Comparison of Success Rate and Complications of Totally Percutaneous Decannulation in Patients With Veno-Arterial Extracorporeal Membrane Oxygenation and Endovascular Aneurysm Repair.

Background: Total percutaneous closure of a femoral artery access site using Perclose ProGlide has become prevalent after percutaneous endovascular aortic repair and veno-arterial extracorporeal membrane oxygenation. Objective: To evaluate the safety and efficacy of total percutaneous closure of the femoral artery access site after veno-arterial extracorporeal membrane oxygenation compared with that after endovascular aortic repair. Methods: This was a retrospective observational study conducted over an almost 4-year period and included 88patients who underwent endovascular aortic repair (64 patients) and veno-arterial extracorporeal membrane oxygenation (24 patients). The femoral artery puncture sites of the patients were closed percutaneously using Perclose ProGlide devices. Technical success was defined as successful arterial closure of the common femoral artery, without additional surgical or endovascular procedures. Access site complications, such as major bleeding requiring transfusion or surgical intervention, minor bleeding, groin infection, pseudoaneurysm, and lymphocele, were recorded 24 h and 30 days after arterial closure. Results: Each group's technical success rates were 95.8% (veno-arterial extracorporeal membrane oxygenation) and 92.2% endovascular aortic repair, respectively. There were no differences in the periprocedural complications of major bleeding, pseudoaneurysm, minor bleeding, acute limb ischemia, and groin infection. Furthermore, no arterial thrombosis, dissection, stenosis, arteriovenous fistula, hematoma, groin infection, or lymphocele was observed at the patients' access site who underwent follow-up ultrasound examination. There was no significant difference in the technical success rate of percutaneous closure by the Perclose ProGlide device in the endovascular aortic repair and veno-arterial extracorporeal membrane oxygenation groups. Also, no periprocedural or 30-day complications were observed at the access site of the endovascular aortic repair and veno-arterial extracorporeal membrane oxygenation patients.