Single-center comparative study of MANTA and ProGlide vascular closure devices in percutaneous endovascular aneurysm repair.

Abstract

The aim of this study is to compare the clinical outcomes of the MANTA and ProGlide devices in a real-world population of patients undergoing elective percutaneous endovascular aneurysm repair (pEVAR). All consecutive patients undergoing percutaneous EVAR (pEVAR) in a single center were retrospectively reviewed. Technical success was defined as achieving hemostasis after device deployment. Complications were registered, including improper sealing after deployment, to conform with the instructions for use, bleeding after leaving the operating room, occlusion, stenosis, and false aneurysm. The conversion rate to femoral cut-down was registered as well. A total of 263 patients were included in the analysis, resulting in 511 common femoral artery puncture sites. There were 325 that were closed using MANTA and 186 using ProGlide. Technical failure occurred in 27 cases (8.3%) in the MANTA group and 29 cases (15.6%) in the ProGlide group (P < .001). Within these cases, improper sealing at the end of the procedure was found in 19 cases (5.8%) in the MANTA group and 26 (13.9%) in the ProGlide group (P = .002). Bleeding after the procedure ended occurred in two cases (1.2%) in the MANTA group and three cases (1.6%) in the ProGlide group (P = .721). Femoral cut-down was necessary in 15 cases in the MANTA group (4.6%). Cut-down was performed in 9 patients in the ProGlide group, representing 4.8% of the ProGlide group (P = .909). Both MANTA and ProGlide are safe options for the closure of large-bore arteriotomies in pEVAR. Although the ProGlide has a lower first success rate, its shortcomings are solved easily by adding another device, resulting in comparable conversion rates. Furthermore, ProGlide was less expensive to use than MANTA.