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Five‐loop coil occlusion of patent ductus arteriosus prevents recurrence of shunt at follow‐up
Author(s) -
Rao P. Syamasundar,
Balfour Ian C.,
Jureidini Saadeh B.,
Singh Gautam K.,
Chen SuChiung
Publication year - 2000
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/(sici)1522-726x(200006)50:2<202::aid-ccd13>3.0.co;2-1
Subject(s) - medicine , ductus arteriosus , shunt (medical) , occlusion , thrombus , descending aorta , thrombosis , left pulmonary artery , cardiology , electromagnetic coil , surgery , pulmonary artery , aorta , electrical engineering , engineering
Abstract Recent reports suggest reopening of the patent ductus arteriosus (PDA) after complete occlusion with three‐loop Gianturco coils. We hypothesize that five‐loop coils may produce a larger thrombus than three‐loop coils, which will result in no or less probability of recanalization of PDA during follow‐up. This study is designed to test this hypothesis. Follow‐up echocardiographic and Doppler data of 30 patients who underwent five‐loop coil occlusion of small to medium‐sized PDA during a 33‐month period ending December 1998 were examined. Thirty patients had no residual shunt on echo Doppler study on the day following the procedure and were followed for 6 to 30 months (median, 12) after coil implantation. At the last follow‐up study, none of the patients had a residual shunt and left atrial size decreased. Careful pulsed, continuous wave, and color Doppler interrogation of left/main pulmonary artery junction and proximal descending aorta did not reveal any evidence for obstruction. The follow‐up data suggest that complete occlusion of small‐ to medium‐sized PDAs is feasible with five‐loop coils without evidence for recanalization at a mean follow‐up of 12 months. Much longer (2 to 5 years) follow‐up data may be necessary to confirm these observations. We speculate that a greater degree of thrombosis is produced within the ductus by the five‐loop coils, which in turn may be responsible for lack of shunt recurrence. We recommend use of five‐loop instead of three‐loop coils for transcatheter occlusion of small‐ to medium‐sized PDAs. Cathet. Cardiovasc. Intervent. 50:202–206, 2000. © 2000 Wiley‐Liss, Inc.