Advances in arterial closure: Novel closure strategies with the Celt ACD device

The Celt Arterial Closure Device (ACD) is a steel plug system that enables hemostasis for arteriotomies. Though typically used for femoral access, its precision and guide tube length allow for closure of nontraditional sites. A single center, retrospective review of 3609 Celt ACD cases from 2020 to 2024 identified two nonfemoral accesses. One used cone beam computed tomography-guided access of the posterior division of the internal iliac artery for endovascular aneurysm repair, and the other involved thoracic aortic access for endoleak embolization status post thoracic endovascular aortic repair. In the first case, a 5 Fr sheath at a depth of 5 cm was closed under fluoroscopic guidance, with stable device position at 7 months. In the second case, a 5 Fr sheath, 2.5 cm deep was closed after thoracic aortic access with stable device position at 1 month post procedure. The Celt ACD enabled successful closure in two nonfemoral, anatomically complex arterial access sites.