Rao P S
Am Heart J. 1996 Oct;132(4):905-9. doi: 10.1016/s0002-8703(96)90334-8.
Many devices have been developed for transcatheter occlusion of PDA. Bulkiness of the device, complexity of the procedure, and significant residual complications make the majority of the devices unsuitable for routine clinical use. Although no randomized comparative clinical trials exist, on the basis of published literature and my personal experience, coil occlusion may be best suited to close small ducts (< or = 3.5 mm) and the adjustable buttoned device may be most appropriate for large PDAs (> 3.5 mm). Clinical trials on larger patient populations than are currently available and long-term follow-up are necessary to further support these recommendations. Indications for transcatheter closure should be exactly as those used for surgical closure: PDA with audible continuous murmur with echo Doppler confirmation. The so-called silent ducts need not be closed.
已经开发出许多用于经导管封堵动脉导管未闭（PDA）的装置。这些装置体积庞大、操作复杂且残留并发症严重，使得大多数装置不适合常规临床使用。尽管目前尚无随机对照临床试验，但根据已发表的文献和我的个人经验，弹簧圈封堵可能最适合封堵小导管（≤3.5毫米），而可调节纽扣式装置可能最适合封堵大的动脉导管未闭（>3.5毫米）。需要对比目前更大的患者群体进行临床试验和长期随访，以进一步支持这些建议。经导管封堵的适应证应与外科手术封堵完全相同：经超声心动图多普勒证实有可闻及的连续性杂音的动脉导管未闭。所谓的无声导管无需封堵。
