Closure device and method
First Claim
1. For use in closing an aperture in a body organ having at least a fibrous portion in proximity to the aperture, a closing device comprising:
- support means having a distal end for extending through the aperture beyond the fibrous portion in proximity to the aperture to be closed and having a proximal end for selectively providing a first manipulation and a second manipulation;
engaging means mounted at said distal end of said support means, for engaging the fibrous portion in proximity to the aperture, whereby said first manipulation of said support means causes the aperture to be closed by said engaging means; and
sealing means for causing the closed aperture to be sealed, wherein said sealing means includes cauterizing means for cauterizing the closed aperture, said sealing means being connected to said support means.
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Accused Products
Abstract
An apparatus is provided for closing a perforation in a wall of a patient'"'"'s blood vessel or other organs, and a method of introducing the apparatus and causing the closure are described. The apparatus includes an elongated support member having a distal end supporting one or more tissue engaging hooks configured to engage fibrous vessel tissue when moved in a first direction and to disengage the tissue when moved in a second direction, and a proximal end for applying rotational torque to the support member to cause the hooks to engage collagen fibrous tissue in the adventitia of the blood vessel or fibrous tissue in other body organs. The hooks engaging the collagen fiber causes the blood vessel tissue surrounding the perforation to be drawn into close proximity such that the perforation can be closed. The apparatus can be removed by applying reverse rotation of the support member, whereby the hooks are disengaged. The apparatus is deployed in an outer sheath with the hooks encased until a selected engaging location has been achieved. When positioned in the aperture to be closed, the hooks are exposed to allow interaction with the adventitia. Puncture closure can be accomplished by various techniques, including stasis, cauterizing, or by clamping. Various embodiments of the apparatus are described.
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Citations
55 Claims
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1. For use in closing an aperture in a body organ having at least a fibrous portion in proximity to the aperture, a closing device comprising:
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support means having a distal end for extending through the aperture beyond the fibrous portion in proximity to the aperture to be closed and having a proximal end for selectively providing a first manipulation and a second manipulation; engaging means mounted at said distal end of said support means, for engaging the fibrous portion in proximity to the aperture, whereby said first manipulation of said support means causes the aperture to be closed by said engaging means; and sealing means for causing the closed aperture to be sealed, wherein said sealing means includes cauterizing means for cauterizing the closed aperture, said sealing means being connected to said support means. - View Dependent Claims (2, 3, 4, 5, 6)
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7. An improved method of closing an aperture in the wall of an blood vessel, wherein the blood vessel has a lumen carrying blood, an outer facia, an adventitia layer, and a media layer, said method comprising the steps of:
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a. inserting a plurality of hooks through the aperture into the lumen; b. extending the plurality of hooks to engage the adventitia layer surrounding the aperture; c. withdrawing the plurality of hooks through the media layer to engage the adventitia layer; d. manipulating the plurality of hooks to cause the engaged adventitia to close the aperture; and e. sealing the closed aperture, wherein the step of sealing includes cauterizing the closed aperture. - View Dependent Claims (8, 9, 10)
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11. For use in closing an opening in a blood vessel having a lumen carrying blood and collagen fibrous tissue in proximity to the opening, a closing device comprising:
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a support member having an outer surface, a proximal end, a distal end, and having a length sufficient to place said distal end in proximity to the opening; a plurality of hooks mounted in a predetermined pattern on said outer surface in predetermined proximity to said distal end, and adapted to cooperate with and to engage the fibrous tissue when said support member is actuated, wherein said support member includes a compliant inflatable balloon having a predetermined length, a distal atraumatic tip portion, and a proximal portion supporting said plurality of hooks. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19)
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20. For use in closing an opening in a blood vessel, the blood vessel having a lumen carrying blood and fibrous tissue in proximity to the opening, a closing device comprising:
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a heating element having a distal end, a proximal end, and a tip surface at said distal end; a support member having a first end coupled to said proximal end and having a length sufficient to position said distal end in proximity to the opening, and a second end to manipulate said heating element; and a plurality of hooks mounted in a predetermined pattern on said tip surface and arranged to engage the fibrous tissue when said second end is manipulated in a first direction and to release the fibrous tissue when said second end is manipulated in a second direction. - View Dependent Claims (21, 22, 23, 24, 25, 26, 27, 28)
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29. For use in closing an opening in a blood vessel utilizing the adventitia in proximity to the opening, a closing device comprising:
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a support mechanism having a distal end, a proximal end, and a predetermined length sufficient to position said distal end through the opening while said proximal end is externally manipulatable; a plurality of hooks coupled to said distal end, and arranged to engage the adventitia when said support member is manipulated, wherein each of said plurality of hooks includes a hooking portion, a shank portion, and a proximal interconnecting portion; and a closure mechanism to engage said plurality of hooks and close the opening, wherein said closure mechanism includes an annular ring portion having an inner annular surface, a locking structure mounted to said inner annular surface and arranged to cooperate with said shank portion of each of said plurality of hooks, a peripheral surface on said locking structure, a first portion extending outwardly a predetermined distance from said peripheral surface, and a second annular portion extending toward said plurality of hooks. - View Dependent Claims (30, 31)
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32. For use in closing an opening in a blood vessel utilizing the adventitia in proximity to the opening, a closing device comprising:
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a positioning probe having a distal tip and a predetermined length sufficient to locate said distal tip through the opening, said positioning probe having a longitudinal channel along a predetermined portion of said predetermined length, said longitudinal channel having a proximal opening and a distal opening at said distal tip; an electrode having a head portion having a distal end and configured to slidably cooperate with said longitudinal channel from said proximal opening to said distal opening, and having a handle portion to manipulate said head portion; and a plurality of hooks mounted on said distal end and arranged to engage the adventitia when said handle portion is manipulated. - View Dependent Claims (33)
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34. A closing device for use in closing a perforation in a body organ having fibrous tissue adjacent to at least a portion of the perforation, the closing device comprising:
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an elastic material ring having an inner surface, an outer surface, a predetermined length, and first and second ends, said elastic material ring capable of having a stretched position and a relaxed position; a plurality of fibrous tissue engaging members mounted on said outer surface; and a hook and pile structure mounted on said inner surface. - View Dependent Claims (35, 36, 37, 38, 39)
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40. For use in closing an opening in a blood vessel having a lumen carrying blood and collagen fibrous tissue in proximity to the opening, a closing device comprising:
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a support member having an outer surface, a proximal end, a distal end, and having a length sufficient to place said distal end in proximity to the opening; a plurality of hooks mounted in a predetermined pattern on said outer surface in predetermined proximity to said distal end, and adapted to cooperate with and to engage the fibrous tissue when said support member is actuated, and further including a closure mechanism, wherein said closure mechanism includes a plurality of engaging members to engage the fibrous tissue when brought in contact by said plurality of hooks, wherein said closure mechanism includes a selectively actuatable electrode. - View Dependent Claims (41, 42, 43, 44)
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45. For use in closing an opening in a blood vessel utilizing the adventitia in proximity to the opening, a closing device comprising:
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a support mechanism having a distal end, a proximal end, and a predetermined length sufficient to position said distal end through the opening while said proximal end is externally manipulatable; a plurality of hooks coupled to said distal end, and arranged to engage the adventitia when said support member is manipulated, wherein each of said plurality of hooks includes a hooking portion, a shank portion, and a proximal interconnecting portion; and a closure mechanism to engage said plurality of hooks and close the opening, wherein said proximal interconnecting portion of each of said plurality of hooks is coupled to said support mechanism by dissolvable glue. - View Dependent Claims (46)
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47. For use in closing an opening in a blood vessel utilizing the adventitia in proximity to the opening, a closing device comprising:
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a support mechanism having a distal end, a proximal end, and a predetermined length sufficient to position said distal end through the opening while said proximal end is externally manipulatable; a plurality of hooks coupled to said distal end, and arranged to engage the adventitia when said support member is manipulated, wherein each of said plurality of hooks includes a hooking portion, a shank portion, and a proximal interconnecting portion; and a closure mechanism to engage said plurality of hooks and close the opening, wherein said support mechanism includes a plurality of distal connecting members each having a distal interconnection portion, each of said plurality of distal connecting members coupled to a respective one of said plurality of hooks. - View Dependent Claims (48, 49, 50, 51, 52, 53, 54, 55)
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Specification