Conservative treatment of hemolytic complication following coil embolization in two adult cases of patent ductus arteriosus

Two adult cases of relatively large patent ductus arteriosus (PDA) were tre ated by coil embolization, but were complicated by hemolysis that was succe ssfully managed by medical treatment. Case I was a 67-year-old woman and Ca se 2 was a 71-year-old woman with a PDA of minimal diameter of 5.3 mm and 5 .5 mm, respectively. The approach was via the pulmonary artery and 2 coils were delivered simultaneously into the ductus, known as the 'kissing coil t echnique'. Although immediately after the procedure only a small residual s hunt was revealed by aortogram, hemolysis occurred for several hours after the procedure in both cases. A hemolytic complication usually needs additio nal coil embolization or surgical treatment, but in these 2 cases it was su ccessfully treated by haptoglobin infusion to prevent nephropathy and by an tiplasmin infusion to promote thrombus formation. Hemolytic complications o f coil embolization of PDA can managed by medication when the residual shun t is minimal and the degree of hemolysis is mild.