Percutaneous angiography of Patent Ductus Arteriosus in dogs: techniques, results and implications for intravascular occlusion

Abstract

Objectives To evaluate the percutaneous angiography and the morphology of patent ductus arteriosus (PDA) in dogs. Background In contrast to surgical ligation the knowledge of angiographic morphology is necessary for intravascular PDA occlusion. Methods Forty-nine dogs with a left to right shunting PDA were included in a three-year, prospective study. In 43 dogs with a body weight ≥ 3.0 kg a percutaneous approach to brachial artery was tested. In six miniature dogs (< 3.0 kg) placement of angiographic catheter from femoral vein antegrade through the PDA was studied. Angiographic morphology and dimensions of PDA were analyzed. Results Percutaneous approach to brachial artery was performed successfully in 41/43 (95%) dogs, in the remaining 2 dogs this approach was not possible and the femoral artery had to be used. Two dogs did not survive the procedure. Arterial bleeding was not a problem in any of the 39 cases in which percutaneous brachial artery catheterization was performed. Two dogs developed transient radial nerve paralysis that resolved 4 to 6 days later. The transvenous technique was successful in all 6 small dogs. In 39 dogs there was an elongated conical duct (type E). A conical duct (type A) was found in nine dogs and one dog had a PDA with two constrictions (type D). The mean PDA minimal diameter was 3.78 ± 1.55 mm (range 1.5 to 6.9), in 20/49 dogs (41%) the minimal PDA diameter measured more than 4.0 mm. Conclusions Percutaneous catheterization of the brachial artery using a vascular introducer is feasible and entails minimal risk of hemorrhage. Angiographic evaluation of the ductus arteriosus is easily performed with this technique, but coilimplantation is not possible by this approach. The frequency of PDA-types is different in dogs and humans and the PDA minimal diameter is larger in dogs.