Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
Pediatric Cardiology and Cardiac Surgery 38(3): 158-165 (2022)


動脈管に対するコイル塞栓術のTIPsTips for the Coil Occlusion of Patent Ductus Arteriosus

たかの橋中央病院小児循環器内科Department of Pediatric Cardiology, Takanobashi Central Hospital ◇ Hiroshima, Japan


元広島市民病院循環器小児科Former Department of Pediatric Cardiology, Hiroshima City Hiroshima Citizen’s Hospital, Hiroshima Japan

発行日:2022年8月1日Published: August 1, 2022

わが国においても2009年以降,Amplatzer™ duct occluder I[Abbott社;Chicago, IL]を始めとする各種デバイスが保険収載となり,コイルを用いた動脈管(patent ductus arteriosus: PDA)閉鎖術の件数は減少した.さらに最近ではFlipper PDA coil(F-coil)[Cook社;Turlock, CA]も製造中止となり,PDA閉鎖栓としてのコイルの役割はますます減少していかざるを得ないだろう.しかし,長い間F-coilを使用して培った経験や知識,すなわちPDAの形態や特性,診断・読影上の注意,コイル塞栓術の適応や手技の留意点,合併症などは,他のデバイスを使用してのPDA閉鎖術,様々な血管系のコイル塞栓術にも有用な情報を提供してくれるだろう.またF-coilの供給が途絶えた後にも,他のコイルを使用して小さな動脈管を閉鎖することも考えられる.そのような時代の中で,今後のカテーテル治療にも役立つと思われる知識・情報について,広島市民病院・循環器小児科時代に得た経験をもとにまとめてみたい.

In Japan, Amplatzer™ duct occluder I (ADO I), Amplatzer™ duct occluder II (ADO II), and Amplatzer Piccolo occluder™ (Piccolo) were included in insurance in 2009, 2019, and 2020 respectively. Since then, the occlusion of patent ductus arteriosus (PDA) using coils has become less common. However, knowledge and information about the anatomy and pathophysiology of PDA are very important for catheter interventions for PDA using other devices. Moreover, experiences of PDA coil occlusion have provided information related to catheter interventions using coils for other vessels. We describe our knowledge and experience and provide tips to improve PDA coil occlusion, focusing on 1) indications for PDA coil occlusion in the device era, 2) anatomy and pathophysiology of PDA, 3) performances of coils when deployed in the PDA, 4) complications of PDA coil occlusion, and 5) procedures useful for the closure of moderate or severe PDA.

Key words: patent ductus arteriosus (PDA); cross-section of the PDA; tips for PDA coil occlusion; complications

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This page was last modified on 2022-11-08T18:12:54.000+09:00