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Bioptome‐assisted simultaneous delivery of multiple coils for occlusion of the large patent ductus arteriosus
Author(s) -
Kumar R. Krishna,
Krishnan M.N.,
Venugopal K.,
Sivakumar Kothandam,
Anil Sivadasan Radha
Publication year - 2001
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/ccd.1247
Subject(s) - medicine , ductus arteriosus , fluoroscopy , stenosis , occlusion , embolization , pulmonary artery , electromagnetic coil , shunt (medical) , radiology , surgery , nuclear medicine , electrical engineering , engineering
Abstract We describe a novel method that allows bioptome–assisted delivery of multiple Gianturco coils simultaneously for occlusion of the large patent ductus arteriosus (PDA). Two or more coils were intertwined at one end and held by a bioptome (5.2 Fr) and pulled into a short introducer. The coils were then deployed in the PDA via a long sheath (7–11 Fr) previously placed across the duct via the femoral vein. Twelve patients (6 months to 64 years; median, 10.5 years) with large PDAs (4.7 ± 1.3 mm; range, 3.1–8.4 mm; PA mean pressure, 40 ± 17 mm Hg; pulse pressure 63 ± 18 mm Hg) underwent bioptome‐assisted occlusion with multiple coils at our institutions. The procedure was uneventful in nine patients (fluoroscopy time, 6–23 min) and prolonged in three patients (fluoroscopy time, 26, 72, and 120 min) because of dislodgment of the coil mass and embolization of an additional coil. Successful coil deployment was feasible in all patients. Three patients required repeat coil deployment for flow elimination (hemolysis occurred in two). Flow elimination was demonstrated on the last follow‐up evaluation in all except two patients. One infant has developed significant left pulmonary artery stenosis. Bioptome‐assisted PDA occlusion using multiple coils delivered simultaneously may be a promising alternative to devices for transcatheter closure of large PDAs. Cathet Cardiovasc Intervent 2001;54:95–100. © 2001 Wiley‐Liss, Inc.