Safety and efficacy of the Celt arterial closure device in a femoral first neuroendovascular practice: prospective cohort study.

Abstract

To evaluate the safety and efficacy of the Celt arterial closure device (ACD), allowing immediate upright position and ambulation within 30 minutes, for femoral access closure in neuroendovascular procedures. Single center prospective study of consecutive neuroendovascular procedures performed via transfemoral access over 6 months. The Celt ACD was preferentially used for arterial closure in eligible cases. Patient demographics, comorbidities, procedural characteristics, antithrombotic regimens, and access site complications were recorded. The primary outcome was the rate of major access site complications resulting in red blood cell transfusion, interventional repair, retroperitoneal hematoma, or death. The secondary outcome was the rate of minor access site complications, including groin hematomas, pseudoaneurysms, ipsilateral deep vein thrombosis, limb ischemia, and infections. During the study period, 456 patients underwent 520 femoral access procedures using Celt ACD closure. Most procedures were routine (82.5%, 429/520), with the remaining cases performed urgently (8.7%, 45/520) or emergently (8.8%, 46/520). Mean age of patients was 60.2±16.2 years and 62.1% (283/456) were women. 30.2% (157/520) of cases were on dual antiplatelet therapy (DAPT) or therapeutic anticoagulation. Among the 520 Celt ACD closures, there were no major access site complications. Minor complications occurred in only 1.3% (7/520) of cases, which were limited to small groin hematomas that all resolved after manual compression. The rate of groin hematoma was higher in cases on DAPT or anticoagulation versus those not on therapy (3.2% (5/157) vs 0.6% (2/363), P=0.017). In this study, the Celt ACD was safe and effective in providing rapid femoral artery closure in neuroendovascular procedures.