Xu Chen, Xu Guo-Xiong, Cao Yi-Fei, Chen Lei, Jin Yi-Qi
Department of Vascular and Endovascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
Department of Critical Care Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
Front Cardiovasc Med. 2025 Jan 15;11:1522789. doi: 10.3389/fcvm.2024.1522789. eCollection 2024.
To evaluate the safety and efficacy of the area reduction post-closure technique for bedside weaning of veno-arterial extracorporeal membrane oxygenation (V-A ECMO).
A retrospective study was conducted from December 2022 to November 2023, analyzing data from patients who underwent V-A ECMO weaning at our center. The area reduction post-closure technique, utilizing two ProGlide devices (Abbott Vascular, Santa Clara, CA), was adopted as a standard practice. The technical success was defined as achieving complete hemostasis without a bailout open repair. The complications associated with access included hemorrhagic events, pseudoaneurysm formation, limb ischemia, distal embolization, and wound infections.
A total of 18 patients were included. The median age of the cohort was 72.0 years [interquartile range (IQR), 57.5-81.5 years], with a male-to-female ratio of 2:1. The median size of arterial sheath utilized was 18.0 Fr (IQR, 17.0-20.0 Fr). The median duration of the procedure was 10.0 min (IQR, 9.0-13.0 min), and the median length of total hospital stay was 31.0 days (IQR, 25.5-39.0 days). Furthermore, the technique demonstrated a success rate of 100%. One patient (5.6%) experienced minor bleeding, which was successfully managed through compression. No additional complications associated with access were observed after the procedure.
The post-closure area reduction technique emerges as a viable option for bedside weaning of V-A ECMO. Nonetheless, it is essential that this technique be validated through larger comparative studies.
评估区域缩小闭合技术用于静脉-动脉体外膜肺氧合（V-A ECMO）床边撤机的安全性和有效性。
对2022年12月至2023年11月在本中心接受V-A ECMO撤机的患者数据进行回顾性研究。采用区域缩小闭合技术，使用两个ProGlide装置（雅培血管，加利福尼亚州圣克拉拉）作为标准操作。技术成功定义为实现完全止血且无需补救性开放修复。与血管通路相关的并发症包括出血事件、假性动脉瘤形成、肢体缺血、远端栓塞和伤口感染。
共纳入18例患者。队列的中位年龄为72.0岁[四分位间距（IQR），57.5 - 81.5岁]，男女比例为2:1。使用的动脉鞘管中位尺寸为18.0 Fr（IQR，17.0 - 20.0 Fr）。手术中位持续时间为10.0分钟（IQR，9.0 - 13.0分钟），总住院时间中位长度为31.0天（IQR，25.5 - 39.0天）。此外，该技术成功率为100%。1例患者（5.6%）出现轻微出血，通过压迫成功处理。术后未观察到与血管通路相关的其他并发症。
区域缩小闭合技术成为V-A ECMO床边撤机的可行选择。尽管如此，该技术仍需通过更大规模的对照研究进行验证。
