Vessel wound closure device

• US 20070149987A1
• Filed: 12/22/2005
• Published: 06/28/2007
• Est. Priority Date: 12/22/2005
• Status: Abandoned Application

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Johnson, Paul, Beckett, Trevor, Szabo, David, Wellman, Parris, Ogle, Bryan, Wicks, Benjamin
• Application Number:
  US11/317,039
• Publication Number:
  US 20070149987A1
• Time in Patent Office: Days
• US Class Current: 606/148
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/00672 Locating means therefor, e.g. bleed back lumen
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0461 with features cooperating with special features on the suture, e.g. protrusions on the suture
• CPC Class Codes: A61B 2017/0462 One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/06176 with protrusions, e.g. barbs

Abstract

A vessel wound closure device that separately deploys a suture and a snare within a vessel to produce a stitch across a puncture site of a vessel. Once deployed within the vessel, the suture is captured within the snare, withdrawn, and then secured to provide a stitch across the puncture site of the vessel. The vessel wound closure device minimizes the amount of material introduced or left within the vessel or between edges of the puncture site, maximizes healing of the puncture site, and renders the vessel amenable to subsequent interventional or therapeutic procedures at or near the same site.

Claims

1. A vessel wound closure device for use with a vessel wound comprising:

a sheath having a proximal end and a distal end;

a first hollow vessel penetrating member associated with the sheath and a second hollow vessel penetrating member associated with the sheath, wherein the first and second vessel penetrating members are movable from a first position to a second position beyond the distal end of the sheath to penetrate through a vessel wall adjacent the vessel wound;

a suture slidably housed within the first hollow vessel penetrating member; and

a single filament snare loop slidably housed within the second hollow vessel penetrating member, wherein the snare loop is positionable to capture the suture when the first and second vessel penetrating members are in the second position.

2. The vessel wound closure device of claim 1, further comprising a needle at a distal end of the first hollow vessel penetrating member, and a needle at a distal end of the second hollow vessel penetrating member.

3. The vessel wound closure device of claim 1, further comprising a bioabsorbable locking means applied to the suture and snare loop.

4. The vessel wound closure device of claim 3, wherein the locking means is one of a collar, a knot, a snap-fitting, a ratcheting connection, or sutures and wires.

5. The vessel wound closure device of claim 3, further comprising a thrombogenic material incorporated into the locking means.

6. The vessel wound closure device of claim 1, further comprising a guide associated with the sheath for each respective first and second vessel penetrating member.

7. The vessel wound closure device of claim 1, wherein the suture further comprises knots or other projections.

8. The vessel wound closure device of claim 11, wherein at least one of the first and second vessel penetrating members comprises a blood flashback conduit configured to identify when the vessel has been penetrated by the respective at least one of the first and second vessel penetrating members.

9. The vessel wound closure device of claim 1, wherein the second hollow vessel penetrating member is located downstream of the first hollow vessel penetrating member.

10. The vessel wound closure device of claim 1, wherein the suture further comprises at least one barb at a distal end thereof.

11. The vessel wound closure device of claim 1, wherein the suture further comprises a fibrous structure at a distal end of the suture and at least one barb along the suture.

12. A method for closing a vessel wound in a vessel of a patient, the method comprising:

deploying a first hollow vessel penetrating member and a second hollow vessel penetrating member through a vessel wall and into the vessel adjacent the vessel wound;

deploying a suture from the first hollow vessel penetrating member;

deploying a single filament snare loop from the second hollow vessel penetrating member; and

capturing the suture within the single filament snare loop within the vessel.

13. The method of claim 12, wherein the first and second vessel penetrating members are associated with a sheath and deployed through an introducer.

14. The method of claim 12, wherein the first and second vessel penetrating members are associated with a sheath and deployed over a guidewire.

15. The method of claim 14, further comprising determining the location of the first and second vessel penetrating members within the vessel by providing flashback of blood from the vessel through at least one of the first and second hollow vessel penetrating members.

16. The method of claim 12, further comprising orienting the second hollow vessel penetrating member downstream of the first hollow vessel penetrating member within the vessel.

17. The method of claim 16, wherein capture of the suture within the snare loop is determined by sensing resistance in at least one of the first and second vessel penetrating members.

18. The method of claim 16, wherein the snare loop is deployed to be approximately perpendicularly situated between vessel walls of the vessel.

19. The method of claim 16, wherein the snare loop is deployed to have a portion thereof approximately beneath the first hollow vessel penetrating member.

20. The method of claim 16, wherein the suture and snare loop are withdrawn from the vessel through one of the first and second hollow vessel penetrating members and extravascularly secured.

21. The method of claim 20, wherein extravascularly securing the suture and snare loop comprises sliding a bioabsorbable locking means over the suture and snare loop.

22. The method of claim 20, wherein extravascularly securing the suture and snare loop further comprises providing at least one barb on a distal portion of the suture that deflects against an outer surface of the vessel wall when the suture is tightened.

23. The method of claim 20, wherein extravascularly securing the suture and snare loop further comprises providing a fibrous structure at distal end of the suture and at least one barb that penetrates through and deflects so that it is positioned against the fibrous structure after capture and withdrawal of the suture from the vessel by the snare loop.

24. A vessel wound closure device comprising:

a sheath having a proximal end and a distal end;

a thumb grip between the proximal end and the distal end of the sheath;

the sheath extending distally from the thumb grip and having a first exit port, a second exit port, and a movable stabilizer foot at a distal end thereof;

a first hollow vessel penetrating member extending through the sheath;

a second hollow vessel penetrating member extending through the sheath;

a slidable suture extending through the first hollow vessel penetrating member;

a slidable snare loop extending through the second hollow vessel penetrating member; and

a first rail extending proximally from the thumb grip, the first rail having a first slide mounted thereon for regulating movement of the first hollow vessel penetrating member and a second slide mounted thereon for regulating movement of the suture.

25. The vessel wound closure device of claim 24, further comprising a needle at a distal end of each of the first and the second hollow vessel penetrating members.

26. The vessel wound closure device of claim 24, wherein the thumb grip further comprises a stabilizer foot activation lever for deploying the stabilizer foot from a retracted position to a deployed position.

27. The vessel wound closure device of claim 26, wherein the thumb grip further comprises a flashback port through which flashback blood from the vessel and through at least one of the respective first and second hollow vessel penetrating members flows to identify the location of the vessel penetrating members in the vessel.

28. The vessel wound closure device of claim 24, further comprising a suture storage unit.

29. The vessel wound closure device of claim 24, further comprising a locking means for securing the suture and snare loop after capture and withdrawal thereof from the vessel to form a stitch across the vessel wound.

30. The vessel wound closure device of claim 24, further comprising:

a second rail, generally parallel to the first rail, extending proximally from the thumb grip, the second rail having a third slide mounted thereon for regulating movement of the second hollow vessel penetrating member and a fourth slide mounted thereon for regulating movement of the snare loop, wherein the suture deployed from the first exit port is captured within the snare loop deployed from the second exit port and withdrawn and secured extravascularly to form a stitch across the vessel wound.

31. A method of closing a vessel wound in a vessel, the method comprising:

deploying a first hollow vessel penetrating member and a second hollow vessel penetrating member through a vessel wall and into the vessel adjacent the vessel wound;

deploying a suture into the vessel from the first hollow vessel penetrating member;

deploying a snare loop into the vessel from the second hollow vessel penetrating member; and

capturing the suture within the snare loop.

32. The method of claim 31, further comprising regulating deployment of the first hollow vessel penetrating member by a first slide and regulating deployment of the suture by a second slide, wherein the first slide and the second slide are on a common rail.

33. The method of claim 32, further comprising stopping movement of the first slide after the first hollow vessel penetrating member is deployed within the vessel and then deploying the suture by further sliding of the second slide.

34. The method of claim 33, wherein the first hollow vessel penetrating member proceeds through a first exit port and includes a needle to penetrate a vessel wall adjacent the vessel wound.

35. The method of claim 34, further comprising regulating deployment of the second hollow vessel penetrating member by a third slide and regulating deployment of the snare loop by a fourth slide, wherein the third slide and fourth slide are on a common rail.

36. The method of claim 35, further comprising stopping movement of the third slide after the second hollow vessel penetrating member is deployed within the vessel and deploying the snare loop within the vessel by further sliding of the fourth slide.

37. The method of claim 36, wherein the second hollow vessel penetrating member proceeds through a second exit port and includes a needle to penetrate the vessel wall adjacent the vessel wound.

38. The method of claim 36, further comprising orienting the second hollow vessel penetrating member to be deployed downstream of the first hollow vessel penetrating member.

39. The method of claim 38, further comprising withdrawing the captured suture and snare loop from the vessel by proximal sliding of the fourth slide.

40. The method of claim 39, further comprising withdrawing the second hollow vessel penetrating member from the vessel by proximal sliding of the third slide.

41. The method of claim 40, further comprising extravascularly securing the captured suture and snare loop with a bioabsorbable locking means.

42. The method of claim 41, further comprising deploying a stabilizer foot prior to identifying the location of the first and second exit ports within the vessel prior to deployment of the first and second hollow vessel penetrating members.

43. The method of claim 41, further comprising identifying the location of the first and second exit ports within the vessel prior to deployment of the first and second hollow vessel penetrating members by flashback of blood from the vessel.