Modified Percutaneous Post-closure Technique for Bedside Weaning of Veno-arterial Extracorporeal Membrane Oxygenation

Objectives: This study aimed to assess the safety and efficacy of a modified percutaneous post-closure technique for bedside arterial cannula removal of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Materials: Between December 2022 and August 2023, the data of all VA-ECMO patients weaned at our center were retrospectively reviewed. A modified post-closure technique with two ProGlide devices (Abbott Vascular, Santa Clara, CA) was adopted as a routine practice. The success of the technique was defined as achieving immediate hemostasis without a bailout open repair. The post-procedural complications included bleeding events, pseudoaneurysm, limb ischemia, distal embolization, and infection at the access site. Results Overall, nine patients were included in this study. The mean age was 69.7 ± 12.9 years with a male-to-female ratio of 2:1. The mean arterial sheath size was 16.7 ± 1.3 Fr. The mean duration of the procedure was 10.9 ± 2.2 min, and the mean length of stay in the intensive care unit after weaning was 16.2 ± 4.5 days. The efficacy of the technique achieved a success rate of 100%. A single patient (11.1%) developed minor bleeding, successfully managed with compression, and no more problems were observed following the procedure. Conclusions A modified post-closure technique was a feasible and safe strategy for VA-ECMO bedside weaning and may be considered an alternative option.