[Early results of MANTA percutaneous closure device employment after aortic endovascular procedures].

E L Kalmykov, I A Suchkov, R Dammrau
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Abstract

Objective: The aim of the study was to assess safety and reliability of using the MANTA closure device in endovascular treatment of patients with aortic aneurysms.

Patients and methods: The obtained results were retrospectively analysed based on the experience of treating 19 patients (from July 01, 2021 to November 31, 2021) for abdominal aortic aneurysms (n=14) and thoracic aortic pathology (n=5). All operations were performed at the Vascular and Endovascular Surgery Clinic, St. Katharine's Hospital, Frechen, Germany. In all cases, sheaths 9-14F were used for graft implantation. The primary endpoint of efficacy was technical success, with neither acute bleeding nor thromboembolic complications. In our study we used the MANTA closure device (Teleflex, Wayne, Pennsylvania), a novel device for closing percutaneous access to the femoral artery following the use of 10-20F (12-25F OD) devices or sheaths in endovascular catheterization procedures.

Results: Of the total number of patients, three had a dissection of the thoracic aorta, two penetrating aortic ulcer, in 14 cases aneurysm of the abdominal aorta. The mean age of the patients was 67±2.2 years. There were 16 males and 3 females. Of the 19 patients, bilateral access was used in 18 (37 inguinal approaches), in one case a monoiliac graft was implanted. The technical success of implantation of the MANTA closure device was 100%, with no conversion to open access to the femoral vessels. The findings of CT angiography confirmed neither complications in the area of the vascular access, nor stenosis of the access area requiring surgical treatment. Fourteen of the 19 patients underwent ultrasound duplex scanning of vessels in the access zone prior to discharge from the clinic, demonstrating no significant stenosis in the area of arterial closing.

Conclusion: The use of the MANTA CD closure device is safe and accompanied by good immediate results, however, further experience is needed with this device.

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[主动脉血管内手术后经皮使用MANTA闭合装置的早期结果]。
目的:本研究的目的是评估使用MANTA封闭装置在血管内治疗主动脉瘤患者的安全性和可靠性。患者和方法:回顾性分析19例(2021年7月1日至2021年11月31日)腹主动脉瘤(n=14)和胸主动脉病理(n=5)的治疗经验。所有手术均在德国Frechen St. Katharine医院血管和血管内外科诊所进行。在所有病例中,鞘9-14F用于移植物植入。疗效的主要终点是技术上的成功,没有急性出血和血栓栓塞并发症。在我们的研究中,我们使用了MANTA封闭装置(Teleflex, Wayne, Pennsylvania),这是一种新型装置,用于在血管内插管过程中使用10-20F (12-25F OD)装置或鞘后关闭经皮股动脉通路。结果:14例腹主动脉动脉瘤中,3例发生胸主动脉夹层,2例发生穿透性主动脉溃疡。患者平均年龄67±2.2岁。男性16人,女性3人。在19例患者中,18例(37例腹股沟入路)采用双侧入路,1例植入单髂移植物。MANTA闭合装置植入的技术成功率为100%,没有转换为开放的股血管通道。CT血管造影结果证实血管通路区域未出现并发症,也未出现需要手术治疗的通道狭窄。19例患者中有14例在出院前对通道区血管进行超声双工扫描,显示动脉闭合区无明显狭窄。结论:使用MANTA CD闭合装置是安全的,并具有良好的立竿见影的效果,但需要进一步的经验。
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