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Transcatheter occlusion of arterial duct with new detachable coils

Published online by Cambridge University Press:  19 August 2008

Kyousuke Hazama
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Toshio Nakanishi*
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Tohru Tsuji
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Yoshikazu Kinugawa
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Suguru Matsuoka
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Kazuhiro Mori
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Akihiro Saitou
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Hitoshi Tomita
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
Kazuo Momma
Affiliation:
From the Department of Pediatric Cardiology, Tokyo Women's Medical College, Tokyo, Department of Pediatrics, Hakodate National Hospital, Hakodate City, Department of Pediatrics, Tokushima University, Tokushima and Saitama Cardiovascular Center, Saitama, Japan
*
Dr. Toshio Nakanishi, Pediatric Cardiology, The Heart Institute of japan, Tokyo Women's Medical College, 8–1 Kawada-cho, Shinjuku, Tokyo, Japan. Tel. 81-3-3353-8111, ext 23110; Fax 81-3-3356-0441.

Summary

Percutaneous transcatheter embolization of the arterial duct, using new detachable coils, was performed in 19 patients aged from two to 16 years. The minimal ductal diameter ranged from 0.5 to 2.7 mm. We used a 5 mm diameter coil, 8 cm in length and/or an 8 mm diameter coil, which was 10 cm in length. The coil was connected to a delivery wire with a screw system, and could be detached by rotation of the delivery wire. The coil was straightened by inserting a mandril, with loops then being formed by withdrawal of the mandril. In all patients, the coil was advanced retrogradely and either one or two coils were successfully implanted. Implantation was performed in four patients without the catheter entering the pulmonary trunk across the arterial duct. The ductal ampulla was either absent or very small in five patients, so we implanted a coil which had been cut short. Angiography revealed no residual shunting in 14 patients (74%) and trace residual shunting in five patients. Migration of the coils to the pulmonary arteries, or to a systemic artery, did not occur in any patient. Follow-up using Doppler color flow imaging showed complete closure of the arterial duct in all patients (100%), and no turbulence either in the left pulmonary artery or in the descending aorta in any patient. The use of the new detachable coil may improve the accuracy of placement of the device and reduce the incidence of its migration.

Type
Original Manuscripts
Copyright
Copyright © Cambridge University Press 1996

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References

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