PMID- 37427753
OWN - NLM
STAT- MEDLINE
DCOM- 20231201
LR  - 20231217
IS  - 1799-7267 (Electronic)
IS  - 1457-4969 (Linking)
VI  - 112
IP  - 4
DP  - 2023 Dec
TI  - Ultrasound-guided closure of the femoral artery during venoarterial decannulation 
      using a large-bore closure device.
PG  - 256-264
LID - 10.1177/14574969231181232 [doi]
AB  - BACKGROUND: Peripheral femoro-femoral venoarterial extracorporeal membrane 
      oxygenation (VA-ECMO) is viable for fast hemodynamic assistance during 
      cardiogenic shock. Ultrasound-guided closure with a large-bore device (MANTA((R))) 
      is a feasible option potentially replacing surgical arteriotomy closure in 
      peripheral VA-ECMO decannulation. METHODS: This retrospective study included 
      patients weaning from percutaneously inserted femoro-femoral VA-ECMO at the 
      Helsinki University Hospital, Finland in 2012-2020. The primary endpoints were 
      access-site complications, a composite of hematomas/seromas/surgical site 
      infections (SSIs), and the safety endpoint of vascular complications (VCs). 
      RESULTS: A total of 100 consecutive percutaneously implanted and weaned VA-ECMO 
      patients were stratified into two groups by decannulation strategy: percutaneous 
      ultrasound-guided MANTA device (n = 21, 21.0%) or surgical approach (n = 79, 
      79.0%). The mean age of the cohort was 51 +/- 13 years and females represented 
      25.0%. The technical success rate of the percutaneous ultrasound-guided MANTA 
      technique was 95.2%. In multivariate analysis, surgical closure was associated 
      with a higher incidence of combined access site hematomas/seromas/SSIs compared 
      to percutaneous ultrasound-guided deployment of MANTA device (44.3% versus 9.5%, 
      odds ratio (OR): 7.162, 95% confidence interval (CI): 1.544-33.222; p = 0.012). 
      Similarly, access-site complications necessitating interventions were more 
      frequent in the surgical closure group compared to US-MANTA (ultrasound-guided 
      MANTA) group (26.6% versus 0.0%, p = 0.005). VCs were infrequent in both groups 
      without any significant intergroup difference (p > 0.99). CONCLUSIONS: 
      Percutaneous ultrasound-guided MANTA closure of the femoral artery after VA-ECMO 
      decannulation was associated with high technical success rate and low incidence 
      of VCs. Compared to surgical closure, access-site complications were 
      significantly less frequent, along with access-site complications necessitating 
      interventions.
FAU - Rahman, Tasnia
AU  - Rahman T
AUID- ORCID: 0000-0002-0995-1000
AD  - Heart and Lung CenterUniversity of Helsinki and Helsinki University Hospital, 
      Haartmaninkatu 4, Helsinki 00290, Finland.
FAU - Herajarvi, Johanna
AU  - Herajarvi J
AD  - Heart and Lung Center, University of Helsinki and Helsinki University Hospital, 
      Helsinki, Finland.
AD  - Research Unit of Surgery, Anesthesia and Critical Care, University of Oulu, Oulu, 
      Finland.
FAU - Ahonen, Henri
AU  - Ahonen H
AD  - Heart and Lung Center, University of Helsinki and Helsinki University Hospital, 
      Helsinki, Finland.
FAU - Jormalainen, Mikko
AU  - Jormalainen M
AD  - Heart and Lung Center, University of Helsinki and Helsinki University Hospital, 
      Helsinki, Finland.
FAU - Syrjala, Simo
AU  - Syrjala S
AD  - Heart and Lung Center, University of Helsinki and Helsinki University Hospital, 
      Helsinki, Finland.
FAU - Jarvinen, Tommi
AU  - Jarvinen T
AD  - Heart and Lung Center, University of Helsinki and Helsinki University Hospital, 
      Helsinki, Finland.
FAU - Juvonen, Tatu
AU  - Juvonen T
AD  - Heart and Lung Center, University of Helsinki and Helsinki University Hospital, 
      Helsinki, Finland.
AD  - Research Unit of Surgery, Anesthesia and Critical Care, University of Oulu, Oulu, 
      Finland.
FAU - Dahlbacka, Sebastian
AU  - Dahlbacka S
AD  - Heart and Lung Center, University of Helsinki and Helsinki University Hospital, 
      Helsinki, Finland.
LA  - eng
PT  - Journal Article
DEP - 20230710
PL  - England
TA  - Scand J Surg
JT  - Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical 
      Society and the Scandinavian Surgical Society
JID - 101144297
SB  - IM
MH  - Female
MH  - Humans
MH  - Adult
MH  - Middle Aged
MH  - *Femoral Artery/diagnostic imaging/surgery
MH  - Retrospective Studies
MH  - Seroma
MH  - *Catheterization, Peripheral/methods
MH  - Hematoma/etiology
MH  - Surgical Wound Infection
MH  - Ultrasonography, Interventional
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Percutaneous arterial closure
OT  - VA-ECMO
OT  - ultrasound-guided vascular closure device
OT  - venoarterial extracorporeal membrane oxygenation
COIS- Declaration of conflicting interestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2023/07/10 13:05
MHDA- 2023/12/01 06:44
CRDT- 2023/07/10 07:03
PHST- 2023/12/01 06:44 [medline]
PHST- 2023/07/10 13:05 [pubmed]
PHST- 2023/07/10 07:03 [entrez]
AID - 10.1177/14574969231181232 [doi]
PST - ppublish
SO  - Scand J Surg. 2023 Dec;112(4):256-264. doi: 10.1177/14574969231181232. Epub 2023 
      Jul 10.