CA2417962A1 - Method and apparatus for closing vascular puncture using hemostatic material - Google Patents
Method and apparatus for closing vascular puncture using hemostatic material Download PDFInfo
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- CA2417962A1 CA2417962A1 CA002417962A CA2417962A CA2417962A1 CA 2417962 A1 CA2417962 A1 CA 2417962A1 CA 002417962 A CA002417962 A CA 002417962A CA 2417962 A CA2417962 A CA 2417962A CA 2417962 A1 CA2417962 A1 CA 2417962A1
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- catheter
- sponge
- wound
- hemostatic
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00491—Surgical glue applicators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—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
- A61B2017/00637—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 for sealing trocar wounds through abdominal wall
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—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
- A61B2017/00646—Type of implements
- A61B2017/00654—Type of implements entirely comprised between the two sides of the opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—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
- A61B2017/00646—Type of implements
- A61B2017/00659—Type of implements located only on one side of the opening
Abstract
A method and apparatus for closing a vascular wound includes a guidewire (58) and/or other surgical implement (32) extending from the wound (w). A sponge-like hemostatic material (80) is advanced over the surgical implement and into contact with an area of the blood vessel (94) surrounding the wound. The surgical implement (32) is removed. Blood (b) soaks the hemostatic material (80), and blood clotting is facilitated by the hemostatic agent within the material. A sealing layer of adhesive (106) can be applied to the sponge-like material (80), confining the blood flow to the sponge. Thus, the vascular puncture wound (w) is sealed by natural blood clot formation.
Description
METHOD AND APPARATUS FOR CLOSING VASCULAR
PUNCTURE USING HEMOSTATIC MATERIAL
Background of the Lnvention Field of the Invention [0001] The present invention generally relates to a system that facilitates closure of openings in blood vessels. More specifically, the present device delivers a hemostatic material to the opening to facilitate sealing of the blood vessel wound.
Description of the Related Art
PUNCTURE USING HEMOSTATIC MATERIAL
Background of the Lnvention Field of the Invention [0001] The present invention generally relates to a system that facilitates closure of openings in blood vessels. More specifically, the present device delivers a hemostatic material to the opening to facilitate sealing of the blood vessel wound.
Description of the Related Art
(0002] In many medical procedures, it is necessary to locate an opening in tissue so that some form of treatment, diagnosis or revision, can be applied to that opening. For example, in order to perform transluminal balloon angioplasty, an opening must be created in an artery in order to insert a balloon. This opening must later be closed.
(0003] Transluminal balloon angioplasty is used in the treatment of peripheral vascular disease to increase or restore blood flow through a significantly narrowed artery in a limb; it is also used in the treatment of blockage of the coronary arteries. In fact, coronary angioplasty has emerged as a major viable alternative to bypass surgery for revascularization of stenotic and occluded coronary arteries.
Unlike bypass surgery, angioplasty does not require general anesthesia, opening of the chest wall, use of a heart-lung machine, or transfusion of blood. Angioplasty is not only less invasive and less traumatic to the patient, it is also less expensive because of the shorter hospital stay and shorter recovery time.
Unlike bypass surgery, angioplasty does not require general anesthesia, opening of the chest wall, use of a heart-lung machine, or transfusion of blood. Angioplasty is not only less invasive and less traumatic to the patient, it is also less expensive because of the shorter hospital stay and shorter recovery time.
[0004] Transluminal balloon angioplasty is performed by first inserting a hollow needle through the skin and surrounding tissues and into the patient's femoral artery. A
guidewire is advanced through the hollow needle and into the artery, then along the patient's vasculature toward the site of the blocked blood vessel or heart valve to be treated. X-ray imaging is used to help move the guidewire through the vascular system and into position just past the stenosis to be treated. A balloon catheter is then threaded over the guidewire and advanced until the deflated balloon is within the stenosis. The balloon is then repeatedly inflated to widen the narrowed blood vessel. After the procedure is complete, the catheter and guidewire are withdrawn from the blood vessels and the patient.
guidewire is advanced through the hollow needle and into the artery, then along the patient's vasculature toward the site of the blocked blood vessel or heart valve to be treated. X-ray imaging is used to help move the guidewire through the vascular system and into position just past the stenosis to be treated. A balloon catheter is then threaded over the guidewire and advanced until the deflated balloon is within the stenosis. The balloon is then repeatedly inflated to widen the narrowed blood vessel. After the procedure is complete, the catheter and guidewire are withdrawn from the blood vessels and the patient.
[0005] Angiography, which is used to detect diseases that alter the appearance of blood vessels, is performed in a similar manner. A hollow needle is first inserted into the femoral artery and a guidewire is inserted through the needle and into the affected blood vessel. A catheter is threaded over the guidewire and into the blood vessel. X-ray imaging is used to guide the catheter to a desired position.
Contrast medium is then injected, and a rapid sequence of x-ray pictures are taken so that blood flow along the affected vessel can be studied. The catheter and guidewire are later removed from the patient's body.
Contrast medium is then injected, and a rapid sequence of x-ray pictures are taken so that blood flow along the affected vessel can be studied. The catheter and guidewire are later removed from the patient's body.
[0006] After the catheter used during angioplasty or angiography are removed, the puncture wound in the femoral artery must be closed and the bleeding through the puncture site in the artery stopped. Currently, ice packs andlor pressure are applied to the area surrounding the wound for a period lasting up to several hours in an attempt to stop the bleeding. There exists, however, a significant chance that the wound will reopen and begin bleeding again when the patient moves. Another possible complication is the development of a false aneurysm, which increases the risks of both infection and reopening.
[0007] Although efforts have been made to close the puncture wound using staples, clips, collagen plugs, and sutures, they have been unsuccessful, largely due to the inability to see the puncture wound in the femoral artery, and also because of the difficulty of controllably modifying the artery in the limited space provided.
[00081 Other wounds in the vasculature of a patient can also be difficult to see, and are thus difficult to locate, access and close. Thus, a device and method to facilitate locating and closing of such wounds in the vasculature of a patient would be extremely beneficial. A device having the ability to consistently and reliably locate, isolate and close the puncture wound would eliminate the prolonged bleeding currently associated with such wounds.
Summary of the Invention [0009] Accordingly, there is a need in the art for a device and method for precisely locating a blood vessel wound and sealing the wound.
[0010] In accordance with one embodiment, an assembly for closing a blood vessel wound is provided.
An elongate catheter of the assembly accommodates a guidewire threaded therethrough. The catheter is configured to slide over the guidewire so that a tip of the catheter extends into a blood vessel wound. A hemostatic material comprises a hemostasis-facilitating agent. A push member is adapted to slide relative to the catheter. The push member has a lumen adapted to communicate a flowable adhesive therethrough.
[00111 In accordance with another embodiment, an assembly is provided for closing a vascular wound. A surgical implement is configured to extend at least partially through a vascular wound. A hemostatic material member comprises a hemostatic agent. A push member is configured to be longitudinally slidable relative to the surgical implement. The push member is adapted to engage and push the hemostatic material longitudinally over the surgical implement.
[0012] For purposes of summarizing the preferred embodiments and the advantages achieved over the prior art, certain embodiments and advantages have been described herein above. Of course, it is to be understood that not necessarily all such advantages may be achieved in accordance with any particular embodiment. Thus, for example, those skilled in the art will recognize that the invention may be embodied or carried out in a manner that achieves or optimizes one advantage or group of advantages as taught herein without necessarily achieving other objects or advantages as may be taught or suggested herein.
[0093] The embodiments discussed above and other embodiments will become readily apparent to those skilled in the art from the following detailed description of the preferred embodiments having reference to the attached figures, the invention not being limited to any particular preferred embodiments) disclosed.
Brief Description of the Drawinus [0014] Figure 1 is a side view of an embodiment of a vascular closure apparatus shown assembled and ready far use.
[0015] Figure 2 is a side view of a distal portion of the apparatus of Figure 1.
[0016] Figure 3 is a side view of a push member having features in accordance with the present invention.
[0017] Figure 4 shows the apparatus of Figure 1 advanced over a guidewire into a blood vessel of a patient.
[0018] Figure 5 shows the arrangement of Figure 4 with the retractor arms open and a suction tool in use.
[0019] Figure 6 shows the arrangement of Figure 5, wherein a hemostatic sponge has been advanced into contact with the blood vessel wall.
[0020] Figure 7 shows the arrangement of Figure 6, with the retractor arms removed.
[0021] Figure 8 shows the arrangement of Figure 7 with the catheter and guidewire removed.
[0022] Figure 9 shows the arrangement of Figure 8, wherein a flowable adhesive is being delivered to the sponge.
[0023] Figure 10 shows the arrangement of Figure 8, wherein the push member is being removed from the patient.
[0024] Figure 11 shows a sealed puncture wound after treatment with an embodiment of the device and method.
[0025] Figure 12 shows an embodiment wherein an additional sponge is being advanced toward the wound.
[0026] Figure 13 shows the embodiment of Figure 12 with the additional sponge in place.
[0027] Figure 14 shows another embodiment of a hemostatic sponge member.
[0028] Figure 15 shows the sponge member of Figure 14 in contact with the vessel wall and having a cathetertherethrough.
extending [0029] Figure 16 shows the arrangement of Figure 15 with the catheter removed.
[0030] Figure 17 shows an embodiment in which a lock member is provided proximal a hemostatic sponge member.
[00311 Figure 18 shows a sealed puncture wound after treatment with the device of Figure 12.
[0032] Figure 19 shows a schematic view of an unfolded two-layer patch.
[0033] Figure 20 shows the patch of Figure 19 in a folded position.
[0034] Figure 21 shows the patch of Figure 19 slidably mounted onto a catheter and being advanced by a push member.
Detailed Description of the Preferred Embodiment [0035] The present apparatus and method is especially useful for closing vascular puncture wounds that are difficult to access andlor visualize. It is difficult to directly and accurately modify the wounded blood vessel in order to close such wounds. Additionally, there are pitfalls associated with directly modifying the blood vessel. For example, since the clinician cannot see the wound, it is difficult to correctly place closure media such as sutures, staples, or clips. Incorrect placement of such closure media likely results in inadequate closure; the puncture wound remains open, perhaps without the clinician being aware. Additionally, incorrect placement of closure media may cause permanent damage to the vessel, including tearing and additional puncture wounds. Further, if closure media extends through the wound and into the blood flow, this media can increase the likelihood of thrombus formation or could introduce potentially toxic substances into the bloodstream. Of course, closure media inadvertently released into the bloodstream could lead to serious blood vessel blockage complications.
[0036] With reference to Figure 1, a vascular wound closure assembly 30 includes an elongate catheter 32 having a distal end 34 and a proximal end 36 of the catheter 32. A
distal opening 38 is formed through the distal end 34 of the catheter 32 and opens along a longitudinal axis of the catheter 32. The catheter 32 includes a tapered tip 40 at the distal end 34. An elongate main body 42 of the catheter 32 is disposed proximal the tapered tip 40. Preferably the main body 42 has a substantially uniform diameter along its length. A lumen 44 extends longitudinally within the catheter 32 from the distal opening 38 to the proximal end 36.
[0037] A connector portion 46 is provided on the proximal end 36. The connector portion 46 includes a main lumen 48 and a secondary lumen 50. The main lumen 48 extends along the longitudinal axis of the catheter 32 and is coextensive with the catheter lumen 44. The secondary lumen 50 extends outwardly from the main lumen 48, but communicates with the main lumen 48 and the catheter lumen 44. A proximal opening 52 is provided at the proximal end of the main lumen 48 and, like the distal opening 38, opens along the longitudinal axis. A secondary opening 54 opens into the secondary lumen 50.
[00381 The distal and proximal openings 38, 52 are sized and adapted to accommodate a guidewire 58 such as the guidewire used in angioplasty and other vascular surgeries. As such, the guidewire 58 can be threaded through the catheter 32 and the catheter can be advanced over the guidewire 58.
[0039] Holes 60 are formed through a side wall 0f the catheter 32 near the distal end 34 of the catheter 32. Preferably, at least two holes 60 are provided. All of the holes 60 preferably are disposed substantially the same distance from the distal end 34 of the catheter 32. Preferably, a raised portion 62 of the catheter 32 is provided in the region around the holes 60, which region is proximal of the tip 40 and distal of the main body 42. At the raised portion 62, the catheter 32 has an outer diameter that is slightly larger than the outer diameter throughout the catheter main body 42.
[0040] With continued reference to Figure 1, a vacuum or other source of suction 64 is provided and communicates, through tubing 66, with the secondary lumen 50 of the catheter connector portion 46. Thus, a vacuum is drawn through the catheter lumen 44. Preferably, the distal and proximal openings 38, 52, which accommodate, the guidewire 58, are sized so that the guidewire 58 substantially plugs the openings; thus, the vacuum is drawn through the holes 60. A viewing port 68 is arranged between the source of suction 64 and the catheter 32. The viewing port 68 is configured to allow a clinician to view the material that is drawn by suction through the holes 60 and through the catheter lumen 44. The viewing port 68 will he discussed in more detail below.
[0041] With reference to Figures 1 and 2, a retractor 70 is preferably mounted on the catheter 32.
The retractor 70 includes opposing elongate retractor arms 72 that are aligned longitudinally on the catheter 32. A
retractor body 74 is configured to selectively open and close the retractor arms 72 when operated by a clinician. The elongate retractor arms 72 of the retractor 70 are positioned on the catheter 32 so that distal ends 76 of the arms are positioned proximal of the catheter holes 60 a distance that is at least the same as the width of an artery wall, preferably at least about .5 to 2 millimeters.
[0042] With reference again to Figure 1, a hemostatic member 80 is arranged on the catheter 32 proximal of the retractor 70. As will be discussed in more detail below, the hemostatic member comprises a material that is made of or includes a hemostatic agent. The hemostatic agent is adapted to aid blood clotting. In one embodiment, the hemostatic member 80 comprises a sponge or sponge-like material. In this description, sponge is a broad term that is used in accordance with it ordinary meaning and includes, without limitation, a material that is adapted to soak up at least a portion of blood that may came in contact with the material.
[0043] For purposes of this description, the hemostatic member 80 is referred to as the sponge 80.
However, it is to be understood that use of the term "sponge' does not limit the scope of materials that can be used as the hemostatic member. In fact, any material that aids or facilitates blood clotting can be used as the hemostatic member.
[0044] Preferably, the sponge 80 extends circumferentially around the catheter main body 42, and is arranged so that it can be slid longitudinally along the catheter 32. Most preferably, the catheter 32 extends through a passageway 82 through the sponge 80. The passageway 82 is formed as the catheter 32 is forced through the sponge 80.
[0045] A push member 84 is also arranged on the catheter 32 distal of the sponge 80. With reference also to Figure 3, the push member 84 comprises a body portion 86 and a proximal handle portion 88. An elongate lumen 90 is formed through the body portion 86. As shown in Figure 1, the lumen 90 preferably encircles the catheter 32 so as to allow the push member 84 to slide relative to the catheter 32. A plurality of holes 92 are formed through the body portion 86 at a point near the distal end of the push member 84.
[0046] As will be discussed in more detail below in connection with Figure 4, the vascular wound closure assembly 30 enables a clinician to precisely locate a subcutaneous vascular wound "w", access the wound w, and deliver the hemostatic sponge 80 to the wound site. The hemostatic sponge 80 includes a hemostatic agent that helps facilitate closure of the wound w.
[0047] In order to properly apply the hemostatic sponge 80, the vascular closure assembly 30 first precisely locates and provides access to the vascular wound w. It is to be understood that the present method and apparatus can be used to close various vascular and other wounds. Figures 1-11, and the accompanying discussion, present an example using an embodiment to close a puncture wound w in a patient's femoral artery 94.
[00481 With specific reference to Figures 1, 2. 4 and 5, in order to precisely locate and provide access to a femoral artery puncture wound w, the catheter 32 is first threaded over a guidewire 58 that has been previously inserted into the patient's femoral artery 94 through the puncture wound w. The lumen 44 is attached to the source of suction 64 and the assembly 30 is advanced over the guidewire 58 through a patient's tissue 96 so that the distal tip 40 of the catheter 32 extends through the vascular puncture wound w.
[0049] As the assembly 30 is advanced, the source of suction 64 draws bodily fluids through the holes 60. The fluids pass through the viewing port 68, which allows the clinician to identify the fluids being withdrawn. The viewing port 68 can have any suitable structure or location.
For example, the viewing port can comprise clear tubing attached to the catheter, a substantially transparent syringe that functions as both a source of suction and a viewing port, or a portion of the catheter that is substantially transparent. Most preferably, the catheter 32 is formed of a transparent material so that the clinician becomes aware as soon as blood begins to be drawn through the catheter.
[0050] When the holes 60 pass the artery wall 98 and enter the blood vessel 94, as shown in Figure 4, blood "b" begins to be drawn through the holes 60 into the catheter 32 and is conducted past the viewing port 68.
Thus, when blood b is observed in the viewing port 68, the clinician will Know that the holes 60 have just passed into the puncture wound w and that the distal ends 76 of the retractor arms 72 are thus positioned adjacent the outer wall 98 of the artery 94, preferably within about 2mm of the artery wall 98. The retractor arms 72 are then separated as shown in Figure 5, thus drawing surrounding tissue 9.6 away from the wound w and creating a field 100 around the puncture wound w. The catheter 32 remains disposed partially within the puncture wound w, effectively plugging the wound and preventing blood from flowing through the wound. The raised portion 62 flexes the edges of the wound w to enhance the seal between the catheter 32 and the puncture wound edges.
[0051] With continued reference to Figure 5, a suction tool 102 can be used to clear away bodily fluids and other matter that may be within the field 100 and to clean the wall 98 of the blood vessel 94 adjacent the puncture wound w.
[0052] With reference next to Figure 6, once the puncture wound w has been precisely located, the push member 84 is advanced distally along the catheter 32, thus advancing the sponge 80 into contact with the vessel wall 98 so as to surround the puncture wound w. As mentioned above and discussed in more detail below, the sponge 80 comprises a hemostatic agent that will help accelerate blood clot formation at the wound site w in order to help the wound heal faster.
[0053] Preferably, the sponge 80 is at least partially coated with an adhesive so that the sponge will at least partially bond to the vessel wall 98. Alternatively, or in addition, flowable adhesive can be delivered into the field around the puncture wound before the sponge is advanced into contact with the vessel wall. Of course, the sponge can be delivered without using any adhesive.
[0054] The sponge 80 is preferably mounted onto the catheter 32 so as to substantially encircle the catheter 32. Thus, since the tip 40 of the catheter is disposed in the wound, the sponge 80 substantially surrounds the wound w when the sponge is positioned adjacent the vessel wall 98. When the sponge 80 is in place adjacent the wound w, the retractor 70 can be removed, as shown in Figure 7. When the retractor 70 is removed, the surrounding body tissues 96 collapse around the sponge 80 and push member 84. The push member 84 holds the sponge 80 in position while body tissue 96 surrounds the sponge 80 and while the adhesive cures.
[0055] With reference next to Figure 8, with the push member 84 in place, the catheter 32 and guidewire 58 can also be removed from the patient. The passage 82 through the sponge 80, which had been occupied by the catheter 32, collapses onto itself so that it is substantially closed.
The vessel wound w is no longer plugged by the catheter 32, and it is anticipated that blood b from the vessel 94 will flow into the sponge 80, at least partially soaking the sponge 80. Although the retractor 70 is removed prior to the catheter 32 in the above-discussed embodiment, it is to be understood that, in another embodiment, the catheter may be removed prior to the retractor.
[0056] In still another embodiment, additional pressure can be applied to the push member 84 in order to at least partially block blood flow through the blood vessel 94. In this manner, the clinician can control how quickly blood will flow through the wound w and into the sponge 80. Of course, other methods and apparatus can be used to temporarily reduce or stop blood flow through the vessel.
[0057] In a preferred embodiment, the sponge 80 comprises a material made of or soaked in a hemostatic agent. The agent is specially adapted to aid blood clotting. Thus, blood that flows into the sponge will quickly become clotted, causing natural sealing of the wound through blood clotting. Sponge-like hemostasis agents are available and can include products such as Gelfoam~", Oxycell~" and Avitene~". Other appropriate hemostatic sponges may be impregnated with thrombin, a liquid clotting agent, to help accelerate blood clot formation. Another material that may advantageously be used is a collagen Ultrafoam~" sponge marketed by C.R. BardIDavol, Inc. The Ultrafoam~" sponge is made from Avitene'~ collagen, a natural clotting agent, and does not require the addition of thrombin. This reduces preparation time and the risk that a patient will experience a potentially hazardous reaction to bovine thrombin. Other medicants can also be included in the sponge. For example, antibiotic medicines, anti-inflammatory drugs, healing aids, and the like can be impregnated into the sponge material.
[0058] The sponge-like material is preferably soft and pliable and will conform to the structure of the blood vessel, the wound and the field around the blood vessel. Thus, the sponge-like material is specially suited for use in the confined space surrounding a vascular puncture. Additionally, the hemostatic sponge 80 will be held in place by the tissue 96 surrounding the puncture wound w, which tissue 96 collapses over the sponge 80 when tools such as the retractor 70 are removed.
[0059] To further help hold the sponge 80 in place, flowable adhesive 106 from a source of adhesive 108 can be delivered through the lumen 90 of the push member 84 and onto the sponge 80, as shown in Figure 9.
The adhesive 106 flows through the open distal end of the push member 84 and also through the holes 92 through the push member body portion 86. Upon curing, the adhesive 106 can form a sealing layer around and within the sponge 80, thus confining the blood b to the sponge area. This helps minimize bleeding and even further speeds clot formation.
Adding adhesive 106 will also facilitate more complete closure of the passage through the sponge, which passage was vacated by the catheter 32. Further, the adhesive 106 will help hold the sponge 80 in place relative to the puncture wound w and the surrounding tissue 96.
[0060] As discussed above, prior to being advanced into contact with the blood vessel wall, the sponge 80 may be soaked in an adhesive or, more preferably, coated with a layer of adhesive. In this manner, adhesive distribution on the sponge can be controlled. By controllably applying a coating of adhesive around the outer surface of the sponge, the adhesive will bond the sponge to the area surrounding the blood vessel wound w, including the vessel 94 itself, and also can form a perimeter seal of the sponge when the adhesive cures. The coating of adhesive can act as a membrane confining the blood b to the sponge 80. It is to be understood that a coating of adhesive may be used instead of or in addition to applying additional adhesive 106 through the push member 84.
[0061] Various Kinds of flowable adhesives may be acceptable for use with the sponge. For example, fibrin tissue sealants such as Tisseel~, which is available from Baxter Healthcare Corp., may be appropriate. Other commercially available adhesives that may be appropriate include Bioglue~", available from Cryolife, Inc., and Floseal'T", which is available from Fusion Medical Technologies. Various cyanoacrylate adhesives are currently commercially available and can be used with this invention. Of course, any product that is capable of sealing the sponge or at least retarding blood flow through or beyond the sponge would be acceptable. It is also to be understood that certain adhesives will not require that the field andlor the outer wall of the blood vessel be cleared before the adhesive is injected.
[0062] Curing time and ease of use will vary depending on the adhesive used.
For example, some adhesives cure to a malleable gel-like state within a few seconds, while others will cure directly to a hardened state in a few minutes. The time period for curing is chosen to allow the clinician to advance the sponge into position adjacent the wound and in contact with the artery, at which time the sponge will begin to be bonded to the vessel wall and substantially sealed by the adhesive. It should be appreciated that any acceptable adhesive having any acceptable curing time may be used.
[0063] The push member 84 may be Kept in place for any reasonable time period in order to allow the adhesive 106 to cure. Also, multiple sponges can be used, if desired.
Preferably, however, the adhesive 106 will cure sufficiently in about five minutes or less. Other tools, such as an ultraviolet light source or a heat application device, may be used to help speed adhesive curing.
[0064] Once the sponge 80 is correctly placed, the push member 84 can be removed. Removal of the push member 84 can be aided by a release rod 110 which, as shown in Figure 10, is advanced through the push member lumen 90 and into contact with the sponge 80. The release rod 110 holds the sponge 80 in place as the push member 84 is withdrawn from the patient. Thus, the release rod 110 engages the sponge 80 so as to provide counter traction when the push member 84 is withdrawn. In this way, the push member 84 can be removed even if some adhesion occurs between the sponge 80 and the push member 84. With reference next to Figure 11, once the release _g_ rod 110 is withdrawn, the patient's skin 112 is closed by any appropriate closure media such as, for example, sutures 114. The hemostatic sponge 80 is left in place. The body's natural blood clotting process will plug and repair the vascular wound w with the aid of the hemostatic sponge 80. Thus, healing will proceed without the danger of false aneurysms, missed or faulty wound closure, or the like.
[0065] As discussed above and shown in Figures 1 and 7, the hemostatic sponge 80 circumferentially surrounds the catheter 32, and the catheter 32 preferably extends through a puncture hole 82 through the sponge 80.
When the catheter 32 is removed, however, the hole 82 remains. Sponges that are relatively elastic will spring back into place, filling the hole 82. However, some hemostatic sponge materials have relatively poor elastic resilience and mechanical strength. Such materials may not be able to spring back into place to fill the hole. This is problematic because the hole 82 is aligned with the blood vessel wound w; thus, blood b may flow substantially unimpeded through the hole 82, possibly leading to complications. Also, adhesive that is injected can possibly flow through the hole 82 in the sponge 80 and further through the wound w and into the bloodstream.
[0066] Accordingly, in another embodiment depicted in Figures 12 and 13, the release rod 110 can be used to advance one or more additional hemostatic members 118 through the push member lumen 90 and into contact with the original sponge 80. The additional sponge material 118 can help further plug the hole 82 in the sponge 80 through which the catheter 32 was disposed, and will stem the flaw of blood b with the hemostatic sponge material 118, which will facilitate blood clotting. The additional sponge material 118 will also plug the hole 82 left in the original sponge 80 so that adhesive that may be added later will be blocked from entering the wound w.
[0067] With reference next to Figures 14-16, another embodiment of a hemostatic sponge member 120 comprises a hemostatic sponge layer 122 and a highly elastic layer 124. A
layer of cement 126 attaches the hemostatic layer 122 to the elastic layer 124. Alternatively, the hemostatic layer 122 and elastic layer 124 can be integrally formed. As with the hemostatic sponge 80 described above, the hemostatic layer 122 comprises a hemostatic agent which facilitates and speeds blood clotting. The elastic layer 124 improves the overall elasticity and mechanical strength of the sponge 120. Preferably the elastic layer 124 comprises a polymer having relatively high elastic resilience and mechanical strength. Polymer elastomers such as polyurethane, SDS and silicon rubber can advantageously be used for the elastic layer 124. It is to be understood that the elastic layer 124 preferably is non-toxic. Also, it is not necessary for the elastic layer to include a hemostasis agent or any other medicament.
[0068] As discussed above, the catheter 32 preferably extends through a puncture hole 82 through the hemostatic sponge 120. With continued reference to Figure 15, the elastic layer 124 is preferably oriented on a side of the sponge 120 away from the wound w, while the hemostatic sponge layer 122 is oriented so as to directly contact the blood vessel wall 98 and wound w. With specific reference to Figure 16, when the catheter 32 is removed from the hemostatic sponge 120, the highly elastic layer 124 will immediately retract, substantially sealing the hole 82. Since the hemostatic sponge layer 122 is connected to the elastic layer 124, the sponge material 122 will also be retracted, closing the hole. Accordingly, not only will the hole be sealed, but the hemostatic material 122 will fill the hole 82 so as to be placed directly in the path of blood b coming from the vascular wound w. Accordingly, more thorough and speedier blood clotting is achieved.
[0069] In the embodiment illustrated in Figures 1-9, the catheter comprises a single-lumen catheter.
In another embodiment [not shown), the elongate catheter has a first lumen comprising a tube that extends from the distal end opening to the proximal end opening and slidingly accommodates the guidewire therewithin. The outer wall of the catheter defines a second lumen that concentrically surrounds the first lumen. The holes through the outer wall of the catheter open into the second lumen. Additionally, an access lumen communicates with the second lumen. In this embodiment, the distal and proximal openings, which accommodate the guidewire, do not communicate with the' second lumen, which lumen communicates with the source of suction through the access lumen. Accordingly, in this embodiment, there may be less of a chance that body fluids will be drawn into the catheter through the distal and proximal guidewire openings than in an embodiment employing a single lumen.
However, the single-lumen catheter can be less expensive to manufacture and can be expected to have a smaller diameter than the dual-lumen catheter.
[0070] Figure 17 shows another additional embodiment wherein a lock apparatus 130 is employed to help hold the sponge 80 in place against the artery wall 98. The lock apparatus 130 is preferably slidably disposed about the catheter 32 between the push member 84 and the sponge 80. The lock apparatus 130 accompanies the sponge 80 as it is advanced into position on the blood vessel wall 98 surrounding the vascular wound w. The lock apparatus 130 has arms that preferably are configured to allow movement through tissue 96 toward the wound w, but resist movement of the apparatus 130 in the direction away from the wound w.
Thus, the lock apparatus 130 holds the sponge 80 tightly in place adjacent the wound w as shown in Figure 18.
[0071] It is to be understood that several forms of the lock apparatus may be advantageously employed. For example, in the illustrated embodiment, the lock apparatus 130 has swept-back arms 132 that are adapted so that the apparatus 130 can be advanced through a tissue 96 toward the vascular wound w, but cannot be moved away from the vascular wound w because the arms 132 will engage the surrounding tissue 96. In another embodiment, selectively actuable arms may be provided within the lock apparatus. A trigger may be provided so that the arms will extend into the surrounding tissue when the trigger is actuated, thus locking the device in place and holding the sponge next to the vascular wound.
[0072] The lock apparatus is preferably formed of a material that can be absorbed by the body over time. However, other materials, such as stainless steel, can be advantageously used.
[0073] In a further additional embodiment illustrated in Figures 19-21, a multi-layer patch 140 is used in addition to or instead of the sponge 80. The patch 140 may be soaked or coated with a hemostatic agent andlor adhesive and is specially adapted to be advancable over the catheter 32 and to cover the vascular wound w.
As shown in Figure 19, the patch 140 preferably comprises a single piece of material 142 having a fold line 144 disposed roughly down the middle thereof. A first slit 146 is provided in a first half 148 of the patch 140 and a second slit 150 is provided in a second half 152 of the patch 140. Preferably, the second slit 150 is substantially normal to the first slit 146. The patch material 142 is folded over itself as shown in Figure 20 and is threaded over the catheter 32 as shown in Figure 21. The catheter 32 fits through each of the slits 146, 150, which provide room for the catheter 32 to slidingly fit therethrough. However, as the patch 140 is advanced into position and the catheter 32 is removed from the patch, the slits 146, 150 overlap each other, leaving only a small hole; if any. Adhesive can be applied over the small hole andJor between the halves to ensure sealing of the patch and closure of the wound.
[0074] A number of other embodiments may be employed that combine various aspects that have been discussed above. For example, the multi-layer patch 140 of Figure 17 may be bonded to the artery wall 98 using an adhesive applied to the base of the patch and then a sponge may be advanced over the patch, or vice versa.
Additionally, rather than the two-arm retractor 70 disclosed herein, other means may be used for providing access to the blood vessel 94. For instance, access and location may be provided by a cannula, balloon, or the like. Still further, in some embodiments, an elastic and conformable sponge can be positioned adjacent the wound by being advanced over the catheter, or even over a bare guidewire, without using any additional access-providing device.
[0075] Although this invention has been disclosed in the context of certain preferred embodiments and examples, it will be understood by those skilled in the art that the present invention extends beyond the specifically-disclosed embodiments to other alternative embodiments andlor uses of the invention and obvious modifications and equivalents thereof. In addition, while a number of variations have been shown and described in detail, other modifications, which are within the scope of this invention, will he readily apparent to those of skill in the art based upon this disclosure. It is also contemplated that various combinations or subcombinations of the specific features and aspects of the embodiments may be made and still fall within the scope of the invention. Accordingly, it should be understood that various features and aspects of the disclosed embodiments can be combined with or substituted far one another in order to form varying modes of the disclosed modular arrangement and method. Thus, it is intended that the scope of the present invention should not be limited by the particular disclosed embodiments described above, but should be determined only by a fair reading of the claims that follow.
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[00081 Other wounds in the vasculature of a patient can also be difficult to see, and are thus difficult to locate, access and close. Thus, a device and method to facilitate locating and closing of such wounds in the vasculature of a patient would be extremely beneficial. A device having the ability to consistently and reliably locate, isolate and close the puncture wound would eliminate the prolonged bleeding currently associated with such wounds.
Summary of the Invention [0009] Accordingly, there is a need in the art for a device and method for precisely locating a blood vessel wound and sealing the wound.
[0010] In accordance with one embodiment, an assembly for closing a blood vessel wound is provided.
An elongate catheter of the assembly accommodates a guidewire threaded therethrough. The catheter is configured to slide over the guidewire so that a tip of the catheter extends into a blood vessel wound. A hemostatic material comprises a hemostasis-facilitating agent. A push member is adapted to slide relative to the catheter. The push member has a lumen adapted to communicate a flowable adhesive therethrough.
[00111 In accordance with another embodiment, an assembly is provided for closing a vascular wound. A surgical implement is configured to extend at least partially through a vascular wound. A hemostatic material member comprises a hemostatic agent. A push member is configured to be longitudinally slidable relative to the surgical implement. The push member is adapted to engage and push the hemostatic material longitudinally over the surgical implement.
[0012] For purposes of summarizing the preferred embodiments and the advantages achieved over the prior art, certain embodiments and advantages have been described herein above. Of course, it is to be understood that not necessarily all such advantages may be achieved in accordance with any particular embodiment. Thus, for example, those skilled in the art will recognize that the invention may be embodied or carried out in a manner that achieves or optimizes one advantage or group of advantages as taught herein without necessarily achieving other objects or advantages as may be taught or suggested herein.
[0093] The embodiments discussed above and other embodiments will become readily apparent to those skilled in the art from the following detailed description of the preferred embodiments having reference to the attached figures, the invention not being limited to any particular preferred embodiments) disclosed.
Brief Description of the Drawinus [0014] Figure 1 is a side view of an embodiment of a vascular closure apparatus shown assembled and ready far use.
[0015] Figure 2 is a side view of a distal portion of the apparatus of Figure 1.
[0016] Figure 3 is a side view of a push member having features in accordance with the present invention.
[0017] Figure 4 shows the apparatus of Figure 1 advanced over a guidewire into a blood vessel of a patient.
[0018] Figure 5 shows the arrangement of Figure 4 with the retractor arms open and a suction tool in use.
[0019] Figure 6 shows the arrangement of Figure 5, wherein a hemostatic sponge has been advanced into contact with the blood vessel wall.
[0020] Figure 7 shows the arrangement of Figure 6, with the retractor arms removed.
[0021] Figure 8 shows the arrangement of Figure 7 with the catheter and guidewire removed.
[0022] Figure 9 shows the arrangement of Figure 8, wherein a flowable adhesive is being delivered to the sponge.
[0023] Figure 10 shows the arrangement of Figure 8, wherein the push member is being removed from the patient.
[0024] Figure 11 shows a sealed puncture wound after treatment with an embodiment of the device and method.
[0025] Figure 12 shows an embodiment wherein an additional sponge is being advanced toward the wound.
[0026] Figure 13 shows the embodiment of Figure 12 with the additional sponge in place.
[0027] Figure 14 shows another embodiment of a hemostatic sponge member.
[0028] Figure 15 shows the sponge member of Figure 14 in contact with the vessel wall and having a cathetertherethrough.
extending [0029] Figure 16 shows the arrangement of Figure 15 with the catheter removed.
[0030] Figure 17 shows an embodiment in which a lock member is provided proximal a hemostatic sponge member.
[00311 Figure 18 shows a sealed puncture wound after treatment with the device of Figure 12.
[0032] Figure 19 shows a schematic view of an unfolded two-layer patch.
[0033] Figure 20 shows the patch of Figure 19 in a folded position.
[0034] Figure 21 shows the patch of Figure 19 slidably mounted onto a catheter and being advanced by a push member.
Detailed Description of the Preferred Embodiment [0035] The present apparatus and method is especially useful for closing vascular puncture wounds that are difficult to access andlor visualize. It is difficult to directly and accurately modify the wounded blood vessel in order to close such wounds. Additionally, there are pitfalls associated with directly modifying the blood vessel. For example, since the clinician cannot see the wound, it is difficult to correctly place closure media such as sutures, staples, or clips. Incorrect placement of such closure media likely results in inadequate closure; the puncture wound remains open, perhaps without the clinician being aware. Additionally, incorrect placement of closure media may cause permanent damage to the vessel, including tearing and additional puncture wounds. Further, if closure media extends through the wound and into the blood flow, this media can increase the likelihood of thrombus formation or could introduce potentially toxic substances into the bloodstream. Of course, closure media inadvertently released into the bloodstream could lead to serious blood vessel blockage complications.
[0036] With reference to Figure 1, a vascular wound closure assembly 30 includes an elongate catheter 32 having a distal end 34 and a proximal end 36 of the catheter 32. A
distal opening 38 is formed through the distal end 34 of the catheter 32 and opens along a longitudinal axis of the catheter 32. The catheter 32 includes a tapered tip 40 at the distal end 34. An elongate main body 42 of the catheter 32 is disposed proximal the tapered tip 40. Preferably the main body 42 has a substantially uniform diameter along its length. A lumen 44 extends longitudinally within the catheter 32 from the distal opening 38 to the proximal end 36.
[0037] A connector portion 46 is provided on the proximal end 36. The connector portion 46 includes a main lumen 48 and a secondary lumen 50. The main lumen 48 extends along the longitudinal axis of the catheter 32 and is coextensive with the catheter lumen 44. The secondary lumen 50 extends outwardly from the main lumen 48, but communicates with the main lumen 48 and the catheter lumen 44. A proximal opening 52 is provided at the proximal end of the main lumen 48 and, like the distal opening 38, opens along the longitudinal axis. A secondary opening 54 opens into the secondary lumen 50.
[00381 The distal and proximal openings 38, 52 are sized and adapted to accommodate a guidewire 58 such as the guidewire used in angioplasty and other vascular surgeries. As such, the guidewire 58 can be threaded through the catheter 32 and the catheter can be advanced over the guidewire 58.
[0039] Holes 60 are formed through a side wall 0f the catheter 32 near the distal end 34 of the catheter 32. Preferably, at least two holes 60 are provided. All of the holes 60 preferably are disposed substantially the same distance from the distal end 34 of the catheter 32. Preferably, a raised portion 62 of the catheter 32 is provided in the region around the holes 60, which region is proximal of the tip 40 and distal of the main body 42. At the raised portion 62, the catheter 32 has an outer diameter that is slightly larger than the outer diameter throughout the catheter main body 42.
[0040] With continued reference to Figure 1, a vacuum or other source of suction 64 is provided and communicates, through tubing 66, with the secondary lumen 50 of the catheter connector portion 46. Thus, a vacuum is drawn through the catheter lumen 44. Preferably, the distal and proximal openings 38, 52, which accommodate, the guidewire 58, are sized so that the guidewire 58 substantially plugs the openings; thus, the vacuum is drawn through the holes 60. A viewing port 68 is arranged between the source of suction 64 and the catheter 32. The viewing port 68 is configured to allow a clinician to view the material that is drawn by suction through the holes 60 and through the catheter lumen 44. The viewing port 68 will he discussed in more detail below.
[0041] With reference to Figures 1 and 2, a retractor 70 is preferably mounted on the catheter 32.
The retractor 70 includes opposing elongate retractor arms 72 that are aligned longitudinally on the catheter 32. A
retractor body 74 is configured to selectively open and close the retractor arms 72 when operated by a clinician. The elongate retractor arms 72 of the retractor 70 are positioned on the catheter 32 so that distal ends 76 of the arms are positioned proximal of the catheter holes 60 a distance that is at least the same as the width of an artery wall, preferably at least about .5 to 2 millimeters.
[0042] With reference again to Figure 1, a hemostatic member 80 is arranged on the catheter 32 proximal of the retractor 70. As will be discussed in more detail below, the hemostatic member comprises a material that is made of or includes a hemostatic agent. The hemostatic agent is adapted to aid blood clotting. In one embodiment, the hemostatic member 80 comprises a sponge or sponge-like material. In this description, sponge is a broad term that is used in accordance with it ordinary meaning and includes, without limitation, a material that is adapted to soak up at least a portion of blood that may came in contact with the material.
[0043] For purposes of this description, the hemostatic member 80 is referred to as the sponge 80.
However, it is to be understood that use of the term "sponge' does not limit the scope of materials that can be used as the hemostatic member. In fact, any material that aids or facilitates blood clotting can be used as the hemostatic member.
[0044] Preferably, the sponge 80 extends circumferentially around the catheter main body 42, and is arranged so that it can be slid longitudinally along the catheter 32. Most preferably, the catheter 32 extends through a passageway 82 through the sponge 80. The passageway 82 is formed as the catheter 32 is forced through the sponge 80.
[0045] A push member 84 is also arranged on the catheter 32 distal of the sponge 80. With reference also to Figure 3, the push member 84 comprises a body portion 86 and a proximal handle portion 88. An elongate lumen 90 is formed through the body portion 86. As shown in Figure 1, the lumen 90 preferably encircles the catheter 32 so as to allow the push member 84 to slide relative to the catheter 32. A plurality of holes 92 are formed through the body portion 86 at a point near the distal end of the push member 84.
[0046] As will be discussed in more detail below in connection with Figure 4, the vascular wound closure assembly 30 enables a clinician to precisely locate a subcutaneous vascular wound "w", access the wound w, and deliver the hemostatic sponge 80 to the wound site. The hemostatic sponge 80 includes a hemostatic agent that helps facilitate closure of the wound w.
[0047] In order to properly apply the hemostatic sponge 80, the vascular closure assembly 30 first precisely locates and provides access to the vascular wound w. It is to be understood that the present method and apparatus can be used to close various vascular and other wounds. Figures 1-11, and the accompanying discussion, present an example using an embodiment to close a puncture wound w in a patient's femoral artery 94.
[00481 With specific reference to Figures 1, 2. 4 and 5, in order to precisely locate and provide access to a femoral artery puncture wound w, the catheter 32 is first threaded over a guidewire 58 that has been previously inserted into the patient's femoral artery 94 through the puncture wound w. The lumen 44 is attached to the source of suction 64 and the assembly 30 is advanced over the guidewire 58 through a patient's tissue 96 so that the distal tip 40 of the catheter 32 extends through the vascular puncture wound w.
[0049] As the assembly 30 is advanced, the source of suction 64 draws bodily fluids through the holes 60. The fluids pass through the viewing port 68, which allows the clinician to identify the fluids being withdrawn. The viewing port 68 can have any suitable structure or location.
For example, the viewing port can comprise clear tubing attached to the catheter, a substantially transparent syringe that functions as both a source of suction and a viewing port, or a portion of the catheter that is substantially transparent. Most preferably, the catheter 32 is formed of a transparent material so that the clinician becomes aware as soon as blood begins to be drawn through the catheter.
[0050] When the holes 60 pass the artery wall 98 and enter the blood vessel 94, as shown in Figure 4, blood "b" begins to be drawn through the holes 60 into the catheter 32 and is conducted past the viewing port 68.
Thus, when blood b is observed in the viewing port 68, the clinician will Know that the holes 60 have just passed into the puncture wound w and that the distal ends 76 of the retractor arms 72 are thus positioned adjacent the outer wall 98 of the artery 94, preferably within about 2mm of the artery wall 98. The retractor arms 72 are then separated as shown in Figure 5, thus drawing surrounding tissue 9.6 away from the wound w and creating a field 100 around the puncture wound w. The catheter 32 remains disposed partially within the puncture wound w, effectively plugging the wound and preventing blood from flowing through the wound. The raised portion 62 flexes the edges of the wound w to enhance the seal between the catheter 32 and the puncture wound edges.
[0051] With continued reference to Figure 5, a suction tool 102 can be used to clear away bodily fluids and other matter that may be within the field 100 and to clean the wall 98 of the blood vessel 94 adjacent the puncture wound w.
[0052] With reference next to Figure 6, once the puncture wound w has been precisely located, the push member 84 is advanced distally along the catheter 32, thus advancing the sponge 80 into contact with the vessel wall 98 so as to surround the puncture wound w. As mentioned above and discussed in more detail below, the sponge 80 comprises a hemostatic agent that will help accelerate blood clot formation at the wound site w in order to help the wound heal faster.
[0053] Preferably, the sponge 80 is at least partially coated with an adhesive so that the sponge will at least partially bond to the vessel wall 98. Alternatively, or in addition, flowable adhesive can be delivered into the field around the puncture wound before the sponge is advanced into contact with the vessel wall. Of course, the sponge can be delivered without using any adhesive.
[0054] The sponge 80 is preferably mounted onto the catheter 32 so as to substantially encircle the catheter 32. Thus, since the tip 40 of the catheter is disposed in the wound, the sponge 80 substantially surrounds the wound w when the sponge is positioned adjacent the vessel wall 98. When the sponge 80 is in place adjacent the wound w, the retractor 70 can be removed, as shown in Figure 7. When the retractor 70 is removed, the surrounding body tissues 96 collapse around the sponge 80 and push member 84. The push member 84 holds the sponge 80 in position while body tissue 96 surrounds the sponge 80 and while the adhesive cures.
[0055] With reference next to Figure 8, with the push member 84 in place, the catheter 32 and guidewire 58 can also be removed from the patient. The passage 82 through the sponge 80, which had been occupied by the catheter 32, collapses onto itself so that it is substantially closed.
The vessel wound w is no longer plugged by the catheter 32, and it is anticipated that blood b from the vessel 94 will flow into the sponge 80, at least partially soaking the sponge 80. Although the retractor 70 is removed prior to the catheter 32 in the above-discussed embodiment, it is to be understood that, in another embodiment, the catheter may be removed prior to the retractor.
[0056] In still another embodiment, additional pressure can be applied to the push member 84 in order to at least partially block blood flow through the blood vessel 94. In this manner, the clinician can control how quickly blood will flow through the wound w and into the sponge 80. Of course, other methods and apparatus can be used to temporarily reduce or stop blood flow through the vessel.
[0057] In a preferred embodiment, the sponge 80 comprises a material made of or soaked in a hemostatic agent. The agent is specially adapted to aid blood clotting. Thus, blood that flows into the sponge will quickly become clotted, causing natural sealing of the wound through blood clotting. Sponge-like hemostasis agents are available and can include products such as Gelfoam~", Oxycell~" and Avitene~". Other appropriate hemostatic sponges may be impregnated with thrombin, a liquid clotting agent, to help accelerate blood clot formation. Another material that may advantageously be used is a collagen Ultrafoam~" sponge marketed by C.R. BardIDavol, Inc. The Ultrafoam~" sponge is made from Avitene'~ collagen, a natural clotting agent, and does not require the addition of thrombin. This reduces preparation time and the risk that a patient will experience a potentially hazardous reaction to bovine thrombin. Other medicants can also be included in the sponge. For example, antibiotic medicines, anti-inflammatory drugs, healing aids, and the like can be impregnated into the sponge material.
[0058] The sponge-like material is preferably soft and pliable and will conform to the structure of the blood vessel, the wound and the field around the blood vessel. Thus, the sponge-like material is specially suited for use in the confined space surrounding a vascular puncture. Additionally, the hemostatic sponge 80 will be held in place by the tissue 96 surrounding the puncture wound w, which tissue 96 collapses over the sponge 80 when tools such as the retractor 70 are removed.
[0059] To further help hold the sponge 80 in place, flowable adhesive 106 from a source of adhesive 108 can be delivered through the lumen 90 of the push member 84 and onto the sponge 80, as shown in Figure 9.
The adhesive 106 flows through the open distal end of the push member 84 and also through the holes 92 through the push member body portion 86. Upon curing, the adhesive 106 can form a sealing layer around and within the sponge 80, thus confining the blood b to the sponge area. This helps minimize bleeding and even further speeds clot formation.
Adding adhesive 106 will also facilitate more complete closure of the passage through the sponge, which passage was vacated by the catheter 32. Further, the adhesive 106 will help hold the sponge 80 in place relative to the puncture wound w and the surrounding tissue 96.
[0060] As discussed above, prior to being advanced into contact with the blood vessel wall, the sponge 80 may be soaked in an adhesive or, more preferably, coated with a layer of adhesive. In this manner, adhesive distribution on the sponge can be controlled. By controllably applying a coating of adhesive around the outer surface of the sponge, the adhesive will bond the sponge to the area surrounding the blood vessel wound w, including the vessel 94 itself, and also can form a perimeter seal of the sponge when the adhesive cures. The coating of adhesive can act as a membrane confining the blood b to the sponge 80. It is to be understood that a coating of adhesive may be used instead of or in addition to applying additional adhesive 106 through the push member 84.
[0061] Various Kinds of flowable adhesives may be acceptable for use with the sponge. For example, fibrin tissue sealants such as Tisseel~, which is available from Baxter Healthcare Corp., may be appropriate. Other commercially available adhesives that may be appropriate include Bioglue~", available from Cryolife, Inc., and Floseal'T", which is available from Fusion Medical Technologies. Various cyanoacrylate adhesives are currently commercially available and can be used with this invention. Of course, any product that is capable of sealing the sponge or at least retarding blood flow through or beyond the sponge would be acceptable. It is also to be understood that certain adhesives will not require that the field andlor the outer wall of the blood vessel be cleared before the adhesive is injected.
[0062] Curing time and ease of use will vary depending on the adhesive used.
For example, some adhesives cure to a malleable gel-like state within a few seconds, while others will cure directly to a hardened state in a few minutes. The time period for curing is chosen to allow the clinician to advance the sponge into position adjacent the wound and in contact with the artery, at which time the sponge will begin to be bonded to the vessel wall and substantially sealed by the adhesive. It should be appreciated that any acceptable adhesive having any acceptable curing time may be used.
[0063] The push member 84 may be Kept in place for any reasonable time period in order to allow the adhesive 106 to cure. Also, multiple sponges can be used, if desired.
Preferably, however, the adhesive 106 will cure sufficiently in about five minutes or less. Other tools, such as an ultraviolet light source or a heat application device, may be used to help speed adhesive curing.
[0064] Once the sponge 80 is correctly placed, the push member 84 can be removed. Removal of the push member 84 can be aided by a release rod 110 which, as shown in Figure 10, is advanced through the push member lumen 90 and into contact with the sponge 80. The release rod 110 holds the sponge 80 in place as the push member 84 is withdrawn from the patient. Thus, the release rod 110 engages the sponge 80 so as to provide counter traction when the push member 84 is withdrawn. In this way, the push member 84 can be removed even if some adhesion occurs between the sponge 80 and the push member 84. With reference next to Figure 11, once the release _g_ rod 110 is withdrawn, the patient's skin 112 is closed by any appropriate closure media such as, for example, sutures 114. The hemostatic sponge 80 is left in place. The body's natural blood clotting process will plug and repair the vascular wound w with the aid of the hemostatic sponge 80. Thus, healing will proceed without the danger of false aneurysms, missed or faulty wound closure, or the like.
[0065] As discussed above and shown in Figures 1 and 7, the hemostatic sponge 80 circumferentially surrounds the catheter 32, and the catheter 32 preferably extends through a puncture hole 82 through the sponge 80.
When the catheter 32 is removed, however, the hole 82 remains. Sponges that are relatively elastic will spring back into place, filling the hole 82. However, some hemostatic sponge materials have relatively poor elastic resilience and mechanical strength. Such materials may not be able to spring back into place to fill the hole. This is problematic because the hole 82 is aligned with the blood vessel wound w; thus, blood b may flow substantially unimpeded through the hole 82, possibly leading to complications. Also, adhesive that is injected can possibly flow through the hole 82 in the sponge 80 and further through the wound w and into the bloodstream.
[0066] Accordingly, in another embodiment depicted in Figures 12 and 13, the release rod 110 can be used to advance one or more additional hemostatic members 118 through the push member lumen 90 and into contact with the original sponge 80. The additional sponge material 118 can help further plug the hole 82 in the sponge 80 through which the catheter 32 was disposed, and will stem the flaw of blood b with the hemostatic sponge material 118, which will facilitate blood clotting. The additional sponge material 118 will also plug the hole 82 left in the original sponge 80 so that adhesive that may be added later will be blocked from entering the wound w.
[0067] With reference next to Figures 14-16, another embodiment of a hemostatic sponge member 120 comprises a hemostatic sponge layer 122 and a highly elastic layer 124. A
layer of cement 126 attaches the hemostatic layer 122 to the elastic layer 124. Alternatively, the hemostatic layer 122 and elastic layer 124 can be integrally formed. As with the hemostatic sponge 80 described above, the hemostatic layer 122 comprises a hemostatic agent which facilitates and speeds blood clotting. The elastic layer 124 improves the overall elasticity and mechanical strength of the sponge 120. Preferably the elastic layer 124 comprises a polymer having relatively high elastic resilience and mechanical strength. Polymer elastomers such as polyurethane, SDS and silicon rubber can advantageously be used for the elastic layer 124. It is to be understood that the elastic layer 124 preferably is non-toxic. Also, it is not necessary for the elastic layer to include a hemostasis agent or any other medicament.
[0068] As discussed above, the catheter 32 preferably extends through a puncture hole 82 through the hemostatic sponge 120. With continued reference to Figure 15, the elastic layer 124 is preferably oriented on a side of the sponge 120 away from the wound w, while the hemostatic sponge layer 122 is oriented so as to directly contact the blood vessel wall 98 and wound w. With specific reference to Figure 16, when the catheter 32 is removed from the hemostatic sponge 120, the highly elastic layer 124 will immediately retract, substantially sealing the hole 82. Since the hemostatic sponge layer 122 is connected to the elastic layer 124, the sponge material 122 will also be retracted, closing the hole. Accordingly, not only will the hole be sealed, but the hemostatic material 122 will fill the hole 82 so as to be placed directly in the path of blood b coming from the vascular wound w. Accordingly, more thorough and speedier blood clotting is achieved.
[0069] In the embodiment illustrated in Figures 1-9, the catheter comprises a single-lumen catheter.
In another embodiment [not shown), the elongate catheter has a first lumen comprising a tube that extends from the distal end opening to the proximal end opening and slidingly accommodates the guidewire therewithin. The outer wall of the catheter defines a second lumen that concentrically surrounds the first lumen. The holes through the outer wall of the catheter open into the second lumen. Additionally, an access lumen communicates with the second lumen. In this embodiment, the distal and proximal openings, which accommodate the guidewire, do not communicate with the' second lumen, which lumen communicates with the source of suction through the access lumen. Accordingly, in this embodiment, there may be less of a chance that body fluids will be drawn into the catheter through the distal and proximal guidewire openings than in an embodiment employing a single lumen.
However, the single-lumen catheter can be less expensive to manufacture and can be expected to have a smaller diameter than the dual-lumen catheter.
[0070] Figure 17 shows another additional embodiment wherein a lock apparatus 130 is employed to help hold the sponge 80 in place against the artery wall 98. The lock apparatus 130 is preferably slidably disposed about the catheter 32 between the push member 84 and the sponge 80. The lock apparatus 130 accompanies the sponge 80 as it is advanced into position on the blood vessel wall 98 surrounding the vascular wound w. The lock apparatus 130 has arms that preferably are configured to allow movement through tissue 96 toward the wound w, but resist movement of the apparatus 130 in the direction away from the wound w.
Thus, the lock apparatus 130 holds the sponge 80 tightly in place adjacent the wound w as shown in Figure 18.
[0071] It is to be understood that several forms of the lock apparatus may be advantageously employed. For example, in the illustrated embodiment, the lock apparatus 130 has swept-back arms 132 that are adapted so that the apparatus 130 can be advanced through a tissue 96 toward the vascular wound w, but cannot be moved away from the vascular wound w because the arms 132 will engage the surrounding tissue 96. In another embodiment, selectively actuable arms may be provided within the lock apparatus. A trigger may be provided so that the arms will extend into the surrounding tissue when the trigger is actuated, thus locking the device in place and holding the sponge next to the vascular wound.
[0072] The lock apparatus is preferably formed of a material that can be absorbed by the body over time. However, other materials, such as stainless steel, can be advantageously used.
[0073] In a further additional embodiment illustrated in Figures 19-21, a multi-layer patch 140 is used in addition to or instead of the sponge 80. The patch 140 may be soaked or coated with a hemostatic agent andlor adhesive and is specially adapted to be advancable over the catheter 32 and to cover the vascular wound w.
As shown in Figure 19, the patch 140 preferably comprises a single piece of material 142 having a fold line 144 disposed roughly down the middle thereof. A first slit 146 is provided in a first half 148 of the patch 140 and a second slit 150 is provided in a second half 152 of the patch 140. Preferably, the second slit 150 is substantially normal to the first slit 146. The patch material 142 is folded over itself as shown in Figure 20 and is threaded over the catheter 32 as shown in Figure 21. The catheter 32 fits through each of the slits 146, 150, which provide room for the catheter 32 to slidingly fit therethrough. However, as the patch 140 is advanced into position and the catheter 32 is removed from the patch, the slits 146, 150 overlap each other, leaving only a small hole; if any. Adhesive can be applied over the small hole andJor between the halves to ensure sealing of the patch and closure of the wound.
[0074] A number of other embodiments may be employed that combine various aspects that have been discussed above. For example, the multi-layer patch 140 of Figure 17 may be bonded to the artery wall 98 using an adhesive applied to the base of the patch and then a sponge may be advanced over the patch, or vice versa.
Additionally, rather than the two-arm retractor 70 disclosed herein, other means may be used for providing access to the blood vessel 94. For instance, access and location may be provided by a cannula, balloon, or the like. Still further, in some embodiments, an elastic and conformable sponge can be positioned adjacent the wound by being advanced over the catheter, or even over a bare guidewire, without using any additional access-providing device.
[0075] Although this invention has been disclosed in the context of certain preferred embodiments and examples, it will be understood by those skilled in the art that the present invention extends beyond the specifically-disclosed embodiments to other alternative embodiments andlor uses of the invention and obvious modifications and equivalents thereof. In addition, while a number of variations have been shown and described in detail, other modifications, which are within the scope of this invention, will he readily apparent to those of skill in the art based upon this disclosure. It is also contemplated that various combinations or subcombinations of the specific features and aspects of the embodiments may be made and still fall within the scope of the invention. Accordingly, it should be understood that various features and aspects of the disclosed embodiments can be combined with or substituted far one another in order to form varying modes of the disclosed modular arrangement and method. Thus, it is intended that the scope of the present invention should not be limited by the particular disclosed embodiments described above, but should be determined only by a fair reading of the claims that follow.
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Claims (26)
1. An assembly for closing a vascular wound, comprising:
a surgical implement configured to extend at least partially through a vascular wound;
a hemostatic material member comprising a hemostatic agent; and a push member configured to be longitudinally slidable relative to the surgical implement, the push member adapted to engage and push the hemostatic material longitudinally over the surgical implement.
a surgical implement configured to extend at least partially through a vascular wound;
a hemostatic material member comprising a hemostatic agent; and a push member configured to be longitudinally slidable relative to the surgical implement, the push member adapted to engage and push the hemostatic material longitudinally over the surgical implement.
2. The assembly of Claim 1 additionally comprising an access device configured to provide an access passage to the vascular wound.
3. The assembly of Claim 2, wherein the access device comprises a retractor having at least two elongate retractor arms adapted to selectively open and close around the surgical implement.
4. The assembly of Claim 1, wherein the hemostatic material member comprises a sponge-like material comprising a hemostatic agent adapted to facilitate blood clotting.
5. The assembly of Claim 4, wherein the hemostatic material member is adapted to soak up blood.
6. The assembly of Claim 1, wherein the surgical implement comprises a guidewire.
7. The assembly of Claim 6, wherein the surgical implement comprises a catheter, the catheter being slidable over the guidewire.
8. The assembly of Claim 7, wherein the hemostatic material member and the push member are mounted onto the catheter so as to slide longitudinally over the catheter, and the hemostatic material member is mounted distally of the push member.
9. The assembly of Claim 1, wherein the push member comprises an elongate body and a proximal handle portion, and a longitudinal lumen is formed through the push member.
10. The assembly of Claim 9 additionally comprising an elongate release rod, the rod configured to slidably fit through the push member lumen.
11. The assembly of Claim 10 additionally comprising a second hemostatic material member, the second hemostatic material member sized and configured to be pushably advanced through the push member lumen by the rod.
12. The assembly of Claim 9, wherein the push member body has a plurality of holes formed through a side wall thereof near a distal end of the body.
13. The assembly of Claim 1, wherein the hemostatic material member comprises a first layer having relatively high elasticity and a second layer comprising a hemostasis agent, and the first and second layers are attached.
14. The assembly of Claim 13, wherein the first and second layers are attached to each other by a cement.
15. The assembly of Claim 13, wherein the first and second layers are integrally formed.
16. The assembly of Claim 13, wherein the hemostatic material member is configured so that a puncture hole through the first and second layers is substantially sealingly closed by the elastic first layer.
17. The assembly of Claim 16, wherein the surgical implement extends through a puncture hole through the first and second layers.
18. The assembly of Claim 13, wherein the hemostatic material member comprises a sponge-like material comprising a hemostatic agent adapted to facilitate blood clotting.
19. The assembly of Claim 1, wherein the hemostatic material member is at least partially coated with an adhesive.
20. An assembly for closing a blood vessel wound, the assembly comprising:
an elongate catheter accommodating a guidewire threaded therethrough, the catheter configured to slide over the guidewire so that a tip of the catheter extends into a blood vessel wound;
a hemostatic material comprising a hemostasis-facilitating agent; and a push member adapted to slide relative to the catheter, the push member having a lumen adapted to communicate a flowable adhesive therethrough.
an elongate catheter accommodating a guidewire threaded therethrough, the catheter configured to slide over the guidewire so that a tip of the catheter extends into a blood vessel wound;
a hemostatic material comprising a hemostasis-facilitating agent; and a push member adapted to slide relative to the catheter, the push member having a lumen adapted to communicate a flowable adhesive therethrough.
21. The assembly of Claim 20 additionally comprising a retractor having at least two retractor arms adapted to selectively open and close around the catheter.
22. The assembly of Claim 21 additionally comprising a rod slidable within the push member lumen.
23. The assembly of Claim 20, wherein the catheter has a lumen connectable to a source of suction and has a hole formed through a wall thereof near a distal end of the lumen
24. The assembly of Claim 23, wherein the catheter comprises at least two lumens.
25. The assembly of Claim 23, wherein the catheter comprises a single lumen.
26. The assembly of Claim 20 additionally comprising a source of flowable adhesive.
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PCT/US2001/024462 WO2002009591A2 (en) | 2000-08-02 | 2001-08-02 | Method and apparatus for closing vascular puncture |
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CA2417962C CA2417962C (en) | 2016-11-15 |
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---|---|
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EP (1) | EP1307141B1 (en) |
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Families Citing this family (148)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6287322B1 (en) * | 1995-12-07 | 2001-09-11 | Loma Linda University Medical Center | Tissue opening locator and everter and method |
US8323305B2 (en) * | 1997-02-11 | 2012-12-04 | Cardiva Medical, Inc. | Expansile device for use in blood vessels and tracts in the body and method |
US7790192B2 (en) * | 1998-08-14 | 2010-09-07 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
JP4953540B2 (en) * | 2000-02-24 | 2012-06-13 | ローマ リンダ ユニヴァーシティ メディカル センター | Patch and adhesive delivery system for closing tissue openings during surgery |
US6890342B2 (en) | 2000-08-02 | 2005-05-10 | Loma Linda University | Method and apparatus for closing vascular puncture using hemostatic material |
US6896692B2 (en) | 2000-12-14 | 2005-05-24 | Ensure Medical, Inc. | Plug with collet and apparatus and method for delivering such plugs |
US6846319B2 (en) | 2000-12-14 | 2005-01-25 | Core Medical, Inc. | Devices for sealing openings through tissue and apparatus and methods for delivering them |
US6623509B2 (en) | 2000-12-14 | 2003-09-23 | Core Medical, Inc. | Apparatus and methods for sealing vascular punctures |
US8083768B2 (en) | 2000-12-14 | 2011-12-27 | Ensure Medical, Inc. | Vascular plug having composite construction |
US6890343B2 (en) | 2000-12-14 | 2005-05-10 | Ensure Medical, Inc. | Plug with detachable guidewire element and methods for use |
JP2004537365A (en) * | 2001-08-10 | 2004-12-16 | タイコ ヘルスケア グループ エルピー | Retractor for vascular surgery and method of using same |
US7025748B2 (en) * | 2001-11-08 | 2006-04-11 | Boston Scientific Scimed, Inc. | Sheath based blood vessel puncture locator and depth indicator |
US7037323B2 (en) * | 2001-11-08 | 2006-05-02 | Sub-Q, Inc. | Pledget-handling system and method for delivering hemostasis promoting material to a blood vessel puncture site by fluid pressure |
US20030109820A1 (en) * | 2001-12-07 | 2003-06-12 | Gross T. Daniel | Hemostatic agent delivery system |
US7923431B2 (en) | 2001-12-21 | 2011-04-12 | Ferrosan Medical Devices A/S | Haemostatic kit, a method of preparing a haemostatic agent and a method of promoting haemostatis |
ES2274253T3 (en) * | 2002-06-14 | 2007-05-16 | Loma Linda University Medical Center | DEVICE FOR THE CLOSURE OF VASCULAR WOUNDS. |
US7771454B2 (en) | 2002-08-01 | 2010-08-10 | Abbott Laboratories Vascular Enterprises Limited | Autologous wound sealing apparatus |
US7070582B2 (en) * | 2002-08-09 | 2006-07-04 | Boston Scientific Scimed, Inc. | Injection devices that provide reduced outflow of therapeutic agents and methods of delivering therapeutic agents |
PL377477A1 (en) * | 2002-12-11 | 2006-02-06 | Ferrosan A/S | Gelatine-based materials as swabs |
DE60210997T2 (en) * | 2002-12-17 | 2007-01-11 | N.G.C. Medical S.P.A. | Double lumen suction catheter for distal protection during percutaneous surgery |
US20040122349A1 (en) | 2002-12-20 | 2004-06-24 | Lafontaine Daniel M. | Closure device with textured surface |
US8709038B2 (en) | 2002-12-20 | 2014-04-29 | Boston Scientific Scimed, Inc. | Puncture hole sealing device |
US7223266B2 (en) | 2003-02-04 | 2007-05-29 | Cardiodex Ltd. | Methods and apparatus for hemostasis following arterial catheterization |
US7322976B2 (en) | 2003-03-04 | 2008-01-29 | Cardiva Medical, Inc. | Apparatus and methods for closing vascular penetrations |
WO2004093649A2 (en) * | 2003-04-22 | 2004-11-04 | Sub-Q, Inc. | Puncture closure systeme with pin and pull technique |
US9289195B2 (en) | 2003-06-04 | 2016-03-22 | Access Closure, Inc. | Auto-retraction apparatus and methods for sealing a vascular puncture |
US7331979B2 (en) * | 2003-06-04 | 2008-02-19 | Access Closure, Inc. | Apparatus and methods for sealing a vascular puncture |
US20040260269A1 (en) * | 2003-06-23 | 2004-12-23 | Yair Assaf | Method for treating false aneurysm and a needle for use in such a method |
US7942897B2 (en) | 2003-07-10 | 2011-05-17 | Boston Scientific Scimed, Inc. | System for closing an opening in a body cavity |
CA2535452C (en) * | 2003-08-14 | 2013-04-02 | Loma Linda University Medical Center | Vascular wound closure device |
US8187627B2 (en) * | 2003-09-05 | 2012-05-29 | Loma Linda University Medical Center | Dressing delivery system for internal wounds |
US8852229B2 (en) * | 2003-10-17 | 2014-10-07 | Cordis Corporation | Locator and closure device and method of use |
US7361183B2 (en) | 2003-10-17 | 2008-04-22 | Ensure Medical, Inc. | Locator and delivery device and method of use |
US20050096633A1 (en) * | 2003-10-31 | 2005-05-05 | Ari Moskowitz | Apparatus and method for catheterizing the dura of a patient using a dural patch |
US20050245876A1 (en) * | 2003-12-24 | 2005-11-03 | Accessclosure, Inc. | Apparatus and methods for facilitating access through a puncture including sealing compound therein |
US20050149117A1 (en) * | 2003-12-24 | 2005-07-07 | Farhad Khosravi | Apparatus and methods for delivering sealing materials during a percutaneous procedure to facilitate hemostasis |
US20070060950A1 (en) * | 2003-12-24 | 2007-03-15 | Farhad Khosravi | Apparatus and methods for delivering sealing materials during a percutaneous procedure to facilitate hemostasis |
CA2554994C (en) * | 2004-01-30 | 2015-05-19 | Ferrosan A/S | Haemostatic sprays and compositions |
US9017374B2 (en) * | 2004-04-09 | 2015-04-28 | Cardiva Medical, Inc. | Device and method for sealing blood vessels |
US7993366B2 (en) | 2004-05-27 | 2011-08-09 | Cardiva Medical, Inc. | Self-tensioning vascular occlusion device and method for its use |
US7572274B2 (en) | 2004-05-27 | 2009-08-11 | Cardiva Medical, Inc. | Self-tensioning vascular occlusion device and method for its use |
US20080154303A1 (en) | 2006-12-21 | 2008-06-26 | Cardiva Medical, Inc. | Hemostasis-enhancing device and method for its use |
US20050267520A1 (en) | 2004-05-12 | 2005-12-01 | Modesitt D B | Access and closure device and method |
US8021684B2 (en) * | 2004-07-09 | 2011-09-20 | Ferrosan Medical Devices A/S | Haemostatic composition comprising hyaluronic acid |
US7678133B2 (en) | 2004-07-10 | 2010-03-16 | Arstasis, Inc. | Biological tissue closure device and method |
US8348971B2 (en) | 2004-08-27 | 2013-01-08 | Accessclosure, Inc. | Apparatus and methods for facilitating hemostasis within a vascular puncture |
US7918800B1 (en) * | 2004-10-08 | 2011-04-05 | Endovascular Technologies, Inc. | Aneurysm sensing devices and delivery systems |
US8262693B2 (en) * | 2004-11-05 | 2012-09-11 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
EP1814478A4 (en) | 2004-11-22 | 2011-05-18 | Cardiodex Ltd | Techniques for heat-treating varicose veins |
SE0403070D0 (en) * | 2004-12-16 | 2004-12-16 | Radi Medical Systems | Closure Device |
US20060142798A1 (en) * | 2004-12-27 | 2006-06-29 | Holman Thomas J | Device and method for closing an opening in a body cavity or lumen |
US20060229670A1 (en) * | 2005-04-01 | 2006-10-12 | Bates Brian L | Method and a medical closure system for sealing a puncture |
US7806856B2 (en) | 2005-04-22 | 2010-10-05 | Accessclosure, Inc. | Apparatus and method for temporary hemostasis |
US8002742B2 (en) * | 2005-04-22 | 2011-08-23 | Accessclosure, Inc. | Apparatus and methods for sealing a puncture in tissue |
EP2260770B1 (en) * | 2005-04-29 | 2014-07-02 | Vivasure Medical Limited | An interventional medical closure device |
US7622628B2 (en) * | 2005-05-04 | 2009-11-24 | Innovasa Corporation | Hemostatic wire guided bandage and method of use |
US20060276838A1 (en) * | 2005-06-07 | 2006-12-07 | Wensel Jeffrey P | Vascular puncture sealing method, apparatus, and system |
US20060276836A1 (en) * | 2005-06-07 | 2006-12-07 | Bergin Patrick J | Hemostatic wire guided bandage and method of use |
US8088144B2 (en) | 2005-05-04 | 2012-01-03 | Ensure Medical, Inc. | Locator and closure device and method of use |
US8926654B2 (en) | 2005-05-04 | 2015-01-06 | Cordis Corporation | Locator and closure device and method of use |
US20080015481A1 (en) * | 2005-05-04 | 2008-01-17 | Bergin Patrick J | Hemostatic bandage and method of use |
CN103190942A (en) | 2005-05-12 | 2013-07-10 | 阿尔斯塔西斯公司 | Access and closure device and method |
US7135377B1 (en) * | 2005-05-20 | 2006-11-14 | Phoenix Precision Technology Corporation | Semiconductor package substrate with embedded resistors and method for fabricating same |
WO2007044510A1 (en) | 2005-10-05 | 2007-04-19 | Loma Linda University Medical Center | Vascular wound closure device and method |
CA2630452C (en) * | 2005-12-02 | 2011-02-22 | Cook Incorporated | Devices, systems, and methods for occluding a defect |
US8911472B2 (en) | 2005-12-13 | 2014-12-16 | Cardiva Medical, Inc. | Apparatus and methods for delivering hemostatic materials for blood vessel closure |
US20100168767A1 (en) * | 2008-06-30 | 2010-07-01 | Cardiva Medical, Inc. | Apparatus and methods for delivering hemostatic materials for blood vessel closure |
US9179897B2 (en) | 2005-12-13 | 2015-11-10 | Cardiva Medical, Inc. | Vascular closure devices and methods providing hemostatic enhancement |
US7691127B2 (en) * | 2005-12-13 | 2010-04-06 | Cardiva Medical, Inc. | Drug eluting vascular closure devices and methods |
US8317822B2 (en) * | 2005-12-22 | 2012-11-27 | Ethicon, Inc. | Systems and methods for closing a vessel wound |
US9427216B2 (en) * | 2005-12-23 | 2016-08-30 | CARDINAL HEALTH SWITZERLAND 515 GmbH | Systems and methods for closing a vessel wound |
US20070154509A1 (en) * | 2005-12-30 | 2007-07-05 | Wilcher Steve A | Adsorbent-Containing Hemostatic Devices |
US20070154510A1 (en) * | 2005-12-30 | 2007-07-05 | Wilcher Steve A | Adsorbent-Containing Hemostatic Devices |
US7909983B2 (en) * | 2006-05-04 | 2011-03-22 | Nipro Diagnostics, Inc. | System and methods for automatically recognizing a control solution |
CA2594239A1 (en) * | 2006-08-02 | 2008-02-02 | Tyco Healthcare Group Lp | Stabilization assist device for trocar |
US20080063697A1 (en) * | 2006-09-08 | 2008-03-13 | Bedard Robert L | Use of Unactivated Calcium Exchanged Zeolites in Hemostatic Devices and Products |
EP2077765A2 (en) * | 2006-09-13 | 2009-07-15 | Accessclosure, Inc. | Apparatus for sealing a vascular puncture |
US20080145455A1 (en) * | 2006-12-13 | 2008-06-19 | Bedard Robert L | Combination of Inorganic Hemostatic Agents with Other Hemostatic Agents |
ES2696538T3 (en) * | 2007-06-15 | 2019-01-16 | Vivasure Medical Ltd | Closing device |
US20090047366A1 (en) * | 2007-08-15 | 2009-02-19 | Bedard Robert L | Inorganic Coagulation Accelerators for Individuals taking Platelet Blockers or Anticoagulants |
EP2182875A4 (en) | 2007-08-15 | 2011-08-24 | Cardiodex Ltd | Systems and methods for puncture closure |
US20090069843A1 (en) * | 2007-09-10 | 2009-03-12 | Agnew Charles W | Fistula plugs including a hydration resistant component |
US7993367B2 (en) | 2007-09-28 | 2011-08-09 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
US8795326B2 (en) | 2007-10-05 | 2014-08-05 | Covidien Lp | Expanding seal anchor for single incision surgery |
EP2209426A4 (en) | 2007-11-02 | 2015-04-22 | Incept Llc | Apparatus and methods for sealing a vascular puncture |
US8883194B2 (en) * | 2007-11-09 | 2014-11-11 | Honeywell International, Inc. | Adsorbent-containing hemostatic devices |
US8642831B2 (en) * | 2008-02-29 | 2014-02-04 | Ferrosan Medical Devices A/S | Device for promotion of hemostasis and/or wound healing |
US9364206B2 (en) | 2008-04-04 | 2016-06-14 | Access Closure, Inc. | Apparatus and methods for sealing a vascular puncture |
US8029533B2 (en) | 2008-04-04 | 2011-10-04 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
US8016857B2 (en) * | 2008-04-18 | 2011-09-13 | Medtronic Vascular, Inc. | Vascular puncture closure |
WO2009132331A1 (en) * | 2008-04-25 | 2009-10-29 | Zymogenetics, Inc. | Medical devices for delivering fluids during surgery and methods for their use |
US8795718B2 (en) * | 2008-05-22 | 2014-08-05 | Honeywell International, Inc. | Functional nano-layered hemostatic material/device |
US8979882B2 (en) | 2008-07-21 | 2015-03-17 | Arstasis, Inc. | Devices, methods, and kits for forming tracts in tissue |
WO2010027693A2 (en) | 2008-08-26 | 2010-03-11 | Killion Douglas P | Method and system for sealing percutaneous punctures |
KR100959996B1 (en) | 2008-08-29 | 2010-05-28 | 이제수 | make arterial and vein identification a breeze injection needle structure |
EP2364112B1 (en) | 2008-11-12 | 2016-03-09 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
EP3181074A1 (en) | 2009-01-30 | 2017-06-21 | St. Jude Medical, Inc. | Transapical mini-introducer homeostasis valve and punch |
US9839415B2 (en) * | 2009-01-30 | 2017-12-12 | St. Jude Medical, Llc | Apex closure device |
US8529598B2 (en) | 2009-02-20 | 2013-09-10 | Boston Scientific Scimed, Inc. | Tissue puncture closure device |
US8292918B2 (en) | 2009-02-20 | 2012-10-23 | Boston Scientific Scimed, Inc. | Composite plug for arteriotomy closure and method of use |
US8375553B2 (en) | 2009-02-20 | 2013-02-19 | Boston Scientific Scimed, Inc. | Locking element for vascular closure device |
US8052914B2 (en) | 2009-02-20 | 2011-11-08 | Boston Scientific Scimed, Inc. | Modified plug for arteriotomy closure |
US20100217309A1 (en) * | 2009-02-20 | 2010-08-26 | Boston Scientific Scimed, Inc. | Plug for arteriotomy closure and method of use |
US8317824B2 (en) * | 2009-02-20 | 2012-11-27 | Boston Scientific Scimed, Inc. | Tissue puncture closure device |
US9913634B2 (en) * | 2009-02-20 | 2018-03-13 | Boston Scientific Scimed, Inc. | Locking element for vascular closure device |
US20100256672A1 (en) * | 2009-04-01 | 2010-10-07 | Weinberg Medical Physics Llc | Apparatus and method for wound weaving and healing |
AU2010246115A1 (en) * | 2009-05-04 | 2011-12-08 | Incept. Llc | Biomaterials for track and puncture closure |
CN101601595B (en) * | 2009-07-07 | 2012-11-21 | 南京大学 | Blood vessel plugging device and preparation method of embolism colloid |
WO2011080588A2 (en) | 2009-12-30 | 2011-07-07 | Vivasure Medical Limited | Closure system and uses thereof |
US8444673B2 (en) | 2010-02-11 | 2013-05-21 | Boston Scientific Scimed, Inc. | Automatic vascular closure deployment devices and methods |
US20110276087A1 (en) * | 2010-05-10 | 2011-11-10 | Morris Edward J | Method and apparatus for sealing access with an anti-inflammatory infused member |
US8597340B2 (en) | 2010-09-17 | 2013-12-03 | Boston Scientific Scimed, Inc. | Torque mechanism actuated bioabsorbable vascular closure device |
US8758402B2 (en) | 2010-12-17 | 2014-06-24 | Boston Scientific Scimed, Inc. | Tissue puncture closure device |
MY154109A (en) * | 2010-12-23 | 2015-04-30 | Univ Malaya | A haemostatic agent delivery system |
US9060751B2 (en) | 2010-12-30 | 2015-06-23 | Vivasure Medical Limited | Surgical closure systems and methods |
US9820728B2 (en) | 2011-01-19 | 2017-11-21 | Access Closure, Inc. | Apparatus and methods for sealing a vascular puncture |
ES2870965T3 (en) | 2011-01-19 | 2021-10-28 | Access Closure Inc | Procedures to seal a vascular puncture |
US9386968B2 (en) | 2011-05-11 | 2016-07-12 | Access Closure, Inc. | Apparatus and methods for sealing a vascular puncture |
WO2012158740A1 (en) * | 2011-05-19 | 2012-11-22 | St. Jude Medical Puerto Rico Llc | Vascular closure device with a plug having a variable expansion rate and method for using the same |
EP2819586A2 (en) | 2012-02-29 | 2015-01-07 | Vivasure Medical Limited | Percutaneous perforation closure systems, devices, and methods |
WO2013131520A2 (en) | 2012-03-06 | 2013-09-12 | Ferrosan Medical Devices A/S | Pressurized container containing haemostatic paste |
US9161756B2 (en) * | 2012-03-16 | 2015-10-20 | Covidien Lp | Closure tape dispenser |
US9757105B2 (en) | 2012-03-23 | 2017-09-12 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
US8721680B2 (en) | 2012-03-23 | 2014-05-13 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
US20130317481A1 (en) | 2012-05-25 | 2013-11-28 | Arstasis, Inc. | Vascular access configuration |
US20130317438A1 (en) | 2012-05-25 | 2013-11-28 | Arstasis, Inc. | Vascular access configuration |
RU2636240C2 (en) | 2012-06-12 | 2017-11-21 | Ферросан Медикал Дивайсиз А/С | Dry haemostatic composition |
US9554785B2 (en) | 2012-12-21 | 2017-01-31 | Essential Medical, Inc. | Vascular locating systems and methods of use |
US9107646B2 (en) * | 2013-03-11 | 2015-08-18 | St. Jude Medical Puerto Rico Llc | Active securement detachable sealing tip for extra-vascular closure device and methods |
US9850013B2 (en) | 2013-03-15 | 2017-12-26 | Vivasure Medical Limited | Loading devices and methods for percutaneous perforation closure systems |
JP6390873B2 (en) | 2013-06-21 | 2018-09-19 | フェッローサン メディカル ディバイス エー/エス | Dry composition expanded under reduced pressure and syringe for holding the same |
RU2678592C1 (en) | 2013-12-11 | 2019-01-30 | Ферросан Медикал Дивайсиз А/С | Dry composition comprising extrusion enhancer |
BR112017007466B1 (en) | 2014-10-13 | 2021-03-02 | Ferrosan Medical Devices A/S | method for preparing a dry composition, method for reconstituting the dry composition, paste, dry composition, container, homeostatic kit, and, using a dry composition |
WO2016096932A1 (en) | 2014-12-15 | 2016-06-23 | Vivasure Medical Limited | Closure apparatus with flexible sealable member and flexible support member |
US11141142B2 (en) | 2014-12-15 | 2021-10-12 | Vivasure Medical Limited | Implantable sealable member with mesh layer |
JP6747650B2 (en) | 2014-12-24 | 2020-08-26 | フェロサン メディカル デバイシーズ エイ/エス | Syringe for holding and mixing the first substance and the second substance |
US10918796B2 (en) | 2015-07-03 | 2021-02-16 | Ferrosan Medical Devices A/S | Syringe for mixing two components and for retaining a vacuum in a storage condition |
US11311280B2 (en) | 2015-12-15 | 2022-04-26 | Vivasure Medical Limited | Arteriotomy closure apparatus with slotted shoe for advantageous pressure distribution |
JP6920312B2 (en) | 2016-09-01 | 2021-08-18 | テルモ株式会社 | Introducer sheath |
US10542996B2 (en) | 2017-06-27 | 2020-01-28 | Covidien Lp | Vessel closure device |
US10952710B2 (en) * | 2017-07-16 | 2021-03-23 | Steven Jay Blumenthal | Balloon closure device |
CN107802311A (en) * | 2017-11-20 | 2018-03-16 | 乐普(北京)医疗器械股份有限公司 | A kind of Wholly-degradable vessel sealing structure |
KR20210008479A (en) | 2018-05-09 | 2021-01-22 | 훼로산 메디칼 디바이스 에이/에스 | How to prepare a hemostatic composition |
US11350919B2 (en) * | 2019-02-19 | 2022-06-07 | Teleflex Life Sciences Limited | Puncture locating system with blood pulsation indicator |
US11452841B2 (en) * | 2019-04-11 | 2022-09-27 | Covidien Lp | Aspiration catheter system |
WO2021234574A1 (en) | 2020-05-19 | 2021-11-25 | Boston Scientific Limited | Medical delivery systems and methods of using the same |
CN113940724A (en) * | 2021-12-01 | 2022-01-18 | 厦门大学附属中山医院 | False aneurysm sealer |
CN115252039B (en) * | 2022-09-28 | 2023-03-10 | 苏州美创医疗科技有限公司 | Vascular closure device and method |
Family Cites Families (173)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US1064307A (en) | 1912-08-28 | 1913-06-10 | William T Remington | Syringe. |
US3483870A (en) | 1963-04-22 | 1969-12-16 | Eastman Kodak Co | Surgical use of adhesive compositions |
US3518993A (en) | 1967-05-01 | 1970-07-07 | American Hospital Supply Corp | Surgical clip applicator |
US3653388A (en) | 1969-12-04 | 1972-04-04 | Battelle Development Corp | Catheter insertion trocar |
DE2324658B2 (en) | 1973-05-16 | 1977-06-30 | Richard Wolf Gmbh, 7134 Knittlingen | PROBE FOR COAGULATING BODY TISSUE |
SE7316352L (en) | 1973-12-04 | 1975-05-05 | ||
US4611595A (en) | 1977-08-05 | 1986-09-16 | Charles H. Klieman | Spring activated hemostatic clip applicator |
CA1082552A (en) | 1977-08-05 | 1980-07-29 | Charles H. Klieman | Hemostatic clip applicator |
US4900303A (en) * | 1978-03-10 | 1990-02-13 | Lemelson Jerome H | Dispensing catheter and method |
US4306562A (en) | 1978-12-01 | 1981-12-22 | Cook, Inc. | Tear apart cannula |
US4530698A (en) | 1979-03-19 | 1985-07-23 | The United States Of America As Represented By The Department Of Health And Human Services | Method and apparatus for traversing blood vessels |
EP0028452A1 (en) | 1979-09-27 | 1981-05-13 | Smith and Nephew Associated Companies p.l.c. | Adhesive skin closure |
US4317445A (en) | 1980-03-31 | 1982-03-02 | Baxter Travenol Laboratories, Inc. | Catheter insertion unit with separate flashback indication for the cannula |
US4351466A (en) | 1980-10-16 | 1982-09-28 | United States Surgical Corporation | Disposable instrument for surgical fastening |
US4532134A (en) | 1981-04-06 | 1985-07-30 | Malette William Graham | Method of achieving hemostasis, inhibiting fibroplasia, and promoting tissue regeneration in a tissue wound |
US4487204A (en) | 1981-10-14 | 1984-12-11 | Nomel | Device for applying haemostatic clips |
US4492232A (en) | 1982-09-30 | 1985-01-08 | United States Surgical Corporation | Surgical clip applying apparatus having fixed jaws |
US4534351A (en) | 1982-10-20 | 1985-08-13 | Senmed, Inc. | Ligator |
US4585437A (en) | 1983-03-17 | 1986-04-29 | Simms Mark D | Introducer for an umbilical artery catheter |
US4539990A (en) | 1983-09-16 | 1985-09-10 | Stivala Oscar G | Sutureless closure system |
US4917087A (en) | 1984-04-10 | 1990-04-17 | Walsh Manufacturing (Mississuaga) Limited | Anastomosis devices, kits and method |
US4616650A (en) | 1984-07-27 | 1986-10-14 | United States Surgical Corporation | Apparatus for applying surgical clips |
US4821719A (en) | 1984-12-03 | 1989-04-18 | Fogarty Thomas J | Cohesive-adhesive atraumatic clamp |
JPS61240963A (en) | 1985-04-18 | 1986-10-27 | ユニチカ株式会社 | Wound covering protective material |
US4622970A (en) | 1985-08-29 | 1986-11-18 | The Johns Hopkins University | Vascular everting instrument |
US4738658A (en) | 1986-09-19 | 1988-04-19 | Aries Medical Incorporated | Tapered hemostatic device for use in conjunction with a catheter for alleviating blood leakage and method for using same |
US4889112A (en) | 1987-01-23 | 1989-12-26 | Waltap Ltd. | Apparatus for performing a tracheostomy operation |
US4890612A (en) * | 1987-02-17 | 1990-01-02 | Kensey Nash Corporation | Device for sealing percutaneous puncture in a vessel |
US4772266A (en) | 1987-05-04 | 1988-09-20 | Catheter Technology Corp. | Catheter dilator/sheath assembly and method |
US4865593A (en) | 1987-06-25 | 1989-09-12 | Sherwood Medical Company | Splittable cannula |
US4999235A (en) | 1987-07-24 | 1991-03-12 | Ethicon, Inc. | Conformable, stretchable surgical wound closure tape |
US5114400A (en) | 1990-06-19 | 1992-05-19 | Lynn Lawrence A | Blood withdrawal apparatus and method |
US4921479A (en) | 1987-10-02 | 1990-05-01 | Joseph Grayzel | Catheter sheath with longitudinal seam |
US4905267A (en) | 1988-04-29 | 1990-02-27 | Loma Linda University Medical Center | Method of assembly and whole body, patient positioning and repositioning support for use in radiation beam therapy systems |
US5632727A (en) | 1988-10-03 | 1997-05-27 | Atrix Laboratories, Inc. | Biodegradable film dressing and method for its formation |
US4961729A (en) | 1988-12-13 | 1990-10-09 | Vaillancourt Vincent L | Catheter insertion assembly |
FR2641692A1 (en) | 1989-01-17 | 1990-07-20 | Nippon Zeon Co | Plug for closing an opening for a medical application, and device for the closure plug making use thereof |
US4930674A (en) | 1989-02-24 | 1990-06-05 | Abiomed, Inc. | Surgical stapler |
US5002557A (en) | 1989-04-06 | 1991-03-26 | Hasson Harrith M | Laparoscopic cannula |
US5620461A (en) | 1989-05-29 | 1997-04-15 | Muijs Van De Moer; Wouter M. | Sealing device |
US5057083A (en) | 1989-07-25 | 1991-10-15 | C. R. Bard, Inc. | Vascular dilator with truncated tip |
US4931058A (en) | 1989-08-16 | 1990-06-05 | Applied Vascular Devices, Inc. | Parallel jaw spring clip and method of making same |
US4984564A (en) | 1989-09-27 | 1991-01-15 | Frank Yuen | Surgical retractor device |
CA2122041A1 (en) | 1989-12-04 | 1993-04-29 | Kenneth Kensey | Plug device for sealing openings and method of use |
US5015249A (en) | 1989-12-26 | 1991-05-14 | Nakao Naomi L | Endoscopic stapling device and method |
DE4014653A1 (en) | 1990-05-08 | 1991-11-14 | Beiersdorf Ag | SURGICAL CLAMP |
US5391183A (en) | 1990-09-21 | 1995-02-21 | Datascope Investment Corp | Device and method sealing puncture wounds |
US5006106A (en) | 1990-10-09 | 1991-04-09 | Angelchik Jean P | Apparatus and method for laparoscopic implantation of anti-reflux prosthesis |
CA2704193C (en) | 1990-12-13 | 2011-06-07 | United States Surgical Corporation | Method and apparatus for tipping sutures |
US6325789B1 (en) * | 1990-12-27 | 2001-12-04 | Datascope Investment Corporation | Device and method for sealing puncture wounds |
US5419765A (en) | 1990-12-27 | 1995-05-30 | Novoste Corporation | Wound treating device and method for treating wounds |
US5129882A (en) | 1990-12-27 | 1992-07-14 | Novoste Corporation | Wound clotting device and method of using same |
US5176128A (en) | 1991-01-24 | 1993-01-05 | Andrese Craig A | Organ retractor |
US5176129A (en) | 1991-03-01 | 1993-01-05 | Tekdyne, Inc. | Self-retaining refractor |
US5297714A (en) | 1991-04-17 | 1994-03-29 | Ethicon, Inc. | Surgical staple with modified "B" shaped configuration |
US5312355A (en) | 1991-07-09 | 1994-05-17 | H L Medical Inventions, Inc. | Splittable hemostatic valve and sheath and the method for using the same |
US5259835A (en) | 1991-08-29 | 1993-11-09 | Tri-Point Medical L.P. | Wound closure means and method using flowable adhesive |
CA2078530A1 (en) | 1991-09-23 | 1993-03-24 | Jay Erlebacher | Percutaneous arterial puncture seal device and insertion tool therefore |
US5290310A (en) * | 1991-10-30 | 1994-03-01 | Howmedica, Inc. | Hemostatic implant introducer |
US5282827A (en) | 1991-11-08 | 1994-02-01 | Kensey Nash Corporation | Hemostatic puncture closure system and method of use |
US5411520A (en) | 1991-11-08 | 1995-05-02 | Kensey Nash Corporation | Hemostatic vessel puncture closure system utilizing a plug located within the puncture tract spaced from the vessel, and method of use |
US5676689A (en) | 1991-11-08 | 1997-10-14 | Kensey Nash Corporation | Hemostatic puncture closure system including vessel location device and method of use |
US6056768A (en) | 1992-01-07 | 2000-05-02 | Cates; Christopher U. | Blood vessel sealing system |
US5810810A (en) | 1992-04-23 | 1998-09-22 | Scimed Life Systems, Inc. | Apparatus and method for sealing vascular punctures |
US5293863A (en) | 1992-05-08 | 1994-03-15 | Loma Linda University Medical Center | Bladed endoscopic retractor |
US5242387A (en) | 1992-05-08 | 1993-09-07 | Brigham & Women's Hospital | Suction-irrigator |
US5352207A (en) | 1992-05-18 | 1994-10-04 | Nussbaum Eric S | Ventricular drainage catheter with guard |
US5407427A (en) | 1992-06-16 | 1995-04-18 | Loma Linda University Medical Center | Trocar facilitator for endoscopic surgery |
US5443484A (en) | 1992-06-16 | 1995-08-22 | Loma Linda University Medical Center | Trocar and method for endoscopic surgery |
US5257979A (en) | 1992-07-27 | 1993-11-02 | Ravindar Jagpal | Instrument for catheterization |
US5292332A (en) | 1992-07-27 | 1994-03-08 | Lee Benjamin I | Methods and device for percutanceous sealing of arterial puncture sites |
US5306259A (en) | 1992-08-10 | 1994-04-26 | Cathco, Inc. | Vascular access needle having an extended length body |
US5458131A (en) | 1992-08-25 | 1995-10-17 | Wilk; Peter J. | Method for use in intra-abdominal surgery |
US5342393A (en) | 1992-08-27 | 1994-08-30 | Duke University | Method and device for vascular repair |
US5397311A (en) | 1992-09-09 | 1995-03-14 | Menlo Care, Inc. | Bloodless splittable introducer |
US5306254A (en) | 1992-10-01 | 1994-04-26 | Kensey Nash Corporation | Vessel position locating device and method of use |
US5300065A (en) | 1992-11-06 | 1994-04-05 | Proclosure Inc. | Method and apparatus for simultaneously holding and sealing tissue |
US5417699A (en) | 1992-12-10 | 1995-05-23 | Perclose Incorporated | Device and method for the percutaneous suturing of a vascular puncture site |
US5425705A (en) | 1993-02-22 | 1995-06-20 | Stanford Surgical Technologies, Inc. | Thoracoscopic devices and methods for arresting the heart |
US5320639A (en) | 1993-03-12 | 1994-06-14 | Meadox Medicals, Inc. | Vascular plug delivery system |
US5552452A (en) | 1993-03-15 | 1996-09-03 | Arch Development Corp. | Organic tissue glue for closure of wounds |
CA2158139C (en) | 1993-03-16 | 2002-05-14 | Geoffrey S. Martin | Catheters and method of manufacture |
US5383896A (en) | 1993-05-25 | 1995-01-24 | Gershony; Gary | Vascular sealing device |
US5360397A (en) | 1993-07-02 | 1994-11-01 | Corvita Corporation | Hemodiaylsis catheter and catheter assembly |
US5486195A (en) | 1993-07-26 | 1996-01-23 | Myers; Gene | Method and apparatus for arteriotomy closure |
US5725551A (en) | 1993-07-26 | 1998-03-10 | Myers; Gene | Method and apparatus for arteriotomy closure |
US5431639A (en) * | 1993-08-12 | 1995-07-11 | Boston Scientific Corporation | Treating wounds caused by medical procedures |
NL9301526A (en) | 1993-09-03 | 1995-04-03 | Cordis Europ | Device for hemostasis treatment after catheter surgery. |
US5759194A (en) | 1993-09-28 | 1998-06-02 | Hemodynamics, Inc. | Vascular patch applicator |
US5843124A (en) | 1993-09-28 | 1998-12-01 | Hemodynamics, Inc. | Surface opening adhesive sealer |
US5383899A (en) | 1993-09-28 | 1995-01-24 | Hammerslag; Julius G. | Method of using a surface opening adhesive sealer |
US5653730A (en) | 1993-09-28 | 1997-08-05 | Hemodynamics, Inc. | Surface opening adhesive sealer |
US5370660A (en) * | 1993-11-01 | 1994-12-06 | Cordis Corporation | Apparatus and method for delivering a vessel plug into the body of a patient |
US5658298A (en) | 1993-11-09 | 1997-08-19 | Inamed Development Company | Laparoscopic tool |
US5460621A (en) * | 1994-03-04 | 1995-10-24 | Merocel Corporation | Composite tissue displacement sponge |
DE9404048U1 (en) | 1994-03-10 | 1994-08-18 | Infus Medical International Ve | Device for the vacuum wound closure and / or for suctioning secretions or the like. |
WO1995026683A1 (en) | 1994-03-31 | 1995-10-12 | Boston Scientific Corporation | Vascular plug with vessel locator |
US5545178A (en) | 1994-04-29 | 1996-08-13 | Kensey Nash Corporation | System for closing a percutaneous puncture formed by a trocar to prevent tissue at the puncture from herniating |
US5531759A (en) | 1994-04-29 | 1996-07-02 | Kensey Nash Corporation | System for closing a percutaneous puncture formed by a trocar to prevent tissue at the puncture from herniating |
WO1998020939A2 (en) | 1996-11-15 | 1998-05-22 | Advanced Bio Surfaces, Inc. | Biomaterial system for in situ tissue repair |
US5556375A (en) | 1994-06-16 | 1996-09-17 | Hercules Incorporated | Wound dressing having a fenestrated base layer |
US5549633A (en) * | 1994-08-24 | 1996-08-27 | Kensey Nash Corporation | Apparatus and methods of use for preventing blood seepage at a percutaneous puncture site |
AU1287895A (en) | 1994-10-03 | 1996-04-26 | Otogen Corporation | Differentially biodegradable biomedical implants |
AU1965895A (en) | 1995-02-07 | 1996-08-27 | Cardiovascular Ventures, Inc. | Puncture sealing system |
US5649959A (en) | 1995-02-10 | 1997-07-22 | Sherwood Medical Company | Assembly for sealing a puncture in a vessel |
JP3633032B2 (en) | 1995-05-26 | 2005-03-30 | 佐々木 寛 | Puncture device |
US5645566A (en) | 1995-09-15 | 1997-07-08 | Sub Q Inc. | Apparatus and method for percutaneous sealing of blood vessel punctures |
US6071300A (en) * | 1995-09-15 | 2000-06-06 | Sub-Q Inc. | Apparatus and method for percutaneous sealing of blood vessel punctures |
AU7398196A (en) | 1995-10-11 | 1997-04-30 | Fusion Medical Technologies, Inc. | Device and method for sealing tissue |
US5674231A (en) | 1995-10-20 | 1997-10-07 | United States Surgical Corporation | Apparatus and method for vascular hole closure |
US6425901B1 (en) * | 1995-12-07 | 2002-07-30 | Loma Linda University Medical Center | Vascular wound closure system |
US6287322B1 (en) | 1995-12-07 | 2001-09-11 | Loma Linda University Medical Center | Tissue opening locator and everter and method |
US6524326B1 (en) | 1995-12-07 | 2003-02-25 | Loma Linda University Medical Center | Tissue opening locator and everter and method |
US6004341A (en) | 1996-12-05 | 1999-12-21 | Loma Linda University Medical Center | Vascular wound closure device |
DE69638352D1 (en) * | 1995-12-07 | 2011-05-19 | Univ Loma Linda Med | |
US5814065A (en) | 1996-02-09 | 1998-09-29 | Cordis Corporation | Suture delivery tool |
US5759169A (en) | 1996-03-13 | 1998-06-02 | New York Blood Center Inc. | Fibrin sealant glue-gun |
HUP9903586A3 (en) * | 1996-04-04 | 2003-02-28 | Baxter Ag | Hemostatic sponge based on collagen |
US5728132A (en) | 1996-04-08 | 1998-03-17 | Tricardia, L.L.C. | Self-sealing vascular access device |
US5662681A (en) | 1996-04-23 | 1997-09-02 | Kensey Nash Corporation | Self locking closure for sealing percutaneous punctures |
US5649911A (en) | 1996-05-17 | 1997-07-22 | Indiana University Foundation | Intravenous catheter and delivery system |
US5776096A (en) | 1996-06-06 | 1998-07-07 | Hdc Corporation | Dual lumen vascular catheter with expanding side portal |
US5728133A (en) * | 1996-07-09 | 1998-03-17 | Cardiologics, L.L.C. | Anchoring device and method for sealing percutaneous punctures in vessels |
US5836970A (en) | 1996-08-02 | 1998-11-17 | The Kendall Company | Hemostatic wound dressing |
US6346093B1 (en) | 1996-09-13 | 2002-02-12 | Scimed Life Systems, Inc. | Single operator exchange biliary catheter with common distal lumen |
GB2318295A (en) | 1996-10-17 | 1998-04-22 | Malachy Gleeson | Wire-guided surgical stapler for closure of a puncture site in a blood vessel |
GB2319955B (en) * | 1996-12-03 | 2000-05-17 | Food Machinery Design Ltd | Weight adjusting apparatus |
US5684042A (en) | 1997-01-10 | 1997-11-04 | Medlogic Global Corporation | Cyanoacrylate compositions comprising an antimicrobial agent |
US6371975B2 (en) * | 1998-11-06 | 2002-04-16 | Neomend, Inc. | Compositions, systems, and methods for creating in situ, chemically cross-linked, mechanical barriers |
US6016806A (en) * | 1997-03-27 | 2000-01-25 | Eaglevision, Inc | Punctum plug |
US5971956A (en) | 1997-04-15 | 1999-10-26 | Biosurgical Corporation | Medical suctioning apparatus and methods of use |
US5944730A (en) | 1997-05-19 | 1999-08-31 | Cardio Medical Solutions, Inc. | Device and method for assisting end-to-side anastomosis |
US6146373A (en) * | 1997-10-17 | 2000-11-14 | Micro Therapeutics, Inc. | Catheter system and method for injection of a liquid embolic composition and a solidification agent |
JPH11128360A (en) | 1997-10-31 | 1999-05-18 | Aisin Seiki Co Ltd | Catheter set |
US5906631A (en) | 1997-12-05 | 1999-05-25 | Surface Genesis, Inc. | Method and device for sealing vascular puncture wounds |
US6022554A (en) | 1997-12-15 | 2000-02-08 | American Home Products Corporation | Polymeric microporous film coated subcutaneous implant |
WO1999030629A1 (en) | 1997-12-17 | 1999-06-24 | Hemodynamics, Inc. | Sealing media for surgery and wound closure |
US6159178A (en) | 1998-01-23 | 2000-12-12 | Heartport, Inc. | Methods and devices for occluding the ascending aorta and maintaining circulation of oxygenated blood in the patient when the patient's heart is arrested |
US6174919B1 (en) | 1998-02-18 | 2001-01-16 | Closure Medical Corporation | Cyanoacrylate compositions with vinyl terminated ester groups |
US6033413A (en) * | 1998-04-20 | 2000-03-07 | Endocare, Inc. | Stent delivery system |
US6315753B1 (en) | 1998-05-01 | 2001-11-13 | Sub-Q, Inc. | System and method for facilitating hemostasis of blood vessel punctures with absorbable sponge |
US5910155A (en) | 1998-06-05 | 1999-06-08 | United States Surgical Corporation | Vascular wound closure system |
US6048358A (en) | 1998-07-13 | 2000-04-11 | Barak; Shlomo | Method and apparatus for hemostasis following arterial catheterization |
AU758665B2 (en) | 1998-07-22 | 2003-03-27 | Angiolink Corporation | Vascular suction cannula, dilator and surgical stapler |
US6613070B2 (en) | 1998-08-04 | 2003-09-02 | Baxter International Inc. | System and method for sealing vascular penetrations with hemostatic gels |
AUPP633798A0 (en) | 1998-10-02 | 1998-10-29 | White, Geoffrey H. | Device for the occlusion of a puncture in a bodily duct |
US6198016B1 (en) | 1998-12-01 | 2001-03-06 | 3M Innovative Properties Company | Wet skin adhesive article |
WO2000033744A1 (en) * | 1998-12-08 | 2000-06-15 | University Of Virginia Patent Foundation | Device and technique for percutaneous closure of vascular puncture sites |
US6060461A (en) | 1999-02-08 | 2000-05-09 | Drake; James Franklin | Topically applied clotting material |
US6110184A (en) * | 1999-08-04 | 2000-08-29 | Weadock; Kevin S. | Introducer with vascular sealing mechanism |
US7303552B1 (en) | 1999-10-29 | 2007-12-04 | Boston Scientific Scimed, Inc. | Split valve for peel-away sheath |
US6589212B1 (en) | 1999-11-08 | 2003-07-08 | Janin Group, Inc. | Guide for surgical device |
US6197042B1 (en) | 2000-01-05 | 2001-03-06 | Medical Technology Group, Inc. | Vascular sheath with puncture site closure apparatus and methods of use |
US6461364B1 (en) | 2000-01-05 | 2002-10-08 | Integrated Vascular Systems, Inc. | Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use |
US7842068B2 (en) | 2000-12-07 | 2010-11-30 | Integrated Vascular Systems, Inc. | Apparatus and methods for providing tactile feedback while delivering a closure device |
US6391048B1 (en) | 2000-01-05 | 2002-05-21 | Integrated Vascular Systems, Inc. | Integrated vascular device with puncture site closure component and sealant and methods of use |
AU2001232873A1 (en) * | 2000-01-20 | 2001-07-31 | Biolink Corporation | Anti-microbial barrier |
JP4953540B2 (en) | 2000-02-24 | 2012-06-13 | ローマ リンダ ユニヴァーシティ メディカル センター | Patch and adhesive delivery system for closing tissue openings during surgery |
AU2001273401A1 (en) | 2000-07-14 | 2002-01-30 | Sub-Q Inc. | Sheath-mounted arterial plug delivery device |
US6890342B2 (en) | 2000-08-02 | 2005-05-10 | Loma Linda University | Method and apparatus for closing vascular puncture using hemostatic material |
US6508828B1 (en) * | 2000-11-03 | 2003-01-21 | Radi Medical Systems Ab | Sealing device and wound closure device |
US6695867B2 (en) | 2002-02-21 | 2004-02-24 | Integrated Vascular Systems, Inc. | Plunger apparatus and methods for delivering a closure device |
US6846319B2 (en) | 2000-12-14 | 2005-01-25 | Core Medical, Inc. | Devices for sealing openings through tissue and apparatus and methods for delivering them |
US6969397B2 (en) | 2000-12-14 | 2005-11-29 | Ensure Medical, Inc. | Guide wire element for positioning vascular closure devices and methods for use |
US20020147479A1 (en) | 2001-04-06 | 2002-10-10 | Integrated Vascular Systems, Inc. | Apparatus and methods for sealing openings through tissue |
US7066934B2 (en) | 2001-07-19 | 2006-06-27 | Loma Linda University | Adhesive including medicament and device and method for applying same |
US20030044380A1 (en) | 2001-07-19 | 2003-03-06 | Zhu Yong Hua | Adhesive including medicament |
US6776784B2 (en) | 2001-09-06 | 2004-08-17 | Core Medical, Inc. | Clip apparatus for closing septal defects and methods of use |
US6702835B2 (en) | 2001-09-07 | 2004-03-09 | Core Medical, Inc. | Needle apparatus for closing septal defects and methods for using such apparatus |
US20030109820A1 (en) | 2001-12-07 | 2003-06-12 | Gross T. Daniel | Hemostatic agent delivery system |
US6897348B2 (en) | 2001-12-19 | 2005-05-24 | Kimberly Clark Worldwide, Inc | Bandage, methods of producing and using same |
US6966896B2 (en) | 2002-09-04 | 2005-11-22 | Paul A. Kurth | Introducer and hemostatic valve combination and method of using the same |
WO2007044510A1 (en) | 2005-10-05 | 2007-04-19 | Loma Linda University Medical Center | Vascular wound closure device and method |
-
2001
- 2001-08-01 US US09/921,158 patent/US6890342B2/en not_active Expired - Fee Related
- 2001-08-02 CA CA2417962A patent/CA2417962C/en not_active Expired - Lifetime
- 2001-08-02 DE DE60130770T patent/DE60130770T2/en not_active Expired - Lifetime
- 2001-08-02 AT AT01959511T patent/ATE374574T1/en not_active IP Right Cessation
- 2001-08-02 WO PCT/US2001/024462 patent/WO2002009591A2/en active IP Right Grant
- 2001-08-02 CN CN01816011A patent/CN1461204A/en active Pending
- 2001-08-02 AU AU2001281060A patent/AU2001281060B2/en not_active Ceased
- 2001-08-02 AU AU8106001A patent/AU8106001A/en active Pending
- 2001-08-02 EP EP01959511A patent/EP1307141B1/en not_active Expired - Lifetime
- 2001-08-02 JP JP2002515148A patent/JP4947872B2/en not_active Expired - Fee Related
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2013
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AU8106001A (en) | 2002-02-13 |
US20020072767A1 (en) | 2002-06-13 |
WO2002009591A8 (en) | 2003-11-20 |
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US9320505B2 (en) | 2016-04-26 |
WO2002009591A3 (en) | 2002-08-01 |
DE60130770T2 (en) | 2008-07-17 |
WO2002009591A2 (en) | 2002-02-07 |
AU2001281060B2 (en) | 2006-06-01 |
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DE60130770D1 (en) | 2007-11-15 |
US20050209637A1 (en) | 2005-09-22 |
US6890342B2 (en) | 2005-05-10 |
JP2004521663A (en) | 2004-07-22 |
CA2417962C (en) | 2016-11-15 |
US8425552B2 (en) | 2013-04-23 |
CN1461204A (en) | 2003-12-10 |
JP4947872B2 (en) | 2012-06-06 |
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