Pediatric Cardiovascular Embolization Therapy

Rothman, Abraham

doi:10.1007/s002469900250

Cited by 14 publications

(7 citation statements)

References 46 publications

(78 reference statements)

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“…Coils can be delivered through small catheters and through tortuous catheter passes, whereas the GGVOD does not permit the same maneuverability. However, multiple coils are required to close vessels of large diameter, and in the setting of an arteriovenous or aortopulmonary communication, the risk of embolization is significant [1][2][3][4]. Consequently, balloon occlusion of flow during coil delivery has been employed to decrease this risk [2,4].…”

Section: Discussionmentioning

confidence: 98%

“…However, as transcatheter techniques continue to evolve, closure of unnecessary vascular structures, such as patent arterial ducts, arteriovenous fistulae, and arterial and venous collaterals, become more commonplace. Reports of transcatheter closure of systemic-pulmonary artery shunts are few [1][2][3][4][5][6], and devices used thus far consist of embolization coils, detachable balloons, and Rashkind ductal occluders (USCI Angiographics). To our knowledge, the following case represents the first use of a Gianturco-Grifka Vascular Occlusion Device for closure of a modified Blalock-Taussig shunt.…”

Section: Introductionmentioning

confidence: 99%

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Transcatheter closure of modified Blalock-Taussig shunt with Gianturco-Grifka vascular occlusion device

Hoyer

León

Fricker

1999

Cathet. Cardiovasc. Intervent.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Transcatheter closure of modified Blalock-Taussig shunt with Gianturco-Grifka vascular occlusion device

Hoyer

León

Fricker

1999

Cathet. Cardiovasc. Intervent.

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“…Since its outcome is satisfactory with low complications, this technique has been accepted in the treatment of congenital vascular diseases in the past decades. [12,[15][16][17] In 1992 Cambier et al [18] used coils in transcatheter embolization of PDA. Thereafter coils have been designed to make the occlusion technique simpler so as to decrease the rate of complications.…”

Section: Discussionmentioning

confidence: 99%

Interventional occlusion of congenital vascular malformations

et al. 2009

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“…Am haufigsten werden dazu Gianturco-Spiralen verwandt [42,89], aber auch Mikrocoils aus Platin, abl6sbare Ballons, Polyvinylpartikel oder ein Ny-lons¡ das erst vor Ort mit Spiralen gefª wird, finden Verwendung [35,36,91]. Am haufigsten werden dazu Gianturco-Spiralen verwandt [42,89], aber auch Mikrocoils aus Platin, abl6sbare Ballons, Polyvinylpartikel oder ein Ny-lons¡ das erst vor Ort mit Spiralen gefª wird, finden Verwendung [35,36,91].…”

Section: C) Kollateralenunclassified

Neue Therapiemöglichkeiten in der interventionellen Kardiologie

Schmaltz

Neudorf

Sack³

et al. 1999

Herz

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The advancements of cardiac surgery over the last decades led to larger numbers of patients with operated congenital heart diseases surviving into adulthood. In Germany it is estimated that over 120,000 adults have operated congenital heart diseases. Five to 7% of them will need yearly hospital admissions. Interventional procedures are additional tools used to treat these patients with various sequelae or residua (Table 1). In the following review we concentrate on 2 different interventional procedures: dilatation and stent implantations for treatment of stenosis and the different devices used for the closure of shunt lesions. For congenital valvular pulmonary stenosis, balloon dilatation is the therapy of choice regardless the age of the patient. Stent implantation for the treatment of peripheral pulmonary stenosis (e.g., after previous systemic pulmonary shunts) can decrease the need for redo surgery, which is accompanied with increased risk. Stent implantations proved also to be useful to treat stenoses after Mustard patch in patients with transposition of the great arteries, after Fontan procedures or dealing with the rare pulmonary venous stenosis. In contrast, dilatation of bioprosthesis and conduit stenosis are not promising. Balloon dilatation of valvular aortic stenosis is an accepted therapy in childhood up to adolescents. Table 2 compares a surgical series including many infants with critical aortic stenosis with a series of balloon dilatation in children and another one in adults regarding lethality, complications, and results. Table 3 illustrates the immediate and late results of balloon dilatation of aortic coarctation in 3 different studies. The high recurrence rate in infants made clinicians refrain from taking this age group for balloon dilatation. In children and adult patients, good results are reported (75% reduction of gradients). The complication rate is low (2.3 to 3.3%) and aneurysm formation rate seldom (1 to 7%). Stenosed aorto-pulmonary collaterals will rarely need balloon dilatation. Surgical closure of atrial septal defect is a low risk procedure with a very low rate of residual shunts (2%). Of the 5 available devices for transcatheter closure of atrial septal defect Type II, only 2 occluders are in use in Germany, the Clamshell and the Amplatzer device. The largest clinical studies of the different systems, their efficacy, complications and residual shunt rate are presented in Table 4. For the deployment of these occluders a TEE is always needed. There are many more systems in clinical use to close the patent arterial duct (PDA) (Table 5). The Ivalon plug as well as the Rashkind device have probably only historical value. Different types of coils (Gianturco, Cook detachable, PFM) are now in use worldwide. The reason for their widespread use, besides their easy application, is the fact that most coils are relatively cheap and need only small sheaths for deployment. Their further evaluation identified a residual shunt rate of 5% as well as a number of complications (embolization, hemol...

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Pediatric Cardiovascular Embolization Therapy

Cited by 14 publications

References 46 publications

Transcatheter closure of modified Blalock-Taussig shunt with Gianturco-Grifka vascular occlusion device

Transcatheter closure of modified Blalock-Taussig shunt with Gianturco-Grifka vascular occlusion device

Interventional occlusion of congenital vascular malformations

Neue Therapiemöglichkeiten in der interventionellen Kardiologie

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