TRANSCATHETER CLOSURE OF PATENT ARTERIAL DUCTS USING CONTROLLED-RELEASE COILS

Objective To determine the efficacy of transcatheter closure of patent arterial ducts using controlled-release coils. Design Transcatheter c losure of patent arterial ducts was attempted in 52 patients using con trolled-release coils. Setting For the study, four tertiary paediatric cardiology units were used, two of which were in the U.K., one in Ita ly and one in Turkey. Patients The 52 patients ranged in age between 3 .5 months and 61 years (median 3.5 years), and weighed between 4.5 kg and 62 kg. The duct diameters were 1 mm to 6.5 mm. Results In four pat ients the ducts were too large for safe release of the coils. In the r emaining 48, one coil was inserted in 33 patients, two coils in nine? three coils in four and four coils in two patients. Immediately at the end of the procedure, the duct was completely occluded in 26/47 (55%) patients. Haemolysis occurred in one patient, in whom the coil was re moved by a snare catheter and a large umbrella device was implanted wi th resolution of the haemolysis. Coil embolization to the pulmonary ar tery occurred in five (10%) patients. All were easily retrieved and re placed by larger coils. At the latest follow-up by colour Doppler echo cardiography, the duct was completely occluded in 44/47 (94%) patients . Conclusions Transcatheter closure of patent arterial ducts by contro lled-release coils is effective and safe. Even when more than one coil is inserted the technique is still less cumbersome and considerably c heaper than transcatheter umbrella closure.