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Stretched minimal diameter of the ductus and coil occlusion
1Department of Pediatrics, Sapporo Medical University, School of Medicine, Japan. tomitah@sapmed.ac.jp
Background:
Stretching of the ductus was supposed to determine the size mismatch of the coil with the ductus in coil occlusion that results in residual leak or migration.
Methods:
We measured the minimal diameter (D) and the stretched minimal diameter (S) of the ductus in 12 patients with patent ductus arteriosus (PDA). The stretch index (SI) was calculated as S divided by D. We calculated ratios of the loop diameter of the first implanted coil to D (C1/D) and S (C1/S) and those of the sum of all the loop diameters of all implanted coils for complete closure to D (total C/D) and to S (total C/S).
Results:
Stretched minimal diameter divided by D was 1.8 +/- 0.3. Ratios of the loop diameter of the first implanted coil to D (C1/D), and S (C1/S) were 3.7 +/- 1.8 and 2.1 +/- 0.9, respectively. Ratios of the sum of all the loop diameters of all coils to D (total C/D) and S (total C/S) were 5.2 +/- 1.6 and 2.9 +/- 0.9, respectively. Standard deviations of C1/S and total C/S are significantly smaller than those of C1/D and total C/D, respectively.
Conclusions:
The narrowest segment of the ductus could be stretched to twice the size of the minimal diameter. The stretched minimal diameter may be a more reliable parameter to select the loop diameter of coils than the angiographic minimal diameter.
Insights
The stretched diameter of the ductus arteriosus is a more reliable measure for selecting coils during patent ductus arteriosus (PDA) occlusion. This method helps prevent coil migration and residual leaks.
Area of Science:
- Cardiovascular Medicine
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Coil occlusion for patent ductus arteriosus (PDA) can lead to residual leaks or migration due to coil-duct size mismatch.
- Stretching of the ductus during the procedure is a suspected factor influencing this mismatch.
Purpose of the Study:
- To evaluate the ductus arteriosus stretch index (SI) and its correlation with coil selection for PDA occlusion.
- To determine if stretched diameter is a more reliable parameter than minimal diameter for coil sizing.
Main Methods:
- Measured minimal (D) and stretched minimal (S) ductus diameters in 12 PDA patients.
- Calculated SI (S/D) and coil-to-duct diameter ratios (C1/D, C1/S, total C/D, total C/S).
Main Results:
- The ductus could be stretched to 1.8 times its minimal diameter (SI).
- Coil size ratios to stretched diameter (C1/S, total C/S) showed smaller standard deviations than ratios to minimal diameter (C1/D, total C/D).
Conclusions:
- The ductus arteriosus exhibits significant stretchability, up to twice its minimal diameter.
- Stretched minimal diameter is a more dependable parameter for selecting appropriate coil sizes in PDA coil occlusion, improving procedural outcomes.