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Hydrogel expandable coils for vascular occlusion in congenital cardiovascular disease: a single center experience
Bryan H Goldstein1, Ranjit Aiyagari, Martin L Bocks
1Department of Pediatrics, C. S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA. bryan.goldstein@cchmc.org
Insights
The AZUR hydrogel-polymer coated platinum coil (hydrocoil) is safe and effective for vascular occlusion in congenital cardiovascular disease patients. Pre-treating the hydrocoil with steam improves successful implantation rates.
Area of Science:
- Cardiovascular Medicine
- Medical Devices
- Interventional Cardiology
Background:
- Congenital cardiovascular disease (CCVD) often requires interventions to occlude abnormal vascular structures.
- Platinum coils are commonly used for vascular occlusion, but novel materials are being explored for improved efficacy and safety.
Purpose of the Study:
- To evaluate the safety and feasibility of the AZUR hydrogel-polymer coated platinum coil (hydrocoil) for vascular occlusion in patients with CCVD.
- To assess the procedural success rates and complications associated with hydrocoil use.
Main Methods:
- Retrospective case review of eight patients with CCVD undergoing attempted vascular occlusion with hydrocoils.
- Assessment of complete vascular occlusion via angiography and noninvasive imaging.
- Evaluation of procedural variables and adverse events.
Main Results:
- Twenty-one hydrocoils were successfully placed in seven vessels across six patients.
- Complete vascular occlusion was achieved in 100% of treated vessels.
- Pretreatment of hydrocoils with steam significantly increased successful implant rates (100% vs. 60%) with no attributable complications.
Conclusions:
- Hydrocoils are safe and effective for vascular occlusion in diverse blood vessels within CCVD patients.
- Pretreatment of hydrocoils with steam enhances procedural success, making them a viable option for CCVD interventions.
Objective:
The objective of this study is to evaluate the safety and feasibility of the AZUR hydrogel-polymer coated platinum coil (hydrocoil) for vascular occlusion in patients with congenital cardiovascular disease (CCVD).
Design:
Retrospective case review.
Patients:
Eight patients with CCVD who underwent attempted vascular occlusion procedure with the hydrocoil at the University of Michigan between January 1, 2008 and March 1, 2011. Median patient age was 1.6 years (range 0.6-27.5 years) and median weight was 10.6 kg (3.9-74.8 kg).
Outcome Measures:
Complete vascular occlusion of the target vessel was assessed at procedural completion with angiography and noninvasive imaging at follow-up. Key procedural variables and adverse events were also evaluated.
Results:
A total of 21 hydrocoils were successfully placed in seven vessels, in six patients. Vessels included four (57%) veno-venous collaterals, two (29%) aortopulmonary collaterals, and one (14%) main pulmonary artery. Hydrocoils could not be placed successfully in two patients, including one baffle leak and one veno-venous collateral. Pretreatment of the hydrocoil with steam to soften the coil, prior to vascular introduction, increased the likelihood of successful implant (100% vs. 60%). Complete occlusion was observed in 100% of vessels either at the time of catheterization or at follow-up. There were no complications attributable to the hydrocoil.
Conclusions:
Hydrocoils are safe and effective devices that can be utilized for vascular occlusion in a variety of blood vessels in patients with CCVD. Coil pretreatment may increase the likelihood of procedural success.
