Initial Single-Centre Experience With the Abbott Pro-Style Closure Device for Percutaneous Decannulation Following Venoarterial Extracorporeal Membrane Oxygenation Weaning.

INTRODUCTION

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides temporary circulatory support for patients with severe cardiac failure. Traditionally, decannulation involves open surgical cut-down of the common femoral artery, which carries a high risk of wound complications. Percutaneous techniques using vascular closure devices have emerged as a less invasive alternative. This pilot study evaluates the feasibility and early outcomes of a percutaneous VA-ECMO decannulation technique using the Abbott Pro-Style closure device, compared with surgical cut-down.

METHODS

A retrospective, single-centre review was conducted of patients undergoing percutaneous VA-ECMO decannulation at Royal Prince Alfred Hospital between November 2023 and July 2024. Patients were matched by age and sex to a control group treated with surgical cut-down. Data included demographics, ECMO indication and duration, procedural characteristics, vascular complications and groin wound outcomes.

RESULTS

The percutaneous technique was performed in 15 patients (mean age 56.7 ± 13.9 years). Technical success was achieved in 87% (n = 13), with two cases converted to open surgery due to device failure and haemorrhage. Mean procedure time was 74.3 ± 26.3 min versus 101.5 ± 47.2 min for surgical cut-down (p = 0.06). Groin wound complication occurred in one percutaneous patient compared to five surgical patients (p = 0.07). ICU stay and survival to discharge were comparable between the groups.

CONCLUSION

This early experience supports the feasibility of percutaneous VA-ECMO decannulation using the Abbott Pro-Style closure device, with promising signals toward reduced wound complications and shorter procedure times. Larger prospective studies are needed to confirm these preliminary findings.