Catheter Closure Through a Venous Approach of Patent Ductus Arteriosus in Small Pediatric Patients Using Combined Angiographic and Echocardiographic Guidance

Thanopoulos, Basil Vasilios D; Ninios, Vlassis; Dardas, Petros S.; Giannopoulos, Andreas A.; Deleanou, Dan; Iancovici, S

doi:10.1016/j.amjcard.2016.08.023

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…Our findings align with previous literature, demonstrating a notable reduction in vascular complications compared to conventional techniques. [9][10][11] Notably, we did not observe any instances of bleeding or loss of femoral pulse in our study cohort. By eschewing arterial access, we achieved shorter procedure and fluoroscopy times, consequently reducing the need for excessive contrast dye, which is particularly advantageous in pediatric patients.…”

Section: Discussionmentioning

confidence: 46%

Venous-Only Transcatheter Closure: A Safe and Effective Strategy for Patent Ductus Arteriosus

Kanwal,

Sheikh,

Akbar

et al. 2024

Pak Heart J

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Objectives: This study aimed to assess the feasibility and effectiveness of transcatheter device closure of patent ductus arteriosus (PDA) exclusively through an isolated venous route. Methodology: A retrospective descriptive study was conducted at the Rawalpindi Institute of Cardiology. Patient data from 2019 to 2023 undergoing PDA closure using transcatheter devices were analyzed. PDA diagnosis was established via echocardiography, and the procedure was performed solely through a venous line under fluoroscopy, omitting the traditional method of using both arterial and venous lines. Results: A total of 212 patients underwent transcatheter PDA closure through a venous-only route, with ages ranging from 6 months to 14 years. The mean weight was 10.07 kg (range: 5 kg to 27 kg, SD 4.43). The average procedure time was 30 ± 10.3 minutes (range: 15.0 to 65 minutes), and fluoroscopy time was 5.4 ± 3.18 minutes (range: 2.1 to 19 minutes). Immediate closure was achieved in all patients, with no residual leaks or device embolization observed. Additionally, there were no reported complications such as arrhythmia, vascular access issues, or significant blood loss. No cases of aortic or pulmonary stenosis were identified, and no deaths occurred. All patients were discharged within 48 hours post-procedure. Conclusion: Transcatheter closure of PDA exclusively through the venous route, without the use of an arterial line, demonstrates itself as an effective and safe method for PDA closure.

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Section: Discussionmentioning

confidence: 46%

Venous-Only Transcatheter Closure: A Safe and Effective Strategy for Patent Ductus Arteriosus

Kanwal,

Sheikh,

Akbar

et al. 2024

Pak Heart J

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“…In a randomized controlled trial by Thanopoulas et al [18], in young children 2-24 months of age, 112 children were randomized for either venous only or standard access approach. Arterial complications were observed in 16% of the cases undergoing device closure via standard technique.…”

Section: Discussionmentioning

confidence: 99%

Comparison of isolated venous approach with the standard approach in children undergoing patent ductus arteriosus device closure

et al. 2020

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Background Transcatheter device closure is a safe procedure recommended in children with patent ductus arteriosus (PDA). While the standard procedure uses arterial and venous femoral access, it poses risk of vascular complications especially in young infants. Isolated venous approach has been tried in a few studies and was found to be non-inferior to the standard technique. In this prospective observational study, we have compared the two vascular approaches of PDA device closure in pediatric patients and have also studied the feasibility of this approach in young children with weight < 6 kg. Results PDA device occlusion was performed with either one of the approaches—venous alone (group I) or standard approach (group II) in a total of 135 children enrolled prospectively. The baseline data, procedural outcomes, vascular complications, and radiation dose were compared between the two groups. Fifty-two and 83 children were included in group I and group II, respectively. A total of 22 children (16%) (13 in group I; 9 in group II) had weight < 6 kg. In group II, 6 children (7.2%) had vascular site complications treated with heparin infusion with two children requiring thrombolysis. Another child in group II developed intravascular hemolysis following residual shunt, requiring surgical device retrieval and closure. No significant differences were observed in mean fluoroscopic time (p = 0.472) and air kerma between the two groups (p = 0.989). Conclusion Transcatheter PDA device closure without arterial access is a feasible and safe option in children including young infants. This technique avoids the risk of vascular complications although requires careful case selection.

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“…Many recent studies have confirmed the feasibility of PDA occlusion via femoral access. Thanopoulos et al ( 17 ) reported 110 cases of stand-alone echocardiography-guided percutaneous PDA occlusion via femoral access and concluded that the procedure was safe and feasible. Baykan et al ( 18 ) and Garg et al ( 19 ) reported successful stand-alone percutaneous PDA occlusion via femoral access and noted the wide range of indications for this procedure.…”

Section: Discussionmentioning

confidence: 99%

Clinical study of stand-alone transthoracic echocardiography-guided percutaneous occlusion of patent ductus arteriosus

Cao

Chen²,

Zhang³

et al. 2018

Anatol J Cardiol

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Objective:We aimed to investigate the feasibility and safety of stand-alone transthoracic echocardiography-guided percutaneous occlusion of patent ductus arteriosus (PDA) without the use of X-ray equipment.Methods:From January to December 2015, we performed stand-alone transthoracic echocardiography-guided percutaneous PDA occlusion using an occluder delivered via a delivery sheath introduced via femoral vein access without the use of X-ray equipment in 12 PDA patients.Results:PDA occlusion was successfully performed in all 12 patients. The procedure duration ranged from 30 to 110 min (50.4±22.8 min), and the size of the implanted occluder ranged from 12 to 20 mm (15.2±2.8 mm). No occluder migration, residual shunt, or thrombotic complications were observed in the perioperative period. There was no clinical death, hemolysis, infection, or embolism during patients’ hospitalization and the follow-up period.Conclusion:Stand-alone transthoracic echocardiography-guided percutaneous PDA occlusion without the use of X-ray equipment is a safe and effective procedure.

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Catheter Closure Through a Venous Approach of Patent Ductus Arteriosus in Small Pediatric Patients Using Combined Angiographic and Echocardiographic Guidance

Cited by 6 publications

References 12 publications

Venous-Only Transcatheter Closure: A Safe and Effective Strategy for Patent Ductus Arteriosus

Venous-Only Transcatheter Closure: A Safe and Effective Strategy for Patent Ductus Arteriosus

Comparison of isolated venous approach with the standard approach in children undergoing patent ductus arteriosus device closure

Clinical study of stand-alone transthoracic echocardiography-guided percutaneous occlusion of patent ductus arteriosus

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