Background/Objectives: To compare technical hemostasis outcomes of collagen-based Obtura and nitinol clip-based StarClose vascular closure devices (VCDs) for femoral access-site closure after transfemoral neurointerventional procedures in two cohorts treated during non-overlapping periods. Methods: In this single-center retrospective cohort study, 166 of 250 consecutive patients undergoing transfemoral neurointervention (2022–2025) were included after exclusions; closure was performed via a 6F sheath with Obtura in 2025 (n = 98) or StarClose in 2022–2024 (n = 68). The primary endpoint was hemostasis with gentle pressure within 2 min of device deployment without additional procedure or prolonged manual compression. Unadjusted, adjusted, and propensity-score-matched (PSM) analyses were performed, along with a threshold-sensitivity analysis. Results: Technical success was 52.9% in the StarClose period and 70.4% in the Obtura period (OR, 2.11; 95% CI, 1.11–4.03; p = 0.033); the association was not significant after adjustment (OR, 1.99; 95% CI, 0.99–3.99; p = 0.053) or PSM (OR, 1.55; 95% CI, 0.72–3.30; p = 0.261). Additional compression time among failures was shorter in the StarClose period (5.5 vs. 10.0 min; p < 0.001). One pseudoaneurysm and one hematoma occurred per group; no major complications occurred. A ≤7-min threshold reversed the direction (OR, 0.77; 95% CI, 0.38–1.57; p = 0.592). Conclusions: The devices were used in completely different, non-overlapping periods; therefore, device effects cannot be separated from period effects. These findings do not demonstrate the superiority of either device. They are hypothesis-generating and provide a basis for designing prospective, concurrent comparative studies.
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Kat et al. (2026) studied this question.
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