Percutaneous Closure of Patent Ductus Arteriosus Using Coil Embolization

ABSTRACT

PURPOSE: Percutaneous closure with occluding coils has been recently described as a method of nonsurgical treatment of the small patent ductus arteriosus (PDA). The snare-assisted technique or detachable coil has been newly developed, improving coil delivery and eliminating the incidence of coil embolization. This method is also applicable to residual PDA following surgical ligation or device implantation. The study purpose is to discuss our experience with percutaneous closure of the small patent ductus arteriosus by occluding coils. METHODS: Between February 1995 and September 1996, 41 patients underwent coil occlusion. Thirty-one patients had native PDAs and 10 residual PDAs. Mean age was 5.0 +/- 3.2 years (1.5 to 14.0 years), and mean body weight 18.0 +/- 7.2kg (8.7 to 45kg). Mean ductal diameter was 1.9 +/- 0.6mm (1.0 to 3.5mm). Occlusion was performed by using the snare technique in 34 patients and by using a detachable coil in 6 patients. Follow-up was done at week 1, 3, 6, and a 12-month postprocedure was dont by echocardiography. RESULTS: Of the 41 patients with successful coil implantation, 32 patients (78%) had no residual shunting, 8 trace residual shunting, and 1 small residual shunting shown by angiogram immediately after coil embolization. All the patients except for one were followed up for 6.5 +/- 4.5 months (1 day to 12 months). Complete closure was confirmed in 38 patients (95%) at 6 months after implantation (34/40 at 1 month, 37/40 at 3 months, 38/40 at 6 months). There were no significant complications. CONCLUSION: Percutaneous occlusion of PDA can be safely and effectively performed in patients with small PDA, irrespective of native or residual nature, by using the snare technique or a detachable coil.