Prospective study of Detachable coil embolization for PDA

背景资料。近年来，弹簧圈栓塞术已成为治疗动脉导管未闭的有效替代方法。本文报告了使用可拆卸和不可拆卸的栓塞器对动脉导管未闭进行栓塞术的结果，其中改良的Gianturco长线圈有5个以上的螺旋环。此外，它还提供了植入导管的线圈的中期自然历史。方法和结果。22例患者，年龄2岁9个月至12岁10个月，平均(SY+-)SD：6.5(SY+-)3.6岁。导管最窄处直径1.0~3.5 mm，平均2.6(SY+-)0.7 mm。其中11例采用非可脱性系统植入常规弹簧圈，另11例采用可脱性弹簧圈栓塞术。12例(55%)患者在单圈输液手术后立即无明显残余渗漏。其余10例(45%)术后即刻有残余漏，仅2例(9%)术后12~18个月有少量残余漏。在线圈的X线测量过程中，所有植入的线圈在咬合后立即缩小到原来大小的65%~85%。这种收缩在残余分流自发关闭和/或有直径8 mm的线圈的患者中更为明显。动脉导管未闭的栓塞术是一种可以接受的方法。在随访期内，植入线圈的收缩是常见的。这种收缩可能与残余分流的自发闭合有关。

Background. Coil embolization has recently been used as an effective alternative to surgery in treating patent ductus arteriosus. This report presents the results of coil occlusion of patent ductus arteriosus using detachable and non-detachable embolization systems with modified long Gianturco coils having more than 5 helical loops. Furthermore, it provides an intermediate-term natural history of coils implanted in the ductus.Methods and Results. Twenty-two patients, ranging in age from 2 years and 9 months to 12 years and 10 months (mean(]SY+-[)SD : 6.5(]SY+-[)3.6 years), underwent coil occlusion. The ductus ranged from 1.0 to 3.5mm (mean2.6(]SY+-[)0.7mm) in diameter at the narrowest point. In 11 of these patients regular coils were implanted using the non-detachable system, while in the other 11 patients the detachable coil embolization system was used. Twelve (55%) patients had no significant residual leaks immediately after the procedure involving a single coil delivery. The remaining 10 (45%) patients had residual leaks immediately after the procedure, although only 2 (9%) of the patients with a large ductus showed trace residual leakage 12 to 18 months after the procedure. During the radiographic measurement of coils, all implanted coils were shrunk to 65 to 85% of their original size immediately after occlusion. This shrinkage was more evident in patients exhibiting spontaneous closure of the residual shunt and/or having a coil 8 mm in diameter.Conclusions. Coil embolization is an acceptable method for occluding patent ductus arteriosus. Shrinkage of implanted coils is common in the follw-up period. Such shrinkage may be related to spontaneous closure of the residual shunt.