StarClose SE Vascular Closure System

Added Sep 6, 2007

Manufactured by Abbott Vascular

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Comment by IRtrainee Commented Jan 7, 2019

Impact factor: 20

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Generally very reliable and quick to deploy closure device, with a low failure rate. Have deployed in scarred groins (previous endarterectomy etc) and successfully achieved haemostasis. Care must be taken to ensure adequate blunt dissection (usually easily achieved with Mosquito forceps alongside the sheath) down to the vessel - this will ensure that the clip is successfully deployed right down on to the vessel wall.

Downside of the system is it leaves a nitinol clip permanently in the vessel wall - this could be an issue if multiple punctures are anticipated in the same vessel and there is relatively little healthy vessel to puncture. This is likely to mean greater precision is required for future punctures to avoid the clip, which can be challenging especially in obese patients or those with difficult anatomy.

Comment by Commented Jun 30, 2008

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This is an excellent device and has largely eliminated my concerns over hemostasis at the end of the case. Here are some fine points I have learned to increase chances of success with this device: (These may not be fully appreciated by anyone who has not used the device.) 1. Be sure to generously dissect the access site incision/track before puncture or the shaft of the device will not fit easily and can pull out the metal loops that allow vessel fixation during deployment. 2. Be cautious when pulling the metal loops along the vessel as they can become lodged on plaque and damage the vessel. If necessary the loops can be retracted with the abort button and can be redeployed after the plaque has been passed. 3. Be cautious when using in the arm as the vessels here may not be large enough to allow free passage of the metal loops as they are withdrawn. I would like to see a version that would allow you to maintain wire access in the event the clip does not result in hemostasis.

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