title: Single catheter approach for occlusion of a patent arterial duct with a Rashkind double umbrella.
abstract: OBJECTIVE
  To determine the benefits of using a single venous catheter and a single angiogram during catheter occlusion of a patient arterial duct with the Rashkind double umbrella compared with those of venous and arterial catheters and multiple angiograms.
  
  
  METHODS
  Retrospective review of case notes.
  
  
  METHODS
  103 consecutive patients. The long sheath could not be advanced adequately in two patients. 101 patients had 104 implantations. Median (range) age was 35 (7-549) months and median (range) weight 13 (7-62) kg. Fifty four implantations were performed using the venous and arterial method and 50 using the venous only method.
  
  
  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 significantly 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).
  
  
  CONCLUSIONS
  Considerable improvements can be made in the technique of catheter closure of patent arterial ducts using the Rashkind double umbrella without compromising outcome using venous cannulation alone and a single angiogram, rather than venous and arterial cannulation and multiple angiograms. reduced risk to arteries from cannulation, The benefits are reduced radiation exposure, reduced risk to arteries from cannulation, shorter procedures, and lower equipment costs.
authors.affiliation: Heart Clinic, Royal Liverpool Children's Hospital, Alder Hey, Liverpool.
authors.forename: S E
authors.initials: SE
authors.lastname: Abrams
authors.forename: K P
authors.initials: KP
authors.lastname: Walsh
authors.forename: E A
authors.initials: EA
authors.lastname: McDonald
authors.forename: A E
authors.initials: AE
authors.lastname: Boothroyd
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D002932:Cineangiography; D003287:Contrast Media; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005268:Femoral Vein; D005471:Fluoroscopy; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery; D011829:Radiation Dosage; D013997:Time Factors
chemical_list: D003287:Contrast Media