Borisov A A, Tsytko A S, Il'in A S, Aleksandrov K Iu, Borisova N A
Vestn Khir Im I I Grek. 2004;163(3):55-8.
An analysis of fails and complications of transcatheter coil occlusion of patent ductus arteriosus (PDA) was made. An attempt to close PDA with Gianturco coils was undertaken in 132 patients. Fails were noted in 4 (3.1%) children, 3 of them failed to hold the coil in PDA due to its greater width, and in 1 patient the catheter could not be delivered through a narrow duct. Complications were noted in 9 patients (7%): migration of the coils into the pulmonary artery branches took place in 8 patients, and in 1 patient there appeared haemolysis due to a large residual shunt. Snare-assisted removal of the migrating coils was carried out in 7 children, in 1 girl the coil could not be extracted from the peripheral branch of the left pulmonary artery. In 7 patients reocclusion of PDA was made, in 1 case no reembolization was performed. Haemolysis was liquidated by an additional implantation of the coils in repeated procedure. Risk of fail and complications was associated with great minimal diameter of patent ductus arteriosus.
对动脉导管未闭(PDA)经导管弹簧圈封堵术的失败情况及并发症进行了分析。对132例患者尝试使用Gianturco弹簧圈封堵PDA。4例(3.1%)儿童封堵失败,其中3例因动脉导管较宽导致弹簧圈无法固定在PDA内,1例患者因导管无法通过狭窄的导管送达。9例(7%)出现并发症:8例弹簧圈迁移至肺动脉分支,1例因大量残余分流出现溶血。7例儿童通过圈套器辅助取出迁移的弹簧圈,1名女孩的弹簧圈无法从左肺动脉外周分支取出。7例患者再次封堵PDA,1例未进行再次栓塞。通过再次手术额外植入弹簧圈消除了溶血。封堵失败及并发症的风险与动脉导管未闭的最小直径较大有关。