Godart François, Rey Christian, Devos Patrick, Brevière Georges-Marie, Francart Charles
Department of Paediatric Cardiology, Cardiac Hospital, Lille, France.
Cardiol Young. 2003 Oct;13(5):413-9.
To report results of transcatheter occlusion of moderate to large patent arterial ducts, having a minimum diameter above 2.5 mm, with the Amplatzer duct occluder, and to compare these with results achieved using Rashkind or Sideris devices and Cook detachable coils.
Retrospective study conducted on intention-to-treat data from a tertiary referral centre.
Since 1989, 116 consecutive patients, 77 females and 39 males, underwent percutaneous closure with several devices. We used the Rashkind double umbrella in 23 patients, the Sideris buttoned device in 39 patients, coils in 17 patients, and the Amplatzer duct occluder in 37 patients. The median age of the patients was 37 months, and the median weight 13 kg. The mean minimum diameter of the duct was 3.8 +/- 1.22 mm, with a median of 3.5 mm, and range from 2.5 to 10 mm.
Implantation succeeded in all but 9 of the children (92%). The time of fluoroscopy was shorter, and full occlusion was better as judged on angiography, in patients closed using the Amplatzer device, despite closure of larger ducts, than in patients closed using other devices (p < 0.0001, p = 0.0003, and p = 0.0015 for the Rashkind, Sideris, and coils, respectively). Complications included embolisation in 2 patients, and haemolysis in 3 patients. In 12 patients, a second device was inserted because of residual shunting noted during follow-up. Complete occlusion was achieved earlier after implantation (p = 0.0002), and the rate of complete occlusion was better in patients receiving an Amplatzer device (97%, p = 0.024) than in patients undergoing closure with other devices.
Transcatheter closure of moderate to large patent arterial ducts using the Amplatzer duct occluder is an effective and safe procedure, providing better results than those achieved using other occluders.
报告使用Amplatzer动脉导管封堵器经导管封堵直径至少2.5mm的中度至大型动脉导管未闭的结果，并将其与使用Rashkind或Sideris装置及Cook可拆线圈获得的结果进行比较。
对来自一家三级转诊中心的意向性治疗数据进行回顾性研究。
自1989年以来，116例连续患者（77例女性，39例男性）接受了多种装置的经皮封堵治疗。我们对23例患者使用了Rashkind双伞，39例患者使用了Sideris纽扣装置，17例患者使用了线圈，37例患者使用了Amplatzer动脉导管封堵器。患者的中位年龄为37个月，中位体重为13kg。动脉导管的平均最小直径为3.8±1.22mm，中位数为3.5mm，范围为2.5至10mm。
除9例儿童外（92%），所有患者植入均成功。尽管封堵的动脉导管较大，但与使用其他装置封堵的患者相比，使用Amplatzer装置封堵的患者透视时间更短，血管造影显示完全封堵效果更好（Rashkind、Sideris和线圈组分别为p<0.0001、p=0.0003和p=0.0015）。并发症包括2例患者发生栓塞，3例患者发生溶血。12例患者因随访期间发现残余分流而植入了第二个装置。植入后较早实现了完全封堵（p=0.0002），接受Amplatzer装置治疗的患者完全封堵率更高（97%，p=0.024），高于使用其他装置封堵的患者。
使用Amplatzer动脉导管封堵器经导管封堵中度至大型动脉导管未闭是一种有效且安全的方法，其效果优于使用其他封堵器获得的效果。
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