Preliminary Experience with the Celt Arterial Closure Device – a Retrospective Institutional Study

Introduction: The CELT arterial closure device (ACD) is a novel method of closing arteriotomy sites following endovascular procedures. We investigate the efficacy and safety of the CELT ACD.

Methods: We conducted a retrospective review of electronic medical records of adult patients who underwent procedures using the CELT ACD after neuroendovascular procedures. Data collected included patient demographics, comorbidities, closure site location, prior closure devices, procedure type, and complications related to arterial closure. We analyze the incidence of complications.

Results: We analyzed 242 procedures using the CELT ACD for arterial closure in 222 patients, with a median age of 65 years (IQR: 51-74). The cohort predominantly consisted of females (61.2%) and Caucasians (71.2%). Common comorbidities included hypertension (64.9%) and hyperlipidemia (46.8%). Half of the patients were on antiplatelet therapy, while 12.8% were on anticoagulants. Most procedures were performed via the femoral approach (96.7%); other routes included radial, brachial, and carotid access (one each). Prior closure devices were used in 15 procedures (6.2%), including 7 instances involving the CELT device due to repeat interventions in five patients. The most frequent procedures were diagnostic angiograms (53.7%), carotid stenting (13.6%), aneurysm embolization, stenting, or flow diversion (12.4%), and mechanical thrombectomies (10.7%). Complications occurred in 11 procedures (4.5%), including technical difficulties in 3, device malfunction in 1, retroperitoneal hemorrhage following 4, and minor subcutaneous bleeding in 3. Rescue closure strategies included attempts in 7 cases, with manual compression in 6, groin clamping in 2, and one using FemStop. One patient who experienced difficulty with the CELT ACD required surgical intervention for retroperitoneal hematoma and additional blood transfusion. None of the patients required heparin reversal with protamine sulfate.

Conclusion : The CELT ACD provides effective hemostasis and demonstrates a low incidence of complications, making it a safe and efficient choice for neuroendovascular interventions.