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Updated: Aug 16, 2026
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
[A comparative study of Rashkind, Grifka and coil devices in percutaneous closing of patent ductus arteriosus]
J L Lázaro Castillo1, J Munayer Calderón, T Aldana Pérez
1Servicio Hemodinámica Pediátrica, Hospital General Centro Médico La Raza, IMSS, México, D.F.
Insights
Transcatheter Coil and Grifka devices demonstrate superior immediate closure rates for patent ductus arteriosus (PDA) compared to the Rashkind umbrella. Device selection should be guided by PDA morphology and size for optimal outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pediatric Cardiology
Background:
- Patent ductus arteriosus (PDA) is a common congenital heart defect.
- Transcatheter closure devices offer an alternative to surgical intervention.
- Comparing the efficacy of different PDA closure devices is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate and compare the efficacy of transcatheter Coil and Grifka devices for PDA closure against the Rashkind umbrella device.
- To analyze variables including occlusion time, residual shunt, and complications associated with each device.
Main Methods:
- A retrospective study involving 97 patients undergoing transcatheter PDA occlusion.
- Comparison of Rashkind (17 and 12 French), Coil, and Grifka devices.
- Statistical analysis using Student's t-test and Chi-squared test to compare outcomes.
Main Results:
- Coil and Grifka devices showed significantly higher immediate closure rates (83.3% and 91.7%) compared to Rashkind devices (26.7% and 57.9%).
- Occlusion within 24 hours was superior with Coil (94.4%) and Grifka (100%) versus Rashkind (60% and 78.9%).
- Lower complication rates were observed with Coil (5.2%) compared to Rashkind (15.5% and 26.3%) and Grifka (30%).
Conclusions:
- Transcatheter Coil and Grifka occlusion are more effective for immediate PDA closure than the Rashkind device.
- Device choice should be tailored based on ductus arteriosus morphology and diameter.
- Further research may explore long-term outcomes and specific indications for each device.
Abstract:
This study was performed to evaluate the efficacy of transcatheter Coil and Grifka closure of the patent ductus arteriosus in comparison to our experience with the Rashkind umbrella device. Ninety seven patients (36 male and 61 females) underwent occlusion of the PDA. The following variables were compared: age, sex, ductus diameter, morphology, device, occlusion time, residual shunt, multiple device and complications. Data obtained were compared using the Student's test and Chi 2. Median patient age was 7.82 +/- 6.89, forty five patients underwent transcatheter Rashkind-17 closure, 19 patients with Rashkind-12, 18 patients with Coil and 13 patients with Grifka device, in two patients the closure could not be performed. There were differences between the morphology and device used (p = 0.008), between the ductus diameter and device used (p < 0.001). There was immediate closure in 26.7% in the Rashkind-17 group compared with, 57.9% for the Rashkind-12 group, 83.3% for Coil group and of 91.7% for Grifka group. The occlusion within 24 hrs of implantation was 60% with Rashkind-17, 78.9% with Rashkind-12, 94.4% with Coil and 100% with Grifka. Residual shunt persisted for more than a year in 7 patients with Rashkind-17 and 1 with Rashkind 12, (p = 0.001), in 4 patients two devices wore placed. The complications were, 15.5% for Rashkind-17, 26.3% for Rashkind-12, 5.2% for Coil and 30% for Grifka, (p = 0.004), one coil and one Grifka embolized. Transcatheter Coil and Grifka occlusion are more effective in achieving immediate closure than the Rashkind device. The indication to use each device is made according to the morphology and size of the ductus.
