Nonoperative Treatment of PDA Using the Duct-Occlud

Shin, Dong Woon; Lee, Kyung Hee; Han, Heon Seok

Abstract

PURPOSE: Among the several transcatheter devices of PDA occlusion, Rashikind device was the most extensively experienced, but it had risk of occluder embolism and incomplete occlusion of PDA, approximately 27%. The authors used Duct-Occlud , made of 0.028 inch stainless steel coil. The coil is double cone-shape in released state, and used in streched condition through 4F implantation catheter for ductus occlusion. We are to report the short-term result of PDA occlusion using Duct-Occlud.
METHODS
Six patients with internal ductal diameter of less than 3.5mm were selected for ductus occlusion. The Duct-Occlud was selected as follows : the diameter of aortic end was same as aortic ampulla, and the length was slightly shorter than that of ductus. The streched coil was introduced into descending aorta through implantation catheter, and the remaining coil was released in ductus and pulmonary artery subsequently. Postprocedure aortic angiogram was obtained and echocardiography was performed at 1day, 1 week, 1 month and 3 month after the procedure.
RESULTS
Except one hourglass type, all the other PDA were tunnel shaped. The range of internal diameter of ductus was 0.83-2.4mm, the length 5.36-P12.4mm, and Qp/Qs 1.04-1.67. Three cases required repositioniong of coils, while the others were successful in one procedure. The residual shunts were resolved at 1 day in most cases, but two cases in 1 month after the procedure. There were no complications, such as coil embolism, migration, or pulmonary stenosis.
CONCLUSIONS
In small PDA with internal diameter of less than 3.5mm, transcatheter occlusion using Duct-Occlud is easy, safe and accurate, except with high cost.