Clinical outcomes of MANTA vs suture-based vascular closure devices after transcatheter aortic valve replacement: An updated meta-analysis

Doshi, Rajkumar; Vasudev, Rahul; Guragai, Nirmal; Patel, Kunal N; Kumar, Ashish; Majmundar, Monil; Doshi, Preet; Patel, Prem; Shah, Kalpesh; Santana, Melvin; Roman, Sherif; Vallabhajosyula, Saraschandra; Virk, Hartaj; Bikkina, Mahesh; Shamoon, Fayez

doi:10.1016/j.ihj.2023.01.007

Cited by 4 publications

(4 citation statements)

References 40 publications

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“…We can speculate that this higher rate of bleeding complications in our study was related to higher immediate closure failure in the Prostar group (13.6% versus 4.5% in the Manta group, p = 0.01), which is in line with the literature with suture-based devices [29][30][31][32] and required more frequent use of covered stents.…”

Section: Bleeding Complicationssupporting

confidence: 90%

“…The data from this study are consistent with the literature in terms of vascular complications, with no significant differences between MANTA and suture-based devices [9][10][11][12]25,[29][30][31][32].…”

Section: Vascular Complicationssupporting

confidence: 89%

“…In terms of specific complications, there was a higher rate of femoral stenosis in the Manta group, with no difference in terms of clinical impact or need for surgery. Moccetti et al [21] report this same difference, although this was not found in the most recent meta-analysis [29][30][31][32]. Femoral stenosis can be due to poor toggle positioning of the anchor on the internal side of the artery, especially in the presence of calcifications and in small femoral arteries, and this could be an explanation for the higher rate of femoral stenosis in our study.…”

Section: Vascular Complicationssupporting

confidence: 57%

“…These results are in line with the Moriyama study [9], where the bleeding complication rate was 18% in the MANTA group versus 33% in the ProGlide group (OR = 0.44, CI 95 0.23-0.83, p = 0.01). However, this difference was not found in the most recent meta-analysis in terms of major and minor bleeding complications [29][30][31][32].…”

Section: Bleeding Complicationsmentioning

confidence: 83%

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Vascular Complications Following Transcatheter Aortic Valve Implantation, Using MANTA (Collagen Plug-Based) versus PROSTAR (Suture-Based), from a French Single-Center Retrospective Registry

Benic,

Nicol,

Hannachi

et al. 2023

JCM

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TAVI requires a large-bore arteriotomy. Closure is usually performed by the suture system. Some studies report a vascular complication rate of up to 21%. MANTA is a recently developed percutaneous closure system dedicated to large caliber vessels based on an anchoring system. Early studies report a lower rate of vascular complications with MANTA devices. This single-center retrospective study included all patients who underwent femoral TAVI at the Brest University Hospital from 20 November 2019 to 31 March 2021. The primary endpoint is the rate of vascular complications (major and minor) pre and post-TAVI procedure. In total, 264 patients were included. There were no significant differences in vascular complications (major and minor) between the two groups (13.6% in the MANTA group versus 21.2% in the PROSTAR group; p = 0.105), although there was a tendency to have fewer minor vascular complications in the Manta group (12.1% versus 20.5%; p = 0.067). Manta was associated with a lower rate of bleeding complications (3.8% versus 15.2%; p = 0.002), predominantly minor complications with fewer closure failures (4.5% versus 13.6%; p = 0.01), less use of covered stents (4.5% versus 12.9%; p = 0.016), and with no difference in the need for vascular surgery compared to the Prostar group (1.5% versus 2.3%; p = 0.652). On the other hand, Manta was associated with a higher rate of femoral stenosis (4.5% versus 0%; p = 0.013) without clinical significance (1.5% versus 0%; p = 0.156). The Manta and Prostar devices are equivalent in terms of vascular complications. The Manta, compared to the Prostar, is associated with fewer bleeding complications.

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Section: Bleeding Complicationssupporting

confidence: 90%

Section: Vascular Complicationssupporting

confidence: 89%

Section: Vascular Complicationssupporting

confidence: 57%

Section: Bleeding Complicationsmentioning

confidence: 83%

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Vascular Complications Following Transcatheter Aortic Valve Implantation, Using MANTA (Collagen Plug-Based) versus PROSTAR (Suture-Based), from a French Single-Center Retrospective Registry

Benic,

Nicol,

Hannachi

et al. 2023

JCM

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Clinical outcomes of MANTA closure device in percutaneous endovascular aortic aneurysm repair

Peeters,

Oosterveld,

Decraemer

et al. 2024

Journal of Vascular Surgery

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SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study)

Cammardella,

Russo,

Di Mauro

et al. 2024

JCM

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Background: The transfemoral (TF) approach is the most common route in TAVI, but it is still associated with a risk of bleeding and vascular complications. The aim of this study was to compare the clinical outcomes between surgical cut-down (SC) and percutaneous (PC) approach. (2) Methods: Between January 2018 and June 2022, 774 patients underwent a transfemoral TAVI procedure. After propensity matching, 323 patients underwent TAVI in each group. (3) Results: In the matched population, 15 patients (4.6%) in the SC group vs. 34 patients in the PC group (11%) experienced minor vascular complications (p = 0.02), while no difference for major vascular complication (1.5% vs. 1.9%) were reported. The rate of minor bleeding events was higher in the percutaneous group (11% vs. 3.1%, p <.001). The SC group experienced a higher rate of non-vascular-related access complications (minor 8% vs. 1.2%; major 2.2% vs. 1.2%; p < 0.001). (4) Conclusions: SC for TF-TAVI did not alter the mortality rate at 30 days and was associated with reduced minor vascular complication and bleeding. PC showed a lower rate of non-vascular-related access complications and a lower length of stay. The specific approach should be tailored to the patient’s clinical characteristics.

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Clinical outcomes of MANTA vs suture-based vascular closure devices after transcatheter aortic valve replacement: An updated meta-analysis

Cited by 4 publications

References 40 publications

Vascular Complications Following Transcatheter Aortic Valve Implantation, Using MANTA (Collagen Plug-Based) versus PROSTAR (Suture-Based), from a French Single-Center Retrospective Registry

Vascular Complications Following Transcatheter Aortic Valve Implantation, Using MANTA (Collagen Plug-Based) versus PROSTAR (Suture-Based), from a French Single-Center Retrospective Registry

Clinical outcomes of MANTA closure device in percutaneous endovascular aortic aneurysm repair

SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study)

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