Percutaneous Occlusion of Patent Ductus Arteriosus with Controlled-Release Coil

Abstract

We evaluated the efficacy of the controlled-release Cook coil for percutaneous patent ductus arteriosus occlusion. Between October 1994 and December 1997, 45 consecutive patients with patent ductus arteriosus underwent cardiac catheterization and coil occlusion was attempted in 41, of whom 37 had Cook coils. A single coil was deployed in 34 of these patients and 2 or more coils were deployed in 3, with successful occlusion in 36 (97%). Immediate complete angiographic closure was achieved in 15 (41%), 18 (49%) had a trivial residual shunt, and 3 had a mild residual shunt on post-occlusion aortograms. Color Doppler echocardiography 24 hours after the procedure, revealed no detectable shunt in 33/36 (92%) and only a trivial residual shunt in 3 (8%) patients. Thus, 86% of patients with residual shunts immediately after occlusion had no evidence of residual shunts by 24 hours. No evidence of residual shunt or obstruction of the left pulmonary artery or the descending aorta was present at a mean follow-up of 26 months We concluded that Cook coils are a safe and cost-effective modality for percutaneous occlusion of patent ductus arteriosus with a high success rate and favorable intermediate-term follow-up.

Oclusão percutânea do canal arterial com molas de liberação controlada

“…A oclusão completa do canal arterial persistente imediatamente após o procedimento com a utilização de molas varia de 33% a 90%, de acordo com a experiência de cada serviço. 6 Kumar et al 7 apresentaram eficácia de 41% de oclusão completa e 50% com fluxo residual difuso de baixa velocidade imediatamente após o procedimento. Na mesma série, o acompanhamento ecocardiográfico em 24 horas evidenciou fechamento completo em 92% dos casos e após 3 meses, em 100%.…”

Recent Strategies and Outcomes of Transcatheter Closure for Patent Ductus Arteriosus

“…Gianturco embolization coils, detachable coils (Cook Cardiology, Bloomington, IN, USA), and the Duct-Occlud (Pfm, Cologne, Germany) device have proven both safe and effective in the closure of small to moderate-sized PDAs. However, they have not been shown to be effective in the transcatheter approach to a large PDA 2)4)7)9)15). These surgical or catheter-derived techniques became complementary applied for PDA closure at that time.…”

“…However, they have not been shown to be effective in the transcatheter approach to a large PDA. 2) 4) 7) 9) 15) These surgical or catheter-derived techniques became complementary applied for PDA closure at that time. Percutaneous embolization of coils has been used predominantly for smaller ducts, while larger ones were interrupted by open thoracotomy or, occasionally, by video-assisted ligation.…”

“…According to serial data with a controlled-release Cook coil, immediate and complete angiographic closure was achieved in 41%; color Doppler echocardiography 24 hours after the procedure revealed no detectable shunt in 33 of 36 patients (92%). 9) …”