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Impact of Device Evolution in Transcatheter Closure of Patent Ductus Arteriosus Using Duct-Occlud Coils : Comparison of Mid-term Results

Korean Journal of Pediatrics 2005;48(2):158-164.
Published online February 15, 2005.
Impact of Device Evolution in Transcatheter Closure of Patent Ductus Arteriosus Using Duct-Occlud Coils : Comparison of Mid-term Results
Myung Kwan Kim, Dong Ki Han, Jae Young Choi, Yuria Kim, Byung Won Yoo, Deok Young Choi, Jun Hee Sul, Sung Kue Lee
Division of Pediatric Cardiology, Yonsei Cardiovascular Center, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
경피적 동맥관 폐쇄술에 사용된 Duct-Occlud Coil의 종류에 따른 중-단기 결과의 비교
김명관, 한동기, 최재영, 김유리아, 유병원, 최덕영, 설준희, 이승규
연세대학교 의과대학 심장혈관병원 심혈관연구소, 소아심장과
Correspondence: 
Jae Young Choi, Email: cjy0122@yumc.yonsei.kr
Abstract
Purpose
: We reviewed the therapeutic results of various Duct-Occlud coils(pfm AG, K ln, Germany) to evaluate the efficacy of the most-recently modified Duct-Occlud coil(Nit-Occlud) in the transcatheter closure of patent ductus arteriosus(PDA), including large defects more than 4 mm in diameter.
Methods
: Two hundred and five patients who underwent percutaneous PDA occlusion using Duct- Occlud devices from March 1996 to December 2003 were enrolled and four types of Duct-Occlud [Standard(S), Reinforced(R), Reinforced reverse cone(RR) and Nit-Occlud(N)] were used in this study. The patients were followed up by echocardiogram and physical examination before discharge, one month, six months and 12 months after the procedure.
Results
: The rate of residual shunt according to the type of Duct-Occlud were as follows : S-54%, R-72%, RR-50%, N-14%(P<0.05 compared with other devices) at one month, S-25%, R-44%, RR- 37%, N-0%(P<0.05 compared with other devices) at six months, S-8%, R-8%, RR-4%, N-0%(P< 0.05 compared with S and R) at 12 months and later. Nit-Occlud coil showed the complete occlusion of PDA after six months of follow-up, even in 12 patients with relatively large PDA(>4 mm).
Conclusion
: The transcatheter closure of PDA using Duct-Occlud was an effective treatment and our study revealed that a Nit-Occlud coil which showed higher rate of occlusion even in PDA with large diameters over than 4 mm, was a more effective modality compared to previous devices.
Key Words: Patent ductus arteriosus , Transcatheter occlusion , Duct-Occlud


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