Percutaneous vascular sealing method
First Claim
1. A percutaneous procedure for positioning a vascular sealing assembly to enable percutaneous sealing of a puncture opening at a puncture site in a blood vessel comprising the steps of:
- aligning an elongated guide in axial alignment with the puncture opening, said guide extending from the puncture opening through tissue overlying the blood vessel to an exterior thereof;
mounting said sealing assembly to said guide for guided movement therealong; and
inserting said sealing assembly into the blood vessel through the puncture site and reciprocating said sealing assembly by moving said sealing assembly in a rearward direction and then in a forward direction along said guide in sufficiently small increments to detect substantially direct engagement of a shoulder on said sealing assembly with an exterior surface of a wall of the blood vessel surrounding the puncture opening as said sealing assembly is withdrawn from the puncture site.
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Accused Products
Abstract
A percutaneous vascular sealing assembly (30) for sealing a puncture opening (17) in a blood vessel (16) following an invasive medical procedure. The sealing assembly includes an elongated tubular shaft (32) having a distal end (36) carrying an electrosurgical sealing assembly (34). An energy source assembly (38) is connected to the sealing assembly (34) to enable hemostasis of the puncture site. An associated method for percutaneous positioning of the sealing assembly (30) in substantially direct engagement with the blood vessel (16) at the puncture (17) following a medical procedure is provided. The method includes the steps of aligning guide means (12,28) in axial alignment with the puncture, mounting the sealing assembly (30) for movement along the guide means (12,28), and moving at least one of the sealing assembly (30) and guide means (12,28) until a transverse shoulder (20,36) encounters increased resistance to movement toward the blood vessel (16) by reason of engaging the exterior surface (40) of the blood vessel ( 16).
560 Citations
20 Claims
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1. A percutaneous procedure for positioning a vascular sealing assembly to enable percutaneous sealing of a puncture opening at a puncture site in a blood vessel comprising the steps of:
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aligning an elongated guide in axial alignment with the puncture opening, said guide extending from the puncture opening through tissue overlying the blood vessel to an exterior thereof; mounting said sealing assembly to said guide for guided movement therealong; and inserting said sealing assembly into the blood vessel through the puncture site and reciprocating said sealing assembly by moving said sealing assembly in a rearward direction and then in a forward direction along said guide in sufficiently small increments to detect substantially direct engagement of a shoulder on said sealing assembly with an exterior surface of a wall of the blood vessel surrounding the puncture opening as said sealing assembly is withdrawn from the puncture site.
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2. A procedure for percutaneously sealing a puncture opening at a puncture site in a wall of a blood vessel comprising the steps of:
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positioning a guide to extend through tissue overlying the blood vessel and into and through the puncture opening to establish a positive alignment of said guide with the puncture opening; mounting a sealing assembly to said guide for movement with respect thereto and moving said sealing assembly through the tissue along said guide to the blood vessel; inserting said sealing assembly into the blood vessel through the puncture site and then incrementally withdrawing and advancing said sealing assembly along said guide until increased resistance is encountered upon advancement of said sealing assembly indicating a shoulder of said sealing assembly is in substantially direct contact with the wall surrounding the puncture opening; and thereafter percutaneously sealing the puncture opening while maintaining said sealing means aligned with the puncture opening and in substantially direct engagement with the wall of the blood vessel. - View Dependent Claims (3, 4, 5, 6, 7)
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8. A method of obtaining a percutaneous vascular seal at a puncture site in a blood vessel comprising the steps of:
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positioning a percutaneous vascular sealing assembly having electrosurgical sealing means carried thereon inside the blood vessel through a puncture opening at the puncture site; withdrawing said sealing assembly from the blood vessel until said electrosurgical sealing means can be sensed to be positioned substantially in direct contact with an exterior wall of the blood vessel at the puncture site; and applying one of sufficient heat and sufficient coagulating current to blood escaping the blood vessel while said electrosurgical sealing means is substantially in direct contact with the exterior surface of the blood vessel to effect hemostasis of the puncture opening. - View Dependent Claims (9, 10, 11, 12)
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13. A percutaneous procedure for positioning a vascular sealing assembly to enable percutaneous sealing of a puncture opening at a puncture site in a blood vessel comprising the steps of:
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inserting an elongated guide wire into the puncture opening, said guide wire extending from the puncture opening through tissue overlying the blood vessel to an exterior thereof; mounting a tubular electrosurgical sealing device having a lumen dimensioned for sliding engagement with said guide wire onto said guide wire, said sealing device having a sealing surface transversely oriented relative to said guide wire with a dimension greater than the transverse dimension of the puncture opening; and manually manipulating said sealing device axially on said guide wire until said sealing surface can be felt to engage an exterior surface of a wall of the blood vessel surrounding the puncture opening. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20)
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Specification