Journal of the Formosan Medical Association (Jan 2006)
Outcome of Percutaneous Transarterial Coil Occlusion in Patients with Isolated Patent Ductus Arteriosus Using an Upstream-and-Push Maneuver
Abstract
There are limited data on the outcome of percutaneous transarterial coil occlusion for isolated patent ductus arteriosus (PDA) in Taiwan. This study evaluated the 2-year outcome of 52 patients with isolated PDA who received percutaneous transarterial coil occlusion by an upstream-and-push maneuver. Methods: From July 1997 to June 2002, a total of 52 patients (25 infants, 27 children) underwent occlusion of PDA with standard Gianturco coils. There were 39 females and 13 males. Patient age ranged between 7 days and 14 years, and weight was between 3 and 45 kg. Percutaneous transarterial coil occlusion was performed by an upstream-and-push maneuver. Chest auscultations, chest radiographs, and Doppler echocardiography were performed in all patients within 24 hours, and 1, 3, 6, 12 and 24 months after coil occlusion. Results: Mean PDA diameter at the pulmonary end was 2.34 ± 1.00 mm (range, 1.00-4.80 mm). Angio-graphic classification was megaphone type in 32 patients, window type in seven, tubular type in six, an-eurysmal type in three, and elongated conical type in four. Complete PDA occlusion was performed with a single coil in 41 (79%) patients and with multiple coils in 11 (21%). The mean ratio of pulmonary to systemic blood flow was 1.95 ± 0.95 (range, 1.10-5.80) before the procedure, and 1.02 ± 0.04 (range, 1.00-1.20) after the procedure (p < 0.001). Immediate occlusion of the ductus was achieved 15 minutes after the procedure in 44 (85%) patients. Occlusion was achieved in 92% of patients within 24 hours and in 100% of patients by the 1-month follow-up. Follow-up at 24 months after the procedure revealed no complications. Conclusion: Percutaneous transarterial coil occlusion with 5-loop Gianturco coils can be effectively and safely achieved in patients with a PDA minimum diameter < 5 mm.
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