Related Experiment Video
Updated: Mar 14, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Catheter Closure Through a Venous Approach of Patent Ductus Arteriosus in Small Pediatric Patients Using Combined
Basil Vasilios D Thanopoulos1, Vlassis Ninios2, Petros Dardas2
1Department of Pediatric Cardiology, "Agios" Lukas Clinic, Thessaloniki, Greece; Iatrikon Medical Center, Athens, Greece.
Insights
An exclusive venous approach for patent ductus arteriosus (PDA) closure in small children is safe and effective. This method prevents arterial complications associated with the standard catheter closure technique.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Standard catheter closure of patent ductus arteriosus (PDA) can lead to arterial complications in pediatric patients.
- A need exists for safer, effective PDA closure techniques in small children.
Purpose of the Study:
- To evaluate the safety and efficacy of an exclusive venous approach for catheter closure of PDA in small children.
- To compare the exclusive venous approach with the standard technique regarding complications.
Main Methods:
- A randomized controlled trial involving 112 pediatric patients (2-24 months) comparing standard PDA closure with an exclusive venous approach.
- Procedures were guided by echocardiography and contrast media injections in the venous group.
- Outcomes were assessed based on complication rates and echocardiographic closure at 1-month follow-up.
Main Results:
- The standard technique group experienced 5 cases of arterial pulse loss and 4 groin hematomas.
- The exclusive venous approach group reported no complications.
- Complete echocardiographic PDA closure was achieved in all 110 patients across both groups at 1-month follow-up.
Conclusions:
- Exclusive transvenous PDA occlusion is a safe and effective alternative for small children.
- This technique effectively prevents the arterial complications seen with the standard approach.
Abstract:
The standard technique of catheter closure of patent ductus arteriosus (PDA) may be associated with arterial complications particularly in small pediatric patients. The aim of this study was to evaluate whether catheter closure of PDA in small children using an exclusive venous approach is a safe and effective alternative to closure with the standard technique. One hundred-twelve patients, aged 2 to 24 months, were randomly assigned in a 1:1 ratio to catheter closure of PDA using the standard technique (group 1) and an exclusive venous approach (group 2), respectively. In group 2, the procedure was guided using hand injections of contrast media through the delivery sheath and 2-dimensional and color Doppler echocardiography. Group 1: the PDA diameter ranged from 2 to 5.5 mm and the device diameter ranged from 4 to 8 mm. The PDA occluders were permanently implanted in all patients. Five losses of the arterial pulses that were restored with intravenous infusion of heparin and recombinant tissue plasminogen activator (rtPA), and 4 groin hematomas were the main complications of the procedure. Group 2: the mean PDA diameter ranged from 2.5 to 6 mm and the device diameter ranged from 3 to 8 mm. The PDA occluders were permanently implanted in all but 2 patients. There were no complications. Complete echocardiographic closure of PDA at 1-month follow-up was observed in all 110 patients. Exclusive transvenous PDA occlusion is an effective and safe technique that prevents the arterial complications of the standard approach in small children.
