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J Vet Intern Med. 2012 Jan-Feb;26(1):85-92. doi: 10.1111/j.1939-1676.2011.00859.x. Epub 2011 Dec 23.

Occlusion devices and approaches in canine patent ductus arteriosus: comparison of outcomes.

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1
William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, CA, USA.

Abstract

BACKGROUND:

A comparison of transvascular occlusion methods for closing patent ductus arteriosus (PDA) in dogs has not been done.

OBJECTIVES:

To determine if clinically important differences exist between the approaches and devices currently used.

ANIMALS:

A total of 112 client-owned dogs with left-to-right shunting PDA.

METHODS:

Retrospective study. Records from dogs that underwent attempted transvascular PDA occlusion from January 2006 to December 2009 were examined. Dogs were placed into 4 groups: Group 1: Amplatz Canine Duct Occluder (ACDO) (transarterial) - 36 dogs; Group 2: Gianturco or MReye Flipper Detachable Embolization (Flipper) coil (transarterial) - 38 dogs; Group 3: Amplatzer Vascular Plug (AVP) (transarterial) - 23 dogs; Group 4: Flipper coil (transvenous) - 15 dogs.

RESULTS:

The overall success rate of the procedures was high (92%) with comparable success rates among groups (87-97%). There were significantly fewer complications (P < .0001) in dogs receiving an ACDO than in the remaining groups (3% for ACDO versus 26-33% for the other groups). Fluoroscopy time for the transvenous method was significantly longer (median, 13 minutes) than for the other groups (median, 6 minutes) (P < .0001). Severity of residual flow 24 hours postprocedure was significantly less in the ACDO group than in the remaining groups (P = .0001-.05).

CONCLUSIONS:

The ACDO appears superior in ease of use, complication rate, and completeness of occlusion. The remaining limiting factor with this device is patient size. Until a smaller ACDO device is marketed, coils remain the only choice for interventional closure in very small dogs.

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