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Biodegradation of tungsten embolisation coils used in children
Christoph Kampmann1, Rita Brzezinska, Moji Abidini
1Division of Paediatric Cardiology, University Children's Hospital of Mainz, Langenbeckstrasse 1, 55101 Mainz, Germany. christoph.kampmann@uni-mainz.de
Insights
Tungsten coils used in transcatheter embolisation of aorto-pulmonary collaterals in children showed significant degradation, with all coils losing radio-opacity within 39.3 months. This degradation led to recanalisation in over half of the treated vessels.
Area of Science:
- Pediatric Cardiology
- Interventional Radiology
- Biomaterials Science
Background:
- Tungsten coils (TCs) are used for transcatheter embolisation (TCE) of aorto-pulmonary collaterals (APCs).
- Concerns exist regarding TC corrosion approximately 30 months post-TCE.
Purpose of the Study:
- To evaluate the long-term fate of tungsten coils (TCs) after transcatheter embolisation (TCE) of aorto-pulmonary collaterals (APCs) in children.
Main Methods:
- Chest radiographs were used to monitor 152 TCs in 99 APCs post-TCE.
- Follow-up included immediate post-procedure, 3-6 months, 9-12 months, and yearly thereafter.
Main Results:
- After a mean follow-up of 39.3 months, all TCs exhibited decreased radio-opacity or loss of visibility.
- Coil degradation (decreased radio-opacity/width) was observed in 37.6% by 9-12 months and 57.2% by 25 months.
- Complete biodegradation of 95% of TCs is predicted within 10 years; recanalisation occurred in 58.3% of treated APCs.
Conclusions:
- Tungsten coils undergo significant dissolution and loss of radio-opacity within 39.3 months post-TCE.
- The observed degradation is associated with a high rate of recanalisation in embolised APCs.
Background:
It has been suggested that tungsten coils (TCs) may corrode 30 months after transcatheter embolisation (TCE). The aim of this study was to follow up children after TCE of aorto-pulmonary collaterals (APCs) with TCs.
Materials And Methods:
Successful TCE of 99 APCs was performed in children using 152 TCs. Chest radiographs were obtained on the day after the procedure, after 3-6 months and 9-12 months, and yearly thereafter.
Results:
Mean follow-up was 39.3 months. After 9-12 months, radiographs revealed a decrease in radio-opacity and reduction of coil width in 29 (37.6%) of 77 APCs. After a mean of 25 months (range 13-51 months), there was loss of visibility in 44 (57.2%) of 77 TCs and a reduction in 29 (37.6%) of 77. After a mean of 39.3 months, all TCs showed decrease or loss of radio-opacity. Exponential function predicts complete biodegradation of 95% of TCs within 10 years after TCE (r2= 0.923). After a mean of 28.4 months, repeat catheterisation was performed in 24 APCs with TCs with decreased or lost radio-opacity. Recanalisation had occurred in 58.3%.
Conclusions:
Dissolution occurred in 57.2% of TCs within a mean of 25 months, and within 39.3 months all TCs showed decrease or loss of radio-opacity. Recanalisation of closed APCs occurred in 58.3%.