Amplatzer封堵器和Rashkind封堵伞治疗动脉导管未闭的对比研究

Transcatheter Closure of Patent Ductus Arteriosus: Comparison Between the Rashkind Occluder Device and the Amplatzer Duct Occluder

目的 :比较Amplatzer封堵器和Rashkind封堵伞治疗动脉导管未闭 (PDA)的疗效。方法 :42例PDA患者施行Rashkind封堵伞封堵术 (为Rashkind组 )。在施行Amplatzer封堵器封堵术的PDA患者中 ,选出年龄、体重匹配且PDA最小直径≤ 8mm的患者共 42例 (为Amplatzer组 )。对比两种方法治疗PDA的临床效果、并发症等情况。结果 :Amplatzer组 ,技术成功率 10 0 % ,溶血 1例。即刻残余分流发生率 16 7% ,术后 1～ 18个月 ,均无残余分流。Rashkind组 ,技术成功率 97 7% ,1例患者Rashkind封堵伞脱落至右肺动脉 ,经手术取出并行PDA结扎术。术后即刻和12个月残余分流发生率分别为 83 3%和 41 2 % ,均显著高于Amplatzer组 ,有非常显著性差异 (P <0 0 1)。结论 :Amplatzer封堵器比Rashkind封堵伞更安全。

Objective: To compare the efficacies of the Rashkind occluder device versus the Amplatzer duct occluder for patent ductus arteriosus (PDA) closure. Methods: Forty-two patients underwent transcatheter closure of the isolated PDA with Rashkind occluder device. Other 42 patients were selected from those who had undergone transcatheter closure of their PDAs (≤8 mm) using Amplatzer duct occluder. Both groups were matched for age and body weight. Effectiveness and complications were compared between the two groups. Results: In Amplatzer group, the technical success rate was 100%. Hemolysis occurred in one patient. The incidence of residual shunt was 16.7% ten minutes after closure. All patients had complete closure 1 to 18 months after the procedure. In Rashkind group, the technical success rate was 97.7%. One Rashkind device embolized into the right pulmonary artery and was removed at the time of surgical ligation. The incidences of residual shunt 10 minutes and 12 months after closure were 83.3% and 41.2%, respectively, significantly higher than those in Amplatzer group (p<0.01). Conclusion: PDA occlusion using Amplatzer duct occluder is more effective and safer than that using the Rashkind device.