PMID- 33678169
OWN - NLM
STAT- MEDLINE
DCOM- 20210906
LR  - 20231111
IS  - 1466-609X (Electronic)
IS  - 1364-8535 (Print)
IS  - 1364-8535 (Linking)
VI  - 25
IP  - 1
DP  - 2021 Mar 7
TI  - Complete percutaneous angio-guided approach using preclosing for venoarterial 
      extracorporeal membrane oxygenation implantation and explantation in patients 
      with refractory cardiogenic shock or cardiac arrest.
PG  - 93
LID - 10.1186/s13054-021-03522-8 [doi]
LID - 93
AB  - BACKGROUND: The approach for veno-arterial extracorporeal membrane oxygenation 
      implantation (VA-ECMO) in patients with cardiogenic shock can be either surgical 
      or percutaneous. Complete angio-guided percutaneous implantation and explantation 
      could decrease vascular complications. We sought to describe the initial results 
      of complete percutaneous angio-guided ECMO implantation and explantation using 
      preclosing. METHODS: All consecutive patients who underwent peripheral 
      femoro-femoral VA-ECMO percutaneous implantation for refractory cardiogenic shock 
      or cardiac arrest were enrolled in a prospective registry (03/2018-12/2020). 
      Percutaneous preclosing using two closing devices (Perclose ProGlide, Abbott) 
      inserted before cannulation was used in both femoral artery and vein. 
      Explantation was performed using a crossover technique under angiographic 
      guidance. The occurrence of vascular complication was recorded. RESULTS: Among 
      the 56 patients who underwent percutaneous VA-ECMO implantation for cardiogenic 
      shock or refractory cardiac arrest, 41 underwent preclosing. Femoral vessel 
      cannulation was successful in all patients and total cannulation time was 20 
      (10-40) min. Weaning from ECMO was possible in 22/41 patients (54%) and 12 (29%) 
      patients were alive at day 30. Significant vascular complications occurred in 
      2/41 patients. Percutaneous decannulation was performed in 20 patients with 19/20 
      technical success rate. All femoral arteries and veins were properly closed using 
      the pre-closing devices without bleeding on the angiographic control except for 
      one patient in whom surgical closure of the artery was required. No patient 
      required transfusion for access related significant bleeding and no other 
      vascular complication occurred. Furthermore, no groin infection was observed 
      after full percutaneous implantation and removal of ECMO. CONCLUSION: Emergent 
      complete percutaneous angio-guided VA-ECMO implantation and explantation using 
      pre-closing technique can be an attractive strategy in patients referred for 
      refractory cardiogenic shock.
FAU - Martin-Tuffreau, Anne-Sophie
AU  - Martin-Tuffreau AS
AD  - Service de Cardiologie, APHP, Hopitaux Universitaires Henri Mondor, 41 avenue du 
      Marechal de Lattre de Tassigny, 94000, Creteil, France.
FAU - Bagate, Francois
AU  - Bagate F
AD  - AP-HP, Hopitaux Universitaires Henri-Mondor, Service de Medecine Intensive 
      Reanimation, 94010, Creteil, France.
AD  - Univ Paris Est Creteil, CARMAS, 94010, Creteil, France.
AD  - Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.
FAU - Boukantar, Madjid
AU  - Boukantar M
AD  - Service de Cardiologie, APHP, Hopitaux Universitaires Henri Mondor, 41 avenue du 
      Marechal de Lattre de Tassigny, 94000, Creteil, France.
FAU - Saiydoun, Gabriel
AU  - Saiydoun G
AD  - Department of Cardiac Surgery, APHP, Hopitaux Universitaires Henri Mondor, 94010, 
      Creteil, France.
FAU - Mangiameli, Andrea
AU  - Mangiameli A
AD  - Service de Cardiologie, APHP, Hopitaux Universitaires Henri Mondor, 41 avenue du 
      Marechal de Lattre de Tassigny, 94000, Creteil, France.
FAU - Rostain, Laura
AU  - Rostain L
AD  - Service de Cardiologie, APHP, Hopitaux Universitaires Henri Mondor, 41 avenue du 
      Marechal de Lattre de Tassigny, 94000, Creteil, France.
FAU - Mouillet, Gauthier
AU  - Mouillet G
AD  - Service de Cardiologie, APHP, Hopitaux Universitaires Henri Mondor, 41 avenue du 
      Marechal de Lattre de Tassigny, 94000, Creteil, France.
FAU - Fiore, Antonio
AU  - Fiore A
AD  - Department of Cardiac Surgery, APHP, Hopitaux Universitaires Henri Mondor, 94010, 
      Creteil, France.
FAU - Langeron, Olivier
AU  - Langeron O
AD  - Service d'anesthesie-reanimation chirurgicale, DMU CARE, DHU A-TVB, Assistance 
      Publique-Hopitaux de Paris (AP-HP), Hopitaux Universitaires Henri Mondor, 94010, 
      Creteil, France.
FAU - Mekontso-Dessap, Armand
AU  - Mekontso-Dessap A
AD  - AP-HP, Hopitaux Universitaires Henri-Mondor, Service de Medecine Intensive 
      Reanimation, 94010, Creteil, France.
AD  - Univ Paris Est Creteil, CARMAS, 94010, Creteil, France.
AD  - Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.
FAU - Mongardon, Nicolas
AU  - Mongardon N
AD  - Service d'anesthesie-reanimation chirurgicale, DMU CARE, DHU A-TVB, Assistance 
      Publique-Hopitaux de Paris (AP-HP), Hopitaux Universitaires Henri Mondor, 94010, 
      Creteil, France.
AD  - U955-IMRB, Equipe 03, Inserm, Univ Paris Est Creteil (UPEC), Ecole Nationale 
      Veterinaire D'Alfort (EnVA), 94700, Maisons-Alfort, France.
FAU - Folliguet, Thierry
AU  - Folliguet T
AD  - Department of Cardiac Surgery, APHP, Hopitaux Universitaires Henri Mondor, 94010, 
      Creteil, France.
FAU - Teiger, Emmanuel
AU  - Teiger E
AD  - Service de Cardiologie, APHP, Hopitaux Universitaires Henri Mondor, 41 avenue du 
      Marechal de Lattre de Tassigny, 94000, Creteil, France.
AD  - U955-IMRB, Equipe 03, Inserm, Univ Paris Est Creteil (UPEC), Ecole Nationale 
      Veterinaire D'Alfort (EnVA), 94700, Maisons-Alfort, France.
FAU - Gallet, Romain
AU  - Gallet R
AUID- ORCID: 0000-0003-4595-509X
AD  - Service de Cardiologie, APHP, Hopitaux Universitaires Henri Mondor, 41 avenue du 
      Marechal de Lattre de Tassigny, 94000, Creteil, France. romain.gallet@aphp.fr.
AD  - U955-IMRB, Equipe 03, Inserm, Univ Paris Est Creteil (UPEC), Ecole Nationale 
      Veterinaire D'Alfort (EnVA), 94700, Maisons-Alfort, France. 
      romain.gallet@aphp.fr.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20210307
PL  - England
TA  - Crit Care
JT  - Critical care (London, England)
JID - 9801902
SB  - IM
MH  - Adult
MH  - Extracorporeal Membrane Oxygenation/*instrumentation/methods
MH  - Female
MH  - France
MH  - Heart Arrest/therapy
MH  - Hemorrhage/etiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Registries/statistics & numerical data
MH  - Retrospective Studies
MH  - Shock, Cardiogenic/etiology/therapy
MH  - Vascular Closure Devices/*standards/statistics & numerical data
PMC - PMC7938494
OTO - NOTNLM
OT  - Cardiac arrest
OT  - Cardiogenic shock
OT  - Closure device
OT  - ECMO
OT  - Percutaneous cannulation
COIS- The authors declare that they have no competing interests.
EDAT- 2021/03/09 06:00
MHDA- 2021/09/07 06:00
PMCR- 2021/03/07
CRDT- 2021/03/08 05:31
PHST- 2020/12/10 00:00 [received]
PHST- 2021/03/01 00:00 [accepted]
PHST- 2021/03/08 05:31 [entrez]
PHST- 2021/03/09 06:00 [pubmed]
PHST- 2021/09/07 06:00 [medline]
PHST- 2021/03/07 00:00 [pmc-release]
AID - 10.1186/s13054-021-03522-8 [pii]
AID - 3522 [pii]
AID - 10.1186/s13054-021-03522-8 [doi]
PST - epublish
SO  - Crit Care. 2021 Mar 7;25(1):93. doi: 10.1186/s13054-021-03522-8.