https://scholars.lib.ntu.edu.tw/handle/123456789/538458
標題: | Transcatheter closure of patent ductus arteriosus using gianturco coils in adolescents and adults | 作者: | JOU-KOU WANG Liau C.-S. Huang J.-J. Hsu K.-L. Lo P.-H. Hung J.-S. MEI-HWAN WU Lee Y.-T. |
公開日期: | 2002 | 卷: | 55 | 期: | 4 | 起(迄)頁: | 513-518 | 來源出版物: | Catheterization and Cardiovascular Interventions | 摘要: | We present the short- and intermediate-term results of transcatheter closure of patent ductus arteriosus with Gianturco coils in adolescents and adults. During a 5-year period, 55 patients (44 females, 11 males) with ages ranging from 14 to 72 years (median, 23) underwent attempted transcatheter closure of patent ductus with the Gianturco coils. The diameter of the narrowest segment of the ductus ranged from 0.8 to 7.6 mm (3.9 ± 1.3 mm). The 55 patients were divided into three groups. Group I consisted of nine patients with a ductal diameter ? 3 mm, group II consisted of 27 patients with a ductal diameter > 3 mm but ? 4 mm, and group III consisted of 19 patients with a ductal diameter > 4 mm. Four- to five-loop Gianturco coils were used, which were deployed via retrograde aortic route. Multiple-coil technique was generally applied in group II patients. Balloon occlusion technique in combination with multiple-coil technique was generally used in group III patients. Deployment of coil was successful in 51 patients (93%) but failed in 4. The success rate of coil deployment in group I, II, and III were 100% (9/9), 96% (26/27), and 84% (16/19), respectively. A mean of 1.9 ± 0.7 coils was deployed per patient. Of the four patients with unsuccessful coil deployment, three underwent surgery and one received implantation with Amplatzer duct occluder. Distal embolization of 21 coils occurred in 10 patients (3 in group II and 7 in group III), from whom 20 coils were retrieved with a gooseneck snare and 1 coil was removed during surgery. The mean diameter of ductus in the 10 patients with distal embolization was significantly larger than that in those without (5.2 ± 1.4 vs. 3.7 ± 1.1 mm; P < 0.01). Among the 51 patients with successful coil deployment, immediate complete closure was achieved in 20 (39%), while trivial to mild leak was present in 31 (61%). No significant complications were encountered. After a follow-up period ranging from 5 to 42 months, four patients had a small residual shunt and three underwent a second intervention with complete occlusion. None had left pulmonary artery stenosis documented with Doppler echocardiography. Transcatheter closure of ductus with the Gianturco coils is safe and feasible in the majority of adolescents and adults. Taking high embolization rate in patients with a ductus diameter > 4 mm into consideration, controlled-release coils, Buttoned device, or Amplatzer duct occluder can be a better choice. ? 2002 Wiley-Liss, Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0036193494&doi=10.1002%2fccd.10090&partnerID=40&md5=acb97ad09e898fbcbcecedec0812b65c https://scholars.lib.ntu.edu.tw/handle/123456789/538458 |
ISSN: | 1522-1946 | DOI: | 10.1002/ccd.10090 | SDG/關鍵字: | adolescent; adult; aged; aorta balloon; article; artificial embolism; controlled study; device; disease course; Doppler echography; female; follow up; human; implantation; major clinical study; male; patent ductus arteriosus; pulmonary artery stenosis; technique; treatment failure; treatment outcome; Adolescent; Adult; Age Factors; Aged; Aortography; Ductus Arteriosus, Patent; Echocardiography, Doppler; Feasibility Studies; Female; Heart Catheterization; Humans; Male; Middle Aged; Severity of Illness Index; Time Factors; Treatment Outcome |
顯示於: | 醫學系 |
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