolization of a coil to the pulmonary artery or rarely to a systemic artery requiring catheter retrieval, occasional femoral artery injury following cannulation with a 4F to 5F catheter, and very rarely hemolysis associated with a residual shunt.…”

Section: Patent Ductus Arteriosusmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Therapeutic Cardiac Catheterization

Allen¹,

Beekman²,

Garson³

et al. 1998

Circulation

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Section: Patent Ductus Arteriosusmentioning

confidence: 99%

Section: Patent Ductus Arteriosusmentioning

confidence: 99%

Pediatric Therapeutic Cardiac Catheterization

Allen¹,

Beekman²,

Garson³

et al. 1998

Circulation

Self Cite

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“…8 Shim et al described a 20-month completeocclusion rate of 94% with this coil. 9 However, if the Gianturco coil is extruded, it cannot be retrieved without other instruments (eg, snares). Some studies found that the coil migration rate with this method was 8-16%.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Coil Embolization of Large-Size Patent Ductus Arteriosus in Adult Patients

et al. 1999

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ranscatheter occlusion of a small ductus arteriosus is now commonly performed in children. However, there are only a small number of reports of transcatheter coil embolization of adult patent ductus arteriosus (PDAs). We attempted to occlude large PDAs in 3 adult patients with Cook detachable coils and we report the usefulness and problems of such a procedure. Case Reports Case 1A 58-year-old woman had exertional dyspnea and chest discomfort. On physical examination, she had a bounding peripheral pulse and a grade 2/6 continuous murmur at the left upper sternal border. Conventional 2-dimensional echocardiography demonstrated left ventricular and atrial enlargement, and a left ventricular ejection fraction of 71%. On color Doppler echocardiography, left-to-right PDA shunt flow was visible. On transesophageal echocardiography (TEE) the minimal diameter of the PDA was 5 mm. Informed consent for coil embolization was obtained.Right-and left-heart catheterization was performed and an oxygen step-up of the blood samples was detected at the pulmonary artery level.Aortography in the left anterior oblique projection revealed a funnel-shaped PDA (type A1) with a minimal diameter being 5.2 mm (Fig 1A). Following aortography, a 0.032-inch guidewire was advanced retrogradely from the aorta through the PDA into the pulmonary artery, and another guidewire of the same size was advanced anterogradely from the pulmonary artery through the PDA into the aorta. A 6F multipurpose catheter was advanced anterogradely and the guidewire was then removed. A 5-loop coil of 8 mm in diameter was delivered successfully into the PDA. Next, when another 6-F multipurpose catheter was inserted retrogradely, the prepositioned coil was dislodged into the main pulmonary artery. The coil was then successfully retrieved by a snare. Two multipurpose catheters were once more advanced through the PDA, one retrogradely and the other anterogradely. A 5-loop coil of 8 mm in diameter was delivered into the PDA anterogradely. Without detaching the coil, another 5-loop coil of 5 mm in diameter was sequentially delivered retrogradely. Aortography revealed slight residual flow (Fig 1B). Because of the risk of coil migration and the possibility of spontaneous complete closure of the PDA, no additional coiling was attempted and the 2 coils were then detached.The next day, a slight residual shunt was observed on color Doppler echocardiography. However, the patient's exertional dyspnea and chest discomfort disappeared. During her stay in hospital, her urine was not dark colored, and blood chemistry for hemolysis was not examined. Six months after the first procedure, a hematological examination revealed severe hemolytic anemia (Table 1). Transthoracic echocardiography demonstrated a smaller left ventricle and left atrium than that of 6 months previous (Table 2). On the transthoracic and transesophageal color Doppler echocardiography, a residual left-to-right PDA shunt flow was visible. The hemolysis was thought to be due to the shunt, and the patient underwent a sec...

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“…Shim et al 5 recently reported excellent results after coil embolisation using a Jackson detachable system; in their study only two of the 75 patients developed recanalisation after coil occlusion. To our knowledge, this phenomenon has not been reported in another patient until now although there was a report of recanalisation after coil embolisation of a cerebral artery.…”

Section: Discussionmentioning

confidence: 99%