Safety and effectiveness of repeat arterial closure using the StarClose vascular closure device in patients with hepatic malignancy

Aim: To evaluate the safety and effectiveness of the use of the StarClose vascular closure device for repeat arterial closure in patients with hepatic malignancy undergoing transarterial chemoembolization (TACE). Materials and methods: A retrospective analysis of patients with hepatic malignancy who had undergone arterial closure with the StarClose device was performed in Peking Union Medical College Hospital between January 2009 and March 2012. A total of 165 patients (94 men, 71 women; mean age 60.1 ± 17.2 years) had arterial puncture closure after TACE (using a 5 F sheath). Percutaneous closure of the common femoral artery with the StarClose device was performed in accordance with the manufacturer's recommendations. The patients were examined for complications on follow-up. Device success was defined as haemostasis achieved immediately after StarClose device deployment with or without applying 3 min or less of manual compression. All the patients were evaluated clinically for wound complications and follow-up angiograms of the puncture site were obtained at subsequent TACE sessions. Results: There were a total of 593 closures using StarClose devices in 165 patients who underwent TACE, including 194 (32.7%) single closures and 399 (67.3%) repeat closures for the same femoral access. The number of repeat closures for the same femoral access ranged from one to nine (median 2). Haemostasis was achieved in 571 closures, and success rate was 96.3% (96.9% in single closures and 96% in repeat closures). There was no statistically different haemostasis success rate between single closures or repeat closures. No severe complications occurred during follow-up. Conclusion: The repeat use of the StarClose device is safe and effective in patients with hepatic malignancy undergoing TACE