Dr. Junya Matsuura, Saiseikai Kumamoto Hospital

Background

• Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is used not only for cardiogenic shock but also for resuscitation in cases of refractory cardiac arrest because it can be inserted quickly and percutaneously.
• When ECMO is withdrawn, surgical cannulation is commonly performed due to the large diameter of the blood vessels (16Fr-18Fr).
• Perclose ProGlide is a hemostatic device that directly sutures the vessel wall at the puncture site using a non-absorbable suture.
• It can be used for cannulation of large diameters, up to 21Fr for arteries and 24Fr for veins.
• Previous papers have demonstrated the usefulness of ProGlide hemostasis in EVAR and TAVI cases, and the indications for its use are expanding.
  • The PEVAR trial, a randomized trial comparing surgical hemostasis in EVAR with ProGlide hemostasis, demonstrated the non-inferiority of ProGlide hemostasis¹⁾.
  • Subsequently, the usefulness of ProGlide for hemostasis in TAVI was demonstrated, and the indication for ProGlide has been expanded to include TAVR, TMVR, and other procedures²⁾.
• Recently, the use of ProGlide in the removal of ECMO-delivered prolapsed vessels has also been reported³⁾.