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Effectiveness of single detachable COOK coils in closure of the patent ductus arteriosus.

OBJECTIVE
To assess the efficacy and safety of single detachable coils in the closure of PDAs.


METHODS
Review of cases in which a single detachable coil was implanted. The diameter of the ampulla was used to select coil size. Diameters of the PDA, ampulla and residual shunts were measured.


RESULTS
There were 36 patients with a mean minimal ductal diameter of 2.2 +/- 0.6 mm. Immediately after implantation, 46% of the patients had residual shunts and after 24 hours, only 28%. A final spontaneous closure rate of 94% was observed after 21 months. There was a significant (p < 0.01) difference when minimal PDA diameter of those who had complete closure within 24 hours (median: 2 mm, interquartile range: 1.7-2.3 mm) was compared to those with a residual shunt (median: 2.5 mm, interquartile range: 2.3-3.2 mm). Negligible complications were experienced.


CONCLUSIONS
Single Cook detachable coils are effective for PDA closure with a low complication rate if properly selected. There is a high rate of spontaneous closure of trivial residual shunts. In patients with a minimal ductal diameter > or = 2 mm and a residual shunt, more coils may be considered.