Use of interlock fibered detachable coils for occlusion of collaterals, coronary artery fistulae, and patent ductus arteriosus

Abstract

To investigate the utility of interlocking detachable coils (IDC) for transcatheter occlusion of vascular communications in congenital heart disease. The IDC can be delivered in a retractable fashion through hydrophilic Renegade microcatheters. They incorporate thrombogenic synthetic fibers and cost less than comparable neurovascular coils. They are ideally suited for use in many forms of congenital heart disease. A retrospective review of all patients catheterized during the initial 18-month period of IDC availability at our institution was performed. Interlock coils were only used if traditional methods could not be used easily and safely. All congenital patients in whom IDC were used are described. A total of 61 coils were deployed in 17 patients with various vessels not amenable to treatment with conventional coils. Coils were used in aortopulmonary collaterals (n = 7), veno-venous collaterals (n = 9), patent ductus arteriosus (n = 3), and coronary artery fistulae (CAF) (n = 2). Operators were able to control coils and withdraw into the catheter for repositioning without difficulty. Thirteen of 21 vessels demonstrated immediate occlusion. All late angiograms have demonstrated complete occlusion of all vessels, with one exception requiring reintervention. One coil migrated from a large CAF and was easily retrieved with a snare. No serious complications occurred. All patients had an uneventful postcatheterization course. Transcatheter vascular coil embolization with IDCs can be performed safely and effectively in a variety of circumstances.