Tissue puncture closure device with coiled automatic tamping system

• US 20070032823A1
• Filed: 08/04/2005
• Published: 02/08/2007
• Est. Priority Date: 08/04/2005
• Status: Active Grant

• Current Assignee: Terumo Puerto Rico, L.L.C. (Terumo Corporation)
• Original Assignee: St Jude Medical Puerto Rico LLC (Abbott Laboratories Incorporated)
• Inventors: Tegg, Troy
• Granted Patent: US 7,749,247 B2
• Time in Patent Office: Days
• US Class Current: 606/232
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/06123 Flat cylinders, e.g. including an inner reel
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00654 entirely comprised between the two sides of the opening
• CPC Class Codes: A61B 2017/00659 located only on one side of the opening
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0496 for tensioning sutures

Abstract

A method and apparatus for sealing a puncture or incision formed percutaneously in a tissue with an anchor, a sealing plug and a filament or other mechanism connecting the anchor and sealing plug. The method and apparatus provide for automatic tamping and/or cinching of the sealing plug when the apparatus is withdrawn from the puncture site. The automatic tamping and/or cinching is facilitated by a coil transducing a motive force generated by the withdrawl of the apparatus into a tamping and/or cinching force.

Claims

1. An apparatus, comprising:

a tissue puncture closure device, the tissue puncture closure device comprising;

an anchor;

a sealing plug;

a connector slidingly attaching the sealing plug to the anchor;

a coil operatively connected to the sealing plug for automatically tamping the sealing plug toward the anchor.

2. An apparatus according to claim 1 wherein the tissue puncture closure device further comprises:

a tamping tube disposed adjacent to the sealing plug;

wherein the tamping tube is driven by the coil to tamp the sealing plug.

3. An apparatus according to claim 1 wherein the tissue puncture closure device further comprises:

a housing;

a block disposed in the housing and receptive of at least a portion of the coil;

a driving plate adjacent to the coil.

4. An apparatus according to claim 1 wherein the tissue puncture closure device further comprises:

a housing;

a block disposed in the housing comprising a curved channel receptive of at least a portion of the coil;

a driving plate rotatably attached to the block, the driving plate comprising a drive pin extending into the curved channel adjacent to a first end of the coil.

5. An apparatus according to claim 1 wherein the connector comprises a filament, and wherein the tissue puncture closure device further comprises:

a housing;

a block disposed in the housing comprising a curved channel receptive of at least a portion of the coil;

a driving plate rotatably attached to the block, the driving plate comprising a drive pin extending into the curved channel adjacent to a first end of the coil;

a spool connected to the driving plate, wherein a portion of the filament is wound around the spool.

6. An apparatus according to claim 1 wherein the connector comprises a filament, and wherein the tissue puncture closure device further comprises:

a housing;

a block disposed in the housing comprising a curved channel receptive of at least a portion of the coil;

a driving plate rotatably attached to the block, the driving plate comprising a drive pin extending into the curved channel adjacent to a first end of the coil;

a spool connected by a releasable clutch to the driving plate, wherein a portion of the filament is wound around the spool.

7. An apparatus according to claim 1 wherein the tissue puncture closure device further comprises:

a housing;

a block disposed in the housing comprising a spiraled channel receptive of at least a portion of the coil;

a driving plate rotatably attached to the block, the driving plate comprising a drive pin extending into the spiraled channel adjacent to a first end of the coil.

8. An apparatus according to claim 1 wherein the tissue puncture closure device further comprises:

a housing;

a block disposed in the housing comprising a spiraled channel receptive of at least a portion of the coil;

a driving plate rotatably attached to the block, the driving plate comprising a radially free floating, angularly stable drive pin extending into the spiraled channel adjacent to a first end of the coil.

9. An apparatus according to claim 1 wherein the tissue puncture closure device further comprises:

a housing;

a block disposed in the housing comprising a spiraled channel receptive of at least a portion of the coil;

a driving plate rotatably attached to the block, the driving plate comprising a radially compliant, angularly stable drive pin extending into the spiraled channel adjacent to a first end of the coil.

10. An apparatus according to claim 1 wherein the connector comprises a filament, and wherein the tissue puncture closure device further comprises:

a housing;

a block disposed in the housing comprising a curved channel portion leading to a straight channel portion, the curved and straight channel portions receptive of at least a portion of the coil;

a driving plate rotatably attached to the block, the driving plate comprising a drive pin extending into the curved channel adjacent to a first end of the coil;

a spool connected by a releasable clutch to the driving plate, wherein a portion of the filament is wound around the spool.

11. An apparatus according to claim 1 wherein the coil is driven by a disengagable automatic driving mechanism to tamp the sealing plug;

wherein the selectably disengagable automatic driving mechanism comprises a transducer for effecting a tamping force on the sealing plug via the coil upon withdrawal of the closure device from the tissue wall puncture.

12. A tissue puncture closure device for partial insertion into and sealing of a tissue puncture in an internal tissue wall accessible through a percutaneous incision, comprising:

an anchor for disposition on a distal side of the internal tissue wall;

a sealing plug for disposition on a proximal side of the internal tissue wall;

a filament connected to and anchored at a distal end to the anchor and sealing plug for slidably cinching the anchor and sealing plug together about the tissue puncture, wherein the sealing plug is slidably disposed on the filament proximal to the anchor;

a tamping device disposed on the filament for driving the sealing plug along the filament distally towards the anchor;

a storage spool onto which a proximal end of the filament is wound;

a driving plate connected to the storage spool;

a coil operatively connected to the driving plate for providing a tamping force to the sealing plug.

13. A tissue puncture closure device for partial insertion into and sealing of a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 12 wherein the driving plate is connected to the storage spool by a releasable clutch.

14. A tissue puncture closure device for partial insertion into and sealing of a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 12, further comprising:

a housing;

a block disposed in the housing comprising a curved channel receptive of at least a portion of the coil;

wherein the driving plate is rotatably attached to the block, the driving plate comprising a drive pin extending into the curved channel adjacent to a first end of the coil.

15. A tissue puncture closure device for partial insertion into and sealing of a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 12, further comprising:

a housing;

a block disposed in the housing comprising a spiraled channel receptive of at least a portion of the coil;

wherein the driving plate is rotatably disposed adjacent to the block, the driving plate comprising a radially floating, angularly stable drive pin extending into the spiraled channel adjacent to a first end of the coil.

16. A tissue puncture closure device for partial insertion into and sealing of a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 12, further comprising:

a housing;

a block disposed in the housing comprising a spiraled channel receptive of at least a portion of the coil;

wherein the driving plate comprises;

a disk rotatably attached to the block;

a slit in the disk;

a radially flexible cantilevered finger in the slit having a drive pin extending laterally into the spiraled channel at a first end of the coil.

17. A tissue puncture closure device for partial insertion into and sealing of a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 12 wherein the coil also comprises the tamping device.

18. A tissue puncture closure device for partial insertion into and sealing of a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 12 wherein withdrawal of the closure device from the tissue puncture with the anchor bearing against the internal tissue wall unwinds the filament from the storage spool, wherein the storage spool rotates the driving plate, and the driving plate drives the coil to directly or indirectly provide a tamping force to the sealing plug.

19. A method of sealing a tissue puncture in an internal tissue wall accessible through a percutaneous incision, comprising:

withdrawing a closure device from the tissue puncture;

automatically transducing a motive force generated by withdrawal of the closure device in a first direction to a cinching or tamping force from a coil in a second direction;

disabling the tamping force in the second direction.

20. A method of sealing a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 19, further comprising applying the cinching or tamping force in the second direction to a sealing plug.

21. A method of sealing a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 19, further comprising transferring the motive force to a driving plate, and driving the coil with the driving plate.

22. A method of sealing a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 21 wherein the coil abuts a tamping tube that is slidingly disposed about a filament, the filament being connected to the sealing plug.

23. A method of sealing a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 22 wherein the transferring further comprises automatically unwinding the filament from a spool by deploying an anchor attached to the filament inside the tissue puncture, and withdrawing the closure device from the tissue puncture.

24. A method of sealing a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 23 wherein the transferring further comprises driving a pin extending from the driving plate along a channel holding the coil via unwinding.

25. A method of sealing a tissue puncture in an internal tissue wall accessible through a percutaneous incision according to claim 24, wherein the disabling comprises disconnecting the spool from the driving plate.

26. A method of sealing a tissue puncture in an internal tissue wall accessible through a percutaneous incision, comprising:

providing a tissue puncture closure device comprising a filament connected at its distal end to an anchor and to a sealing plug located proximal of the anchor for disposition and anchoring about the tissue puncture, the tissue puncture closure device also comprising a coiled automatic tamping device;

inserting the tissue puncture closure device into the percutaneous incision;

deploying the anchor into the tissue puncture;

at least partially withdrawing the closure device from the percutaneous incision;

automatically tamping the sealing plug toward the anchor upon withdrawal of the closure device from the internal tissue wall puncture with the coiled automatic tamping device;

disengaging the coiled automatic tamping device;

retracting the tissue puncture closure device;

exposing the filament;

cutting the filament;

leaving the anchor and the sealing plug at the tissue puncture.

27. A method of sealing a tissue in an internal tissue wall accessible through a percutaneous incision according to claim 26 wherein the coiled automatic tamping device comprises:

a block comprising a curved channel receptive of at least a portion of a coil;

a driving plate rotatably attached to the block, the driving plate comprising a drive pin extending into a curved channel adjacent to a first end of the coil;

a spool connected by a releasable clutch to a driving plate, wherein a portion of the filament is wound around the spool.