# Rotarex Debulking in a Subtotal Occlusion of the Common Femoral Artery After Intimal Protrusion Caused by a Vascular Closure (StarClose) Device

## TL;DR

A 72-year-old woman developed leg pain after a heart procedure, caused by a device used to close a blood vessel, and was successfully treated with a specialized artery-cleaning procedure.

## Contribution

Demonstrates the successful use of Rotarex debulking to treat a rare complication from a vascular closure device.

## Key findings

- Subtotal occlusion of the femoral artery was caused by intimal protrusion from a StarClose device.
- Rotarex debulking and drug-coated balloon angioplasty restored blood flow without stent placement.
- Follow-up imaging showed improved blood flow to the distal pedal arteries after 4 weeks.

## Abstract

We present a case of a 72‐year‐old female patient who presented with resting pain in her right limb 3 weeks after coronary intervention via femoral access. Duplex sonography and angiography revealed subtotal occlusion of the right common femoral artery, due to vessel wall protrusion into the lumen, caused by the vascular closure (StarClose) device, which was used for puncture site closure during the initial coronary intervention. The patient was successfully treated with 8F Rotarex debulking and subsequent drug‐coated balloon angioplasty without stent placement. Duplex sonography after 4 weeks showed biphasic flow in the right limb down to the distal pedal arteries.