The Utility of the StarClose Arterial Closure Device in Patients with Peripheral Arterial Disease

Safety and efficacy of clip‐based vs. suture mediated vascular closure for femoral access hemostasis: A prospective randomized single center study comparing the StarClose and the ProGlide device

“…Thus, vascular closure after peripheral interventions becomes more important in this group of patients. While StarClose is established in PAD there is only limited data on safety and effectiveness of ProGlide in patients with significant peripheral artery disease . In our study ProGlide showed only one major complication (1.7%) in this cohort and may be safely applied also in PAD patients.…”

Low‐Dose Protamine to Facilitate Earlier Sheath Removal from the Femoral Artery After Peripheral Endovascular Intervention

“…19,20 The advent of vascular closure devices (VCD) decreased the time to hemostasis and ambulation, but has not decreased the incidence of vascular complications. 4,17 VCD are convenient because they allow for immediate removal of the arterial sheath, but our novel protamine-assisted sheath removal has a similar incidence of complications compared to other studies of access site complications. 10,11,17,21,22 Furthermore, there has been some conflicting data that the use of VCD may have a higher incidence of complications compared to manual compression.…”

“…At the inception of PEI, the standard procedure for closure of the femoral catheterization site was manual pressure and several hours of bedrest 19,20 . The advent of vascular closure devices (VCD) decreased the time to hemostasis and ambulation, but has not decreased the incidence of vascular complications 4,17 …”

“…Furthermore, PEI poses a unique problem because the femoral artery itself is often diseased and many of the interventions occur downstream from the access site 3 . Furthermore, patients with PAD are more likely to have common femoral artery disease, frequent catheterizations, groin scarring from previous incisions, and compromised flow due to aortoiliac or infrainguinal disease 4 …”

“…3 Furthermore, patients with PAD are more likely to have common femoral artery disease, frequent catheterizations, groin scarring from previous incisions, and compromised flow due to aortoiliac or infrainguinal disease. 4 The importance of obtaining adequate hemostasis to facilitate earlier femoral arterial sheath removal has previously been demonstrated in the Evaluation of c7E3 Fab in Preventing Ischemic Complications of High-Risk Angioplasty (EPIC), Evaluation of PTCA To Improve Long-term Outcome with Abciximab GP IIb/IIIa Receptor Blockade (EPILOG), and Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis (IMPACT II) trials. These studies found that delayed femoral arterial sheath removal has been shown to be an independent predictor of vascular access site complications.…”