Coil embolization of congenital thoracic vascular anomalies in infants and children.

When significant thoracic vascular anomalies occur in children, they may present surgical difficulties making operative management undesirable. The recent development of a new, accurate coil-delivery system has enabled us to embolize 17 vessels in five children by passing Gianturco steel coils coated with thrombogenic Dacron strands through No. 5 or 6F end-hole catheters suitable for infants. Coils of 0.038 inch packed diameter were fed through the catheter lumen by a flexible guidewire emerging as 3, 5, or 8 mm diameter loose coils. Fifteen of 17 vessels were successfully occluded. No complications or errors in placement of coils occurred. Four of five children clearly benefitted from the procedure. One died in spite of partial occlusion. Coil embolization can be performed accurately and safely even in small infants with a high rate of successful occlusion and may prove to be a valuable adjunct to operative management.