Central Pseudo-Aneurysm Formation Following Arterial Closure with a StarClose SE Device: When a StarClose Doesn’t Completely Close
Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Educational Purpose (only if useful for a systematic review or synthesis)
Sehrish Memon, Timothy C. Ball
Department of Cardiovascular Medicine, Carilion Roanoke Memorial Hospital, Roanoke, VA, USA
Am J Case Rep 2016; 17:207-210
Vascular closure devices (VCDs) are frequently used for hemostasis with endovascular procedures by employing sutures or plug devices (using collagen or hydrogel) or through the use of a metal clip made of nickel and titanium, such as the StarClose SE device. In comparison to manual compression (MC), VCDs are associated with earlier time to discharge and ambulation, improved patient comfort, and better cost-effectiveness.
CASE REPORT: A 77-year-old man with history of ischemic cardiomyopathy with non-ST segment elevation myocardial infarction (NSTEMI) underwent diagnostic cardiac catheterization with deployment of a StarClose SE vascular closure device for hemostasis. Upon repeat access 4 days later for coronary intervention, retrograde sheath angiography revealed a pseudo-aneurysm emanating from the center of the StarClose clip.
CONCLUSIONS: A review of the literature shows VCDs to be non-inferior to MC, with an overall high success rate. Major and minor complications rates are comparable to those with MC, and pseudo-aneurysm is an infrequent complication.
Keywords: Femoral Artery - radiography, Aneurysm, False - radiography, Aged, Humans, Male, Vascular Closure Devices - adverse effects