Transcatheter coil occlusion of the arterial duct; results of the European Registry

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Paediatric Cardiology

Background:

• The arterial duct (ductus arteriosus) is a vital fetal blood vessel that typically closes shortly after birth.
• Failure of the arterial duct to close results in a patent ductus arteriosus (PDA), a common congenital heart defect requiring intervention.
• Transcatheter coil occlusion has emerged as a minimally invasive treatment option for PDA.

Purpose of the Study:

• To analyze data from the Association for European Paediatric Cardiology (AEPC) Registry on transcatheter coil occlusion of the arterial duct.
• To evaluate the safety and efficacy of this procedure.
• To identify factors associated with suboptimal outcomes.

Main Methods:

• Retrospective analysis of intention-to-treat data from 1258 patients undergoing 1291 attempted coil occlusions.
• Data collected from 30 European and Middle Eastern tertiary referral centers.
• Analysis included immediate and long-term occlusion rates, and causes of suboptimal outcomes.

Main Results:

• The procedure involved patients with a median age of 4 years and median weight of 29 kg.
• Immediate occlusion rate was 59%, increasing to 95% at 1 year post-procedure.
• Suboptimal outcomes (10%) included coil embolization, residual leak, and re-canalization. Larger duct size (OR 2.6) and tubular shape (OR 2.4) were associated with unfavorable outcomes.

Conclusions:

• Transcatheter coil occlusion of the persistent arterial duct is a safe and effective treatment.
• Larger and tubular shaped ducts are associated with a higher likelihood of unfavorable outcomes.
• The AEPC Registry data supports the widespread use of this interventional technique.