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Percutaneous coil occlusion of patent ductus arteriosus
A Rothman1, V W Lucas, M S Sklansky
1Department of Pediatrics, University of California, San Diego 92103, USA.
Insights
Percutaneous coil occlusion is a safe and effective treatment for closing small to moderate patent ductus arteriosus (PDA) in pediatric patients. This minimally invasive procedure demonstrated a high success rate with no significant complications observed during follow-up.
Area of Science:
- Cardiovascular Medicine
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Patent ductus arteriosus (PDA) is a common congenital heart defect in pediatric patients.
- Percutaneous closure methods are increasingly utilized for PDA treatment.
- Evaluating the efficacy and safety of coil occlusion for PDAs is crucial.
Purpose of the Study:
- To assess the success rate of percutaneous coil occlusion for small to moderate PDAs.
- To evaluate the safety profile of this interventional procedure.
- To determine the long-term outcomes of coil occlusion in pediatric patients.
Main Methods:
- A prospective study involving 30 pediatric patients with small to moderate PDAs (≤4 mm diameter).
- Percutaneous coil occlusion was performed, with results assessed by angiography and echocardiography.
- Patient demographics and PDA characteristics were recorded, including age, weight, and diameter.
Main Results:
- Successful PDA occlusion was achieved in all 30 patients, with most requiring a single coil.
- Immediate post-procedure angiography showed no or minimal residual shunt in 29 patients.
- Echocardiography and Doppler follow-up confirmed complete occlusion in all patients at a mean follow-up of 11.8 months, with no significant complications.
Conclusions:
- Percutaneous coil occlusion is a safe and highly effective method for closing small to moderate PDAs in children.
- The procedure demonstrates excellent short-term and long-term success rates.
- Further research is needed to define the upper limits for PDA size treatable with this technique.
Objective:
To determine the success rate and safety of percutaneous patient ductus arteriosus (PDA) coll occlusion.
Design:
Thirty consecutive pediatric patients with small to moderate-size PDAs (minimum diameter < or = 4 mm) underwent percutaneous coll occlusion. The results were assessed by angiography and echocardiography. The mean age was 5.1 +/- 4.2 years (range, 0.8 to 18.8 years); mean weight was 19.2 +/- 10.3 kg (range, 8.1 to 40.0 kg). The mean minimum diameter of the PDA was 1.8 +/- 0.8 mm (range, 1.0 to 4.0 mm).
Results:
PDA occlusion was achieved with one coil in 24 patients, 2 coils in 3 patients and 3 coils in 3 patients. The mean coil/PDA diameter ratio was 2.5 +/- 0.5. Immediately after coil occlusion, 29 PDAs had no flow by anglography; one had a small residual shunt. There were no significant complications. In the first 24 hours after coil implantation, echocardiography showed complete occlusion in 28 patients, a small left-to-right shunt in the same patient that had a residual shunt by anglography, and a trace shunt in one additional patient. In the two patients with residual flow by echocardiography, follow-up ultrasonography revealed no residual shunt 1 and 3 months later. At a mean follow-up of 11.8 +/- 9.3 months (range, 0 to 36.0 months), there was no PDA flow by color Doppler echocardiography in any of the 30 patients.
Conclusion:
Coil occlusion is a safe and effective method of percutaneous closure of small to moderate-size PDAs. The largest PDA that can be closed with this technique remains to be determined.