Angiographic classification of the isolated, persistently patent ductus arteriosus and implications for percutaneous catheter occlusion

Abstract

A percutaneous catheter technique for permanent closure of the isolated, persistently patent ductus arteriosus (PDA) was first described in 1967.¹ The development of a spring-loaded double foam disc occluder on a miniaturized (8 or 11Fr) delivery system² placed transvenously^3,4 has allowed this management approach to become an effective alternative to surgery in infants and children. The recent description of an improved release technique and the application of topical thrombin onto the foam of the occluder may further reduce embolization risk and increase total occlusion rates.⁵ Little attention, however, has been given to the variation in anatomy and topology of the isolated PDA and its influence, if any, on the technique of catheter occlusion. This report describes the angiographic appearances of isolated PDA as seen at the time of catheter occlusion, presents a classification of the observed variations and comments on how these may affect the procedure.