Selection of coil for transcatheter closure of small patent ductus arteriosus.

The authors reported the results in transcatheter coil occlusion of patent ductus arteriosus (PDA) less than 4 mm, based on a policy in selection of the appropriate type and number of coils for size of PDA. The authors used one 0.035 inch detachable coil, 5 mm in diameter, in PDA less than or equal to 2 mm, and two 0.035 inch detachable coils or one controlled release 0.052 inch Gianturco coil in PDA larger than 2 mm. The present study included 32 pediatric patients. There were 31 cases of successful coil implantation and 1 case failed. Of the 31 successful cases, PDA size varied from 1.4 to 4.0 mm (mean of 2.7 +/- 0.9 mm). Ten patients had a PDA size of less than or equal to 2 mm (group A), while the other 21 patients had a PDA size of larger than 2 mm (group B). In group A, 9 cases had single-detachable-coil occlusion and one case had double-detachable-coil occlusion. In group B, double-detachable-coil occlusion was performed in 17 cases and controlled release 0.052 inch coil in 4 cases. There were no cases of coil migration or other serious complications. The immediate complete occlusion rate was 58 per cent (18 of 31 cases), which rose to 97 per cent (30 of 31 cases) at the mean follow-up of 2.6 +/- 2.5 months (range from 1 day to 9 months). Transcatheter coil occlusion is an alternative to surgical closure of small PDA (less than 4 mm). Selection of type and number of coils appropriate to the size of PDA will allow safe and excellent results.