Transarterial Coil Embolization in Two Maltese Dogs with Patent Ductus Arteriosus Using a Mini Cobra-tip Angiocatheter

말티스 견에서 시술된 미니코브라 카테터와 코일을 이용한 동맥관 개존증의 치료 2 증례

  • Han, Dong-Hyun (Section of Small Animal Internal Medicine, Institute of Veterinary Medicine, School of Veterinary Medicine, Kangwon National University) ;
  • An, Hyo-Jin (Section of Small Animal Internal Medicine, Institute of Veterinary Medicine, School of Veterinary Medicine, Kangwon National University) ;
  • Hyun, Chang-Baig (Section of Small Animal Internal Medicine, Institute of Veterinary Medicine, School of Veterinary Medicine, Kangwon National University)
  • 한동현 (강원대학교 수의(학부)대학 소동물 내과교실) ;
  • 안효진 (강원대학교 수의(학부)대학 소동물 내과교실) ;
  • 현창백 (강원대학교 수의(학부)대학 소동물 내과교실)
  • Accepted : 2010.12.02
  • Published : 2010.12.31

Abstract

Patent ductus arteiosus (PDA) is the persistent opening of ductus arterious located between pulmonary artery and descending aorta after birth. Although PDA can be occluded by surgical ligation, interventional closure of PDA using various devices is being rapidly replaced to surgical ligation, because of its non-invasive nature of treatment and minimal post-care after treatment. Main problem encountering in interventional treatment in toy breed dogs is vascular inaccessibility due to small size of artery. Although transvenous approach using jugular veins has been developed, this technique requires experienced skill to locate occlude devices into PDA and has high risk of accidental dislodgement of occluding devices (i.e. embolization coils or vascular plugs). Therefore, in this study, we developed a modified technique for coil embolization using mini-angiocatheter with trans-femoral approach in toy breed dogs (< 3.0 kg of body weight). With this modified method, we were successfully treated two toy breed (Maltese) dogs with the left to right shunted PDA.

동맥관개존증은 출생 후에도 폐동맥과 하행대동맥 사이에 동맥관이 지속적으로 열려 있는 선천성 심장질환이다. 동맥관개존증은 외과적인 결찰술로 폐쇄할 수 있지만, 다양한 도구를 이용한 동맥관개존증의 중재적 치료술은 비침습적인 치료과정과 시술 후 관리의 최소화의 이유로 빠르게 대체되고 있다. 소형품종에서의 중재적인 치료술은 동맥의 크기가 작기 때문에 혈관으로의 접근성이 주요한 문제점이 된다. 비록 경정맥을 이용한 정맥 접근법이 개발되었으나 이 기술은 동맥관에 폐색장치를 장착시키기 위해서 숙달된 기술이 필요하며, 폐색 장치 (색전 코일이나 혈관폐색장치)가 예기치 않게 잘못 장착될 위험성을 가지고 있다. 따라서, 우리는 이번 연구에서 소형품종 (체중3 kg미만)에서 대퇴동맥 접근을 통한 미니 혈관카테타를 이용한 변형된 코일 색전법을 개발하였다. 이러한 변형된 방법을 통하여 우리는 좌우 단락된 동맥관개존증을 가진 두마리의 소형품종 (말티즈)을 성공적으로 치료하였다.

Keywords

References

  1. Buchanan JW. Prevalence of cardio-vascular disorders. In: Fox PR, Sisson DD, Moise NS (eds). Textbook of Canine and Feline Cardiology: Principles and Clinical Practice. 2nd ed. Philadelphia: Saunders, 1999: 457-470.
  2. Hyun C. Small Animal Cardiology. 1st ed. Seoul: Panmunbooks, 2005: 277-309.
  3. Heymann MA, Rudolph AM, Silverman NH. Closure of the ductus arteriosus in premature infants by inhibition of prostaglandin synthesis. N Engl J Med 1976; 295: 530-533. https://doi.org/10.1056/NEJM197609022951004
  4. Lee S-G, Moon H-S, Choi R, Hyun C. Transvenous occlusion of patent ductus arteriosus using an embolization coil in a Maltese dog. Korean J Vet Res 2007; 47: 461-467.
  5. Eyster GE, Eyster JT, Cords GB, Johnston J. Patent ductus arteriosus in the dog: characteristics of occurrence and results of surgery in one hundred consecutive cases. J Am Vet Med Assoc 1976; 168: 435-438.
  6. Oyama MA, Sisson DD, Thomas WP, Bonagura JD. Congenital heart disease. In: Ettinger SJ, Feldman EC (eds). Textbook of Veterinary Internal Medicine: Diseases of the Dog and Cat. 6th ed.St. Louis: Saunders, 2005: 978-987.
  7. Gordon SG, Miller MW. Transarterial Coil Embolization for Canine Patent Ductus Arteriosus Occlusion. Clin Tech Small Anim Pract 2005; 20: 196-202. https://doi.org/10.1053/j.ctsap.2005.05.008
  8. Eyster GE, Eyster JT, Cords GB, Johyston J: Patent ductus arteriosus in the dog: Characteristics of occurrence and results of surgery in one hundred consecutive cases. J Am Vet Med Assoc 1976; 168: 435-438.
  9. Van Israel N, Dukes-McEwan J, French AT: Long-term follow-up of dogs with patent ductus arteriosus. J Sm Anim Pract 2003; 44: 480-490. https://doi.org/10.1111/j.1748-5827.2003.tb00108.x
  10. Stanley BJ, Luis-Fuentes V, Darke PG: Comparison of the incidence of residual shunting between two surgical techniques used for ligation of patent ductus arteriosus in the dog. Vet Surg 2003; 32: 231-237. https://doi.org/10.1053/jvet.2003.50025
  11. Ran Choi, Changbaig Hyun. Transjugular occlusion of patent ductus arteriosus using an Amplatz canine ductal occluder in a Cocker spaniel dog. Korean J Vet Res 2009; 50: 49-53.
  12. Prieto LR, DeCamillo DM, Konrad DJ, Scalet-Longworth L, Latson LA. Comparison of cost and clinical outcome between transcatheter coil occlusion and surgical closure of isolated patent ductus arteriosus. Pediatrics 1998; 101: 1020-1024. https://doi.org/10.1542/peds.101.6.1020
  13. Birchard SJ, Bonagura JD, Fingland RB. Results of ligation of patent ductus arteriosus: 201 dogs (1696 to 1988). J Am Vet Med Assoc 1990; 196: 2011-2013.
  14. Nguyenba TP, Tobias AH. Minimally invasive per-catheter patent ductus arteriosus occlusion in dogs using a prototype duct occluder. J Vet Intern Med 2008; 22: 129-134. https://doi.org/10.1111/j.1939-1676.2007.0009.x
  15. Glaus TM, Berger F, Ammann FW, Klowski W, Ohlert S, Boller M, Kastner S, Reusch CE, Sisson D. Closure of large patent ductus arteriosus with a selfexpanding duct occluder in two dogs. J Small Anim Pract 2002; 43: 547-550. https://doi.org/10.1111/j.1748-5827.2002.tb00029.x
  16. Sisson D. Use of a self-expanding occluding stent for nonsurgical closure of patent ductus arteriosus in dogs. J Am Vet Med Assoc 2003; 223: 999-1005. https://doi.org/10.2460/javma.2003.223.999
  17. Lee SG, Hyun C. Retrieval of an embolization coil accidentally dislodged in the descending aorta of a dog with a patent ductus arteriosus. J Vet Sci 2007; 8: 205-207. https://doi.org/10.4142/jvs.2007.8.2.205
  18. Erdmann E. Percutaneous transluminal extraction of an embolized central venous catheter. Dtsch Med Wochenschr 1987; 109: 1361-1363.
  19. Glaus TM, Martin M, Boller M, Stafford Johnson M, Kutter A, Fluckiger M, Tofeig M. Catheter closure of patent ductus arteriosus in dogs: variation in ductal size requires different techniques. J Vet Cardiol 2003; 5: 7-12.