SINGLE CATHETER APPROACH FOR OCCLUSION OF A PATENT ARTERIAL DUCT WITHA RASHKIND DOUBLE UMBRELLA

Objectives-To determine the benefits of using a single venous catheter and a single angiogram during catheter occlusion of a patent arterial duct with the Rashkind double umbrella compared with those of venous and arterial catheters and multiple angiograms. Design-Retrospective r eview of case notes. Patients-103 consecutive patients. The long sheat h could not be advanced adequately in two patients. 101 patients had 1 04 implantations. Median (range) age was 35 (7-549) months and median (range) weight 13 (7-62) kg. Fifty four implantations were performed u sing the venous and arterial method and 50 using the venous only metho d. Results-Median procedure times (70 v 90 min), number of angiograms (one v four), and angiographic dye volume used (2 v 7 ml/kg) were sign ificantly reduced using the venous only method compared with those of the venous and arterial method. There was no significant difference in fluoroscopy time (venous only 9 v venous and arterial 10 min). Conclu sions-Considerable improvements can be made in the technique of cathet er closure of patent arterial ducts using the Rashkind double umbrella without compromising outcome using venous cannulation alone and a sin gle angiogram, rather than venous and arterial cannulation and multipl e angiograms. The benefits are reduced radiation exposure, reduced ris k to arteries from cannulation, shorter procedures, and lower equipmen t costs.