Efficacy of Vascular Closure Devices in Closing Large-Bore Sheath Arterial Sites after Treatment with Extracorporeal Life Support System

Thorac Cardiovasc Surg. 2021 Sep;69(6):537-541. doi: 10.1055/s-0041-1728708. Epub 2021 Aug 10.

Abstract

Background: We retrospectively evaluated vascular complications and wound infections after surgical or percutaneous transfemoral removal of temporary extracorporeal life support systems (ECLSs).

Methods: A total of 83 patients were weaned from ECLS between August 2015 and September 2020. We analyzed for a composite endpoint of vascular complications and wound infections requiring negative-pressure wound therapy. Patients were divided into two groups: percutaneous group using the MANTA vascular occlusion system (VCD; Teleflex, Morrisville, North Carolina, United States) (n = 23) and surgical group (n = 60).

Results: The median age in the entire cohort was 67 years. Vascular complications were seen in 20% (n = 12) in the surgical group and in 13% (n = 3) in the percutaneous group (p = 0.72). A total of 32% (n = 19) in the surgical group and 9% (n = 2) in the percutaneous group (p = 0.031) had wound infections. A composite endpoint of vascular complications and wound infections showed significantly more complications in the surgical group (52%, n = 31) as compared with the percutaneous group (22%, n = 5) (p = 0.020). The median duration in the intensive care unit was 13 days for the surgical group and 12 days for the percutaneous group without any significant difference in both groups (p = 0.93).

Conclusions: Using the MANTA VCD for percutaneous removal of ECLS cannulas after weaning from ECLS is safe and reproducible. A composite endpoint of vascular complications and wound infections was significantly lower in the percutaneous removal group as compared with the surgical group.

Publication types

  • Comparative Study
  • Video-Audio Media

MeSH terms

  • Aged
  • Arteries*
  • Catheterization, Peripheral* / adverse effects
  • Extracorporeal Membrane Oxygenation / adverse effects
  • Female
  • Hemorrhage / etiology
  • Hemorrhage / prevention & control*
  • Hemostatic Techniques / adverse effects
  • Hemostatic Techniques / instrumentation*
  • Humans
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy
  • Punctures
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / therapy
  • Time Factors
  • Treatment Outcome
  • Vascular Closure Devices*