Percutaneous Closure of Patent Ductus Arteriosus.

Percutaneous Closure of Patent Ductus Arteriosus.
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DOI:
10.1016/j.clp.2021.11.009
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发表时间:
2022-03
影响因子:
2.1
通讯作者:
Backes CH
Backes CH
中科院分区:
医学4区
文献类型:
--
作者:
Barcroft M;McKee C;Berman DP;Taylor RA;Rivera BK;Smith CV;Slaughter JL;El-Khuffash A;Backes CH

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经皮PDA封堵术在≤1.5 kg的婴儿中技术上可行。然而,不良事件(如麻醉相关并发症)的类型和性质的显著异质性使当前的安全性特征评估模糊不清。虽然关于器械闭合后综合征(PDCS)风险的数据仍然很有希望,但缺乏手术导管结扎的比较试验以及已发表研究的监督不一致,使得目前对安全性和有效性估计的信心模糊不清。为了将风险降至最低并获得最大获益,PDA治疗的临床研究应考虑纳入更可靠的评估(例如,PDA评分),以确保纳入最有可能发生导管不良后果的婴儿。
Percutaneous-based PDA closure is technically feasible among infants ≤1.5 kg. However, marked heterogeneity in the type and nature of adverse events, such as anesthesia-related complications, obscure current safety profile assessments. While data on the risks of post-device closure syndrome (PDCS) remain promising, a lack of comparative trials of surgical ductal ligation and inconsistent surveillance across published studies obscure confidence in present estimates of safety and efficacy. To minimize risk and yield the greatest benefits, clinical studies of PDA treatment should consider incorporating more robust assessments (e.g., PDA scores) to ensure that infants at greatest risk for adverse ductal consequences are included.
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