Coil on the loop and selectively enhanced stiffness for improved control: feasibility study in the neonatal ovine model of the large patent ductus arteriosus

Coil Occlusion for Patent Ductus Arteriosus Larger Than 3 mm

BACKGROUND

Coil occlusion of patent ductus arteriosus (PDA) is now widely accepted as the first-line treatment, but there are few reports of age-dependent differences in the complications associated with this technique.

METHODS AND RESULTS

Sixteen patients (11 adults, 5 children) with a PDA larger than 3 mm, who underwent coil occlusion at Sapporo Medical University Hospital between September 1995 and August 2004, were enrolled. Immediate and intermediate outcomes and complications were analyzed. Procedural success rate was 72.7% (8/11) in the children and 100% (5/5) in the adults. Coil migration occurred in 4 children and 1 adult, and 3 adult patients had hemolysis.

CONCLUSION

Hemolysis was more frequent in adults than in children even though the residual shunt was trivial.

Results of the phase I food and drug administration clinical trial of duct-occlud device occlusion of patent ductus arteriosus

The purpose of this study was to evaluate the safety and the efficacy of transcatheter patent ductus arteriosus (PDA) occlusion with the Duct-Occlud device. Six centers participated in this phase I U.S. Food and Drug Administration-approved clinical trial with investigational device exemption. Patients with restrictive PDA (less than 4-mm minimum diameter) were eligible for the study. Sixty-two patients were enrolled. Forty-eight patients had successful implantation of Duct-Occlud devices. Patient follow-up evaluations were conducted at hospital discharge and after 2 and 12 months. At discharge and after 1 year, all patients had clinical PDA closure. Closure assessed by color flow Doppler was 55% at discharge, 88% at 2 months, and 94% at 1 year. There were no complications related to implantation or noted in follow-up evaluations. The Duct-Occlud device is safe and efficacious for the closure of small- to moderate-size patent ductus arteriosus.

DuctOcclud--implant for transcatheter closure of patent ductus arteriosus

The DuctOcclud implant is a metal coil device designed for transcatheter closure of small to moderate size patent ductus arteriosus, a Congenital Heart Disease in which a vessel-like communication between the aorta and the pulmonary artery persists after birth. The paper describes the design of the device, its delivery system, and the implant procedure. It also reviews and reports the experimental and the clinical experiences accumulated utilizing the device for occlusion of patent ductus arteriosus.