Jochen Pfeifer, Martin Poryo, Anas Gheibeh, Axel Rentzsch, HashimAbdul-Khaliq
Saarland University Medical Center.
Germany
Journal of Clinical Medicine
J Clin Med 2024; 14:
DOI: 10.3390/jcm14010113
Abstract
Background: Systemic-to-pulmonary collaterals (SPCs) are common in congenital heart disease (CHD). Particularly in single ventricle anatomy and Fontan circulation, SPC can both complicate the postoperative course and lead to clinical deterioration in the long term. The treatment of SPC is controversial. The aim of our study was (1) to retrospectively analyse patients who underwent SPC embolization using Concerto™ Helix nylon-fibred microcoils (CHMs) and (2) to describe the interventional technique.
Methods: In this single-centre retrospective observational cohort study, we analysed clinical and imaging data of all patients who underwent transcatheter embolization of SPCs using CHMs from January 2016 to December 2023.
Results: In 38 consecutive patients (65.8% male, median age 41 months, range 2-490), a total number of 141 CHMs had been implanted into 64 SPCs in 49 procedures. The majority were arterial SPCs (n = 59/64) originating from the thoracic aorta or its branches; 5/64 were veno-venous SPCs. Primary closure succeeded in all procedures. The CHM diameters ranged from 3 to 8 mm, with 5 mm being the most commonly used diameter. The mean coil/SPC ratio was 2.6 (range 1.3-5.3). CHM implantation was performed via four French sheaths. Both detachment and stable positioning were simple and safe. Neither non-target embolization nor coil migration occurred. One complication was a vascular injury with resulting extravasation of contrast medium. In 18/49 procedures (36.7%), coils other than CHMs or vascular plugs were additionally inserted into separate SPCs.
Conclusions: CHMs are appropriate for SPC embolization in all age groups, including infants, with a low complication rate. The coils are particularly suitable for the closure of collaterals with a small diameter or tortuous course. They can be used in combination with other embolization devices to achieve comprehensive collateral closure.
Category
Abnormal Systemic to Pulmonary Arterial Collaterals or Connections
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease or Adult Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes