Optimizing MANTA Closure and Bailout in Large-Bore Femoral Access: Computed Tomography Angiography-Derived...

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Medical Imaging

Background:

• The MANTA device aids hemostasis in large-bore femoral access.
• Accurate common femoral artery depth measurement is crucial for arteriotomy upsizing.
• This measurement may be unavailable in emergency or bailout situations for suture closures.

Purpose of the Study:

• To evaluate computed tomography (CT) angiography-derived common femoral artery depth as an alternative to the MANTA Depth Locator.
• To assess the reliability of CT measurements for large-bore femoral access procedures.

Main Methods:

• Retrospective study of patients undergoing transfemoral aortic valve reintervention with preprocedural CT angiography.
• Comparison of CT-derived skin-to-artery depth measurements with intraprocedural MANTA Depth Locator measurements.
• Analysis of agreement within a ±2 cm threshold, considering body mass index (BMI).

Main Results:

• 91% of CT-derived measurements agreed with MANTA Depth Locator measurements within the 2 cm threshold.
• Higher BMI significantly reduced measurement accuracy (OR 0.89 per unit increase).
• Agreement reached 96% for patients with BMI ≤ 30 kg/m².

Conclusions:

• CT angiography provides a reliable alternative to the MANTA Depth Locator for estimating common femoral artery depth.
• Increasing BMI negatively impacts the accuracy of CT-derived measurements.
• Findings support CT imaging as a valuable tool for guiding large-bore access procedures and MANTA bailout techniques.