Transcatheter occlusion of patent ductus arteriosus using coil embolization

We studied 31 procedures of coil embolization for occlusion of ductus arteriosus, attempted in 29 patients. The mean age was 4.8+/-3.4 years (1-16 years) and the mean diameter of ductus was 1.8+/-0.7 mm (0.8-3.1 mm). Femoral artery approach was used and aortogram in 90 degrees lateral view was performed. Through a Judkin right coronary catheter, the coil was delivered for occlusion of the ductus. In 5 cases, 2 coils were delivered using retrograde and anterograde techniques. Successful placement of coil was accomplished in 29 procedures. Coils 0.038 inch (diameter)-5 cm (length)-5 mm (helical diameter) (Cook, Inc) were used in 16 procedures, coils 0.035 inch-5 cm-5 mm in 9, coil 0.038 inch-8 cm-8 mm in 1, two coils 0.038 inch-5 cm-5 mm in 2, coils 0.038 inch-5 cm-5 mm+0.038 inch-5 cm-8 mm in 1, and 2 coils 0.035 inch-5 cm-5 mm in 2. Aortogram 20 min after the occlusion, showed residual shunt in 9. Coil migration occurred in a ductus type B in the following day. One patient developed severe haemolysis, due to a change in the coil position, 12 h after the procedure. Echodopplercardiogram 4 to 6 h after the procedure showed a residual shunt in 5 patients, 24 h after in 3 and 30 days after, in 1(3.8%). Heparin therapy started 10 days after occlusion of the ductus, caused reappearance of the shunt in 1 patient. This technique is simple and effective, but complications may occur hours or days after successful ductus occlusion.