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Ductal anatomy is often complex with extreme tortuosity and risk of pulmonary artery isolation, thus increasing procedural risks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>CT angiograms were segmented to produce 3D PDA models. Ductal morphology was characterized with attention to access approach, degree of pulmonary artery offset\/risk of isolation and ductal tortuosity. 3D models were retrospectively compared with biplane angiography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>3D modeling was performed in 12 patients with adequate image quality for complete analysis in 11; median (interquartile range) age\/weight 17\u2009days (8\u201320\u2009days) and 3.1 kg (2.4\u20133.9 kg). The PDA was reverse oriented in nine with average length of 17.2\u2009\u00b1\u20092.5\u2009mm and high tortuosity (mean tortuosity index 52, range 3\u2013108). From 3D modeling, two patients were excluded from ductal stenting\u2014extreme ductal tortuosity and threatened pulmonary artery discontinuity, respectively. Ductal stenting was successful in the remaining nine with no major procedural complications. 3D modeling predicted a successful access approach based on the aortic orientation of the ductus in all patients (five carotid, two axillary, two femoral). When comparing 2D angiography with 3D models, angiography consistently underestimated ductal length (\u22123.2\u2009mm\u2009\u00b1\u20091.6\u2009mm) and tortuosity (\u221214.8\u2009\u00b1\u20097.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>3D modeling prior to ductal stent placement for ductal dependent pulmonary blood flow is useful in procedural planning, specifically for eligibility, access approach, and accurate ductal measurements. Further studies are needed to determine if 3D planning improves procedural outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28669","type":"journal-article","created":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T07:08:08Z","timestamp":1576739288000},"page":"1141-1148","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Preprocedural three\u2010dimensional planning aids in transcatheter ductal stent placement: A single\u2010center experience"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3733-2856","authenticated-orcid":false,"given":"Reid C.","family":"Chamberlain","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology Duke University Medical Center  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan E.","family":"Ezekian","sequence":"additional","affiliation":[{"name":"Department 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