Related Experiment Video
Updated: Jul 9, 2025

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Comparison of MANTA versus Perclose Prostyle large-bore vascular closure devices during transcatheter aortic valve
Israel M Barbash1,2, Yishay Wasserstrum1,2, Magdalena Erlebach3
1Interventional Cardiology Unit, Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
Background:
New vascular closure devices (VCD) are being introduced for achieving hemostasis after transcatheter aortic valve implantation (TAVI). However, no safety or efficacy data have been published compared to other contemporary VCD.
Aim:
To compare the safety and efficacy of suture-based Perclose Prostyle as compared to plug-based MANTA device.
Methods:
A total of 408 consecutive TAVI patients from two high volume TAVI centers were included in the present study. Patients were grouped according to VCD: Prostyle versus MANTA. Propensity score matching (PSM) and multivariable analysis were utilized to compare clinical endpoints between the two groups. The primary endpoint was any vascular complication (VC) according to VARC-3 criteria.
Results:
After PSM, a total of 264 patients were analyzed, of them 132 in each group. Overall baseline characteristics of the two groups were comparable. Primary end-point was similar between MANTA as compared to Prostyle (16.7% vs. 15.3% respectively, p = 0.888). The main driver for VC among MANTA group were minor vascular complications (15.2%). Conversely, minor and major VC contributed equally to the primary endpoint among Prostyle group (7.6%) (p = 0.013). No outcome predictors were identified in multivariate analysis.
Conclusions:
VCD for transfemoral TAVI using the new-generation Prostyle device or the MANTA device achieved comparable VARC-3 VC rates.

