de Moor M, Al Fadley F, Galal O
Department of Cardiovascular Diseases (MBC-16), King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Int J Cardiol. 1996 Sep;56(1):5-9. doi: 10.1016/s0167-5273(96)02744-1.
Residual leak after transcatheter occlusion of the patent arterial duct (PDA) using the Rashkind double umbrella technique is a well documented problem. At our institution, there is a 15% incidence of persistent residual leak after 12 months. Since September 1994, 15 patients have undergone successful occlusion of the residual leak using single or multiple Gianturco coils. The median age of the patients was 48 months (range: 12-354 months). The median fluoroscopy time was 11 min (range: 4-14). There were no complications and no embolization of the coils. Eleven patients had total occlusion demonstrated on angiography 5-10 min after coil occlusion. A further three patients were demonstrated on colour Doppler echocardiography to have no residual leak before discharge the same day-despite a small leak on angiography. Only one of 15 patients had a small residual leak at the time of hospital discharge and this was finally occluded 1 year later with another coil. Coil occlusion of a residual leak on the umbrella device is effective and a safe and reliable procedure which appears to be an improvement on using a second umbrella device.
采用拉什金德双伞技术经导管封堵动脉导管未闭（PDA）后出现残余分流是一个有充分文献记载的问题。在我们机构，12个月后持续性残余分流的发生率为15%。自1994年9月以来，15例患者使用单枚或多枚 Gianturco 弹簧圈成功封堵了残余分流。患者的中位年龄为48个月（范围：12 - 354个月）。中位透视时间为11分钟（范围：4 - 14分钟）。未发生并发症，弹簧圈也未发生栓塞。11例患者在弹簧圈封堵后5 - 10分钟的血管造影显示完全封堵。另外3例患者在同日出院前经彩色多普勒超声心动图检查显示无残余分流，尽管血管造影时有小的分流。15例患者中只有1例在出院时有小的残余分流，最终在1年后用另一枚弹簧圈封堵。用弹簧圈封堵伞装置上的残余分流是一种有效且安全可靠的方法，似乎比使用第二个伞装置有所改进。
