{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T07:04:41Z","timestamp":1780038281558,"version":"3.53.1"},"reference-count":13,"publisher":"The Korean Society of Critical Care Medicine","issue":"2","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"funder":[{"name":"Center for Critical Care Medicine, Bach Mai Hospital"}],"content-domain":{"domain":["accjournal.org"],"crossmark-restriction":true},"short-container-title":["ACC"],"published-print":{"date-parts":[[2026,5,31]]},"abstract":"<jats:p>Background: Achieving safe and effective closure of large-bore femoral arterial access after venoarterial extracorporeal membrane oxygenation (VA-ECMO) decannulation remains challenging. Percutaneous closure with suture-mediated devices is an established alternative to surgical repair for VA-ECMO decannulation. However, the optimal suture configuration is not well defined, and conventional cross-suture placement may have limitations. This study describes a parallel percutaneous closure technique with the potential to improve outcomes and evaluates its initial feasibility and safety.Methods: This prospective case series included 30 adult patients who underwent bedside decannulation from percutaneous femoral VA-ECMO between March 2024 and March 2025. The closure technique involved deploying two Perclose ProGlide devices (Abbott Vascular) in a parallel configuration. The primary endpoints of technical success and vascular complications were assessed clinically and by duplex Doppler ultrasound 24 hours post-procedure.Results: Technical success was achieved in all 30 patients (100%) without surgical conversion or adjunctive vascular intervention. Duplex ultrasound confirmed normal arterial flow in 23 patients (76.7%). Vascular complications included arterial thrombosis (16.7%), dissection (3.3%), and hematoma (3.3%). No patient required reintervention or developed limb ischemia within 24 hours.Conclusions: This preliminary case series suggests that the parallel percutaneous closure technique is feasible and potentially safe for large-bore femoral decannulation following VA-ECMO. Its bedside application under local anesthesia and low rate of early complications support its utility in critical care. Further studies comparing closure configurations and evaluating long-term outcomes are warranted.<\/jats:p>","DOI":"10.4266\/acc.002675","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T04:23:52Z","timestamp":1776399832000},"page":"335-343","update-policy":"https:\/\/doi.org\/10.4266\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Percutaneous vascular closure technique using parallel closure in extracorporeal membrane oxygenation decannulation: technical note and case series"],"prefix":"10.4266","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5209-2777","authenticated-orcid":true,"given":"Huong Giang Thi","family":"Bui","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5425-5002","authenticated-orcid":true,"given":"Van 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oxygenation","author":"Majunke","year":"2016"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5442-z"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1106114"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1177\/11297298251356773"},{"key":"ref9","volume-title":"Vascular access closure devices [Internet]","author":"Saleem","year":"2023"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.4244\/eij-d-16-01036"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1053\/j.optechstcvs.2023.04.005"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.4266\/acc.2023.00500"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2022.03.003"}],"container-title":["Acute and Critical 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