Starclose

Manufactured by Abbott

Sourced in United States

The STARCLOSE is a vascular closure device designed to facilitate hemostasis after catheterization procedures. It is intended to provide a rapid and reliable means of sealing the puncture site in the femoral artery.

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Lab products found in correlation

Mynxgrip, by Cardinal Health (3 mentions) Angio seal, by Terumo (3 mentions) Perclose proglide, by Abbott (2 mentions) Renegade hi flo microcatheter, by Boston Scientific (1 mentions) Xenetix 350, by Guerbet (1 mentions) Angioseal, by Abbott (1 mentions) Taxus libert, by Boston Scientific (1 mentions)

8 protocols using starclose

Uterine Artery Embolization Technique

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Under ultrasound guidance, typical TFA UAE was performed by placement of a 5F vascular access sheath, through which a 5F RIM catheter (Angiodynamics, Latham, NY) was advanced to the contralateral internal iliac artery. Through this, a 3F Renegade Hi-Flo microcatheter was advanced (Boston Scientific, Natick, MA) and used to select the uterine artery (Figure 2). Embolization was performed using 500-700 micron particles to stasis.
At the termination of the procedure, an arteriogram was conducted to assess for femoral artery patency. Following this, the catheter and sheath were removed, and full haemostasis was achieved by placement of either of the following vascular closure devices: MYNXGRIP (Cardinal Health, Dublin, OH), STARCLOSE (Abbott Vascular, Chicago, IL), or ANGIO-SEAL (Terumo, Somerset, NJ). The patient was then transferred to the recovery area with his/her lower extremity straightened for 2 hours before discharge.

Ghosh A., Agnihotri T., Gupta V., Sitwala P., Stanley M., Cai S, & Akhter N.M. (2022). Transradial versus transfemoral arterial access in the uterine artery embolization of fibroids. Polish Journal of Radiology, 87, e672-e677.

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Selective Hepatic Artery Catheterization

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Using US guidance, the right common femoral artery was accessed with a 21-gauge needle through which a 5F vascular access sheath was advanced. A Simmons one hydrophilic glidecath (Terumo, Tokyo Japan) was then carried through this to the proper hepatic artery. Subsequently, a Renegade Hi-Flo microcatheter was advanced (Boston Scientific, Natick MA), and used for sub-selective branch therapy [Figure 2]. Typical femoral vascular access closure was obtained by either STARCLOSE (Abbott Vascular, Chicago, IL), MYNXGRIP (Cardinal Health, Dublin, OH), ANGIO-SEAL (Terumo, Somerset, NJ) or manual compression. The patient was then transferred to the recovery area with their lower extremity straight for 2 hours before discharge.

Ghosh A., Gupta V., Al Khalifah A, & Akhter N.M. (2022). Transradial versus transfemoral arterial access in DEB-TACE for hepatocellular carcinoma. Journal of Clinical Imaging Science, 12, 38.

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Femoral Artery Access and Vascular Closure

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Using ultrasound, the right common femoral artery was accessed with a 21gauge needle and a small skin incision was made at the puncture site. The needle was exchanged for a 5 French transitional micropuncture sheath over an 0.018-in nitinol wire. The micropuncture sheath was then exchanged for a 5 French × 10 cm vascular sheath over a 0.035-in × 145 cm Coons wire.
At the termination of the procedure, an arteriogram was conducted to assess for femoral artery patency. Following this, the catheter and sheath were removed and full hemostasis was achieved by placement of either of the following vascular closure devices: MYNXGRIP (Cardinal Health, Dublin, OH), STARCLOSE (Abbott Vascular, Chicago, IL) or ANGIO-SEAL (Terumo, Somerset, NJ). The patient was then transferred to the recovery area with his/her lower extremity straightened for 2 hours before discharge.

Ghosh A., Zhang J, & Akhter N.M. (2022). Transradial versus transfemoral arterial access in Yttrium-90 microspheres radioembolization for hepatocellular carcinoma. Journal of Clinical Imaging Science, 12, 27.

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SMA Thrombosis Endovascular Treatment

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All operations were performed under local anesthesia. Access was established according to the angle between the SMA and abdominal aorta. The puncture was performed via the brachial artery in two patients and through the femoral artery in three patients. After the access was successfully established, the sheath and guidewire were inserted, and the angiographic catheter was placed in the abdominal aorta. The filling defect in the SMA was confirmed by angiography. After administration of heparin at 1 mg/kg, a long 6F sheath was inserted into the abdominal aorta, and a vertebral or Simmons catheter was passed into the SMA with the assistance of the guidewire. The long sheath was then placed in the proximal SMA. A 0.018-inch guidewire was placed in the SMA through the thrombus, reaching the distal end. Along the guidewire, a 6F Rotarex system was inserted to the target lesion, and thrombectomy was performed (Fig. 3). A second angiographic examination was then performed. When a residual thrombus was found, 250,000 IU of urokinase was administered, or an indwelling thrombolytic catheter was placed; if residual stenosis was detected, balloon dilatation or stent implantation was performed. After withdrawing the Rotarex device, a vascular closure device (StarClose; Abbott Vascular, Temecula, CA) was used to seal the arterial access. The wound was compressed with an elastic bandage.

Zhang Z., Chen X., Li C., Feng H., Yu H, & Zhu R. (2020). Percutaneous Mechanical Thrombectomy for Acute Superior Mesenteric Artery Embolism: Preliminary Experience in Five Cases. Annals of vascular surgery, 63.

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Vascular Closure Device Sealing Mechanism

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An FDA-approved VCD (StarClose, Abbott Vascular; Abbott Laboratories, Abbott Park, Il, USA) using a clip-mediated sealing mechanism was used in this study. Therefore, the vascular sheath (5F) in the FA has to be exchanged over a stiff guide wire for the system specific sheath. Thereafter, the tip of the system containing the sealing clip is introduced into the sheath until the system clicks into place. After that, the sheath is split and the sealing clip closes the puncture site. No local compression of the puncture site is performed.

Isfort P., Tanaka T., Penzkofer T., Bruners P., Tolba R., Kuhl C.K, & Mahnken A.H. (2014). Vascular Closure Devices after Endovascular Procedures in Swine: A Reliable Method?. The Scientific World Journal, 2014, 514942.

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Coronary Angiographic Procedures Standardization

Cited 1 time

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CCA was performed after CTA/CTP using the routine clinical protocol and angiographic projections were standardised [17 (link)]. The femoral artery was punctured after local anesthesia with approx. 150–200 mg lidocaine (Lidoject, Hexal AG, Holzkirchen, Germany). A nonionic, iodinated contrast agent (iobitridol, Xenetix 350, Guerbet, Villepinte, France) was used. Fractional flow reserve (FFR) was measured in a total of 8 patients. Adenosine (140 μg/kg/min; Adenosin Life Medical, Carinopharm GmbH, Gronau/Leine, Germany) was infused intra-arterially via the cardiac catheter for 3 to 5 min, at the cardiologist’s discretion to identify culprit lesions [18 (link)]. After the examination, a suture closure device was used in 66 cases (AngioSeal, St. Jude Medical, Minnesota, USA; Starclose and Perclose, Abbott Laboratories, Illinois, USA), and 4–6 h of bed rest were ordered. The compression bandage was removed after 2–3 h. In the 22 cases where manual compression was used, 12 h of bed rest were required, and the compression bandage was removed after 6 h.

Rief M., Feger S., Martus P., Laule M., Dewey M, & Schönenberger E. (2015). Acceptance of Combined Coronary CT Angiography and Myocardial CT Perfusion versus Conventional Coronary Angiography in Patients with Coronary Stents—Intraindividual Comparison. PLoS ONE, 10(9), e0136737.

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Stenosis Treatment with Stent Implantation

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Patients with stenosis diagnosed using Doppler ultrasonography underwent an angiographic study. The access route for the procedures was either the ipsilateral or contralateral common femoral artery. Pelvic and transplanted renal artery angiograms were performed for anatomical evaluation and lesion quantification.
Following angiographic confirmation of stenosis, systemic heparinization was performed with unfractionated heparin, followed by transposition of the lesion with a 0.014 guidewire. All cases were treated with stent implantation: in one case, a self-expanding stent was used, and in the other cases, expandable balloon stents, such as Vision^® Cobalt Chromium (Abbott Laboratories, Chicago, IL, USA), TAXUS™ Liberté™ (Boston Scientific Corporation, Natick, MA, USA), Express™ Vascular Stent (Boston Scientific Corporation), Dynamic Stent (BIOTRONIK, Berlin, Germany), and/or Direct-Stent^® (InSitu Technologies, St. Paul, MN, USA), were used. The materials were used without standardization at the discretion of the interventional physician. At the end of the procedure, hemostatic devices, such as the Perclose Proglide (Abbott) and/or the StarClose (Abbott) devices, were used at the puncture site.

Valle L.G., Cavalcante R.N., Motta-Leal-Filho J.M., Affonso B.B., Galastri F.L., Doher M.P., Guimarães-Souza N.K., Cavalcanti A.K., Garcia R.G., Pacheco-Silva Á, & Nasser F. (2017). Evaluation of the efficacy and safety of endovascular management for transplant renal artery stenosis. Clinics, 72(12), 773-779.

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Arterial Sheath Removal and Hemostasis Techniques

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Arterial sheaths were routinely removed in the operation room and hemostasis was achieved either by manual compression or by use of arterial closure devices. The method of hemostasis was mainly decided on the basis of physician preference, but manual compression was preferred for small caliber sheaths or for heavily calcified access sites. Manual compression was performed by the first assistant for at least 20–30 minutes, a compression bandage was then applied, and patients were advised to stay immobilized for at least 6–8 hours after the procedure. For ACDs, the puncture sites and gloves were sterilized with chlorhexidine solution before application of the devices, and arterial closure was performed according to the instructions for use of each device. The ACDs used were the Perclose ProGlide (Abbott Vascular Inc., Santa Clara, CA, USA), FemoSeal (St. Jude Medical, St. Paul, MN, USA), StarClose (Abbott) and Mynx (Cardinal Health, Dublin, OH, USA). In these patients, bed rest for 4 hours after closure was recommended.

Eleshra A., Kim D., Park H.S, & Lee T. (2019). Access site pseudoaneurysms after endovascular intervention for peripheral arterial diseases. Annals of Surgical Treatment and Research, 96(6), 305-312.

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