Transcatheter closure of persistent arterial ducts with different types ofcoils

Background Different types of coils have been designed for transcatheter cl osure of persistent arterial duels. We ccm pared the efficacy and safety of three types of coils: Gianturco coils (Cook), Cook detachable coils (Cook) , and Duct Occlud devices (pfm). Methods Sixty-three patients underwent coil occlusion of arterial duels bet ween April 1995 and July 2000. The mean age and weight were 4.8 +/- 3.4 yea rs and 16.5 +/- 7.6 kg, respectively. The results and complications of duct al occlusion among the three types of coils were compared. Kaplan-Meier ana lysis was used to assess reduction in the prevalence of residual shunt with time, and multiple regression analysis was performed to identify predictor s of complete occlusion. Results Coil occlusion of persistent arterial ducts that measured 2.2 +/- 0 .8 mm was feasible in 90% (57/63) of patients. Gianturco coils were used in 29, Duct Occlud devices in 16, and Cook detachable coils in 12 patients. T he prevalence of residual shunt at 24 hours, 6 months, 12 months, and 24 mo nths was 42%, 20%, 18%, and 14%, respectively. The reduction in prevalence of residual shunt with time tended to be greater when Gianturco coils were used (P = .067). Logistic regression identified the use of Gianturco coils to be a significant predictor of complete ductal occlusion on Follow-up (P = .04). Pull-through of coils occurred in 4.8% (3/63) and coil embolization in 6.3% (4/63). There was no association between the type of coil and the risk of embolization (P = 1.00). Conclusions Transcatheter occlusion of small persistent arterial ducts with coils is safe and effective. There is no advantage of detachable coils (Co ok detachable coils and Duct Occlud devices) over nondetachable Gianturco c oils in reducing the risk of embolization. Our Findings are in favor of the inexpensive, but more effective, Gianturco coils for occluding smell arter ial ducts of 3 mm or less.