Related Experiment Video
Updated: Aug 5, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Transcatheter occlusion of patent ductus arteriosus: which method to use and which ductus to close
Insights
Coil occlusion is best for small patent ductus arteriosus (PDA) (< or = 3.5 mm), while buttoned devices suit larger PDAs (> 3.5 mm). Further trials are needed to confirm these transcatheter closure recommendations.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Numerous devices exist for transcatheter occlusion of patent ductus arteriosus (PDA).
- Many current devices are limited by bulkiness, procedural complexity, and residual complications, hindering routine clinical adoption.
- Evidence-based recommendations for device selection are lacking due to limited clinical trials.
Discussion:
- Coil occlusion appears suitable for small PDAs (<= 3.5 mm).
- Adjustable buttoned devices may be optimal for larger PDAs (> 3.5 mm).
- These recommendations are based on published literature and expert experience, not randomized trials.
Key Insights:
- Device selection for PDA transcatheter closure should be tailored to duct size.
- Small PDAs (< or = 3.5 mm) may be best treated with coil occlusion.
- Large PDAs (> 3.5 mm) might be more effectively managed with adjustable buttoned devices.
Outlook:
- Larger patient populations and long-term follow-up studies are essential to validate these findings.
- Standardized indications for transcatheter closure should align with surgical closure criteria.
- Continuous murmur with echo Doppler confirmation is a key indication; silent PDAs do not require closure.
Abstract:
Many devices have been developed for transcatheter occlusion of PDA. Bulkiness of the device, complexity of the procedure, and significant residual complications make the majority of the devices unsuitable for routine clinical use. Although no randomized comparative clinical trials exist, on the basis of published literature and my personal experience, coil occlusion may be best suited to close small ducts (< or = 3.5 mm) and the adjustable buttoned device may be most appropriate for large PDAs (> 3.5 mm). Clinical trials on larger patient populations than are currently available and long-term follow-up are necessary to further support these recommendations. Indications for transcatheter closure should be exactly as those used for surgical closure: PDA with audible continuous murmur with echo Doppler confirmation. The so-called silent ducts need not be closed.
