Stokhof A A, Sreeram N, Wolvekamp W T
Department of Clinical Sciences of Companion Animals of the Faculty of Veterinary Medicine, University of Utrecht, The Netherlands.
J Vet Intern Med. 2000 Jul-Aug;14(4):452-5. doi: 10.1892/0891-6640(2000)014<0452:tcopda>2.3.co;2.
The purpose of this study is to report our initial experience with the use of spring coils to close the patent ductus arteriosus in the dog. There are few large-patient series reported in the veterinary literature. Coil closure was attempted in 15 dogs (median weight, 6.5 kg; range, 1.2 to 38.7 kg) presenting with a patent ductus arteriosus between May 1997 and May 1999. Arterial catheterization followed by angiography was used to decide if coil placement was adequate. A 5- or 8-mm embolization coil, depending on the angiographic diameter of the ductus, was delivered, with 1 loop in the pulmonary arterial side and the remainder of the coil in the aortic side of the duct. Additional coils were used if a residual shunt was present, and closure was confirmed by aortography. Patients were discharged the day after the procedure. Successful coil closure, without residual shunt on angiography, was achieved in 11 of 13 dogs in which coils were released. In 6 dogs, a coil embolized to the pulmonary artery. Four of these dogs had successful closure with multiple coils, and 2 others had surgery. None of these dogs experienced adverse effects. In 2 dogs with conical patent ductus arteriosus >5 mm in minimal diameter, coil closure was not done. We conclude that the patent ductus arteriosus size and anatomical shape are crucial in deciding whether coil closure is the method of choice. In selected cases, coil closure represents an elegant alternative to surgical ligation. Although pulmonary embolism occurred commonly, it did not cause any obvious clinical problem.
本研究的目的是报告我们使用弹簧圈闭合犬动脉导管未闭的初步经验。兽医文献中报道的大样本病例系列较少。在1997年5月至1999年5月期间,对15只患有动脉导管未闭的犬(中位体重6.5 kg;范围1.2至38.7 kg)尝试进行弹簧圈闭合术。通过动脉插管随后进行血管造影来确定弹簧圈放置是否合适。根据动脉导管的血管造影直径,输送5或8毫米的栓塞弹簧圈,1个环位于肺动脉侧,弹簧圈的其余部分位于动脉导管的主动脉侧。如果存在残余分流,则使用额外的弹簧圈,并通过主动脉造影确认闭合情况。术后第二天患者出院。在释放弹簧圈的13只犬中,11只成功实现弹簧圈闭合,血管造影无残余分流。6只犬中,1个弹簧圈栓塞至肺动脉。其中4只犬通过多个弹簧圈成功闭合,另外2只进行了手术。这些犬均未出现不良反应。2只最小直径>5毫米的圆锥形动脉导管未闭犬未进行弹簧圈闭合。我们得出结论,动脉导管未闭的大小和解剖形状对于决定弹簧圈闭合是否为首选方法至关重要。在选定的病例中,弹簧圈闭合是手术结扎的一种理想替代方法。虽然肺栓塞常见,但未引起任何明显的临床问题。