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. 2023 Jan 26:10:1106114.
doi: 10.3389/fcvm.2023.1106114. eCollection 2023.

Suture-based vs. pure plug-based vascular closure devices for VA-ECMO decannulation-A retrospective observational study

Clemens Scherer  1   2 , Hans Theiss  1   2 , Mario Istrefi  1 , Leonhard Binzenhöfer  1   2 , Danny Kupka  3 , Thomas Stocker  1   2 , Enzo Lüsebrink  1   2 , Era Stambollxhiu  1 , Ahmed Alemic  1 , Tobias Petzold  1   2 , Konstantin Stark  1   2 , Simon Deseive  1   2 , Daniel Braun  1   2 , Dominik Joskowiak  4 , Sven Peterss  4 , Jörg Hausleiter  1   2 , Christian Hagl  2   4 , Steffen Massberg  1   2 , Martin Orban  1   2
Affiliations

Suture-based vs. pure plug-based vascular closure devices for VA-ECMO decannulation-A retrospective observational study

Clemens Scherer et al. Front Cardiovasc Med. .

Abstract

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a valuable treatment option for patients in cardiogenic shock, but complications during decannulation may worsen the overall outcome. Therefore, the aim of this study was to compare the efficacy and safety of suture-based to pure plug-based vascular closure devices for VA-ECMO decannulation.

Methods: In this retrospective study, the procedural outcome of 33 patients with suture-based Perclose ProGlide closure devices was compared to 38 patients with MANTA plug-based closure devices.

Results: Rate of technically correct placement of closure devices was 88% in the suture-based group and 97% in the plug-based group (p = 0.27). There was a significant reduction of severe bleeding events during VA-ECMO decannulation in plug-based versus suture-based systems (3% vs. 21%, p = 0.04). Ischemic complications occurred in 6% with suture-based and 5% with plug-based device (p = 1.00). Pseudoaneurysm formation was detected in 3% in both groups (p = 1.00). No switch to vascular surgery due to bleeding after decannulation was necessary in both groups.

Conclusion: Based on our retrospective analysis, we propose that plug-based vascular closure should be the preferred option for VA-ECMO decannulation. This hypothesis should be further tested in a randomized trial.

Keywords: MANTA; ProGlide; VA-ECMO; cardiogenic shock; plug-based closure device; suture-based closure device; veno-arterial extracorporeal membrane oxygenation.

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Conflict of interest statement

CS and SD received speaker honoraria from AstraZeneca outside the submitted work. JH received speaker honoraria and research support from Abbott Vascular and Edwards Lifesciences outside the submitted work. MO received speaker honoraria from AstraZeneca, Abiomed, CytoSorbents, and Sedana Medical, outside the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
(A) Device implantation success for veno-arterial extracorporeal membrane oxygenation (VA-ECMO) decannulation with suture-based Proglide closure device and plug-based MANTA closure device. (B) Occurrence of severe residual bleeding after VA-ECMO decannulation in patients with suture-based Proglide closure device and plug-based MANTA closure device. (C) Distribution of severe bleeding events.
See this image and copyright information in PMC

References

    1. Holger T, de Waha-Thiele S, Anne F, Uwe Z, Steffen D, Sean F. Management of cardiogenic shock. EuroIntervention. (2021) 17:451–65. - PMC - PubMed
    1. Samsky M, Morrow D, Proudfoot A, Hochman J, Thiele H, Rao S. Cardiogenic shock after acute myocardial infarction: a review. JAMA. (2021) 326:1840–50. 10.4244/EIJ-D-20-01296 - DOI - PMC - PubMed
    1. Cheng R, Hachamovitch R, Kittleson M, Patel J, Arabia F, Moriguchi J, et al. Complications of extracorporeal membrane oxygenation for treatment of cardiogenic shock and cardiac arrest: a meta-analysis of 1,866 adult patients. Ann Thorac Surg. (2014) 97:610–6. 10.1001/jama.2021.18323 - DOI - PubMed
    1. Dumpies O, Kitamura M, Majunke N, Hartung P, Haag A, Wilde J, et al. Manta versus perclose proglide vascular closure device after transcatheter aortic valve implantation: initial experience from a large European center. Cardiovasc Revasc Med. (2022) 37:34–40. 10.1016/j.carrev.2021.06.134 - DOI - PubMed
    1. Au S, Chan K, Fong K, Leung P, Ng W, So S, et al. One-year experience of bedside percutaneous VA-ECMO decannulation in a high-ECMO-volume center in Hong Kong. Perfusion. (2021) 36:803–7. - PubMed

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