NEW TECHNIQUE USING TEMPORARY BALLOON OCCLUSION FOR TRANSCATHETER CLOSURE OF PATENT DUCTUS-ARTERIOSUS WITH GIANTURCO COILS

We describe our early experience with a new technique involving tempor ary balloon occlusion for transcatheter closure of patent ductus arter iosus (PDA) using single or multiple Gianturco coils. Coil occlusion w as attempted in 21 patients of median age 3 (range 1-11) years, and an giographic PDA diameter 3.0 mm +/- 0.87 mm. The inflated balloon of a pulmonary wedge pressure catheter over a transductal wire was used to mechanically hold the first extruded loop of the coil at the pulmonary end of the duct. If a residual shunt persisted after the delivery of the first coil, additional coils were delivered with or without the ba lloon support. One to nine coils (median 2) of different sizes varying between 3-12 mm diameter and 4-15 cm length were used. Immediate angi ographic occlusion rate was 47.6%. However color Doppler (CD) at 24 ho urs and at 6 weeks revealed complete closure in 66.6% and 80.9%, respe ctively, Blood transfusion was required in 2 (9.5%) patients. Three ou t of 56 coils (5.4%) embolized during deployment. The use of balloon o cclusion is effective and safe in the treatment of ducti up to 4.7 mm. Residual shunts tend to occlude with time. (C) 1997 Wiley-Liss, Inc.