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Cheema T, Venero C, Champaneria S, Younas S, Hadeed Khan MA, Anjum I, Ijaz U, Haider S, Akbar MS, Abdul-Waheed M, Saleem S. Systematic review and meta-analysis comparing Manta device and Perclose device for closure of large bore arterial access. J Vasc Access 2024:11297298231222314. [PMID: 38189215 DOI: 10.1177/11297298231222314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Data comparing MANTA device with Perclose device for large bore arterial access closure is limited. We performed meta-analysis to compare safety and efficacy of the two devices in large (⩾14 Fr sheath) arteriotomy closure post-TAVR. Relevant studies were identified via PubMed, Cochrane, and EMBASE databases until June, 2022. Data was analyzed using random effect model to calculate relative odds of VARC-2 defined access-site complications and short-term (in-hospital or 30-day) mortality. A total of 12 studies (2 RCT and 10 observational studies) comprising 2339 patients were included. The odds of major vascular complications (OR 0.99, 95% CI 0.51-1.92; p = 0.98); life threatening and major bleeding (OR 0.77, 95% CI 0.45-1.33; p = 0.35); minor vascular complications (OR 1.37, 95% CI 0.63-2.99; p = 0.43); minor bleeding (OR 0.94, 95% CI 0.57-1.56; p = 0.82); device failure (OR 0.74, 95% CI 0.49-1.11; p = 0.14); hematoma formation (OR 0.76, 95% CI 0.33-1.75; p = 0.52); dissection, stenosis, occlusion, or pseudoaneurysm (OR 1.08, 95% CI 0.71-1.62; p = 0.73) and short-term mortality (OR 1.01, 95% CI 0.55-1.84; p = 0.98) between both devices were similar. MANTA device has a similar efficacy and safety profile compared to Perclose device.
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Affiliation(s)
| | - Carmelo Venero
- University of Kentucky College of Medicine, Lexington, KY, USA
| | | | - Sundas Younas
- Khyber Medical College, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | | | - Ibrar Anjum
- Vassar Brothers Medical Center, Poughkeepsie, NY, USA
| | - Unaiza Ijaz
- Khyber Medical College, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Sajjad Haider
- University of Kentucky College of Medicine, Lexington, KY, USA
| | | | | | - Sameer Saleem
- University of Kentucky College of Medicine, Lexington, KY, USA
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Scherer C, Theiss H, Istrefi M, Binzenhöfer L, Kupka D, Stocker T, Lüsebrink E, Stambollxhiu E, Alemic A, Petzold T, Stark K, Deseive S, Braun D, Joskowiak D, Peterss S, Hausleiter J, Hagl C, Massberg S, Orban M. Suture-based vs. pure plug-based vascular closure devices for VA-ECMO decannulation-A retrospective observational study. Front Cardiovasc Med 2023; 10:1106114. [PMID: 36776253 PMCID: PMC9908581 DOI: 10.3389/fcvm.2023.1106114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
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.
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Affiliation(s)
- Clemens Scherer
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany,*Correspondence: Clemens Scherer,
| | - Hans Theiss
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
| | - Mario Istrefi
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany
| | - Leonhard Binzenhöfer
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
| | - Danny Kupka
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Thomas Stocker
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
| | - Enzo Lüsebrink
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
| | - Era Stambollxhiu
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany
| | - Ahmed Alemic
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Petzold
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
| | - Konstantin Stark
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
| | - Simon Deseive
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
| | - Daniel Braun
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
| | - Dominik Joskowiak
- Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Sven Peterss
- Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Jörg Hausleiter
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
| | - Christian Hagl
- German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany,Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Steffen Massberg
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
| | - Martin Orban
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany,German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany
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