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. 2019 Jun 26;1(6):e0018.
doi: 10.1097/CCE.0000000000000018. eCollection 2019 Jun.

Percutaneous Decannulation Instead of Surgical Removal for Weaning After Venoarterial Extracorporeal Membrane Oxygenation-A Crossed Perclose ProGlide Closure Device Technique Using a Hemostasis Valve Y Connector

Enzo Lüsebrink  1   2 , Christopher Stremmel  1   2 , Konstantin Stark  1   2 , Tobias Petzold  1   2 , Ralph Hein-Rothweiler  1   2 , Clemens Scherer  1   2 , Dominik Schüttler  1   2 , Steffen Massberg  1   2 , Martin Orban  1   2
Affiliations

Percutaneous Decannulation Instead of Surgical Removal for Weaning After Venoarterial Extracorporeal Membrane Oxygenation-A Crossed Perclose ProGlide Closure Device Technique Using a Hemostasis Valve Y Connector

Enzo Lüsebrink et al. Crit Care Explor. .

Abstract

Improvements in cannula removal techniques, and in particular a standardized decannulation technique with a suitable closure device, are needed to further improve patients' outcomes after percutaneous cannulation. The decannulation techniques described so far are neither sufficiently standardized nor proven enough to be used in the large group of venoarterial extracorporeal membrane oxygenation patients. To meet this challenge, we have established a highly standardized and safe decannulation technique based on the Perclose ProGlide closure system (Abbott Vascular, Lake Bluff, IL).

Design: Establishment of a highly standardized and safe decannulation technique based on the Perclose ProGlide closure system, which is described in detail with comprehensive instructions for the executive clinician and first application in the context of a pilot study.

Measurements and main results: So far our technique has already been used successfully in seven patients since January 2019 as a standard procedure on our ICU with only one minor complication occurred after the first procedure, that is, a small pseudoaneurysm likely originating from antegrade perfusion puncture site which was sealed by thrombin injection.

Conclusions: Our crossed ProGlide technique using a hemostasis valve Y connector ensuring no blood loss seems to be a very promising decannulation technique.

Keywords: ProGlide; decannulation; extracorporeal membrane oxygenation; vascular complications.

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Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Sterile preparation of the cannulation area with asterisk indicating hemostasis valve Y connector (A). Clamping of arterial and venous cannula shortly behind the selectively hardened proximal venous and arterial cannula body (B) and subsequent cutting by scissors (C). Insertion of hemostasis valve Y connector (Merit Angioplasty Pack, South Jordan, UT) (D) and wire insertion (arrow) into the proximal cannula (E). Insertion and releasing of the first ProGlide via guidewire (Abbott Vascular, Lake Bluff, IL) (F). Reinsertion of the guidewire into the side hole of the first ProGlide device (circle) to place a second ProGlide device (G). Tightening of knots by knot pusher (H). Preparation for removal of the venous cannula by insertion of a Z-suture (I).
See this image and copyright information in PMC

References

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