Prospective study of Detachable coil embolization for PDA

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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.