Portosystemic venous shunts occur in patients with polysplenia after the Fontan operation. In the long term, these shunts are associated with hyperammonaemia and portal-systemic encephalopathy. Since some shunts are long and tortuous, catheter interventions to close them could be challenging. Instead, a steerable microcatheter could be used for coil embolisation of tortuous portosystemic venous shunts.

Vessel occlusion is a frequently used procedure to close congenital or acquired collaterals or communications. We report two cases of successful vessel closure, in small infants with CHD, using the Azur CX Peripheral Coil System. The low profile of the device, the controlled delivery of the coils, and the delivery through a microcatheter make it particularly interesting for the occlusion of highly tortuous vessels in children.

Significant aortopulmonary collaterals in cyanotic CHD patients require closure immediately before definitive intracardiac repair. Traditionally, the transfemoral access has been used for this purpose; however in a few cases, selective and stable hooking of collaterals may be extremely difficult. We describe a case in which we used a new approach for collateral embolisation in a difficult situation.