Rothman A, Lucas V W, Sklansky M S, Cocalis M W, Kashani I A
Department of Pediatrics, University of California, San Diego 92103, USA.
J Pediatr. 1997 Mar;130(3):447-54. doi: 10.1016/s0022-3476(97)70209-9.
To determine the success rate and safety of percutaneous patient ductus arteriosus (PDA) coll occlusion.
Thirty consecutive pediatric patients with small to moderate-size PDAs (minimum diameter < or = 4 mm) underwent percutaneous coll occlusion. The results were assessed by angiography and echocardiography. The mean age was 5.1 +/- 4.2 years (range, 0.8 to 18.8 years); mean weight was 19.2 +/- 10.3 kg (range, 8.1 to 40.0 kg). The mean minimum diameter of the PDA was 1.8 +/- 0.8 mm (range, 1.0 to 4.0 mm).
PDA occlusion was achieved with one coil in 24 patients, 2 coils in 3 patients and 3 coils in 3 patients. The mean coil/PDA diameter ratio was 2.5 +/- 0.5. Immediately after coil occlusion, 29 PDAs had no flow by anglography; one had a small residual shunt. There were no significant complications. In the first 24 hours after coil implantation, echocardiography showed complete occlusion in 28 patients, a small left-to-right shunt in the same patient that had a residual shunt by anglography, and a trace shunt in one additional patient. In the two patients with residual flow by echocardiography, follow-up ultrasonography revealed no residual shunt 1 and 3 months later. At a mean follow-up of 11.8 +/- 9.3 months (range, 0 to 36.0 months), there was no PDA flow by color Doppler echocardiography in any of the 30 patients.
Coil occlusion is a safe and effective method of percutaneous closure of small to moderate-size PDAs. The largest PDA that can be closed with this technique remains to be determined.
确定经皮动脉导管未闭（PDA）封堵术的成功率及安全性。
连续30例患有小至中等大小PDA（最小直径≤4mm）的儿科患者接受经皮封堵术。通过血管造影和超声心动图评估结果。平均年龄为5.1±4.2岁（范围0.8至18.8岁）；平均体重为19.2±10.3kg（范围8.1至40.0kg）。PDA的平均最小直径为1.8±0.8mm（范围1.0至4.0mm）。
24例患者用1个弹簧圈实现PDA封堵，3例患者用2个弹簧圈，3例患者用3个弹簧圈。弹簧圈/PDA直径平均比值为2.5±0.5。弹簧圈封堵后立即进行血管造影，29例PDA无血流；1例有少量残余分流。无显著并发症。弹簧圈植入后的头24小时内，超声心动图显示28例患者完全封堵，血管造影有残余分流的同一患者有少量左向右分流，另有1例患者有微量分流。超声心动图显示有残余血流的2例患者，1个月和3个月后的随访超声检查未发现残余分流。平均随访11.8±9.3个月（范围0至36.0个月），30例患者中任何1例经彩色多普勒超声心动图检查均未发现PDA有血流。
弹簧圈封堵术是经皮闭合小至中等大小PDA的一种安全有效的方法。用该技术能够闭合的最大PDA仍有待确定。
