Pre-anchoring and post-securing technique for decannulation in peripheral veno-arterial extracorporeal membrane...

ProGlide is utilized for decannulation of peripheral veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) often associated with pseudoaneurysm formation and failure to achieve hemostasis. These complications arise from the enlargement of the arteriotomy site associated with prolonged VA ECMO support, rendering the standard two-ProGlide suture technique insufficient for effective vessel closure. We introduce a novel approach for peripheral VA ECMO decannulation, the "pre-anchoring and post-securing technique," creating a knot prior to ECMO cannulation, maintaining suture during ECMO support through suture fixation, and securing the knot at the time of decannulation. Outcomes were retrospectively analyzed in five cases. The median arterial cannula size was 17 Fr, and ECMO support lasted a median of 384 h. the procedural success rate was 100%, without complications. No bacterial growth was observed in cultures from the pre-anchored sutures, and no bloodstream infections were detected. Our technique may enhance decannulation success rates for large cannulas post-ECMO.