PDA Stenting with Versus Without Pre-Procedural 3D Reconstruction: Impact on Radiation Exposure and Procedural Outcomes

Marjan Hesari; Mitsuhiro Jo; Kamel Shibbani; Danica Peterson; Justin R Ryan; Howaida El-Said

doi:10.1007/s00246-026-04436-4

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PDA Stenting with Versus Without Pre-Procedural 3D Reconstruction: Impact on Radiation Exposure and Procedural Outcomes

Journal article

Open access

Peer reviewed

PDA Stenting with Versus Without Pre-Procedural 3D Reconstruction: Impact on Radiation Exposure and Procedural Outcomes

Marjan Hesari, Mitsuhiro Jo, Kamel Shibbani, Danica Peterson, Justin R Ryan and Howaida El-Said

Pediatric cardiology

08/24/2026

DOI: 10.1007/s00246-026-04436-4

PMID: 42635738

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Abstract

Managing patients with patent ductus arteriosus (PDA) and complex anatomical features, such as tortuosity and branching anomalies, remains a challenge in interventional cardiology. Recent advances in three-dimensional (3D) reconstruction and morphologic analysis of ductal anatomy have shown promise in improving procedural outcomes. This study evaluates the utility of 3D reconstruction in pre-procedural planning for PDA stenting. This retrospective, single-center study included patients who underwent PDA stenting from June 2018 to March 2025. Pre-procedural CT and 3D reconstructions were performed for a subset of patients, allowing for detailed analysis of ductal tortuosity. Procedural outcomes, including radiation exposure/dose, procedure time, and the need for reintervention were compared between the 3D- and non-3D-guided groups. A total of 46 patients were included in the analysis, with 27 having preprocedural 3D-guided planning. The 3D group demonstrated significantly lower mean effective radiation dose (77 vs. 114 mSv, p = 0.0331). Case length and fluoroscopy time were shorter but not statistically significant. The need for catheter-based reintervention tended to be lower in the 3D group (10% vs. 18%, p = 0.06), but the difference did not reach statistical significance. Stratification by tortuosity type regardless of 3D implementation did not have statistically significant correlation to patient outcomes. Preprocedural 3D reconstruction is a valuable tool in planning PDA interventions with a high success rate and significantly lower radiation exposure. These findings support the incorporation of 3D modeling into routine clinical practice for complex PDA cases, potentially improving procedural efficiency and patient outcomes.

Radiation exposure

3D reconstruction

Patent ductus arteriosus

PDA

PDA stenting

Details

Title: Subtitle: PDA Stenting with Versus Without Pre-Procedural 3D Reconstruction: Impact on Radiation Exposure and Procedural Outcomes
Creators: Marjan Hesari - University of California San Diego
Mitsuhiro Jo - University of California San Diego
Kamel Shibbani - University of California San Diego
Danica Peterson - University of California San Diego
Justin R Ryan - UC San Diego Health System
Howaida El-Said - University of California San Diego
Resource Type: Journal article
Publication Details: Pediatric cardiology
DOI: 10.1007/s00246-026-04436-4
PMID: 42635738
NLM abbreviation: Pediatr Cardiol
ISSN: 0172-0643
eISSN: 1432-1971
Publisher: Springer Nature
Language: English
Electronic publication date: 08/24/2026
Academic Unit: Cardiology; Stead Family Department of Pediatrics
Record Identifier: 9985220940802771

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