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Percutaneous closure of small patent arterial ducts using occluding spring coils and a snare

Published online by Cambridge University Press:  19 August 2008

Benjamin Zeevi ,
Michael Berant ,
Galit Bar-Mor  and
Leonard C. Blieden
Benjamin Zeevi*
Affiliation:
From the Institute of Pediatric Cardiology, Schneider Children's Medical Center of Israel, Petah Tiqva and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
Michael Berant
Affiliation:
From the Institute of Pediatric Cardiology, Schneider Children's Medical Center of Israel, Petah Tiqva and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
Galit Bar-Mor
Affiliation:
From the Institute of Pediatric Cardiology, Schneider Children's Medical Center of Israel, Petah Tiqva and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
Leonard C. Blieden
Affiliation:
From the Institute of Pediatric Cardiology, Schneider Children's Medical Center of Israel, Petah Tiqva and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
*
Dr. Benjamin Zeevi, Institute of Pediatric Cardiology, Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petah Tiqva 49202, Israel. Tel. 972-3-939 3675; Fax. 972-3-939 3146.
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Abstract

In recent years, the percutaneous closure of small and medium-sized patent arterial ducts has been achieved using occluding spring coils. We describe our experience in 33 patients with this technique using a snare to facilitate the procedure. All patients had a clinically apparent patent arterial duct and underwent an attempt at transcatheter closure at a mean age of 5.6 years. In one patient, the duct was a residual lesion following surgical ligation, and in three was residual following attempted closure with a Rashkind double-umbrella. The mean narrowest diameter of the ducts was 1.9 mm. The coil embolized in two of the first four patients, and subsequent to that experience we used a snare to improve delivery. Of the 33 patients, implantation was successful in 32 (97%) using one [29 patients] or two [two patients] coils and in one by a combination of a double-umbrella device and an occluding spring coil. The mean fluoroscopic screening time for the whole group was 26.5 minutes, this time decreasing to 18.5 minutes in the last 26 patients [p <0.05]. Color-Doppler echocardiogram performed the morning after placement of the coils has shown residual leaks in nine of 32 patients [28%]. At a mean follow-up of 7.6 months, repeated imaging has shown residual leaks in four of these patients [12.5%]. No patient had a residual continuous murmur immediately following occlusion. Based on our results, we conclude that occlusion of small to medium-sized ducts using coils appears to be effective. The use of a snare to hold and manipulate the coil as it is delivered improves both control of the coil and the accuracy of its placement.

Keywords

Patent arterial ductinterventional cardiologycongenital heart defect
Type
Original Manuscripts
Information
Cardiology in the Young , Volume 6 , Issue 4 , October 1996 , pp. 327 - 331
Copyright
Copyright © Cambridge University Press 1996

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References

1.Portsmann, W, Wierny, L, Warnke, H, Gerstberger, G, Romaniuk, PA. Catheter closure of patent ductus arteriosus: long-term results of 208 cases treated without thoracotomy. Radiol Clin North Am 1971; 9: 203–218.Google Scholar
2.Rashkind, WJ, Mullins, CE, Hellenbrand, WE, Tait, MA. Nonsurgical closure of patent ductus arteriosus: clinical application of Rashkind patent ductus arteriosus occluder system. Circulation 1987; 75: 583–592.CrossRefGoogle ScholarPubMed
3.Wessel, DL, Keane, JF, Parness, I, Lock, JE. Outpatient closure of the patent ductus arteriosus. Circulation 1988; 77: 1068–1071.CrossRefGoogle ScholarPubMed
4.Hosking, MC, Benson, LN, Musewe, N, Dyck, JD, Freedom, RM. Transcatheter occlusion of the persistently patent ductus arteriosus: forty month follow-up and prevalence of residual shunting. Circulation 1991; 84: 2313–2317.CrossRefGoogle ScholarPubMed
5.Tynan, M. Transcatheter occlusion of persistent arterial duct: report of the European Registry. Lancet 1992; 340: 1062–1066.Google Scholar
6.Khan, MA, Yousef, SA, Mullins, CE, Sawyer, W. Experience with 205 procedures of transcatheter closure of ductus arteriosus in 182 patients, with special reference to residual shunts and long-term follow-up. J Thorac Cardiovasc Surg 1992; 104: 1721–1727.CrossRefGoogle Scholar
7.Benson, LN, Dyck, JD, Hecht, B. Technique for closure of the small patent ductus arteriosus using the Rashkind occluder. Cathet Cardiovasc Diagn 1989; 18: 48–49.CrossRefGoogle Scholar
8.Rao, PS, Sideris, EB, Haddad, J, Rey, C, Hausdorf, G, Wilson, AD, Smith, PA, Chopra, PS. Transcatheter occlusion of patent ductus arteriosus with adjustable button device. Initial clinical experience. Circulation 1993; 88: 1119–1120.CrossRefGoogle Scholar
9.Saveliev, VS, Prokubovski, VI, Kolody, SM, Savieliev, SV, Verin, VE. Patent ductus arteriosus: transcatheter closure with a transvenous technique. Radiology 1992; 184: 341–344.CrossRefGoogle ScholarPubMed
10.Carnbier, PA, Kirby, WC, Worthan, DC, Moore, JW. Percutaneous closure of the small (≥2.5 mm) patent ductus arteriosus using coil embolization. Am J Cardiol 1992; 69: 815–816.Google Scholar
11.Moore, JW, George, L, Kirkpatrick, SE, Mathewson, JR, Spicer, RL, Uzark, K, Rothman, A, Cambier, PA, Slack, MC, Kirby, WC. Percutaneous closure of the small patent ductus arteriosus using occluding spring coils. J Am Coll Cardiol 1994; 23: 759–665.CrossRefGoogle ScholarPubMed
12.Lloyd, TR, Fedderly, R, Mendelsohn, AM, Sandhu, SK, Beekman, RH. Transcatheter occlusion of patent ductus arteriosus with Gianturco coils. Circulation 1993; 88: 1412–1420.CrossRefGoogle ScholarPubMed
13.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: 836–839.CrossRefGoogle ScholarPubMed
14.Hijazi, ZM, Geggel, RL. Results of anterograde transcatheter closure of patent ductus arteriosus using single or multiple Gianturco coils. Am J Cardiol 1994; 74: 925–929.CrossRefGoogle ScholarPubMed
15.Krichenko, A, Benson, LN, Burrows, P, Moes, CAF, McLaughlin, P, Freedom, RM. Angiographic classification of the isolated, persistently patent ductus arteriosus and implications for percutaneous catheter occlusion. Am J Cardiol 1989; 63:877–880.CrossRefGoogle ScholarPubMed
16.Heymann, MA. Patent ductus arteriosus. In: Adams, FH, Emmanouilides, GC, Riemenschneider, TA (eds). Heart Disease in Infants, Children and Adolescents. Williams & Wilkins, Baltimore, MA, 1989; 209–223.Google Scholar
17.Mullins, CE. Patent ductus arteriosus. In: Garson, A, Bricker, JT, McNamara, DG, eds. The Science and Practice of Pediatric Cardiology. Lea and Febiger, Philadelphia, PA, 1990, pp 1055–1072.Google Scholar
18.Latson, LA. Residual shunts after transcatheter closure of patent ductus arteriosus: a major concern or benign “techno-malady”? Circulation 1991; 84: 2591–2593.CrossRefGoogle ScholarPubMed
19.Musewe, NN, Benson, LN, Smallhorn, JF, Freedom, RM. Two-dimensional echocardiographic and color flow Doppler evaluation of ductal occlusion with the Rashkind prosthesis. Circulation 1989; 80: 1706–1710.CrossRefGoogle ScholarPubMed
20.Anderson, JH, Wallace, S, Gianturco, C, Gerson, LD. “Mini” Gianturco stainless steel coils for transcatheter vascular occlusion. Radiology 1979; 132: 301–303.CrossRefGoogle ScholarPubMed
21.Perry, SB, Radtke, W, Fellows, KE, Keane, JF, Lock, JE. Coil embolization to occlude aortopulmonary collateral vessels and shunts in patients with congenital heart disease. J Am Coll Cardiol 1989; 13: 100–108.CrossRefGoogle ScholarPubMed