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Nonoperative Treatment of PDA Using the Duct-OccludⓇ

Journal of the Korean Pediatric Society 1997;40(5):635-640.
Published online May 15, 1997.
Nonoperative Treatment of PDA Using the Duct-OccludⓇ
Dong Woon Shin, Kyung Hee Lee, Heon-Seok Han
Department of Pediatrics, Chungbuk National University, College of Medicine, Cheongju, Korea
Duct-Occlud®를 이용한 동맥관개 존증의 비수술적치료
신동운, 이경희, 한헌석
충북대학교 의과대학 소아과학교실
Abstract
Purpose
: Among the several transcatheter devices of PDA occlusion, Rashikind device was the most extensively experienced, but it had risk of occluder embolism and incomplete occlusion of PDA, approximately 27%. The authors used Duct-OccludⓇ, made of 0.028 inch stainless steel coil. The coil is double cone-shape in released state, and used in streched condition through 4F implantation catheter for ductus occlusion. We are to report the short-term result of PDA occlusion using Duct-OccludⓇ.
Methods
: Six patients with internal ductal diameter of less than 3.5mm were selected for ductus occlusion. The Duct-OccludⓇ was selected as follows : the diameter of aortic end was same as aortic ampulla, and the length was slightly shorter than that of ductus. The streched coil was introduced into descending aorta through implantation catheter, and the remaining coil was released in ductus and pulmonary artery subsequently. Postprocedure aortic angiogram was obtained and echocardiography was performed at 1day, 1 week, 1 month and 3 month after the procedure.
Results
: Except one hourglass type, all the other PDA were tunnel shaped. The range of internal diameter of ductus was 0.83-2.4mm, the length 5.36-P12.4mm, and Qp/Qs 1.04-1.67. Three cases required repositioniong of coils, while the others were successful in one procedure. The residual shunts were resolved at 1 day in most cases, but two cases in 1 month after the procedure. There were no complications, such as coil embolism, migration, or pulmonary stenosis.
Conclusion
: In small PDA with internal diameter of less than 3.5mm, transcatheter occlusion using Duct-OccludⓇ is easy, safe and accurate, except with high cost.
Key Words: Patent ductus arteriosus(PDA), Nonoperative treatment, Coil


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