Abstract
Background: Stenting of the patent ductus arteriosus (PDA) has been accepted as alternative option to surgical shunting to enable additional pulmonary blood flow or for palliation of patients with a truly duct-dependent pulmonary circulation. The procedure can be challenging given the variable and often tortuous anatomy of the PDA and various technical approaches are reported. Objective: To report an alternative technique to treat tortuous ducts with microcatheter assistance and by transfemoral approach. Methods: We applied this technique of PDA stenting in 5 consecutive patients (4/5 age < 1 week, weight 2,7-3,2 kg;1/5 re-do PDA stenting at 6,5 month and 5,9 kg). A soft coronary guidewire was advanced by microcatheter assistance into the branch pulmonary arteries and thereafter replaced by an extrastiff guidewire to enable the placement of long coronary stents. Results: Successful PDA stenting with this stepwise approach and with femoral access only could be achieved in all patients (n = 5/5). A single stent was used in 2 patients (one with re-do stenting and previous stents). 3/5 patients had 2 stents implanted by telescopic technique. Stent sizes used were 4,5 x 15 mm (n = 2) and 4,5 x 18 mm (n = 6). No guide wire or stent dislodgement appeared through all procedures with microcatheter assistance. Conclusions: This technique enables PDA stenting via transfemoral approach in complex and tortuous ducts and thereby offers an attractive addition to the interventional management of truly duct-dependent pulmonary circulation. (C) 2019 Elsevier B.V. All rights reserved.
| Item Type: | Journal article |
|---|---|
| Faculties: | Medicine |
| Subjects: | 600 Technology > 610 Medicine and health |
| ISSN: | 0167-5273 |
| Language: | English |
| Item ID: | 79757 |
| Date Deposited: | 15. Dec 2021 14:49 |
| Last Modified: | 15. Dec 2021 14:49 |
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