Percutaneous coil occlusion of patent ductus arteriosus

Abstract

Objective: To determine the success rate and safety of percutaneous patent ductus arteriosus (PDA) coil occlusion. Design: Thirty consecutive pediatric patients with small to moderate-size PDAs (minimum diameter ≤4 mm) underwent percutaneous coil occlusion. The results were assessed by angiography and echocardiography. The mean age was 5.1 ± 4.2 years (range, 0.8 to 18.8 years); mean weight was 19.2 ± 10.3 kg (range, 8.1 to 40.0 kg). The mean minimum diameter of the PDA was 1.8 ± 0.8 mm (range, 1.0 to 4.0 mm). Results: PDA occlusion was achieved with one coil in 24 patients, 2 coils in 3 patients and 3 coils in 3 patients. The mean coil/PDA diameter ratio was 2.5 ± 0.5. Immediately after coil occlusion, 29 PDAs had no flow by angiography; one had a small residual shunt. There were no significant complications. In the first 24 hours after coil implantation, echocardiography showed complete occlusion in 28 patients, a small left-to-right shunt in the same patient that had a residual shunt by angiography, and a trace shunt in one additional patient. In the two patients with residual flow by echocardiography, follow-up ultrasonography revealed no residual shunt 1 and 3 months later. At a mean follow-up of 11.8 ± 9.3 months (range, 0 to 36.0 months), there was no PDA flow by color Doppler echocardiography in any of the 30 patients. Conclusion: Coil occlusion is a safe and effective method of percutaneous closure of small to moderate-size PDAs. The largest PDA that can be closed with this technique remains to be determined. (J Pediatr 1997;130:447-54)