Transcatheter occlusion of patent ductus arteriosus using coil embolization

Jacob, José Luiz Balthazar; Coelho, Wilson; Machado, Nilton Carlos; Garzon, S.A.C.

doi:10.1016/s0167-5273(97)00076-4

Cited by 4 publications

(6 citation statements)

References 14 publications

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“…Studies analyzing the efficiency of coil occlusion of PDA reported that complete closure rate varied from 63.4 to 96.6% at the end of the procedure, and from 80.5% to 96.2%, at one year [15][16][17][18][19]. When present, the residual ductal shunt was almost invariably hemodynamically insignificant.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter closure of patent ductus arteriosus using Flipper coil and Amplatzer Duct Occluder: Ten-year experience from a single center

et al. 2017

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Introduction/Objective Transcatheter closure is a well-established procedure for treatment of patent ductus arteriosus (PDA). We aimed to make a comparison between transcatheter PDA occlusion with Flipper coil and Amplatzer Duct Occluder (ADO) and to determine the incidence and significance of procedural complications. Methods Between November 2004 and October 2014, 148 patients were eligible for transcatheter PDA closure at the University Children's Hospital in Belgrade, Serbia. The median age was 5.9 years (the range of 0.9 years to 17.3 years) and the median weight was 21 kg (the range of 8.8 kg to 94 kg). Follow-up evaluations with Doppler echocardiogram were performed at one day, three months, and one and two years after the PDA occlusion. Results Median narrowest PDA diameter was 1.5 mm (the range of 0.5 mm to 5.6 mm). Flipper coil was used for PDA closure in 84 (59.2%) and ADO in 58 patients (40.8%). There was no significant difference in the rate of immediate complete closure between the coil and the ADO group (86.9% vs. 75.9%, p = 0.089), but a significantly higher rate of complete closure was achieved with ADO at one day (83.3% vs. 98.3%, p = 0.004), three months (85.7% vs. 100%, p = 0.002), and both one and two years after the implantation (91.7% vs. 100%, p = 0.041). In total, 12 complications occurred during the procedure, seven of which with coil and five with ADO occlusion of PDA. Conclusion Transcatheter closure of PDA using both coils and ADOs is a very safe and effective procedure. ADO proved superior to coil in terms of complete closure rate as early as one day after the procedure.

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Section: Discussionmentioning

confidence: 99%

Transcatheter closure of patent ductus arteriosus using Flipper coil and Amplatzer Duct Occluder: Ten-year experience from a single center

et al. 2017

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“…However, dropout of coils, arctation of the left pulmonary artery and hemolysis are complications of coil embolization, with hemolysis being the major complication, occurring in approximately 1-2% of cases. 2,6,7 If the hemolysis progresses, hemoglobinuria induces renal damage and progression of anemia aggravates the congestive heart failure, so it must prevented. The mechanism for the hemolysis is considered to be mechanical stress through the residual shunt, which destroys the blood cells intravascularly.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,14,15 If the additional coils cannot be inserted, the arterial canal must be closed surgically. 7 Retrieval of the embolized coils through a catheter is another option, but is not recommended when multiple coils are implanted because of the high risk of migration of the coils.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Serious complications of coil embolization are coil migration and hemolysis caused by a residual shunt, 4,5 the latter being reported as the major complication with approximately 1-2% occurrence. 2,6,7 Although a hemolytic complication usually needs additional coil embolization 4,5 or surgical treatment, medical treatment may be preferable when the residual shunt is minimal and the degree of hemolysis is mild. We report 2 cases of large PDA that were treated by multiple coil embolization, complicated by hemolysis, but successfully managed by medical treatment.…”

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confidence: 99%

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Conservative Treatment of Hemolytic Complication Following Coil Embolization in Two Adult Cases of Patent Ductus Arteriosus.

et al. 2001

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oil embolization has been recently used for closure of patent ductus arteriosus (PDA), but because large PDA are difficult to close with this technique, it is generally used when the duct diameter is less than 3.5 mm. 1 However, there are some case reports in which large PDA were closed by placing more than 2 coils. 2,3 Serious complications of coil embolization are coil migration and hemolysis caused by a residual shunt, 4,5 the latter being reported as the major complication with approximately 1-2% occurrence. 2,6,7 Although a hemolytic complication usually needs additional coil embolization 4,5 or surgical treatment, medical treatment may be preferable when the residual shunt is minimal and the degree of hemolysis is mild. We report 2 cases of large PDA that were treated by multiple coil embolization, complicated by hemolysis, but successfully managed by medical treatment. Case Reports Case 1A 67-year-old woman was admitted for evaluation of dyspnea on exersion, paroxysmal atrial fibrillation (AF), and a continuous murmur of grade 4/6 in the second left intercostal space. Physical examination revealed blood pressure of 120/60 mmHg under medical treatment. The ECG finding was left ventricular hypertrophy with ST-T abnormality. Chest X-ray (CXR) showed moderate cardiomegaly with increased pulmonary vascular markings. Color Doppler echocardiography showed a shunt flow in the pulmonary artery. Right heart catheterization revealed the pulmonary artery pressure was 30/14 mmHg and there was an oxygen step-up at the level of the main pulmonary artery. The ratio of pulmonary to systemic flow was 2.0. Aortography revealed the shunt flow and a type A PDA 8 with a minimum ductal diameter of 5.3 mm. Left ventriculography showed an increase in ventricular volume, but the ventricular wall motion and coronary angiogram were normal.Because the ductal diameter was relatively large to be closed by embolization with one coil, we planned to deliver multiple Jackson detachable coils (MWCE-8-PDA5; diameter 8 mm and 5 loops, Cook Cardiology, Bjaeverskov, Denmark). Two 7Fr catheters were inserted into the femoral vein and advanced from the pulmonary artery through the Two adult cases of relatively large patent ductus arteriosus (PDA) were treated by coil embolization, but were complicated by hemolysis that was successfully managed by medical treatment. Case 1 was a 67-year-old woman and Case 2 was a 71-year-old woman with a PDA of minimal diameter of 5.3 mm and 5.5 mm, respectively. The approach was via the pulmonary artery and 2 coils were delivered simultaneously into the ductus, known as the 'kissing coil technique'. Although immediately after the procedure only a small residual shunt was revealed by aortogram, hemolysis occurred for several hours after the procedure in both cases. A hemolytic complication usually needs additional coil embolization or surgical treatment, but in these 2 cases it was successfully treated by haptoglobin infusion to prevent nephropathy and by antiplasmin infusion to promote thrombus formation. Hemolyt...

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“…Therefore, after release, the coils should present with a loop at the pulmonary end and two at the aortic end of the arterial duct [47]. Additionally, the release can be made of a single loop or multiple loops, depending on the diameter of the arterial duct to be occluded and the technical choice made by the surgeon [31,32,[47][48][49] (Figure 5).…”

Section: Percutaneous Occlusionmentioning

confidence: 99%