Arterial puncture closure using a clip device after transpopliteal retrograde approach for recanalization of the superficial femoral artery.
OBJECTIVE
To report the safety and efficacy of a clip device to close retrograde popliteal artery puncture sites used in recanalization of the superficial femoral artery (SFA).


METHODS
From January 2005 to March 2007, 28 patients (20 men; mean age 66+/-10 years) with stable chronic peripheral artery disease were treated for chronic total SFA occlusion. All patients received aspirin and clopidogrel and were heparinized during the procedure. After failed antegrade recanalization, the SFA was revascularized via a retrograde transpopliteal access. The StarClose Vascular System was used to seal the popliteal artery puncture site.


RESULTS
All (100%) interventions were finished successfully, and hemostasis was secured with the StarClose device in all cases. There was 1 (3.6%) major complication with the StarClose system: a transient popliteal artery occlusion induced by plaque shift during sheath removal, which was corrected with balloon angioplasty via the femoral access. Three (10.8%) small hematomas (<5 cm) occurred at the puncture site without causing significant patient discomfort.


CONCLUSIONS
In this small experience, the StarClose Vascular Closure System appeared to be an effective and safe sealing device after percutaneous transpopliteal interventions. Plaque shifting leading to stenosis or occlusion at the puncture site can occur.
Department of Angiology, Herz-Zentrum Bad Krozingen, Germany.
Elias
E
Noory
Aljoscha
A
Rastan
Sebastian
S
Sixt
Uwe
U
Schwarzwälder
Olli
O
Leppännen
Thomas
T
Schwarz
Karlheinz
K
Bürgelin
Michael
M
Hauk
Daniela
D
Branzan
Kirsten
K
Hauswald
Ulrich
U
Beschorner
Taher
T
Nazary
Regina
R
Brantner
Franz-Josef
FJ
Neumann
Thomas
T
Zeller
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D002908:Chronic Disease; D004867:Equipment Design; D005260:Female; D005263:Femoral Artery; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D011677:Punctures / Q000009:adverse effects*; D011859:Radiography; D013525:Surgical Instruments; D016896:Treatment Outcome