Objective: Deploying at least one loop at the pulmonary artery (PA) is recommended to prevent coil migration to the aorta. With increasing experience, we have used a new technique as leaving all loops in the aortic ampulla using transvenous route to close moderate to large PDAs with detachable coils, and compared to standard approach.
Method: 83 of 144 patients who underwent PDA closure with detachable coils, have a minimum PDA diameter of 3- 4.0 mm, were included into the study. Patients were divided into two groups according to leaving coil loop at the PA side (Group I) or not (Group II).
Results: Age, weight and minimum PDA diameter were similar in Groups. However, complete occlusion was higher at catheter laboratory (28/40 vs 19/43, p=0.018) and so additional coil requirement (1/40 vs 10/43, p=0.003) was lower in Group I. The prevalence of residual shunt with time tended to be lower in new technique (P = .032). Thus, three patients in Group I and one patient in Group II required reintervention at one year. Coil migrations to the PA were encountered 1/40 in Group I and 3/43 in Group II, but not to the aorta. A relative decrease of the left lung perfusion was observed in patients in whom initial coil was deployed with leaving loop at the PA side (p=0.018).
Conclusions: Coil occlusion of PDAs with leaving all loops in the aortic ampulla is feasible and safe. It is superior in immediate and overall complete occlusion rate with lower complications.