Endovascular aortic aneurysm repair is currently the gold standard of care. Open access to femoral arteries is traumatic and accompanied by an increase of operation time and local complications. At the same time percutaneus access also showed the risc acute bleeding from the access zone, acute arterial thrombosis, and stenosis of the vessel in long term follow up. At the same time, the development of closure devices technologies prevent this complications, but the results are debatable. Aim. To evaluate the safety of MANTA close device (MCD) after percutaneous femoral access for EVAR and TEVAR.

In our retrospective and multicentre study were 212 patients included from April 2017 till October 2021 with abdominal aortic aneurysms and thoracic aortic pathology. There were 33 females and 179 males, the mean age was 68±6 years. For grafts implantation femoral access was used with 9-14F sheaths. The primary effectiveness endpoint was a technical success, freedom of acute bleeding, acute lower limb ischemia due to thromboembolic events. Groin elastic bandage were used after implantation for 24 hours, with anticoagulation therapy. The MANTA Closure Device, a class III device, is the first clinically approved, fully dedicated large-bore closure device. The MANTA device is comprised of an extravascular collagen patch secured with a minor intravascular resorbable polymer component, providing both biological and mechanical hemostasis. This device not require a preclose technique.

Technical success of MCD implantation was 100%. In two cases was groin hematoma after 24 hours, no any revision was performed. After interventions no any major vascular access site complications requiring surgical treatment was diagnosed. No thrombotic or embolic complication during hospitalisation were detected. No bleedeng in 30 days after operation. No any local aneurysm in 6 month were detected.

MANTA closure device is safe and effective for vascular access closing after percutaneous femoral access for aortic grafts implantations.