Results of coil closure of patent ductus arteriosus using a tapered tip catheter for enhanced control

Rajiv Devanagondi; Larry Latson; Sharon Bradley-Skelton; Lourdes Prieto

doi:10.1002/ccd.26415

Back

Results of coil closure of patent ductus arteriosus using a tapered tip catheter for enhanced control

Journal article

Peer reviewed

Results of coil closure of patent ductus arteriosus using a tapered tip catheter for enhanced control

Rajiv Devanagondi, Larry Latson, Sharon Bradley-Skelton and Lourdes Prieto

Catheterization and cardiovascular interventions, Vol.88(2), pp.233-238

08/2016

DOI: 10.1002/ccd.26415

PMID: 26800854

View Online

Abstract

This article describes the efficacy and embolization rates of coil delivery via modified vertebral catheter (MVC) for patent ductus arteriosus (PDA) closure. Various techniques have been devised to enhance coil control and prevent embolization during PDA closure. Since 1995, they have delivered coils via tapered vertebral catheters for improved coil control. Catheterization reports, angiograms, and echocardiograms were reviewed for patients with PDA occlusion via MVC from 2001 to 2014. Residual shunting was determined by angiography and echocardiogram within 24 hr post-procedure. Procedural success was defined as ≤ trivial angiographic and echocardiographic shunt, and no aortic nor LPA obstruction, after final coil delivery. About 125 coil occlusions were attempted in 103 patients. Minimal PDA diameter was 2 (0.6-6) mm. Four coils were removed with a snare/bioptome due to aortic/LPA obstruction following release. Seven were malpositioned while still held by the MVC of which three embolized while attempting withdrawal. Five embolized after full release from the MVC. The embolization rate was 6.4%. Embolizations were more likely in PDAs ≥ 2.5 mm (P < 0.05). Ultimately, 98/103 PDAs were occluded using the MVC. No patient had greater trivial residual shunt or aortic/LPA obstruction for an overall success rate of 95%. For PDAs < 2.5 mm the success rate was 97%. Coil delivery via MVC was safe and effective for small PDAs. While fully controlled release and retrieval devices are now available for PDA closure with lower embolization rates, coil occlusion by MVC should still be considered for small PDAs, especially in resource limited regions. © 2016 Wiley Periodicals, Inc.

Adolescent

Adult

Aged

Cardiac Catheterization - adverse effects

Cardiac Catheterization - instrumentation

Cardiac Catheters

Child

Child, Preschool

Coronary Angiography

Ductus Arteriosus, Patent - diagnostic imaging

Ductus Arteriosus, Patent - therapy

Electrocardiography

Embolization, Therapeutic - adverse effects

Embolization, Therapeutic - instrumentation

Equipment Design

Female

Humans

Infant

Male

Middle Aged

Retrospective Studies

Treatment Outcome

Young Adult

Details

Title: Subtitle: Results of coil closure of patent ductus arteriosus using a tapered tip catheter for enhanced control
Creators: Rajiv Devanagondi - University of Rochester Medical Center
Larry Latson - Joe DiMaggio Children's Hospital
Sharon Bradley-Skelton - Cleveland Clinic
Lourdes Prieto - Cleveland Clinic
Resource Type: Journal article
Publication Details: Catheterization and cardiovascular interventions, Vol.88(2), pp.233-238
DOI: 10.1002/ccd.26415
PMID: 26800854
ISSN: 1522-1946
eISSN: 1522-726X
Language: English
Date published: 08/2016
Academic Unit: Cardiology; Stead Family Department of Pediatrics
Record Identifier: 9984772266802771

Metrics

3 Record Views

2 Times Cited - Web of Science