Full percutaneous decannulation of VA-ECMO using MANTA® and Femoseal® devices: a propensity-score based study

doi:10.1186/s13054-026-06012-x

Organ support & nutrition

Full percutaneous decannulation of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) using MANTA® and Femoseal® devices: a propensity-score based study

Crit CarePublished 12 Apr 2026Retrospective cohort study with historical control

Main finding · Surgical revisionResultRelative risk 0.55 95% CI 0.32–0.94

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Authors' conclusion

FP-D markedly reduced bleeding, transfusion, infection, and surgical revision compared with manual compression, while preserving short-term survival.

Study context

Population: Patients treated with percutaneous VA-ECMO
Participants: 497 patients

Exposure: Fully percutaneous decannulation vs manual compression
FP-Dn = 250
Manual compression (MC)n = 247reference
Outcome: Surgical revision after decannulation

Methodological detailspropensity score weighting, single-centre

Propensity score weighting
Single-centre

Main finding

Surgical revision

Relative risk

0.55

95% CI 0.32–0.94

P = 0.0311

By group

FP-D3.9%

MC7.2%

FP-D vs MC

RR 0.55 (95% CI 0.32–0.94); P = 0.0311

As reported in the abstract

Observational data: associations, not effects.

Secondary outcomes

Outcome	FP-D	MC	← Lower risk with FP-D ←→ Higher risk with FP-D →	RR (95% CI)	P value
Infection requiring surgeryPropensity score weighted	3.7%	8.4%	0.050.21520	0.44 (0.25–0.77)	P = 0.004
Major bleedingPropensity score weighted	1.4%	11%	0.050.21520	0.13 (0.06–0.30)	P < 0.0001
TransfusionPropensity score weighted	7.1%	45.7%	0.050.21520	0.16 (0.11–0.22)	P < 0.0001
			0.050.21520Relative risk (log scale)

Outcome	P value
30-day death	P = 0.1316

Arterial lesions on systematic CT after FP-D

Frequent but mostly silent arterial lesions after FP-D

Safety

Outcome	FP-D	MC	← Lower risk with FP-D ←→ Higher risk with FP-D →	RR (95% CI)	P value
Major bleedingAfter propensity score weighting	1.4%	11%	0.050.21520	0.13 (0.06–0.30)	P < 0.0001
			0.050.21520Relative risk (log scale)

Arterial lesions on systematic CT after FP-D

Frequent but mostly silent arterial lesions after FP-D

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Full percutaneous decannulation of VA-ECMO using MANTA® and Femoseal® devices: a propensity-score based study. Crit Care. Published 12 April 2026. doi:10.1186/s13054-026-06012-x

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