Comparative Analysis of Isolated Venous, Isolated Arterial, and Standard Access for Transcatheter Closure of Patent Ductus Arteriosus.

Transcatheter closure of patent ductus arteriosus (PDA) is the standard treatment with high success rates. In this study, we aimed to compare single venous access, single arterial access, and the standard approach for transcatheter PDA closure. We included patients with hemodynamically significant PDA referred for transcatheter closure from January-2020 to January-2025. Patients were divided into group I (both venous and arterial access were used), group II (exclusive venous access only), and group III (exclusive arterial access only). Access choice was based on body surface area (BSA), PDA shape, size, device selection, and vascular anomalies. Group I (152 patients), II (113 patients), and III (92 patients) had a mean age of 5.62, 2.82, and 19.61 years, respectively. Arterial access was used more in older patients with larger BSAs. A higher female predominance was observed in all groups (P = 0.038). We commonly used duct occluder I in group I, Nit-Occlude coil, duct occluder I, and II in group II, and KONAR multifunctional occluder (MFO), Nit-Occlud coil, and duct occluder II in group III. We preferred duct occluder I in type A ducts, duct occluder II, and Nit-Occlud coil in type C, D, and E ducts, muscular VSD occluder in type B ducts, while MFO was used in different shaped ducts. Group I had the highest venous access hematomas and femoral artery spasms. Group II had the shortest fluoroscopy time (6.5 min). Choosing the appropriate access for PDA closure requires careful patient selection, detailed pre-intervention echocardiography, and thoughtful procedural planning.