Complications of the MANTA Closure Device: Insights From MAUDE Database.


Journal

Cardiovascular revascularization medicine : including molecular interventions
ISSN: 1878-0938
Titre abrégé: Cardiovasc Revasc Med
Pays: United States
ID NLM: 101238551

Informations de publication

Date de publication:
01 2022
Historique:
received: 21 01 2021
revised: 06 02 2021
accepted: 10 02 2021
pubmed: 23 2 2021
medline: 26 3 2022
entrez: 22 2 2021
Statut: ppublish

Résumé

The collagen-based MANTA device (Teleflex, PA, USA) is used for closure of large-bore vascular access. There is a paucity of data on complications associated with its use in a real-life setting. We queried the "Manufacturer and User Facility Device Experience" MAUDE database between February 2019 and December 2020 for reports on MANTA device. We identified 250 reports in the MAUDE database from February 2019 through December 2020. The most common failure complication of MANTA is persistent bleeding (48.8%) and vessel occlusion or stenosis (29.6%). Most complications were managed successfully with an endovascular approach (48.4%), but a high number of patients required surgical intervention (40.4%). The most commonly reported failure mechanism was the failure of deployment (22%) followed by subcutaneous deployment (7.6%), intraluminal deployment (4.8%) amd detachment of collagen (2.8%). Access site infection was rare (1.2%). The 18 Fr. MANTA was associated with a lower risk of failure of deployment compared with the 14 Fr. device but was associated with a higher risk of vessel occlusion or stenosis (32.4% vs. 16.3%, p = 0.04) and thrombosis (11.6% vs 0%, p = 0.03). The most common complication of the MANTA device reported to the MAUDE registry was persistent bleeding (48.8% of reports) followed by vessel occlusion (29.6%). These complications were managed successfully using an endovascular approach in 48.4% of the reports.

Sections du résumé

BACKGROUND
The collagen-based MANTA device (Teleflex, PA, USA) is used for closure of large-bore vascular access. There is a paucity of data on complications associated with its use in a real-life setting.
METHODS
We queried the "Manufacturer and User Facility Device Experience" MAUDE database between February 2019 and December 2020 for reports on MANTA device.
RESULTS
We identified 250 reports in the MAUDE database from February 2019 through December 2020. The most common failure complication of MANTA is persistent bleeding (48.8%) and vessel occlusion or stenosis (29.6%). Most complications were managed successfully with an endovascular approach (48.4%), but a high number of patients required surgical intervention (40.4%). The most commonly reported failure mechanism was the failure of deployment (22%) followed by subcutaneous deployment (7.6%), intraluminal deployment (4.8%) amd detachment of collagen (2.8%). Access site infection was rare (1.2%). The 18 Fr. MANTA was associated with a lower risk of failure of deployment compared with the 14 Fr. device but was associated with a higher risk of vessel occlusion or stenosis (32.4% vs. 16.3%, p = 0.04) and thrombosis (11.6% vs 0%, p = 0.03).
CONCLUSIONS
The most common complication of the MANTA device reported to the MAUDE registry was persistent bleeding (48.8% of reports) followed by vessel occlusion (29.6%). These complications were managed successfully using an endovascular approach in 48.4% of the reports.

Identifiants

pubmed: 33612411
pii: S1553-8389(21)00097-X
doi: 10.1016/j.carrev.2021.02.013
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

75-79

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest Santiago Garcia: consultant for Surmodics, Osprey Medical, Medtronic, Edwards Lifesciences, and Abbott. Grant support from Edwards Lifesciences and the VA Office of Research and Development. Emmanouil Brilakis: consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Biotronik, Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), CSI, Elsevier, GE Healthcare, InfraRedx, Medtronic, Siemens, and Teleflex; research support from Regeneron and Siemens. Shareholder: MHI Ventures. Sachin Goel: Speaker's bureau for Abbott Structural Heart. All other authors have nothing to disclose.

Auteurs

Michael Megaly (M)

Division of Cardiology, Banner University Medical Center, University of Arizona, Phoenix, AZ, USA.

Ramy Sedhom (R)

Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA.

Peter Abdelmaseeh (P)

Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA.

Bishoy ElBebawy (B)

Division of Cardiology, Arnot Ogden Medical Center- Lake Erie College of Medicine, Elmira, NY, USA.

Sachin S Goel (SS)

Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA.

Joseph Karam (J)

Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA.

Ashish Pershad (A)

Division of Cardiology, Banner University Medical Center, University of Arizona, Phoenix, AZ, USA.

Emmanouil S Brilakis (ES)

Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA.

Santiago Garcia (S)

Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA. Electronic address: santiagogarcia@me.com.

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