Posterior wall capture and resultant common femoral occlusion complicating StarClose access closure

Vascular closure devices have been shown to decrease hemostasis and ambulation time after percutaneous transcatheter procedures. The StarClose Vascular Closure System (Abbott Vascular, Redwood City, Calif) is a shape memory clip-mediated device that is designed to provide extraluminal mechanical closure without compromising the arterial lumen. We report a case of iatrogenic arterial occlusion secondary to mechanical closure of the anterior and posterior walls of the common femoral artery with a StarClose device. We provide objective observations from the rescue surgical intervention and discuss potential mechanisms of device failure.