Clinical Study to Evaluate the Safety and Performance of MANTA Vascular Closure Device

The purpose of this study is to evaluate the safety and performance of MANTA in achieving hemostasis in femoral arterial access sites in patients undergoing percutaneous transcatheter interventional procedures using a 10-18F procedure sheath (such as Transcather Aortic Valve Replacement (TAVR), Balloon Aortic Valvuloplasty (BAV) and Endovascular Aneurysm Repair (EVAR)) for purposes of obtaining a CE Mark in the European Union.

The study will evaluate hemostasis success, time to hemostasis and ambulation, treatment success, and the rate of access-site-related complications in comparison to published literature on other hemostasis techniques for closing these large bore punctures (primarily, surgical closure and suture-mediated percutaneous closure.

Inclusion criteria

• Candidate for non-emergent transcatheter interventional procedure via a 10-18F femoral sheath (e.g., transcatheter aortic valve replacement [TAVR], balloon aortic valvuloplasty [BAV], Abdominal Aortic Aneurysm [AAA] stent-graft placement)
• Eligible for sheath removal in the catheterization lab
• Age ≥18 years
• Understand and sign the study specific written informed consent form
• Able and willing to fulfill the follow-up requirements
• In the Investigator's opinion, the patient is suitable for the MANTA vascular closure device, conventional hemostasis techniques and participation in an investigational trial
• Patients of childbearing age with Negative Pregnancy Test within 7 days of procedure

Exclusion criteria

Baseline Exclusions:

• Patients who are known to be pregnant or lactating
• Patients who are immunocompromised or with pre-existing autoimmune disease
• Patients who have a systemic infection or a local infection at or near the access site
• Patients requiring a re-puncture at a site previously punctured within 48 hours
• Patients with significant anemia (hemoglobin < 6.5 mmol/l, Hct<30)
• Patients who are morbidly obese or cachectic (BMI >40 or <20)
• Patients with Systolic Blood Pressure >180 mmHg, unless Systolic Pressure can be lowered by pharmacological agents prior to closure
• Patients who are currently participating in another clinical trial of an investigational device or drug that has not concluded the follow-up period
• Patients in whom an antegrade puncture is performed or planned
• Patients with a known bleeding disorder including thrombocytopenia (platelet count <150 x 10^9/L), thrombasthenia, hemophilia, or von Willebrand's disease
• Patients with a femoral artery <6 mm in diameter, femoral artery stenosis resulting in a vessel diameter <6 mm, or patients with severe peripheral vascular disease
• Common femoral artery with fluoroscopically visible calcium, as determined by Angio CT, precluding safe access in the opinion of the investigator
• Patients with allergy to bovine materials, collagen and/or collagen products, or polyglycolic or polylactic acid polymers
• Patients who cannot adhere to or complete the investigational protocol for any reason including but not limited to geographical residence or life threatening disease
• Patients with Sheehan Disability Scale (SDS) scores >12
• Patients punctured through a vascular graft
• Patients with known allergy to stainless steel or nickel
• Patients who have acute ST-elevation myocardial infarction within 48 hours prior to procedure
• Patients with unilateral or bilateral lower extremity amputation
• Patients with renal insufficiency (serum creatinine >2.5 mg/dl)
• Patients undergoing therapeutic thrombolysis
• Patients who are unable to ambulate at baseline
• Patients undergoing an interventional procedure whom are being treated with warfarin
• Patients requiring a continuous oral anticoagulation therapy