Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-28T00:54:34.606Z Has data issue: false hasContentIssue false

Transcatheter occlusion of arterial duct with new detachable coils

Published online by Cambridge University Press:  19 August 2008

Kyousuke Hazama
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Toshio Nakanishi*
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Tohru Tsuji
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Yoshikazu Kinugawa
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Suguru Matsuoka
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Kazuhiro Mori
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Akihiro Saitou
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Hitoshi Tomita
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Kazuo Momma
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
*
Dr. Toshio Nakanishi, Pediatric Cardiology, The Heart Institute of japan, Tokyo Women's Medical College, 8–1 Kawada-cho, Shinjuku, Tokyo, Japan. Tel. 81-3-3353-8111, ext 23110; Fax 81-3-3356-0441.

Summary

Percutaneous transcatheter embolization of the arterial duct, using new detachable coils, was performed in 19 patients aged from two to 16 years. The minimal ductal diameter ranged from 0.5 to 2.7 mm. We used a 5 mm diameter coil, 8 cm in length and/or an 8 mm diameter coil, which was 10 cm in length. The coil was connected to a delivery wire with a screw system, and could be detached by rotation of the delivery wire. The coil was straightened by inserting a mandril, with loops then being formed by withdrawal of the mandril. In all patients, the coil was advanced retrogradely and either one or two coils were successfully implanted. Implantation was performed in four patients without the catheter entering the pulmonary trunk across the arterial duct. The ductal ampulla was either absent or very small in five patients, so we implanted a coil which had been cut short. Angiography revealed no residual shunting in 14 patients (74%) and trace residual shunting in five patients. Migration of the coils to the pulmonary arteries, or to a systemic artery, did not occur in any patient. Follow-up using Doppler color flow imaging showed complete closure of the arterial duct in all patients (100%), and no turbulence either in the left pulmonary artery or in the descending aorta in any patient. The use of the new detachable coil may improve the accuracy of placement of the device and reduce the incidence of its migration.

Type
Original Manuscripts
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Moore, JW, George, L, Kirkpatrick, SE, Mathewson, JW, Spicer, RL, Uzark, K, Rothman, A, Cambier, PA, Slack, MC, Kirby, WC. Percutaneous closure of the small patent ductus arterio-sus using occluding spring coils. J Am Coll Cardiol 1994; 23: 759765.Google Scholar
2.Lloyd, TR, Fedderly, R, Mendelsohn, AM, Sandhu, SK, Beekman, RH. Transcatheter occlusion of patent ductus arteriosus with Gianturco coils. Circulation 1993; 88: 14121420.CrossRefGoogle ScholarPubMed
3.Hijazi, ZM, Geggel, RL. Results of anterograde transcatheter closure of patent ductus arteriosus using single or multiple Gianturco coils. Am J Cardiol 1994; 74: 925929.Google Scholar
4.Rashkind, WJ, Mullins, CE, Hellenbrand, WE, Tait, MA. Nonsurgical closure of patent ductus arteriosus: clinical application of the Rashkind PDA Occluder System. Circulaton 1987; 75: 583592.Google Scholar
5.Lloyd, TR, Beekman, RH, Moore, JW, Hijazi, ZM, Hellenbrand, WE, Sommer, RJ, Wiggins, JW, Zamora, R, Vincent, RN. The PDA Coil Registery: Report of the first 535 procedures. Circulation 1995; 92: 1380.Google Scholar
6.Chuang, VP, Wallace, S, Gianturco, C. A new improved coil for tapered-tip catheter for arterial occlusion. Radiolgy 1980; 135: 507509.Google ScholarPubMed
7.Krichenko, A, Benson, LN, Burrows, P, Moes, CAP, McLaughlin, P, Freedom, RM. Angiographic classification of the isolated, persistently patent ductus arteriosus and implication for percutaneous catheter occlusion. Am J Cardiol 1989; 63: 877880.CrossRefGoogle ScholarPubMed
8.Sommer, RJ, Gutierrez, A, Lai, WW, Parness, IA. Use of preformed nitinol snare to improve transcatheter coil delivery in occlusion of patent ductus arteriosus. Am J Cardiol 1994; 74: 836839.CrossRefGoogle ScholarPubMed
9.Latson, LA. Residual shunts after transcatheter closure of patent ductus arteriosus—a major concern or benign “Techno-malady”? Circulation 1991; 84: 25912593.Google Scholar