Real-time ultrasound-guided bedside closure of arteriotomy wound using MANTA closure device during venoarterial extracorporeal membrane oxygenation decannulation

Perfusion ◽  
2020 ◽  
pp. 026765912093242
Author(s):  
Shek-Yin Au ◽  
Ka-Man Fong ◽  
Wing-Yiu George Ng ◽  
Kang-Yin Michael Lee ◽  
Sheung-On So ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Real Time ◽  
Ultrasound Guidance ◽  
Percutaneous Closure ◽  
Closure Device ◽  
Ultrasound Guided ◽  
Vascular Closure Device ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation

Percutaneous closure of arteriotomy wound during peripheral venoarterial extracorporeal membrane oxygenation decannulation was shown to be safe and allow earlier mobilization. The new MantaTM vascular closure device (Essential Medical), designed for the closure of arterotomy wound created by large-bore vascular sheaths up to 25Fr during endovascular catheterization procedures, was reported to be applicable in venoarterial extracorporeal membrane oxygenation decannulation. In this article, we would like to share our experience of using real-time ultrasound guidance to ensure the safe application of Manta during bedside venoarterial extracorporeal membrane oxygenation decannulation.

scholarly journals Venoarterial extracorporeal membrane oxygenation decannulation using the novel Manta vascular closure device

2020 ◽  
Vol 9 (4) ◽  
pp. 342-347
Author(s):  
Xavier Bemtgen ◽  
Timo Heidt ◽  
Viviane Zotzmann ◽  
Jonathan Rilinger ◽  
Tobias Wengenmayer ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Significant Risk ◽  
Closure Device ◽  
The Novel ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Vessel Stenosis ◽  
Patients At Risk ◽  
Viable Approach

Aims: Removal of large calibre arterial sheaths, as employed in venoarterial extracorporeal membrane oxygenation, is still associated with a high risk for vascular access site complications. In this study, we investigated the large bore Manta closure device as an option for venoarterial extracorporeal membrane oxygenation decannulation. Methods and results: Sixteen patients weaned from venoarterial extracorporeal membrane oxygenation between January–June 2019 were prospectively included in a registry (eight during extracorporeal cardiopulmonary resuscitation, seven with severe cardiogenic shock and one patient with fulminant pulmonary embolism). All patients had an arterial sheath removed at bedside using the Manta device achieving rapid haemostasis without clinically relevant complications afterwards. A computed tomography angiography was available for 11 patients (68.8%) and reassessed with regards to relevant pathologies at the closure device. Average intraluminal area was 40.4 mm2 (12.2–76.3 mm2) at the closure site. All devices but one were correctly deployed. Three patients (27.3%) had a visible thrombus at the closure device resulting in a >60% stenosis, two of which had a puncture site distal of the femoral artery bifurcation. Conclusion: Decannulation from venoarterial extracorporeal membrane oxygenation using the Manta closure device is a viable approach for rapid haemostasis, but is also associated with a significant risk of thrombotic vessel stenosis. These preliminary findings indicate that puncture in near proximity or distal to the femoral bifurcation might identify patients at risk and further studies are needed.

Symptomatic vascular complications after vascular closure device use following diagnostic and interventional catheterisation

VASA ◽  
2004 ◽  
Vol 33 (2) ◽  
pp. 78-81 ◽  
Author(s):  
Thalhammer ◽  
Aschwanden ◽  
Jeanneret ◽  
Labs ◽  
Jäger
Keyword(s):  
Current Literature ◽  
Vascular Complications ◽  
University Hospital ◽  
Closure Device ◽  
Ultrasound Guided ◽  
Vascular Closure Device ◽  
Device Use ◽  
Arterial Stenoses ◽  
The University ◽  
Stenotic Lesions

Background: Haemostatic puncture closure devices for rapid and effective hemostasis after arterial catheterisation are a comfortable alternative to manual compression. Implanting a collagen plug against the vessel wall may become responsible for other kind of vascular injuries i.e. thrombotic or stenotic lesions and peripheral embolisation. The aim of this paper is to report our clinically relevant vascular complications after Angio-Seal® and to discuss the results in the light of the current literature. Patients and methods: We report the symptomatic vascular complications in 17 of 7376 patients undergoing diagnostic or therapeutic catheterisation between May 2000 and March 2003 at the University Hospital Basel. Results: Most patients presented with ischaemic symptoms, arterial stenoses or occlusions and thrombotic lesions (n = 14), whereas pseudoaneurysms were extremely rare (n = 3). Most patients with ischaemic lesions underwent vascular surgery and all patients with a pseudoaneurysm were successfully treated by ultrasound-guided compression. Conclusions: Severe vascular complications after Angio-Seal® are rare, consistent with the current literature. There may be a shift from pseudoaneurysms to ischaemic lesions.

scholarly journals Influence of extracorporeal membrane oxygenation on serum microRNA expression

2019 ◽  
Vol 47 (12) ◽  
pp. 6109-6119
Author(s):  
M. Scettri ◽  
H. Seeba ◽  
D. L. Staudacher ◽  
S. Robinson ◽  
D. Stallmann ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Real Time ◽  
Underlying Disease ◽  
Real Time Quantitative Pcr ◽  
Membrane Oxygenation ◽  
Serum Microrna ◽  
Clinical Biomarkers ◽  
Differentially Expressed Mirnas ◽  
Before And After ◽  
Medical Intensive Care

Objective To date, no biomarkers have been established to predict haematological complications and outcomes of extracorporeal membrane oxygenation (ECMO). The aim of this study was to investigate the expression of a panel of microRNAs (miRNAs), which are promising biomarkers in many clinical fields, in patients before and after initiating ECMO. Methods Serum miRNA levels from 14 patients hospitalized for acute respiratory failure and supported with ECMO in our medical intensive care unit were analysed before and 24 hours after ECMO. In total, 179 serum-enriched miRNAs were profiled by using a real-time PCR panel. For validation, differentially expressed miRNAs were individually quantified with conventional real-time quantitative PCR at 0, 24, and 72 hours. Results Under ECMO support, platelet count significantly decreased by 65 × 103/µL (25th percentile = 154.3 × 103/µL; 75th percentile = 33 × 103/µL). Expression of the 179 miRNAs investigated in this study did not change significantly throughout the observational period. Conclusions According to our data, the expression of serum miRNAs was not altered by ECMO therapy itself. We conclude that ECMO does not limit the application of miRNAs as specific clinical biomarkers for the patients’ underlying disease.

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