Use of the Starclose Device for Closure of Inadvertent Subclavian Artery Punctures

Abstract

The placement of central catheters is a common procedure. It is also associated with multiple known complications. One of the potential complications that carry high morbidity and morality is arterial puncture and cannulation. Herein, we describe five case reports of a central line that was inadvertently placed in the subclavian artery and successfully removed using a StarClose device (Abbott Laboratories, Redwood CA). A retrospective chart review of a prospectively maintained database was performed. We identified five cases of inadvertent subclavian artery cannulation during central venous catheter placement. All catheters were removed successfully either in the operating room under fluoroscopic guidance or at the bedside with closure of the arteriotomy using the StarClose device. No cases required conversion to an open procedure for repair. No postremoval hematomas, bleeding episodes, myocardial infarctions, arrhythmias, or adverse clinical sequelae were identified. Based on our limited experience, we feel that this method can be performed safely and expeditiously not only in the operating room but also at the bedside.