Duct-Occlud封堵器和Cook可控弹簧栓子治疗动脉导管未闭的对比研究Transcatheter closure of patent ductus arteriosus: comparison between the Duct-Occlud device and the Cook detachable coil
张庆桥,蒋世良,黄连军,赵世华,徐仲英,凌坚,郑宏,谢若兰,戴汝平
摘要(Abstract)：
目的 对比研究Duct Occlud封堵器和Cook可控弹簧栓子治疗直径≤ 4mm动脉导管未闭 (PDA)的疗效。方法 1996年 4月至 2 0 0 2年 8月 ,4 2例直径 <2mm和 2 9例直径 2～ 4mm的PDA患者施行了Duct Occlud封堵器 (2 5例 )和Cook可控弹簧栓子 (4 6例 )封堵术。结果 (1)直径 <2mm的PDA行Duct Occlud封堵器和Cook可控弹簧栓子封堵后 10min、2 4h和 12个月残余分流率显著小于直径 2～ 4mm的PDA(分别为 4 8%与 6 2 0 % ,0与 37 9% ,0与 13 8% ;P均 <0 0 5 )。 (2 )Duct Oc clud封堵器治疗直径 2～ 4mm的PDA后 10min ,2 4h ,1和 12个月残余分流率显著高于Cook可控弹簧栓子组 (分别为 94 4 %与 9 1% ,6 1 1%与 0 ,4 4 4 %与 0 ,33 3%与 0 ;P均 <0 0 5 ) ,其中Duct Occlud封堵器脱落至腹主动脉远端 1例 ,向左肺动脉内凸出 4例 ;2例直径 2～ 4mm的PDA患者置入 2枚Cook可控弹簧栓子。结论 Duct Occlud封堵器和Cook可控弹簧栓子均是治疗直径 <2mmPDA的安全有效方法 ;Cook可控弹簧栓子封堵直径 2～ 4mm的PDA近、中期疗效优于Duct Occlud封堵器 ,但部分患者需置入 2枚栓子。
关键词(KeyWords)： 动脉导管未闭;Duct-Occlud封堵器;弹簧栓子
基金项目(Foundation):
作者(Author): 张庆桥,蒋世良,黄连军,赵世华,徐仲英,凌坚,郑宏,谢若兰,戴汝平
参考文献(References)：
- 1CambierPA ,KirbyWC ,WorthamDC ,etal.Percutaneousclosureofthesmall(<2.5mm)patentductusarteriosususingcoilembolization.AmJCardiol,1992,69:815816.
- 2LioydTR ,BeekmanRH ,MooreJW ,etal.ThePDAcoilRegistry:reportofthefirst535procedures.Circulation,1995,92(supplⅠ):Ⅰ380.
- 3GalalMO ,BulbulZ ,KakadekarA ,etal.ComparisonbetweenthesafetyprofileandclinicalresultsoftheCookdetachableandGianturcocoilsfortranscatheterclosureofpatentductusarteriosusin272patients.JIntervenCardiol,2001,14:169178.
- 4蒋世良,曾筝,张戈军,等.应用可控弹簧栓子封堵动脉导管未闭.中国循环杂志,1999,14:275277.
- 5JaeggiET ,FasnachtM ,ArbenzU ,etal.Transcatheterocclusionofthepatentductusarteriosuswithasingledevicetechnique:comparisonbetweentheCookdetachablecoilandtheRashkindumbrelladevice.InternatJCardiol,2001,79:7176.
- 6MooreJW ,BoosfeldC .TheDuctOccluddeviceforclosureofpatentductusarteriosus.JIntervenCardiol,1999,12:6571.
- 7蒋世良,戴汝平,赵世华,等.应用Amplatzer封堵器治疗动脉导管未闭.中华放射学杂志,1999,33:745748.
- 8MageeAG ,HuggonIC ,SeedPT ,etal.Transcathetercoilocclusionofthearterialduct:resultsoftheEuropeanRegistry.EurHeartJ,2001,22:18171821.
- 9MooreJW ,DiMeglioD ,JavoisAP ,etal.ResultsofthephaseIFoodandDrugAdministrationclinicaltrialofDuctOccluddeviceocclusionofpatentductusarteriosus.CathetCardiovascIntervent,2001,52:7478.
- 10TometzkiA ,ChanK ,GiovanniDe,etal.TotalUKmulti centreexperiencewithanovelarterialocclusiondevice(DuctOccludpfm).Heart,1996,76:520524.