Skip to main content Accessibility help
×
Home
Hostname: page-component-568f69f84b-klmjj Total loading time: 0.169 Render date: 2021-09-23T01:14:17.522Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Transcatheter embolization of abnormal intrathoracic vessels using coils in the setting of children with congenital heart disease

Published online by Cambridge University Press:  19 August 2008

Jean Pierre Pfammatter*
Affiliation:
Division of Pediatric Cardiology, Children's Hospital, Hannover Medical School, Hannover, Germany
Ingrid Luhmer
Affiliation:
Division of Pediatric Cardiology, Children's Hospital, Hannover Medical School, Hannover, Germany
Hans Carlo Kallfelz
Affiliation:
Division of Pediatric Cardiology, Children's Hospital, Hannover Medical School, Hannover, Germany
*Corresponding
Dr Jean Pierre Pfammatter MD Division of Pediatric Cardiology, Children's Hospital, Freiburgstrasse, CH 3010 Berne, Switzerland. Tel: ++41 31 632 2111. Fax: ++41 31 632 9748

Abstract

Objective

it was the purpose of this retrospective study to assess the efficacy and the rate of complications of transcatheter embolization of abnormal intrathoracic vessels using coils in children with complex congenital heart disease.

Patients and methods

in 17 children (mean age 9.2±5.9 years) with complex congenital heart disease, occlusion by catheter intervention was attempted in 29 abnormal intrathoracic vessels: 13 aorto-pulmonary collaterals, 12 arterio-pulmonary collaterals, 2 systemic arteries supplying pulmonary sequestrations, one central venous connection and a Blalock-Taussig shunt. The mean diameter of the vessels was 4.7 ± 1.6 mm (range 2–8 mm). Steel coils with a helical diameter of three, five or eight mm were used. After selective catheterization of the vessel, they were delivered through a 5 F endhole catheter. The helical diameter of the coils was chosen in order to exceed the inner diameter of the vessel by 10–30%.

Results

as assessed by selective angiography performed 10 minutes or more after release of the coil, 27 of the 29 vessels (93%) were successfully occluded. A mean of 2.6 coils (range 1–11) were necessary for successful occlusion. Complications were encountered during 4 attempts of occlusion (14%). Of a total of 76 coils delivered, 4 coils (5%) secondarily migrated after release from the catheter, mostly to branches of the pulmonary arteries. This complication was seen predominantly in those vessels with the largest diameters. Three of the dislocated coils were left in place as they did not significantly obstruct flow of blood. One coil was retrieved by a basket catheter.

Conclusion

transcatheter embolization of abnormal intrathoracic vessels using coils in children with congenital heart disease is an effective therapy. Potential complications warrant careful evaluation of the indications for these procedures.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Gianturco, C, Anderson, JH, Wallace, S. Mechanical devices for arterial occlusion. Am J Radiol 1975; 124: 428435Google ScholarPubMed
2.Perry, SB, Radtke, W, Fellows, KE, Keane, JF, Lock, JE. Coil embolization to occlude aortopulmonary collateral vessels and shunts in patients with congenital heart disease. J Am CollCardiol 1989; 13: 100108CrossRefGoogle ScholarPubMed
3.Fuhrman, BP, Bass, JL, Castaneda-Zuniga, W, Amplatz, K, Lock, JE. Coil embolization of congenital thoracic vascular anomalies in infants and children. Circulation 1984; 70: 285289CrossRefGoogle ScholarPubMed
4.Reidy, JF, Jones, ODH, Tynan, MJ, Baker, EJ, Joseph, MC. Embolization procedures in congenital heart disease. Br Heart J 1985; 54: 184192CrossRefGoogle ScholarPubMed
5.Kirsch, LR, Sos, TA, Engle, MA. Successful coil embolization for diffuse multiple pulmonary arteriovenous fistulas. Am Heart J 1991; 122: 245247CrossRefGoogle ScholarPubMed
6.Moore, JW, George, L, Kirkpatrick, SE. Percutaneous closure of the small patent ductus arteriosus using occluding spring coils. J Am Coll Cardiol 1994; 23: 759765CrossRefGoogle ScholarPubMed
7.Latson, LA, Forbes, TJ, Cheatham, JP. Transcatheter coil embolization of a fistula from the posterior descending coronary artery to the right ventricle in a two-year old child. Am Heart J 1992; 124: 16241626CrossRefGoogle Scholar
8.Reidy, JF, Tynan, MJ, Qureshi, SA. Embolization of a complex coronary arteriovenous fistula in a 6 year old child: the need for specialised embolization techniques. Br Heart J 1990; 63: 246248CrossRefGoogle Scholar
9.Reidy, JF, Anjos, RT, Qureshi, SA, Baker, EJ, Tynan, MJ. Transcatheter embolization in the treatment of coronary artery fistulas. J Am Coll Cardiol 1991; 18: 187–182CrossRefGoogle ScholarPubMed
10.Zuberbuhler, JR, Ankner, E, Zoltun, R, Burkholder, J, Bahnson, H. Tissue adhesive closure of aortic-pulmonary communications. Am Heart J 1974; 88: 4146CrossRefGoogle ScholarPubMed
11.Gomes, AS, Mali, WP, Oppenheim, WL. Embolization therapy in the management of congenital arteriovenous malformations. Radiology 1982; 144: 4148CrossRefGoogle ScholarPubMed
12.Fellows, KE, Lock, JE. Catheter intervention: septostomy, occlusion techniques and pericardial drainage. In: Lock, JE, Keane, JF, Fellows, KE (eds). Diagnostic and interventional catheterization in congenital heart disease. Martinus Nijhoff Publishing, Boston 1987; pp 11271132Google Scholar
13.Remy-Jardin, M, Wattinne, L, Remy, J. Transcatheter occlusion of pulmonary arterial circulation and collateral supply: failures, incidents and complications. Radiology 1991; 180: 699705CrossRefGoogle ScholarPubMed
14.Huggon, IC, Qureshi, SA, Reidy, JF, Anjos, RT, Baker, EJ, Tynan, MJ. Percutaneous transcatheter retrieval of misplaced therapeutic embolization devices. Br Heart J 1994; 72: 470475CrossRefGoogle Scholar
15.DeRuiter, Mc, Gittenberger-de-Groot, AC, Bogers, AJJC, Elzenga, NJ. The restricted relevance of morphologic criteria to classify systemic-pulmonary collateral arteries in pulmonary atresia with ventricular septal defect. J Thoracic Cardiovasc Surg 1994; 108: 692699Google ScholarPubMed
16.Lois, JF, Gomes, AS, Smith, DC, Laks, H. Systemic-to-pulmonary collateral vessels and shunts: treatment with embolization. Radiology 1988; 169: 671676CrossRefGoogle ScholarPubMed
17.Kaufman, SL, Kan, JS, Mitchell, SE, Flaherty, JT, White, RI. Embolization of systemic to pulmonary artery collaterals in the management of hemoptysis in pulmonary atresia. Am J Cardiol 1986; 58: 11301132CrossRefGoogle ScholarPubMed
18.Spicer, RL, Uzark, K, Cocalis, MW, Moore, JW, Mainwaring, RD, Lamberti, JJ. Aortopulmonary collaterals and prolonged pleural effusions after modified Fontan procedure. Pediatr Cardiol 1994; 15: 256 (abstract)Google Scholar
19.Hardy, C, Wong, J, Young, JN, McCray, J. Balloon occlusion scintigraphy of aortopulmonary collaterals. Pediatr Cardiol 1994; 15:241245CrossRefGoogle ScholarPubMed
1
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Transcatheter embolization of abnormal intrathoracic vessels using coils in the setting of children with congenital heart disease
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Transcatheter embolization of abnormal intrathoracic vessels using coils in the setting of children with congenital heart disease
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Transcatheter embolization of abnormal intrathoracic vessels using coils in the setting of children with congenital heart disease
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *