{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T06:10:23Z","timestamp":1778998223214,"version":"3.51.4"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The MANTA (Teleflex, Wayne, PA, USA) facilitates hemostasis in large\u2010bore femoral access. However, precise measurement of the common femoral artery depth is required before arteriotomy upsizing. This measurement may be unavailable in emergencies or bailout scenarios for suture\u2010based closures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to evaluate computed tomography (CT) angiography\u2010derived common femoral artery depth measurement as an alternative to the MANTA Depth Locator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study at MedStar Washington Hospital Center included all patients with available preprocedural ilio\u2010femoral CT angiography undergoing transfemoral aortic valve reintervention from March 13, 2023, to September 4, 2024. CT measurements of skin\u2010to\u2010artery depth at a designated puncture site, based on the MANTA Instructions for Use 45\u2010degree approach, were compared with intraprocedural MANTA Depth Locator measurements. The acceptable threshold for agreement was defined as \u00b12\u2009cm to ensure safe in\u2010vessel deployment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 289 patients (mean age 78.2 years, 43.6% female), 91% of CT\u2010derived measurements fell within the 2\u2009cm threshold, demonstrating strong agreement. Logistic regression showed that a higher BMI reduced accuracy, with each unit increase in BMI decreasing the odds of meeting the threshold by 11% (OR 0.89;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). For patients with BMI\u2009\u2264\u200930\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009189), the agreement increased to 96%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CT angiography\u2010derived measurements align well with MANTA Depth Locator measurements, although accuracy declines with increasing BMI. These findings support CT imaging as a reliable alternative to MANTA bailout in large\u2010bore access procedures. A practical algorithm for MANTA bailout techniques is proposed to guide clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.31661","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T23:34:37Z","timestamp":1750980877000},"page":"1561-1569","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing MANTA Closure and Bailout in Large\u2010Bore Femoral Access: Computed Tomography Angiography\u2010Derived Measurements and Rescue Strategies"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4873-2887","authenticated-orcid":false,"given":"Lior","family":"Lupu","sequence":"first","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5222-049X","authenticated-orcid":false,"given":"Andrew P.","family":"Hill","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2897-8919","authenticated-orcid":false,"given":"Dan","family":"Haberman","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0602-2684","authenticated-orcid":false,"given":"Kalyan R.","family":"Chitturi","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington District of Columbia 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