Transcatheter coil occlusion of the arterial duct - Results of the European Registry

Aims To report on the data, collected by the Association for European Paedi atric Cardiology (AEPC) Registry, on transcatheter coil occlusion of the ar terial duct. Methods and Results A retrospective study was conducted of intention-to-tre at data from 30 European and Middle Eastern tertiary referral centres which included an analysis of causes of suboptimal outcome. Since 1994, reports have been made on 1291 attempted coil occlusions of the arterial duct in 12 58 patients. Median age at procedure was 4 years (range 0.1 52) and median weight was 29 kg (range 1.8-100). Following coil implantation, the immediat e occlusion rate was 59%, which rose to 95 lo at 1 year. A suboptimal outco me occurred on 129 occasions (10% of procedures) and was defined as coil em bolization, an abandoned procedure, persistent haemolysis, residual leak re quiring a further procedure, flow impairment in adjacent structures and duc t re-canalization. A number of clinical factors were chosen but only increa sing duct size [odds ratio of 2-6:1 (CI 2-3,2)] and the presence of a tubul ar shaped duct [odds ratio 2.4:1 (CI 1-4-4)] were positively associated wit h an unfavourable outcome. Conclusion The results of the European Registry support the view that trans catheter coil occlusion of the persistent arterial duct is a safe and effec tive procedure. Unfavourable outcomes are more likely when closing larger a nd/or tubular shaped ducts. (C) 2001 The European Society of Cardiology.