Comparison of 0.052-Inch Coils vs Amplatzer Duct Occluder for Transcatheter Closure of Moderate to Large Patent Ductus Arteriosus

Abstract

Background Percutaneous device closure is now the widely accepted management technique for patent ductus arteriosus (PDA). In the present study, current practice of closing moderate to large PDA using the Amplatzer duct occluder (ADO) was compared with the previous experience using 0.052-inch coils. Methods and Results From August 1997 to September 2006, 76 patients were selected for either 0.052-inch coils or ADO implantation. Selection criteria were a minimal diameter of ≥2.5 mm and angiographic type A, C, D or E. In group I, 21 patients received 0.052-inch coils in a multiple coil strategy for PDA closure. In group II, 55 patients underwent ADO device implantation. The age, weight, hemodynamics, minimal PDA diameter and shunt size were insignificantly different between groups. However, group I had a higher rate of failed implantation and device embolization, and the immediate and 24-h closure rates (38.9% vs 81.8%, P<0.05; 72.3% vs 96.4%, P<0.05) favored group II. Conclusions ADO implantation is safer and more effective than the 0.052-inch coil strategy for transcatheter closure of moderate to large PDA. (Circ J 2009; 73: 356 - 360)