Document Detail


Transcatheter closure of the arterial duct without arterial access.
MedLine Citation:
PMID:  20350335     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the safety and efficacy of transcatheter occlusion of the arterial duct without femoral arterial catheterization. BACKGROUND: Patent arterial ducts have been closed percutaneously since the 1960s. It remains standard practice to use arterial access for aortography before, during, and after implantation of the device. Femoral arterial catheterisation has well recognised complications, and should be avoided unless absolutely necessary. METHODS: We reviewed prospectively collected data relating to 389 occlusions of the arterial duct performed consecutively between 1994 and 2004. We inserted Cook detachable coils in 288 instances using the Amplatzer duct occluder in the remaining 101. Information was obtained regarding procedural success, displacement of the device, and re-intervention. We have followed out patients for a median of 1.15 years in those closed with the Amplatzer device, and 1.09 years in those closed with a coil. RESULTS: In the patients in whom we used coils, occlusion was possible in 75% using venous access alone. We reintervened in 25 patients, because of embolisation of the device in 6, haemolysis in 5, and residual shunting in 14. On follow-up, complete occlusion had been achieved in 98%. We found trivial stenosis of the left pulmonary artery in 3 patients. When using the Amplatzer device, closure using venous access alone was achieved in 82%, and 2 patients required reintervention because of embolisation of the device. Complete occlusion had been achieved in all patients as judged by follow-up at 1 year, and 2 patients had trivial stenosis of the left pulmonary artery.CONCLUSION: Arterial catheterisation is unnecessary in the great majority of patients undergoing occlusion of the arterial duct. Use of venous catheterisation alone is safe, and does not appear to increase the risk of device-related complications.
Authors:
Fiona E Willcoxson; Sangeetha Viswanathan; John D R Thomson; John L Gibbs
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology in the young     Volume:  20     ISSN:  1467-1107     ISO Abbreviation:  Cardiol Young     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-30     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  England    
Other Details:
Languages:  eng     Pagination:  39-43     Citation Subset:  IM    
Affiliation:
Department of Congenital Cardiology, Leeds General Infirmary, Leeds, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiography / methods
Balloon Occlusion / instrumentation*,  methods
Catheters, Indwelling
Child
Cohort Studies
Ductus Arteriosus, Patent / radiography,  therapy*,  ultrasonography
Echocardiography, Doppler
Female
Femoral Artery
Follow-Up Studies
Heart Catheterization
Humans
Male
Prosthesis Design
Retrospective Studies
Risk Assessment
Septal Occluder Device*
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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