{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:33:12Z","timestamp":1780594392795,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The MANTA vascular closure device (VCD) is dedicated to large bore access closure and associated with favorable results in selected study populations. Anatomical predictors for access site complications are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate MANTA in a real\u2010world population and identify predictors for vascular complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients undergoing transfemoral transcatheter aortic valve replacement (TAVR) between January 2016 and May 2020 with MANTA closure were included. Baseline characteristics were collected, pre\u2010procedural computed tomography and post\u2010deployment femoral angiograms were analyzed for anatomical differences. The primary endpoint was a composite of access site related major and minor vascular complications at 30\u2009days follow\u2010up according to the VARC\u20102 definitions. Secondary endpoints included bleeding, time to hemostasis, procedural length and incomplete arteriotomy closure or arterial occlusion by angiography. A Cox proportional hazards model was used to compare all\u2010cause mortality for patients with and without an access site complication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 512 patients underwent TAVR with MANTA access closure. Median age was 80 (IQR 75\u201385), 53% was male, median BMI was 26.4\u00a0kg\/m2 (IQR 23.4\u201329.7). Access site related major\u2010 or minor vascular complication occurred in 20 (4%) and 23 (4%) of patients respectively. Median time to hemostasis was 42\u2009s (IQR 28\u201398). Post deployment angiogram showed an occlusion in 24 patients (5%), incomplete closure in 60 patients (12%) or both in three patients (1%). Of these 87 patients, 36 (41%) had a vascular complication. Femoral artery diameter (OR 0.70 [0.53\u20130.93]), low\u2010 (OR 3.47 [1.21\u201310.00]) and high (OR 2.43 [1.16\u20135.10]) arteriotomies were independent predictors for vascular complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this contemporary TAVR population, access\u2010site related complications occurred in 8% of patients and were mainly due to percutaneous closure device failure. Small artery diameter and off\u2010target punctures were independent predictors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.29506","type":"journal-article","created":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T12:01:38Z","timestamp":1612612898000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Vascular complications with a plug\u2010based vascular closure device after transcatheter aortic valve replacement: Predictors and bail\u2010outs"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6026-8605","authenticated-orcid":false,"given":"Maarten P.","family":"van Wiechen","sequence":"first","affiliation":[{"name":"Department of Cardiology Erasmus University Medical Center  Rotterdam 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