Transcatheter occlusion of the patent ductus arteriosus with Cook detachable coils.

Tometzki, Andrew; Arnold, Robert; Peart, Ian; Sreeram, Narayanswami; Abdulhamed, Jassim M.; Godman, M J; Patel, Ramon; Kitchiner, Denise; Bu’Lock, Frances; Walsh, Kevin

doi:10.1136/hrt.76.6.531

Cited by 107 publications

(78 citation statements)

References 10 publications

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“…Some studies found that the coil migration rate with this method was 8-16%. [10][11][12] More recently, detachable coils, with a long-term completeocclusion rate of 98-100%, 11,13 have become available. The special characteristic of these coils is controlled release: when the guidewire is screwed, the coil finally leaves the guidewire and so the coil migration rate is only 1.4-8%.…”

Section: Discussionmentioning

confidence: 99%

“…The special characteristic of these coils is controlled release: when the guidewire is screwed, the coil finally leaves the guidewire and so the coil migration rate is only 1.4-8%. 11,13 There are a few recent reports of percutaneous coil embolization for adult PDA. Two of the 3 adult patients in the present study had symptoms of heart failure due to a relatively large PDA, a situation often experienced in adult patients with PDA.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 1999

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“…Literatüre bakıldığında cihaz seçiminde ana kriter PDA'nın çap ve morfolojisidir. Genel olarak önerilen, maliyetin de hesaba katılmasıyla, ince duktuslarda koillerin, geniş duktuslarda ise tıkaç özelliği olan cihazların kullanılmasıdır (32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48).…”

Section: Ayrıcı Tanıunclassified

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2017

Eur J Ther

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ÖzetNormal kardiyovasküler gelişme sürecinde, duktus arteriyozus sol altıncı primitif aortik arktan köken alan, pulmoner arteri sol subklavyen arterin çıkış yerinin hemen distalinden inen aortaya bağlayan yapı olarak gelişir. Duktus arteriyozus, fetal hayatta işlevsel olup, doğumdan hemen sonra term bebeklerde akciğerlerin fonksiyon görmeye başlaması ile 18-24 saat içinde fizyolojik, birkaç hafta içinde anatomik olarak iki aşamalı bir şekilde kapanır. Son yirmi yılda transkateter yolla kapatma işlemi tercih edilen yöntem olmuştur. Sonuç olarak; transkateter yolla patent duktus arteriyozus kapatmada, başlangıç ile karşılaştırıldığında, günümüzde gelinen nokta çok ileridedir. Teknolojinin hızlı gelişiminin getirdiği cihaz çeşitliliği ve uygulama kolaylığı, birçok patent duktus arteriyozus tipinin transkateter yolla kapatılabilir hale gelmesini sağlamıştır. Duktus kapatma işleminde farklı cihazlar kullanılmaya başlanmıştır. Koiller genellikle küçük duktuslarda, oklüderler ise orta ve geniş duktuslarda kullanılmaktadır. Anahtar kelimeler: Doğumsal kalp hastalığı; patent duktus arteriyozus; şant AbstractIn normal cardiovascular development, the proximal portions of the sixth pair of embryonic aortic arches persist as the proximal branch pulmonary arteries and the distal portion of the left sixth arch persists as the ductus arteriosus, connecting the main pulmonary trunk with the left dorsal aorta. In full-term infants, postnatal closure of the ductus is effected in two phases: smooth muscle constriction produces ''functional'' closure of the lumen of the ductus within 18 to 24 hours after birth; and ''anatomical'' occlusion of the lumen occurs over the next few days or weeks. Over the past two decades, transcatheter occlusion of patent ductus arteriosus has evolved to be the procedure of choice. Several devices have been used to close patent ductus arteriosus in children. Coils are generally used for small PDAs and occluding devices for larger PDAs.

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“…Koil yerleştirme işlemleri daha önce yayımlanan araştırmalarda tanımlandığı gibi yapıldı (11)(12)(13)(14). Yerleştirilecek koil'in çapı PDA'nın en dar çapının en az 1.7 katı olacak şekilde belirlendi.…”

Section: Introductionunclassified

Radionuclide evaluation of lung perfusion after transcatheter closure of patent ductus arteriosus: analysis of frequently used two different type of coils

Polat

Çelebi²,

Hacımahmutoğlu³

et al. 2011

Anadolu Kardiyol Derg

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ÖZETAmaç: Transkateter patent duktus arteriyozus (PDA) tedavisi sonrası sol akciğer perfüzyonun da bozulma daha önce bildirilmiştir. Bu çalışmada PDA tedavisinde sıkça kullanılan kontrollü salınımlı Cook koil ve kontrolsüz salınımlı Gianturco koil lerin sol akciğer perfüzyona etkisinin radyonüklit yöntemle değerlendirilmesi amaçlanmıştır. Yöntemler: Bu prospektif çalışmada 49 olguda Cook koil ve 40 olguda Gianturco koil kullanılmak üzere toplam 89 olgunun transkateter yöntemiyle PDA'sı kapatıldı. Olgular PDA tedavisinden medyan 18 ay sonra akciğer perfüzyon sintigrafisi yapıldı. Azalmış sol akciğer perfüzyonunu öngörebile-cek parametreler incelendi. Akciğer sintigrafisi kantitatif değerleri ile hasta parametrelerinin istatistiksel ilişkisi Pearson korelasyon katsayısı ile hesaplandı, düşük akciğer perfüzyonunu predikte eden değişkenlerden optimal kestirim değeri bulabilmek için 'Receiver Operating Characteristic' (ROC) eğrisi analizi kullanıldı. Bulgular: Sol akciğer perfüzyonunda bozulma 10'u Cook koil kullanımı sonrası, 3 olgu Gianturco koil kullanımı sonrası olmak üzere toplam 13 olguda saptandı (p=0.077). Tüm olgular ele alındığında pulmoner arter tarafında bırakılan sarmal sayısı, koil/duktal çap oranı ve birden fazla koil kullanımı ile ilişkilidir (sırasıyla, p=0.002, p=0.006 ve p=0.009). Pulmoner arter tarafındaki sarmal sayısı 1.4 üzerindeki olgularda %77 özgüllük ve %85 duyarlılık ile ilk koil çapı/duktus en dar çapı oranı 1.85 üzerindeki olgular %70 özgüllük ve %77 duyarlılık ile akciğer perfüzyon sintigrafisinde bozulma öngörü-lebilmektedir (ROC eğrisi altındaki alanlar sırasıyla, 0.804, %95GA 0.661-0.947, p<0.001 ve 0.747, %95GA 0.423-0.790, p<0.005). Sonuç: Transkateter PDA tedavisi sonrası sol akciğer perfüzyon bozukluğu Cook koil ya da Gianturco koil kullanımı sonrası gelişebilir. Bu durum pulmoner arter tarafında bırakılan sarmal sayısı, duktus en dar çapına göre koil'in daha büyük seçilmesi ve birden fazla koil kullanımı ile ilişkilidir. ABSTRACTObjective: Impaired left lung perfusion (LLP) has been described after transcatheter closure of the patent ductus arteriosus (PDA). In this study, we aimed to evaluate lung perfusion scans (LPSs) following occlusion of PDA with two frequently used coils: Cook detachable coil and Gianturco coil. Methods: A prospective study of 89 patients who underwent PDA occlusion using the Cook coils in 49 and the Gianturco coils in 40, was conducted. LPSs were performed after a median period of 18 months. The relationships between the LPSs and continuous variables were assessed by Pearson correlation analysis and the cut-off value of the best correlated parameters to predict abnormal LPSs obtained by the Receiver Operating Characteristic (ROC) analysis. Results: Decreased left lung perfusion (LLP) was found in 13 patients including 10 after using Cook coils and 3 after using Gianturco coils (p=0.077). LLP values were significantly correlated with the loops deployed at the pulmonary side, coil/ductal diameter ratio and number of coils 218

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Transcatheter occlusion of the patent ductus arteriosus with Cook detachable coils.

Cited by 107 publications

References 10 publications

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

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

Untitled

Radionuclide evaluation of lung perfusion after transcatheter closure of patent ductus arteriosus: analysis of frequently used two different type of coils

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