Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Catheter Cardiovasc Interv. 2010 Nov 1;76(5):696-702. doi: 10.1002/ccd.22538.
There are no guidelines and multiple devices available now for closure of PDA.
We sought to determine which devices are used and their outcomes.
Prospectively collected data on closure of PDA at 12 US catheterization labs was entered into the MAGIC data registry between November 2005 and September 2008.
PDA closure was accomplished in 357 of 359 attempted closures during the study period. Mean age, weight, and minimum ductal diameter were 4.3 ± 6.8 years, 18.7 ± 18.4 kg, and 2.1 ± 1.4 mm, respectively. Devices used were Gianturco coils (161/359), Amplatzer Duct Occluder (ADO, 174/359), Flipper coils (18/359), and other devices (6/359). Gianturco coils had the least fluoroscopy and contrast exposure (8.7 ± 7.5 min, P = 0.00001, 2.6 ± 1.4 cm(3) kg(-1), P = 0.00001). Immediate angiographic success rates were 96.9% (156/161) for Gianturco coils, 89.7% (156/174) for the ADO, 100% (18/18) for Flipper coils, and 66.7% (4/6) for other devices. Major complication rates were 0.6% for Gianturco coils (1/161), 1.7% for ADO (3/174), and 83.3% for other devices (4/6). Minor complication rates by device were 1.9% for Gianturco coils (3/161), 2.3% for ADO (4/174), and 16.7% (1/6) for other devices.
Gianturco coils, the ADO and Flipper coils were immediately successful with low complication profiles. The ADO and Gianturco coils were the predominate devices. The ADO was the device of choice for PDA > 3 mm with good success. In PDA < 3 mm, the Gianturco coil is as effective and safe as the ADO with less cost, less radiation, and less contrast exposure. © 2010 Wiley-Liss, Inc.
目前尚无关于动脉导管未闭（PDA）封堵的指南，也有多种封堵设备可供选择。
我们旨在确定目前封堵 PDA 所使用的设备及其结果。
2005 年 11 月至 2008 年 9 月，在 12 个美国导管实验室前瞻性收集 PDA 封堵的数据，并录入 MAGIC 数据登记处。
在研究期间，359 次尝试封堵中有 357 次成功。平均年龄、体重和最小动脉导管直径分别为 4.3±6.8 岁、18.7±18.4kg 和 2.1±1.4mm。使用的封堵设备包括 Gianturco 线圈（161/359）、Amplatzer 动脉导管未闭封堵器（ADO，174/359）、Flipper 线圈（18/359）和其他设备（6/359）。Gianturco 线圈的透视和造影剂暴露最少（8.7±7.5min，P=0.00001；2.6±1.4cm3/kg，P=0.00001）。Gianturco 线圈即刻血管造影成功率为 96.9%（156/161），ADO 为 89.7%（156/174），Flipper 线圈为 100%（18/18），其他设备为 66.7%（4/6）。Gianturco 线圈的主要并发症发生率为 0.6%（1/161），ADO 为 1.7%（3/174），其他设备为 83.3%（4/6）。Gianturco 线圈的次要并发症发生率为 1.9%（3/161），ADO 为 2.3%（4/174），其他设备为 16.7%（1/6）。
Gianturco 线圈、ADO 和 Flipper 线圈即刻成功率高，并发症发生率低。ADO 和 Gianturco 线圈是主要的封堵设备。对于直径＞3mm 的 PDA，ADO 是首选封堵设备，其成功率较高。对于直径＜3mm 的 PDA，Gianturco 线圈与 ADO 同样有效且安全，但其费用更低、辐射更少、造影剂暴露更少。
