Invention of a new percutaneous closure technique for vascular haemostasis in percutaneous veno-arterial extracorporeal membrane oxygenation.

Abstract

Objective: To assess the feasibility and safety of a novel closure technique, namely the parallel closure technique (Par-CT), in which the sheath is placed parallel to the ProGlide system during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to enhance the efficiency of percutaneous vascular haemostasis.

Methods: The abdominal aortas of goats were punctured with a 17F sheath to simulate arterial cannula vascular access for VA-ECMO, and the Par-CT was used to achieve vascular haemostasis. In five goats, the abdominal aorta was punctured with a 17F sheath and then a 6 to 10F vascular sheath was introduced. This resulted in a smaller vascular rupture area and successful closure of the aortic rupture using the Par-CT.

Results: If the sheath tube that was introduced was < 8 F, the puncture site could not be closed and would therefore have to be resutured and the Par-CT would have to be repeated. However, the puncture site could be sutured appropriately if the sheath tube that was introduced was ≥ 8F.

Conclusions: This study suggested that the Par-CT is both safe and effective for haemostasis after weaning from VA-ECMO.