Suture-based vs. pure plug-based vascular closure devices for VA-ECMO decannulation–A retrospective observational study
BackgroundVeno-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 pu...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-01-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1106114/full |
| _version_ | 1797943093858664448 |
|---|---|
| author | Clemens Scherer Clemens Scherer Hans Theiss Hans Theiss Mario Istrefi Leonhard Binzenhöfer Leonhard Binzenhöfer Danny Kupka Thomas Stocker Thomas Stocker Enzo Lüsebrink Enzo Lüsebrink Era Stambollxhiu Ahmed Alemic Tobias Petzold Tobias Petzold Konstantin Stark Konstantin Stark Simon Deseive Simon Deseive Daniel Braun Daniel Braun Dominik Joskowiak Sven Peterss Jörg Hausleiter Jörg Hausleiter Christian Hagl Christian Hagl Steffen Massberg Steffen Massberg Martin Orban Martin Orban |
| author_facet | Clemens Scherer Clemens Scherer Hans Theiss Hans Theiss Mario Istrefi Leonhard Binzenhöfer Leonhard Binzenhöfer Danny Kupka Thomas Stocker Thomas Stocker Enzo Lüsebrink Enzo Lüsebrink Era Stambollxhiu Ahmed Alemic Tobias Petzold Tobias Petzold Konstantin Stark Konstantin Stark Simon Deseive Simon Deseive Daniel Braun Daniel Braun Dominik Joskowiak Sven Peterss Jörg Hausleiter Jörg Hausleiter Christian Hagl Christian Hagl Steffen Massberg Steffen Massberg Martin Orban Martin Orban |
| author_sort | Clemens Scherer |
| collection | DOAJ |
| description | BackgroundVeno-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.MethodsIn 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.ResultsRate 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.ConclusionBased 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. |
| first_indexed | 2024-04-10T20:18:57Z |
| format | Article |
| id | doaj.art-759309e857c64f4bae1dd47217423f29 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-10T20:18:57Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-759309e857c64f4bae1dd47217423f292023-01-26T04:44:08ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-01-011010.3389/fcvm.2023.11061141106114Suture-based vs. pure plug-based vascular closure devices for VA-ECMO decannulation–A retrospective observational studyClemens Scherer0Clemens Scherer1Hans Theiss2Hans Theiss3Mario Istrefi4Leonhard Binzenhöfer5Leonhard Binzenhöfer6Danny Kupka7Thomas Stocker8Thomas Stocker9Enzo Lüsebrink10Enzo Lüsebrink11Era Stambollxhiu12Ahmed Alemic13Tobias Petzold14Tobias Petzold15Konstantin Stark16Konstantin Stark17Simon Deseive18Simon Deseive19Daniel Braun20Daniel Braun21Dominik Joskowiak22Sven Peterss23Jörg Hausleiter24Jörg Hausleiter25Christian Hagl26Christian Hagl27Steffen Massberg28Steffen Massberg29Martin Orban30Martin Orban31Department of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Medical Oncology and Hematology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Cardiac Surgery, University Hospital, LMU Munich, Munich, GermanyDepartment of Cardiac Surgery, University Hospital, LMU Munich, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Cardiac Surgery, University Hospital, LMU Munich, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Munich, GermanyGerman Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, GermanyBackgroundVeno-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.MethodsIn 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.ResultsRate 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.ConclusionBased 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.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1106114/fullcardiogenic shockVA-ECMOProGlideMANTAsuture-based closure deviceplug-based closure device |
| spellingShingle | Clemens Scherer Clemens Scherer Hans Theiss Hans Theiss Mario Istrefi Leonhard Binzenhöfer Leonhard Binzenhöfer Danny Kupka Thomas Stocker Thomas Stocker Enzo Lüsebrink Enzo Lüsebrink Era Stambollxhiu Ahmed Alemic Tobias Petzold Tobias Petzold Konstantin Stark Konstantin Stark Simon Deseive Simon Deseive Daniel Braun Daniel Braun Dominik Joskowiak Sven Peterss Jörg Hausleiter Jörg Hausleiter Christian Hagl Christian Hagl Steffen Massberg Steffen Massberg Martin Orban Martin Orban Suture-based vs. pure plug-based vascular closure devices for VA-ECMO decannulation–A retrospective observational study Frontiers in Cardiovascular Medicine cardiogenic shock VA-ECMO ProGlide MANTA suture-based closure device plug-based closure device |
| title | Suture-based vs. pure plug-based vascular closure devices for VA-ECMO decannulation–A retrospective observational study |
| title_full | Suture-based vs. pure plug-based vascular closure devices for VA-ECMO decannulation–A retrospective observational study |
| title_fullStr | Suture-based vs. pure plug-based vascular closure devices for VA-ECMO decannulation–A retrospective observational study |
| title_full_unstemmed | Suture-based vs. pure plug-based vascular closure devices for VA-ECMO decannulation–A retrospective observational study |
| title_short | Suture-based vs. pure plug-based vascular closure devices for VA-ECMO decannulation–A retrospective observational study |
| title_sort | suture based vs pure plug based vascular closure devices for va ecmo decannulation a retrospective observational study |
| topic | cardiogenic shock VA-ECMO ProGlide MANTA suture-based closure device plug-based closure device |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1106114/full |
| work_keys_str_mv | AT clemensscherer suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT clemensscherer suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT hanstheiss suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT hanstheiss suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT marioistrefi suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT leonhardbinzenhofer suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT leonhardbinzenhofer suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT dannykupka suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT thomasstocker suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT thomasstocker suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT enzolusebrink suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT enzolusebrink suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT erastambollxhiu suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT ahmedalemic suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT tobiaspetzold suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT tobiaspetzold suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT konstantinstark suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT konstantinstark suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT simondeseive suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT simondeseive suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT danielbraun suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT danielbraun suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT dominikjoskowiak suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT svenpeterss suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT jorghausleiter suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT jorghausleiter suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT christianhagl suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT christianhagl suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT steffenmassberg suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT steffenmassberg suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT martinorban suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy AT martinorban suturebasedvspureplugbasedvascularclosuredevicesforvaecmodecannulationaretrospectiveobservationalstudy |