ArticleCritical care (London, England)2026
Full percutaneous decannulation of VA-ECMO using MANTA
Article in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
backgroundPercutaneous veno-arterial extracorporeal membrane oxygenation (VA-ECMO) implantation reduces infectious complications compared with surgical cannulation. However, arterial decannulation using manual compression remains associated with bleeding, vascular injury, and infection. We evaluated a fully percutaneous decannulation strategy (FP-D) combining MANTA® and Femoseal® devices.
methodsAll patients undergoing FP-D between October 2020 and May 2022 in our institution were included. Outcomes were compared with a historical cohort decannulated using manual compression (MC). The primary endpoint was surgical revision after decannulation. Secondary endpoints included major bleeding, transfusion, vascular complications, infection, and 30-day survival. A propensity score weighting approach was performed to adjust for baseline differences.
resultsAmong 497 patients treated with percutaneous VA-ECMO, 250 underwent FP-D and 247 MC. After propensity score, FP-D significantly reduced surgical revision (3.9% vs. 7.2%; RR 0.55, 95% CI 0.32–0.94; p = 0.0311), infection requiring surgery (3.7% vs. 8.4%; RR 0.44, 95% CI 0.25–0.77; p = 0.004), and major bleeding (1.4% vs. 11%; RR 0.13, 95% CI 0.06–0.30; p < 0.0001), with lower transfusion requirements (7.1% vs. 45.7%; RR 0.16, 95% CI 0.11–0.22; p < 0.0001). Thirty-day death was comparable between groups (8,2% vs. 5,57%; p = 0.1316). Systematic CT scans revealed frequent but mostly silent arterial lesions after FP-D.
conclusionFP-D markedly reduced bleeding, transfusion, infection, and surgical revision compared with manual compression, while preserving short-term survival. Systematic imaging identified frequent subclinical vascular lesions, supporting targeted surveillance and endovascular management when appropriate.
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