Comparative effectiveness and safety of Angio-Seal and StarClose vascular closure devices: a systematic review and meta-analysis

Objective: This systematic review and meta-analysis aims to evaluate the effectiveness and safety of Angio-Seal and StarClose vascular closure devices (VCDs) in achieving hemostasis after interventional surgery. Methods: Randomized controlled trials (RCTs) and observational studies comparing Angio-Seal and StarClose were identified through systematic searches. Data on vascular closure success rate, complication rates, hematoma formation, pseudoaneurysm, arterial occlusion, and surgical intervention were extracted and pooled using a random effects model. Results: Nine studies met the inclusion criteria, total 5,466 patients. The meta-analysis revealed a slight, statistically significant difference in the success rate of vascular closure in favor of Angio-Seal (risk ratio (RR) 1.05, 95% confidence interval (CI) [1.00-1.09], p = 0.03). No significant difference was found in the overall complication rate, hematoma formation, pseudoaneurysm, arterial occlusion, or surgical intervention. Conclusions: Angio-Seal demonstrated a slightly higher success rate in vessel closure compared to StarClose. Both devices had a comparable safety profile with no significant differences in major complications.