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动脉导管未闭患者采用线圈封堵的长期疗效。

Long-term outcome of coil occlusion in patients with patent ductus arteriosus.

机构信息

Department of Pediatric Cardiology, Stroke & Cardiovascular Center, Ehime University, Ehime, Japan.

出版信息

Circ J. 2011;75(2):407-12. doi: 10.1253/circj.cj-10-0453. Epub 2010 Dec 14.

Abstract

BACKGROUND

Coil occlusion has been widely indicated for the closure of patent ductus arteriosus (PDA). Although many reports have shown the efficacy and safety of coil occlusion, the long-term outcome in patients remains controversial. Here, we analyzed the long-term outcome of coil occlusion in patients with PDA in Japan.

METHODS AND RESULTS

We collected the longitudinal data of patients who underwent coil occlusion between 1995 and 2009. A total of 310 coil occlusions were performed in 298 patients with PDA. The median minimum duct diameter was 1.4mm. Successful coil occlusion was achieved in 286 patients (96.0%), and total adverse events were seen in only 28 cases (9.0%). The median follow-up period was 50 months. The occlusion rates at 1 month, 6 months, 1 year, 2 years and 5 years were 90.1%, 94.4%, 97.4%, 97.8% and 97.8%, respectively. Patients with a large PDA (≥4mm) showed a higher rate of residual leakage than those with a small (<2mm) or moderate (2-4mm) PDA (P=0.004). Patients who underwent this procedure in the early study period also showed a higher rate of residual leakage than those in the late study period.

CONCLUSIONS

Coil occlusion is an effective procedure for patients with PDA. Our data indicate that the long-term outcome is promising without any adverse events.

摘要

背景

线圈封堵已广泛应用于动脉导管未闭(PDA)的封堵。尽管许多报道显示了线圈封堵的疗效和安全性,但患者的长期预后仍存在争议。在此,我们分析了日本 PDA 患者线圈封堵的长期预后。

方法和结果

我们收集了 1995 年至 2009 年期间接受线圈封堵的患者的纵向数据。共有 298 例 PDA 患者进行了 310 次线圈封堵。最小动脉导管直径的中位数为 1.4mm。286 例患者(96.0%)成功进行了线圈封堵,仅 28 例(9.0%)出现总不良事件。中位随访时间为 50 个月。1 个月、6 个月、1 年、2 年和 5 年的闭塞率分别为 90.1%、94.4%、97.4%、97.8%和 97.8%。大 PDA(≥4mm)患者的残余漏发生率高于小(<2mm)或中(2-4mm)PDA 患者(P=0.004)。在早期研究期间接受该手术的患者的残余漏发生率也高于晚期研究期间的患者。

结论

线圈封堵是 PDA 患者的有效治疗方法。我们的数据表明,该方法具有良好的长期预后,无任何不良事件。

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