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. 2019 Sep-Dec;12(3):206-211.
doi: 10.4103/apc.APC_151_18.

Percutaneous closure of patent ductus arteriosus with the Nit-Occlud® patent ductus arteriosus device in 268 consecutive cases

Andrii V Maksymenko  1 , Yulia L Kuzmenko  1 , Arkadii A Dovhaliuk  2 , Oleksandra O Motrechko  1 , Florian E Herrmann  3 , Nikolaus A Haas  4 , Anja Lehner  4
Affiliations

Percutaneous closure of patent ductus arteriosus with the Nit-Occlud® patent ductus arteriosus device in 268 consecutive cases

Andrii V Maksymenko et al. Ann Pediatr Cardiol. 2019 Sep-Dec.

Abstract

Background: The pfm Nit-Occlud® patent ductus arteriosus (PDA) device is well established for interventional closure of PDA. However, there are still limited data concerning its efficacy and follow-up in larger patient groups.

Aims: This study aimed to evaluate the safety and efficacy of the Nit-Occlud® PDA device, implanted both through transpulmonary and transaortic approach, in a large cohort.

Methods: From July 2008 to December 2015, 268 consecutive patients were admitted for transcatheter closure of a PDA and were treated with the Nit-Occlud® coil. Clinical, echocardiographic, and angiographic data were evaluated.

Results: The median age was 5.2 years (range, 5 months to 62 years), and the median weight was 19.3 kg (range: 5.5-97 kg). Ten (3.7%) patients had weight <10 kg. The most common ductus types treated were Krichenko Type E and A (44.0% and 33.2%, respectively). Twelve (4.5%) patients were treated for residual shunting after surgical PDA closure. The median diameter at the narrowest point was 1.5 mm (range: 0.4-4 mm), the median size of the ampulla was 5 mm (range: 1-15 mm), and the median length was 9 mm (range: 2-25 mm). Device implantation could be successfully achieved in all cases. Closure rates documented immediately after the procedure, at 3-10 days, 1 month, and 6 months after intervention were 62%, 95.1%, 97.8%, and 98.5%, respectively. With the exception of one minor thromboembolic event, there were no procedure-related complications.

Conclusion: Closure of PDA with various anatomic variations and sizes can be performed effectively and safely using the Nit-Occlud® coil.

Keywords: Interventional closure; interventional devices; patent ductus arteriosus.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
pfm Nit-Occlud® patent ductus arteriosus device. (a and b) Nitinol-based spiral-shape device for small and medium-sized patent ductus arteriosus. Tight and compact windings are thought to enhance efficient occlusion; no thrombogenic fabrics are incorporated
Figure 2
Figure 2
Transvenous closure of a Type A patent ductus arteriosus (a), angiogram in straight lateral view. The device is advanced through the duct to the descending aorta under fluoroscopic control. All loops located distal to the device waist are deployed within the aorta and the whole delivery system is retracted into the ductal ampulla (b). The implantation catheter is simultaneously retracted, while the delivery system is pushed forward slightly to deploy the remaining coil windings anchoring the pulmonary end of the duct (c)
Figure 3
Figure 3
Transaortic closure of a Type E patent ductus arteriosus (a), angiogram in straight lateral view. Implantation through arterial access only is performed similarly, with the first windings released on the pulmonary side and full deployment and compaction of all remaining windings within the ductal ampulla (b)
See this image and copyright information in PMC

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