Transcatheter Embolization of Systemic-to-Pulmonary Collaterals: A New Approach Using Concerto™ Helix Nylon-Fibered
Jochen Pfeifer1, Martin Poryo1, Anas Gheibeh1
1Department of Pediatric Cardiology, Saarland University Medical Center, D-66421 Homburg, Germany.
Journal of Clinical Medicine
|January 11, 2025
Summary
Concerto™ Helix microcoils (CHMs) effectively close systemic-to-pulmonary collaterals (SPCs) in congenital heart disease patients of all ages. This embolization technique demonstrated a low complication rate and suitability for various collateral types.
Area of Science:
- Interventional Cardiology
- Congenital Heart Disease
- Vascular Embolization
Background:
- Systemic-to-pulmonary collaterals (SPCs) are prevalent in congenital heart disease (CHD), especially single ventricle and Fontan circulation.
- SPCs can complicate postoperative recovery and lead to long-term clinical decline.
- Treatment strategies for SPCs remain a subject of debate.
Purpose of the Study:
- To retrospectively analyze the outcomes of patients undergoing SPC embolization using Concerto™ Helix nylon-fibred microcoils (CHMs).
- To detail the interventional technique employed for CHM-based SPC embolization.
Main Methods:
- Single-center retrospective observational cohort study.
- Analysis of clinical and imaging data from patients treated with CHMs for SPCs between January 2016 and December 2023.
- Inclusion of 38 consecutive patients undergoing 49 embolization procedures.
Main Results:
- 141 CHMs were implanted in 64 SPCs, predominantly arterial (59/64).
- Successful primary closure was achieved in all procedures with no instances of non-target embolization or coil migration.
- A single complication of vascular injury with contrast extravasation was noted.
Conclusions:
- CHMs are a safe and effective option for SPC embolization across all pediatric and adult age groups.
- The microcoils are well-suited for closing small-diameter or tortuous collaterals.
- CHMs can be combined with other devices for comprehensive collateral closure.
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