Vascular closure methods and apparatuses

• US 20070203506A1
• Filed: 08/23/2006
• Published: 08/30/2007
• Est. Priority Date: 08/24/2005
• Status: Active Grant

• Current Assignee: Abbott Vascular Incorporated (Abbott Laboratories)
• Original Assignee: Abbott Vascular Incorporated (Abbott Laboratories)
• Inventors: Sibbitt, Randy, Sibbitt, Wilmer
• Granted Patent: US 9,456,811 B2
• Time in Patent Office: Days
• US Class Current: 606/139
• 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/12009 Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/00668 the implement being a tack or a staple
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/06176 with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/12018 Elastic band ligators

Abstract

A vascular closure device comprised of a sheath-delivered cincture or noose-like device or knot comprised of suture, wire, or other suitable materials, that is placed on the external surface of a puncture wound, and closed. The vascular closure cincture is delivered by a sheath, and after closing is left resident on the external surface of a tissue puncture wound.

Claims

1. ) A tissue closure device, comprising:

a) A delivery sheath;

b) A cincture element, removably mounted with the delivery sheath, defining an opening within the cincture element that has a first size when the cincture element is mounted with the delivery sheath, and can assume a second size, smaller than the first, when the cincture element is no mounted with the delivery sheath.

2. ) A tissue closure device as in claim 1, wherein the delivery sheath defines an inner cross section, and has a cincture-retaining structure near a first end of the delivery sheath, where the cincture element mounts with and is urged to the first size by the cincture-retaining structure.

3. ) A tissue closure device as in claim 2, wherein the cincture-retaining structure comprises a ridge extending from the sheath into the inner cross section.

4. ) A tissue closure device as in claim 2, further comprising a oneway fastener mounted with the cincture element, where the oneway fastener accommodates transition of the cincture element from the first size to the second size and resists transition of the cincture element from the second size to the first size.

5. ) A tissue closure device as in claim 4, wherein the cincture element comprises a flexible elongated element, and wherein the oneway fastener comprises a slipknot tied in the elongated element.

6. ) A tissue closure device as in claim 5, wherein the cincture element comprise a suture, line, string, or wire.

7. ) A tissue closure device as in claim 1, wherein the delivery sheath defines an outer cross section near a first end thereof, wherein the cincture element mounts with the delivery sheath such that the first end delivery sheath mounts within the opening of the cincture element.

8. ) A tissue closure device as in claim 7, wherein the delivery sheath comprises a cincture-retaining structure that discourages motion of the cincture element relative to the delivery sheath way from the first end of the delivery sheath.

9. ) A tissue closure device as in claim 8, wherein the cincture-retaining structure comprises one or more elements mounted with or formed as part of the delivery sheath and extending beyond the outer cross section near the first end.

10. ) A tissue closure device as in claim 7, further comprising a oneway fastener mounted with the cincture element, where the oneway fastener accommodates transition of the cincture element from the first size to the second size and resists transition of the cincture element from the second size to the first size.

11. ) A tissue closure device as in claim 10, wherein the cincture element comprises a flexible elongated element, and wherein the oneway fastener comprises a slipknot tied in the elongated element.

12. ) A tissue closure device as in claim 11, wherein the cincture element comprise a suture, line, string, or wire.

13. ) A tissue closure device as in claim 1, wherein the cincture element assumes the second size absent an externally applied force, and wherein the delivery sheath supplies a sufficient force to the cincture element to maintain the cincture element in the first size while the cincture element is mounted with the delivery sheath.

14. ) A tissue closure device as in claim 7, wherein the cincture element assumes the second size absent an externally applied force, and wherein the first end of the delivery sheath supplies a sufficient force to the cincture element to maintain the cincture element in the first size while the cincture element is mounted with the delivery sheath.

15. ) A method of closing an opening in tissue, comprising:

a) Everting the edges of the opening;

b) Placing a device as in claim 1 proximal the everted edges;

c) Removing the cincture element from the delivery sheath such that the cincture element substantially surrounds the everted edges;

d) Causing the cincture element to assume the second size.

16. ) A method of closing an opening in tissue, comprising:

a) Everting the edges of the opening;

b) Placing a device as in claim 7 proximal the everted edges;

c) Moving the delivery sheath and the cincture element relative to each other such that delivery sheath is not mounted within the cincture element and the everted edges are substantially within the cincture element;

d) Causing the cincture element to assume the second size.

17. ) A method as in claim 15, wherein the cincture element comprises an elongated flexible structure having a oneway fastener mounted therewith, which fastener is operable from a second end of the delivery sheath, and wherein removing the cincture element from the delivery sheath and causing the cincture element to assume the second size comprises operating the oneway fastener.

18. ) A method as in claim 17, wherein the oneway fastener comprises a slipknot.

19. ) A method as in claim 16, wherein the cincture element comprises an elongated flexible structure having a oneway fastener mounted therewith, which fastener is operable from a second end of the delivery sheath, and wherein removing the cincture element from the delivery sheath and causing the cincture element to assume the second size comprises operating the oneway fastener.

20. ) A method as in claim 19, wherein the oneway fastener comprises a slipknot.

21. ) A method as in claim 19, wherein the oneway fastener mounts with a second elongated member that extends from the oneway fastener through a lumen interior to the delivery sheath to the second end of the delivery sheath.

22. ) A device as in claim 1, wherein the delivery sheath comprises a lumen that can accommodate a gripping device and guidewire.

23. ) A device as in claim 7, wherein the delivery sheath comprises a lumen that can accommodate a gripping device and guidewire.

24. ) A device as in claim 1, further comprising a gripping device disposed within a lumen of the delivery sheath, wherein the gripping device comprises two or more gripping elements that grip and evert the edges of a tissue opening.

25. ) A device as in claim 7, further comprising a gripping device disposed within a lumen of the delivery sheath, wherein the gripping device comprises two or more gripping elements that grip and evert the edges of a tissue opening.