Hena Zachary, Sutton Nicole J, Gates Gregory J, Taragin Benjamin H, Pass Robert H
Department of Pediatrics, Division of Pediatric Cardiology, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA.
Department of Radiology, Division of Pediatric Cardiology, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA.
Ann Pediatr Cardiol. 2017 Sep-Dec;10(3):240-244. doi: 10.4103/apc.APC_9_17.
Smaller femoral arterial sheaths may be associated with fewer vascular complications. The 3.3 Fr Mongoose Pediavascular pigtail catheter is a catheter that allows higher flow rates, potentially resulting in improved angiographic quality. We reviewed our experience with this small catheter during patent ductus arteriosus (PDA) closure.
Review of patients ≤20 kg in whom the Mongoose catheter was used during PDA closure from 12/13 to 4/15. Angiographic efficacy and procedural details were compared to ten 4 Fr catheter cases. Comparisons were performed using Mann-Whitney U-test; < 0.05 was statistically significant.
Twelve (9 female) patients were catheterized with a 3.3 Fr Mongoose. Median weight 10.5 kg (range 6.4-18.2), height 81 cm (range 37-111), and body surface area (BSA) 0.47 m (range 0.33-0.75) were similar to ten patients (3 females) in the 4 Fr control group ( = NS); median weight 9.9 kg (range 6-16.8), height 80 cm (range 64-102), and BSA 0.46 m2 (range 0.31-0.74). Angiographic quality was subjectively adequate with both with no difference in the median pixel density between the two techniques (3.3 Fr: 76.7 [range 33.5-90] and 4 Fr: [70; 38-102]; = NS). Contrast used was similar between the groups (3.3 Fr: median 4.2 ml/kg and 4 Fr: 4.9 ml/kg; = NS). Median radiation dose was similar in the two groups (3.3 Fr: 28.1 mGy [range 17.2-38] and 4 Fr: 38 mGy [range 20.4-58.5]; = NS). All ducts were closed at latest follow-up ( = NS). No complications were encountered.
The 3.3 Fr Mongoose allowed similar angiography to the 4 Fr pigtail catheter, allowing safe and effective transcatheter PDA closure in small children.
较小的股动脉鞘可能与较少的血管并发症相关。3.3 Fr的Mongoose儿科血管猪尾导管是一种能够实现更高流速的导管，这可能会提高血管造影质量。我们回顾了在动脉导管未闭（PDA）封堵术中使用这种小导管的经验。
回顾2013年12月至2015年4月期间体重≤20 kg且在PDA封堵术中使用Mongoose导管的患者。将血管造影效果和操作细节与10例使用4 Fr导管的病例进行比较。采用曼-惠特尼U检验进行比较；P<0.05具有统计学意义。
12例（9例女性）患者使用3.3 Fr的Mongoose导管进行插管。中位体重10.5 kg（范围6.4 - 18.2 kg）、身高81 cm（范围37 - 111 cm）和体表面积（BSA）0.47 m²（范围0.33 - 0.75 m²）与4 Fr对照组的10例患者（3例女性）相似（P = 无统计学差异）；中位体重9.9 kg（范围6 - 16.8 kg）、身高80 cm（范围64 - 102 cm）和BSA 0.46 m²（范围0.31 - 0.74 m²）。两种技术的血管造影质量主观上都足够，两种技术之间的中位像素密度无差异（3.3 Fr：76.7 [范围33.5 - 90]和4 Fr：[70；38 - 102]；P = 无统计学差异）。两组使用的造影剂相似（3.3 Fr：中位4.2 ml/kg和4 Fr：4.9 ml/kg；P = 无统计学差异）。两组的中位辐射剂量相似（3.3 Fr：28.1 mGy [范围17.2 - 38 mGy]和4 Fr：38 mGy [范围20.4 - 58.5 mGy]；P = 无统计学差异）。所有导管在末次随访时均已闭合（P = 无统计学差异）。未遇到并发症。
3.3 Fr的Mongoose导管与4 Fr猪尾导管的血管造影效果相似，能够在小儿中安全有效地进行经导管PDA封堵。
