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Systemic heparinization does not prevent clot formation in coil embolization.

W H Johnson¹, R K Peterson, D F Howland

¹Division of Pediatric Cardiology, University of Minnesota, Minneapolis.

Catheterization and Cardiovascular Diagnosis

|August 1, 1990

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Systemic heparinization did not affect the success rate of therapeutic transcatheter coil embolization in lambs, supporting its use in children with congenital heart disease when needed.

Area of Science:

Cardiovascular Surgery
Interventional Cardiology
Pediatric Cardiology

Background:

Therapeutic transcatheter closure using Gianturco-type steel coils is used for vascular communications in pediatric congenital heart disease.
Successful vessel occlusion relies on thrombus formation around the coil.
Systemic anticoagulation with heparin is common during catheterization and cardiac surgery.

Purpose of the Study:

To investigate the impact of systemic heparinization on the efficacy of vessel occlusion via coil embolization in a lamb model.

Main Methods:

36 systemic arteries in 9 lambs were identified and sized using arteriography.
Vessels were embolized with coils, either before or after systemic heparinization (400 u/kg).
Activated clotting time (ACT) >300 seconds confirmed effective anticoagulation.

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Main Results:

Pre-heparinization embolization: 71% successful occlusion.
Post-heparinization embolization: 75% successful occlusion.
Recanalization was observed in only 1 of 17 vessels after heparinization.

Conclusions:

Systemic heparinization demonstrated no measurable effect on the occlusion rates of coil-embolized systemic arteries in lambs.
These findings support the continued use of systemic heparinization during or after therapeutic coil embolization in pediatric patients when clinically indicated.