{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T14:00:12Z","timestamp":1790431212378,"version":"4.1.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n Peripheral veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) is commonly used to treat patients with severe cardiorespiratory dysfunction. Percutaneous decannulation (PD) using suture-mediated closure devices has emerged as an alternative to open surgical repair (OSR) following peripheral VA-ECMO. We performed a systematic review and meta-analysis to review and compare outcomes after VA-ECMO decannulation using PD versus OSR.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Six electronic databases were searched to 25 December 2025 for comparative studies evaluating PD versus OSR. Primary outcomes were access-related wound and vascular complications; secondary outcomes were inpatient mortality and procedure time. Outcomes were pooled as risk ratios (RRs) using random-effects models with the Hartung-Knapp adjustment, and are reported with 95% confidence intervals (CIs) and prediction intervals.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Ten comparative studies comprising 829 patients (438 PD, 391 OSR) were included. PD was associated with fewer access-related wound complications than OSR (RR 0.26, 95% CI 0.12-0.56, I2=20.7%), although the 95% prediction interval (0.07-1.01) reached unity. Vascular complications did not differ significantly (RR 0.71, 95% CI 0.47-1.08, I2=0%), nor did inpatient mortality (RR 0.71, 95% CI 0.40-1.28, I2=40.9%). Procedure time was shorter with PD in all four studies reporting it, although the pooled estimate was heterogeneous and imprecise (mean difference -41.6\u2009minutes, 95% CI -75.5 to -7.7, I2=95.0%).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n PD for VA-ECMO is associated with a lower incidence of access-related wound complications than OSR. Given the observational designs, clinical heterogeneity, and non-standardised outcome definitions of the available evidence, PD is best regarded as a reasonable option in carefully selected patients at centres with appropriate endovascular expertise, rather than as a default strategy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/icvts\/ivag274","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T12:22:09Z","timestamp":1790425329000},"source":"Crossref","is-referenced-by-count":0,"title":["Percutaneous decannulation with a suture-mediated closure device versus open surgical repair for peripheral veno-arterial extracorporeal membrane oxygenation: A systematic review and meta-analysis"],"prefix":"10.1093","author":[{"given":"Joshua J","family":"Hon","sequence":"first","affiliation":[{"name":"Imperial College School of Medicine , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Lizwan","sequence":"additional","affiliation":[{"name":"National University Heart Centre Department of Cardiothoracic and Vascular Surgery, ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen Yong","family":"Niam","sequence":"additional","affiliation":[{"name":"Singapore General Hospital Department of Emergency Medicine, ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khi Yung","family":"Fong","sequence":"additional","affiliation":[{"name":"Singapore General Hospital Department of General Surgery, ,","place":["Singapore"]},{"name":"National University of Singapore Yong Loo Lin School of Medicine, ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley E K","family":"Loh","sequence":"additional","affiliation":[{"name":"Woodlands Health Campus Department of Diagnostic Radiology, ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M T L","family":"Choong","sequence":"additional","affiliation":[{"name":"Andrew Choong Vascular Surgery ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Jie","family":"Ng","sequence":"additional","affiliation":[{"name":"National University Heart Centre Department of Cardiothoracic and Vascular Surgery, ,","place":["Singapore"]},{"name":"National University of Singapore Department of Surgery, Yong Loo Lin School of Medicine, ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,26]]},"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivag274\/71402757\/ivag274.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivag274\/71402757\/ivag274.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T13:14:32Z","timestamp":1790428472000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article\/doi\/10.1093\/icvts\/ivag274\/8836600"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,26]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivag274","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,26]]},"article-number":"ivag274"}}