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Publication numberUS20090157101 A1
Publication typeApplication
Application numberUS 11/958,281
Publication dateJun 18, 2009
Filing dateDec 17, 2007
Priority dateDec 17, 2007
Also published asEP2242428A1, US8672953, US20110238089, WO2009079091A1
Publication number11958281, 958281, US 2009/0157101 A1, US 2009/157101 A1, US 20090157101 A1, US 20090157101A1, US 2009157101 A1, US 2009157101A1, US-A1-20090157101, US-A1-2009157101, US2009/0157101A1, US2009/157101A1, US20090157101 A1, US20090157101A1, US2009157101 A1, US2009157101A1
InventorsSteven Reyes, Scott Baron
Original AssigneeAbbott Laboratories
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Tissue closure system and methods of use
US 20090157101 A1
Abstract
A closure element includes a coiled body and a plurality of tissue engaging portions. The tissue engaging portions disposed about at least a portion of the coiled body. The coiled body is formed of a resilient material according to one example. According to another example, a closure element includes a spiral body and a plurality of tissue engaging portions disposed about the spiral body. The spiral body is formed from a resilient material.
Images(19)
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Claims(20)
1. A closure element, comprising:
a coiled body; and
a plurality of vessel engaging elements disposed about at least a portion of said coiled body, said coiled body being formed of a resilient material.
2. The closure element of claim 1, wherein said coiled body forms more than one coil when in said coiled body is in a relaxed state.
3. The closure element of claim 1, wherein said resilient material includes at least one of a biodegradable material, a bioreabsorbable material, and a shape memory alloy.
4. The closure element of claim 1, wherein said coiled body includes a first end and a second end separated by an angular separation, said angular separation corresponding to a relaxed state being greater than an angular separation corresponding to an expanded state.
5. The closure element of claim 1, wherein a radial distance of said coiled body in a relaxed state is less than a radial distance of said coiled body in an expanded state.
6. The closure element of claim 1, wherein said vessel engaging feature includes at least one tine.
7. A closure element, comprising:
a spiral body; and
a plurality of tissue engaging portions disposed about said spiral body, said spiral body being formed from a resilient material.
8. The closure element of claim 7, said spiral body being configured to contract from a partially expanded state to a relaxed state to close an opening in tissue.
9. The closure element of claim 8, wherein said spiral body includes a first end and a second end separated by an angular separation, said angular separation increasing as the spiral body contracts.
10. The closure element of claim 8, wherein said spiral body is further configured to contract radially relative to an axis of said closure element.
11. The closure element of claim 7, wherein said tissue engaging portions include a plurality of tines.
12. The closure element of claim 7, wherein said spiral body includes a proximal end and a distal end, said tissue engaging portions being formed on a distal end of said spiral body.
13. The closure element of claim 12, wherein said proximal end is generally planar.
14. The closure element of claim 12, wherein said closure element is formed from at least one of a biodegradable material, a bioreabsorbable material, and a shape memory alloy.
15. A system for closing an opening in tissue, comprising:
a closure element having a coiled body and a plurality of tissue engaging portions disposed about at least a portion of said body, said body being formed of a resilient material; and
a clip applier apparatus being configured to deploy said closure element into the tissue.
16. The system of claim 15, wherein the clip applier apparatus includes a locator assembly having a distal end region configured to extend into the opening and selectably contact a wall of the tissue and a proximal end configured to cooperate with a movable plunger, a carrier assembly coupled with said locating assembly, said carrier assembly retaining said closure element within said carrier assembly, and a triggering system cooperating with said locator assembly, said triggering system moveable toward said distal end region of said locator assembly as said movable plunger moves toward said distal end region.
17. The system of claim 16, further comprising a housing receiving said locator assembly, said carrier assembly, and said triggering system.
18. The system of claim 16, wherein said locator assembly is configured to selectively control said distal end region of said locator assembly between an expanded state and an unexpanded state.
19. The system of claim 18, wherein said locator assembly further comprises a control member coupled to at least one expansion member and a tubular member configured to surround said control member.
20. The system of claim 19, wherein said locator assembly further comprises a tubular body block mounted to said tubular member, a spring retainer receiving a portion of said tubular body block, and said movable plunger slidably cooperating with said tubular body block and said tubular member.
Description
    CROSS-REFERENCE TO RELATED APPLICATIONS
  • [0001]
    This application incorporates each of the following references in their entirety: U.S. Pat. No. 6,780,197, entitled “Apparatus and Methods for Delivering a Vascular Closure Device to a Body Lumen”, and filed Dec. 7, 2000; U.S. Pat. No. 6,942,674 entitled “Apparatus and Methods for Delivering a Closure Device”, and filed Feb. 21, 2002; and U.S. patent application Ser. No. 11/427,297, entitled “Clip Applier and Methods of Use”, and filed Jun. 28, 2006.
  • FIELD OF THE INVENTION
  • [0002]
    The present invention relates generally to apparatus and methods for closing and/or sealing openings through tissue, and more particularly to a closure element for closing a puncture in a blood vessel or other body lumen formed during a diagnostic or therapeutic procedure.
  • BACKGROUND OF THE INVENTION
  • [0003]
    Catheterization and interventional procedures, such as angioplasty or stenting, generally are performed by inserting a hollow needle through a patient's skin and tissue into the vascular system. A guidewire may be advanced through the needle and into the patient's blood vessel accessed by the needle. The needle is then removed, enabling an introducer sheath to be advanced over the guidewire into the vessel, e.g., in conjunction with or subsequent to a dilator.
  • [0004]
    A catheter or other device may then be advanced through a lumen of the introducer sheath and over the guidewire into a position for performing a medical procedure. Thus, the introducer sheath may facilitate introducing various devices into the vessel, while minimizing trauma to the vessel wall and/or minimizing blood loss during a procedure.
  • [0005]
    Upon completing the procedure, the devices and introducer sheath are removed, leaving a puncture site in the vessel wall. Traditionally, external pressure had often been applied to the puncture site until clotting and wound sealing would occur; however, the patient must remain bedridden for a substantial period of time after clotting to ensure closure of the wound. This procedure, however, may be time consuming and expensive, requiring as much as an hour of a physician's or nurse's time. It is also uncomfortable for the patient and requires that the patient remain immobilized in the operating room, catheter lab, or holding area. In addition, a risk of hematoma exists from bleeding before hemostasis occurs.
  • [0006]
    Various apparatus have been suggested for percutaneously sealing a vascular puncture by occluding the puncture site. For example, U.S. Pat. Nos. 5,192,302 and 5,222,974, issued to Kensey et al., describe the use of a biodegradable plug that may be delivered through an introducer sheath into a puncture site. Another technique has been suggested that involves percutaneously suturing the puncture site, such as that disclosed in U.S. Pat. No. 5,304,184, issued to Hathaway et al.
  • [0007]
    To facilitate positioning devices that are percutaneously inserted into a blood vessel, “bleed back” indicators have been suggested. For example, U.S. Pat. No. 5,676,689, issued to Kenseyet al., discloses a bleed back lumen intended to facilitate positioning of a biodegradable plug within a puncture site. This device, however, requires that an anchor of the plug be positioned within the vessel, and therefore, may increase the risk of over-advancement of the plug itself into the vessel.
  • [0008]
    Alternatively, U.S. Pat. No. 5,674,231, issued to Green et al., discloses a deployable loop that may be advanced through a sheath into a vessel. The loop is intended to resiliently expand in order to engage the inner wall of the vessel, thereby facilitating holding the sheath in a desired location with respect to the vessel. Accordingly, additional apparatus and methods for delivering a device for closing a vascular puncture site or other opening through tissue would be useful.
  • BRIEF SUMMARY
  • [0009]
    The present disclosure is directed to a closure element that is delivered through tissue and into an opening formed in, or adjacent to, a wall of a blood vessel or other body lumen of any size. The closure element is configured to be deployed using a clip applier. The apparatus can be configured to receive and retain the closure element so that the closure element can be disposed substantially within the apparatus.
  • [0010]
    Other aspects and features of the present invention will become apparent from consideration of the following description in conjunction with the accompanying drawings.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0011]
    In order to describe the manner in which the above-recited and other advantages and features of the invention can be obtained, a more particular description of the invention will be rendered by reference to specific embodiments thereof which are illustrated in the appended drawings. Understanding that these drawings depict only typical embodiments of the invention and are not therefore to be considered to be limiting of its scope, the invention will be described and explained with additional specificity and detail through the use of the accompanying drawings.
  • [0012]
    FIG. 1A is a perspective view of an embodiment of a closure element according to one example.
  • [0013]
    FIG. 1B is a top view of an embodiment of a closure element in an unexpanded state according to one example.
  • [0014]
    FIG. 1C is a top view of the embodiment of the closure element of FIG. 1B in a partially expanded state according to one example.
  • [0015]
    FIG. 1D is a side view of the embodiment of the closure element of FIG. 1B in an unexpanded state according to one example.
  • [0016]
    FIG. 2 is a flowchart illustrating an embodiment of a method of closing a puncture in a vessel wall according to one example.
  • [0017]
    FIG. 3 illustrates an embodiment of a closure element delivery apparatus according to one example.
  • [0018]
    FIGS. 4A-4L illustrate various steps in the deployment of an embodiment of a closure element to close a puncture according to one example.
  • [0019]
    FIG. 5 illustrates an exploded view of an embodiment of a closure element delivery apparatus according to one example.
  • [0020]
    FIG. 6A-6F illustrate a tube set used to deliver an embodiment of a closure element in one example.
  • [0021]
    It should be noted that the figures are not drawn to scale and that elements of similar structures or functions are generally represented by like-reference numerals for illustrative purposes throughout the figures. It also should be noted that the figures are only intended to facilitate the description of embodiments of the present invention.
  • DETAILED DESCRIPTION
  • [0022]
    Embodiments described herein extend to methods, systems, and apparatus for closing and/or sealing openings in a blood vessel or other body lumen formed during a diagnostic, therapeutic, and/or other procedure. The closure elements of the present invention may be configured to be delivered through tissue and into an opening formed in and/or adjacent to a wall of a blood vessel or other body lumen. The closure elements provided herein may reliably engage.
  • [0023]
    FIGS. 1A-1D illustrate an embodiment of a closure element 10. The closure element (also referred to herein as a “clip”) 10 can have a generally annular-shaped body 12 defining a channel 14. The channel 14 may include an axis 30. In the present embodiment, the axis 30 may be a central axis. In other embodiments, the axis 30 may be a non-central axis. The closure element 10 may include one or more barbs and/or tines 16 for receiving and engaging tissue (a blood vessel wall for example). The tines 16 in the present embodiment may be disposed about the periphery of the body 12. Although the closure element 10 may have a natural shape and size, the closure element 10 can be deformed into other shapes and sizes, as desired, and may be configured to return to the natural shape and size when released. For example, the closure element 10 can have a natural, planar configuration with a relaxed cross-section as shown in FIGS. 1A and 1B.
  • [0024]
    The closure element 10 can be formed from any suitable material, including any biodegradable and/or bioreabsorbable material, any shape memory alloy, such as alloys of nickel-titanium, or any combination thereof. Such configurations may allow the closure element 10 to draw an opening in tissue substantially closed and/or to enhance hemostasis within the opening. Additionally, it is contemplated that the closure element may be coated with a beneficial agent and/or be constructed as a composite, wherein one component of the composite may include a beneficial agent. As desired, the closure element 10 may further include radiopaque markers (not shown) or may be wholly or partially formed from a radiopaque material to facilitate observation of the closure element 10 using fluoroscopy or other imaging processes.
  • [0025]
    In one example, the closure element 10 may be formed by etching and/or cutting the tines or other attachment features into the body 12. The body may be a thin sheet of material. The sheet may then be moved (i.e. rolled or otherwise set) to a relaxed position and heat treated.
  • [0026]
    The closure element 10 may include a first end 18 and a second end 20 separated by the body 12. The length of the closure element 10 may generally define a spiral that, when in a relaxed state, may coil to form between a portion of a single coil (i.e. a partial coil) to multiple coils. In particular, as seen from above in FIG. 1B the closure element 10 may form a curve on a plane that winds around a center point P and increases in distance from point P. In one example, the spiral may begin at the first end 18 that may be a radial distance RRS1 from the center point P and may extend toward the second end 20 that may be a radial distance RRS2 from the center point P. The first end 18 and second end 20 may be separated by an angular separation ASRS that may be less than, equal to, or greater than 360 degrees. In the present embodiment, the angular separation ASRS between the first end 18 and the second end 20 in the relaxed state may be about 180 degrees.
  • [0027]
    In a partially expanded state, such as that shown in FIG. 1C, the angular separation ASES may approach 0 degrees. In other embodiments, the angular separation ASES in the partially expanded state may approach another angular measurement. In the present embodiment, the angular separation AERS may decrease from about 180 degrees in the relaxed state towards the angular separation AEES of about 0 degrees in the expanded state.
  • [0028]
    In the present embodiment, a radial distance RES1 from the center point P to the first end 18 may increase relative to the radial distance RRS1 from the center point P to the first end 18 a relaxed state (FIG. 1B). A radial distance RES2 from the center point P to the second end 20 may increase relative to the radial distance RRS2 from the center point P to the second end 20 a relaxed state (FIG. 1B). As the radial distances RRS1, RRS2, RES1, RES2 increase, the angular separation of the closure element 10 may decrease. In other words, in a deflected state the coiling formed by the closure element 10 may be loosened.
  • [0029]
    The closure element 10 may be formed of a resilient material. As a result, while in a deflected state (i.e. an expanded state), a biasing force may act on the closure element 10 to return the closure element 10 toward an undeflected state (i.e. a relaxed state). This biasing force may act to tighten the coiling of the closure element 10, while drawing the closure element 10 simultaneously radially inward.
  • [0030]
    The tightening of the closure element 10 may be used to close a puncture in tissue, as will now be discussed. One general method of deploying closure element 10 will first be introduced followed by a discussion of the use of an apparatus configured to deploy the closure element 10.
  • [0031]
    FIG. 2 illustrates an embodiment of a method of closing an opening in tissue (i.e. a vessel wall or other tissue). A sheath may be introduced, as represented by block 50. The sheath may be oriented to facilitate the introduction of devices through the sheath and through tissue (i.e. into a blood vessel) with minimal risk of damage to the tissue. These devices may be used to perform a therapeutic and/or diagnostic procedure, such as angioplasty, atherectomy, stent implantation, and the like, within the patent's vasculature.
  • [0032]
    A clip applier apparatus, such as the clip applier apparatus shown in FIG. 3, may be prepared to deploy a closure element 10 (FIGS. 1A-1D), as represented by block 60. The clip applier apparatus may be located relative to the tissue (i.e. relative to the vessel), as represented by block 70. In one example, the clip applier apparatus may be guided through the tissue by the sheath.
  • [0033]
    The closure element may be delivered, as represented by block 80. Delivering the closure element may include closing the opening in the tissue (i.e. the vessel wall). The clip applier apparatus may be withdrawn, as represented by block 90. This brief description of the deployment process provides an introduction to the processes described below for context. More or fewer steps may be performed in closing an opening through tissue.
  • [0034]
    FIG. 3 illustrates an embodiment of a clip applier apparatus 100 that may be used to apply the closure element 10 (FIGS. 1A-1D). The clip applier apparatus 100 may include a number of assemblies or groups, which may include a locator assembly 200, a carrier assembly 300, and/or a triggering system 400. These assemblies may cooperate to position the closure element 10 through a process similar to that described above with reference to FIG. 2. The clip applier apparatus 100 can be provided as one or more integrated components and/or discrete components. For purposes of illustration, the locator assembly 200 and the carrier assembly 300 are shown in FIG. 3 as substantially separate assemblies. As desired, however, the locator assembly 200 and the carrier assembly 300 each can be provided, in whole or in part, as one or more integrated assemblies.
  • [0035]
    The clip applier apparatus 100 can deliver a closure element 10 (FIG. 1A-1D) to an opening in tissue. In particular, the closure element 10 may be delivered into an opening formed in and/or adjacent to a wall of the blood vessel or other body lumen. When properly positioned, the clip applier apparatus 100 can be activated to deploy the closure element 10.
  • [0036]
    Turning now to FIG. 4A, the clip applier apparatus 100 (FIG. 3) discussed above will now be discussed in the context of a patient and with respect to a blood vessel 600. The blood vessel 600 has a vessel wall 620 with an outer portion 620 a and an inner portion 620 b. The clip applier apparatus 100 may then be used to apply the closure element 10.
  • [0037]
    In particular, a sheath 640 may be inserted or otherwise positioned through skin 650 and tissue 630 and within the blood vessel 600 or other body lumen via an opening 610. The sheath 640 can include a substantially flexible or semi-rigid tubular member. Also, the sheath 640 can have a proximal end region 640 a and a distal end region 640 b. The sheath 640 may further have a predetermined length and a predetermined cross-section, both of which can be of any suitable dimension. The sheath 640 also can form a lumen 644 that extends along a longitudinal axis of the sheath 640 and substantially between the proximal and distal end regions 640 a, 640 b. The lumen 644 can have any suitable internal cross-section 644 b and is suitable for receiving one or more devices (not shown), such as a catheter, a guidewire, or the like.
  • [0038]
    The sheath 640 may be advanced over a guidewire or other rail (not shown) which may have been positioned through the opening 610 and into the blood vessel 600 using conventional procedures. The blood vessel 600 can be a peripheral blood vessel, such as a femoral or carotid artery, although other body lumens may be accessed using the sheath 640. The opening 610, and consequently the sheath 640, may be oriented with respect to the blood vessel 600 such as to facilitate the introduction of devices through the lumen 644 of the sheath 640 and into the blood vessel 600 with minimal risk of damage to the blood vessel 600. One or more devices (not shown), such as a catheter, or the like, may be inserted through the sheath 640 and advanced to a preselected location within the patient's body. For example, the devices may be used to perform a therapeutic and/or diagnostic procedure, such as angioplasty, atherectomy, stent implantation, and the like, within the patient's vasculature.
  • [0039]
    After the procedure is completed, the devices may be removed from the sheath 640. The clip applier apparatus 100 may be prepared to be received by the lumen 644 of the sheath 640 as shown in FIG. 4B. The locator assembly, 200 may include a tubular body 210 having a distal end region 210 b. Being in the unexpanded state, the distal end region 210 b of the tubular body 210 of the locator assembly 200 can be slidably received by the lumen 644 and atraumatically advanced distally into the blood vessel 600 as illustrated in FIGS. 4B-4C. Advancing the distal end region 210 b into the lumen 644 begins the location of the locator assembly 200 relative to the blood vessel 600.
  • [0040]
    Once the distal end region 210 b of the tubular body 210 extends into the blood vessel 600, the distal end region 210 b may transition from the unexpanded state to the expanded state as shown in FIG. 4D when the triggering system 400 (FIG. 3) of the locator assembly 200 is activated.
  • [0041]
    Turning to FIG. 4E, the apparatus 100 and the sheath 640 may be retracted proximally until the distal end region 210 b is substantially adjacent to an inner surface 620 b of the blood vessel wall 620. The distal end region 210 b thereby may draw the blood vessel wall 620 taut and may maintain the proper position of the apparatus 100 as the blood vessel 600 pulsates. Since the expanded cross-section of the distal end region 210 b can be greater than or substantially equal to the cross-section of the opening 610 and/or the cross-section of the lumen 644, the distal end region 210 b may remain in the blood vessel 600 and may engage the inner surface 620 b of the blood vessel wall 620. The distal end region 210 b may frictionally engage the inner surface 620 b of the blood vessel wall 620, thereby securing the apparatus 100 to the blood vessel 600. The sheath 640 can be retracted proximally such that the distal end region 640 b of the sheath 640 may be substantially withdrawn from the blood vessel 600, as shown in FIG. 4E, permitting apparatus 100 to access the blood vessel wall 620.
  • [0042]
    Once the distal end region 210 b of the locator assembly 200 contacts the inner surface 620 b of the blood vessel wall 620, a distal portion 300 b of the carrier assembly 300 may be advanced distally and may be received within the lumen 644 of the sheath 640 as illustrated in FIG. 4F. The sheath 640 may radially expand and/or split in accordance with the predetermined pattern as the distal portion advances because the internal cross-section 644 b of the sheath 640 may be less than an outer portion carrier assembly 300. Once the carrier assembly 300 is located adjacent the outer surface 620 a of the blood vessel wall 620, the carrier assembly 300 may be deployed.
  • [0043]
    The carrier assembly 300 may include a pusher member 320, a cover member 330, and a support member 340 that may be coupled together. Accordingly, the carrier member 310, the pusher member 320, the cover member 330, and the support member 340 may each advance distally and may approach a predetermined position as illustrated in FIG. 4G.
  • [0044]
    Upon reaching the first predetermined position, the distal portion 300 b of the carrier assembly 300 can be disposed substantially adjacent to the outer surface 620 a of the blood vessel wall 620 adjacent to the opening 610 such that the blood vessel wall 620 adjacent to the opening 610 may be disposed substantially between the expanded distal region 210 b of the locator assembly 200 and the distal portion of the carrier assembly 300. The cover member 330 and the support member 340 can each decouple from the carrier member 310 and the pusher member 320 when the tube set 305 is in the first predetermined position. The cover member 330 and the support member 340 can be inhibited from further axial movement and remain substantially stationary as the carrier member 310 and the pusher member 320 each remain coupled and axially slidable.
  • [0045]
    As shown in FIGS. 4H-4L, the cover member 330 and the support member 340 can remain substantially stationary while the carrier member 310 and the pusher member 320 can continue distally and approach a second predetermined position. As the carrier member 310 and the pusher member 320 distally advance toward the second predetermined position, an annular cavity 370 (FIG. 4G) can move distally relative to the substantially-stationary cover member 330 such that the distal end region 330 b of the cover member 330 no longer encloses the annular cavity 370.
  • [0046]
    As a result, the closure element 10 may not be completely enclosed by the annular cavity 370 formed by the distal end regions 310 b, 320 b, and 330 b of the carrier member 310, the pusher member 320, and the cover member 330. Although not completely enclosed by the annular cavity 370, the closure element 10 can be advantageously retained on the outer periphery of the carrier member 310 by the distal end region 330 b of the cover member 330 as illustrated in FIG. 4H. For example, by retaining the closure element 10 between the distal end region 330 b of the cover member 330 and the distal end region 310 b of the carrier member 310, the apparatus 100 can be configured to provide better tissue penetration. The timing between the deployment of the closure element 10 by the tube set 305 and the retraction and transition to the unexpanded state by the locator assembly 200 likewise may be facilitated because the closure element 10 may be retained between the distal end region 330 b of the cover member 330 and the distal end region 310 b of the carrier member 310. Further, the carrier member 310 and the cover member 330 can operate to maintain the closure element 10 in the tubular configuration.
  • [0047]
    As shown in FIGS. 4H-4L, the closure element 10 may be deployed. The closure element 10 may engage the vessel wall 620 (as shown in FIG. 4J) in the partially expanded state. For example, the tissue engaging portions 16 (FIG. 4K) may frictionally, piercingly, and/or otherwise engage the vessel wall 620. The radial distances (not shown) of the first and second ends (not shown) of the closure element 10 may change in size and/or the angular position (not shown) of the first and second ends may change (i.e. decrease). The change in the size of the radial distances and/or angular positions of the first and second ends of the closure element 10 may substantially close the opening 610 in the vessel wall 620.
  • [0048]
    FIG. 5 is an exploded view of the embodiment of a clip applier apparatus 100 of FIG. 3. The locator assembly 200 may be configured to draw the blood vessel wall 620 taut and/or maintain the proper position of the clip applier apparatus 100 in relation to the opening 610 as the blood vessel 600 pulsates (FIGS. 4E-4I). The locator assembly 200 may be provided in the manner disclosed in U.S. Pat. Nos. 6,780,197 and 6,942,674, the disclosures of which are expressly incorporated herein by reference. The locator assembly 200 can include a flexible or semi-rigid tubular body 210. As illustrated in FIG. 5, the tubular body 210 may include a proximal end region 210 a and a distal end region 210 b and may include a predetermined length and/or a predetermined outer cross-section, both of which can be of any suitable dimension. The distal end region 210 b of the locator assembly 200 can include a substantially rounded, soft, and/or flexible distal end or tip 220 to facilitate atraumatic advancement and/or retraction of the distal end region 210 b into tissue (i.e. the blood vessel 600). As desired, a pigtail (not shown) may be provided on the distal end 220 to further aid atraumatic advancement of the distal end region 210 b.
  • [0049]
    The distal end region 210 b of the locator assembly 200 further can be selectably controllable between an unexpanded state and an expanded state. In the unexpanded state, the distal end region 210 b may have an unexpanded size; whereas, the distal end region 210 b in the expanded state may have an expanded size, which may be greater than the unexpanded size of the distal end region 210 b in the unexpanded state. The distal end region 210 b can be configured to expand and/or contract from the unexpanded size to the expanded size to the unexpanded size. The expansion and contraction of the distal end region 210 b can be substantially uniform about a longitudinal axis of the locator assembly 200. For example, one or more expansion elements 230 can be provided on the distal end region 210 b and can be configured to expand substantially transversely with respect to a longitudinal axis of the locator assembly 200. In one configuration, being substantially equally distributed about an outer periphery of the distal end region 210 b, the expansion elements 230 may include radiopaque markers (not shown) or may be wholly or partially formed from a radiopaque material to facilitate observation of the expansion elements 230 and/or the distal end region 210 b using fluoroscopy or other imaging systems. The distal end region 210 b is shown in its expanded state, wherein the expansion elements 230 are flexed outward.
  • [0050]
    Continuing with reference to FIG. 5, a control member 250, such as a rod, wire, or other elongate member, can be moveably disposed within a lumen (not shown) formed by the tubular body 210 and may extend substantially between the proximal end region 210 a and the distal end region 210 b. The control member 250 can have a proximal end region that may be coupled with a control block 260 and a distal end region that may be coupled with the distal end region 210 b of the locator assembly 200 and/or the expansion elements 230. The control block 260 can be a tubular shape and may be formed of a metal and/or rigid plastic. The control block 260 may be adapted to be retained in the housing bottom half 380 to maintain the control block 260 in a substantially fixed position relative to the housing 380. The locator assembly 200 can selectively transition the distal end region 210 b, the expansion elements 230, and/or the substantially flexible members 230 between the unexpanded and expanded states by moving the tubular body 210 axially relative to the control member 250.
  • [0051]
    The tubular body 210 can have a tubular body block 270. The tubular body block 270 can be formed of metal, rigid plastic, or other substantially rigid material and may sometimes be formed integrally with or attached securely to the tubular body 210. The proximal end of the tubular body block 270 can have a shape adapted to cooperate with a locator assembly block 280 whereby the tubular body block 270 may be maintained in a fixed axial relationship with the locator assembly block 280. In this manner, the tubular body block 270 and tubular body 210 can be advanced distally by distal advancement of the locator assembly block 280.
  • [0052]
    A locator assembly spring 290 can be located coaxially with and/or substantially surround a portion of the tubular body block 270. The locator assembly spring 290 can be located so as to provide a force biasing the locator assembly block 280 in the proximal direction relative to the housing 380.
  • [0053]
    The locator assembly block 280 can be formed of metal, plastic, and/or other substantially rigid material. A function of the locator assembly block 280 can allow the user to apply a force causing distal movement of the tubular body 210 relative to the control member 250 to cause the locator assembly 200 to transition from the unexpanded state to the expanded state.
  • [0054]
    The clip applier apparatus 100 may include a triggering system 400 that can be disposed substantially within the housing 380 (illustrated assembled in FIG. 3). The triggering system 400 can be configured to control the relative axial movement and/or positioning of the respective distal end regions 310 b, 320 b, 330 b, and 340 b of the tube set 305 and/or the distal end region 210 b of the locator assembly 200. The triggering system 400 may be coupled to proximal end regions 210 a, 310 a, 320 a, 330 a, and/or 340 a to control the relative axial movement of the distal end regions 210 b, 310 b, 320 b, 330 b, and/or 340 b in any manner, such as by being activated by a switching system. As desired, the triggering system 400 can induce axial motion, such as distal motion, with respect to one or more of the distal end regions 210 b, 310 b, 320 b, 330 b, and/or 340 b. One or more of the distal end regions 210 b, 310 b, 320 b, 330 b, and/or 340 b can be axially moved. Axial motion of one or more of the carrier member 310, the pusher member 320, the cover member 330, and the support member 340 and/or the tubular body 210 can be attained, for example, by applying an axial force to the switching system 450. To facilitate monitoring of the positioning of the carrier assembly 300 and/or closure element 10, one or more of the distal end regions 210 b, 310 b, 320 b, 330 b, and/or 340 b may include radiopaque markers (not shown) or may be wholly or partially formed from a radiopaque material. The discussion of several parts specific to the example illustrated will be omitted for clarity in describing the operation of the clip applier apparatus 100 in delivering the closure element 10. Additional details of some exemplary triggering systems are found in U.S. patent application Ser. No. 11/427,297, entitled “Clip Applier and Methods of Use”, and filed Jun. 28, 2006, which is hereby incorporated by reference in its entirety.
  • [0055]
    The triggering system 400 can be configured to overcome internal resistance such that the relative axial movement and/or positioning of the respective distal end regions 310 b, 320 b, 330 b, and 340 b of the tube set 305 and/or the distal end region 210 b of the locator assembly 200 may be controlled in accordance with a predetermined manner when the triggering system 400 is activated. Movement and/or positioning of the distal end regions 310 b, 320 b, 330 b, 340 b, and/or 210 b can be initiated when at least a predetermined quantity of force is applied to the switching system 450. Stated somewhat differently, a force that is less than the predetermined quantity generally may be insufficient to activate the triggering system 400; whereas, when the force increases to a level that is greater than or substantially equal to the predetermined quantity, the triggering system 400 may be configured to activate, move, and/or position the distal end regions 310 b, 320 b, 330 b, 340 b, and/or 210 b in accordance with the predetermined manner. The triggering system 400, once activated, can continue to move and/or position the distal end regions 310 b, 320 b, 330 b, 340 b, and/or 210 b in accordance with the predetermined manner until the closure element 10 is deployed.
  • [0056]
    The triggering system 400, for example, can include one or more sets of cooperating detents for coupling the axial motion of the distal end regions 310 b, 320 b, 330 b, and 340 b in accordance with a predetermined manner when the triggering system 400 is activated. The term “detents” refers to any combination of mating elements, such as blocks, tabs, pockets, slots, ramps, locking pins, cantilevered members, support pins, and the like, that may be selectively or automatically engaged and/or disengaged to couple or decouple the carrier member 310, the pusher member 320, the cover member 330, and the support member 340 relative to one another. The cooperating detents as illustrated and described herein are merely exemplary and not exhaustive. For example, the cooperating detents can include a first set of cooperating blocks and pockets for releasably coupling the support member 340, the carrier member 310, the pusher member 320, and/or the cover member 330. When the carrier assembly 300 reaches a first predetermined distal position, the support member 340 can be decoupled from the carrier member 310, the pusher member 320, and/or the cover member 330 and can be substantially inhibited from further axial movement. As a result, the carrier member 310, the pusher member 320, and/or the cover member 330 may continue to be directed distally as the support member 340 remains substantially stationary.
  • [0057]
    The triggering system 400 can further include one or more stops for engaging the pusher block 420, the cover block 430, and/or the support block 440, respectively. When an axial force is applied to the tube set 305 via the switching system 450, the cover block 430 can move distally within the housing 380 until the cover block 430 is substantially locked in place, substantially preventing any further motion of the cover block 430. The triggering system 400 may further include a tube release system for inhibiting inadvertent advancement of the tube set 305 and a locator release system 490 for permitting the distal end region 210 b, the expansion elements 230, and/or the substantially flexible members 230 of the locator assembly 200 to transition from the expanded state to the unexpanded state can be included with the triggering system 400. The carrier assembly 300 (FIG. 3) can be coupled with, and slidable relative to, the locator assembly 200. The carrier assembly 300 can include a tube set that includes a carrier member 310, a pusher member 320, a support tube 340, and/or a cover member 330.
  • [0058]
    As illustrated in FIG. 6A, the carrier member 310, the pusher member 320, the support tube 340, and the cover member 330 can be provided as a plurality of nested, telescoping members with a common longitudinal axis 350. This may allow the carrier member 310 to be at least partially disposed within, and slidable relative to, the lumen 334 of the pusher member 320 as shown in FIG. 6C. The pusher member 320, in turn, can be at least partially disposed within, and slidable relative to, the lumen 334 of the cover member 330. To couple the carrier assembly 300 with the locator assembly 200 (FIG. 5), the tubular body 210 of the locator assembly 200 can be at least partially disposed within, and slidable relative to, the lumen 314 of the carrier member 310. The longitudinal axis of the locator assembly 200 can be substantially in axial alignment with the common longitudinal axis 350 of the carrier member 310, the pusher member 320, the cover member 330, and the support tube 340.
  • [0059]
    The tube set 305 can also include a support member 340. The support member 340 may be configured to slidably receive the tubular body 210 of the locator assembly 200 and/or to provide radial support for the distal end region 210 b of the tubular body 210 when the locator assembly 200 is coupled with the carrier assembly 300. The carrier assembly 300 can advantageously include the support member 340, for example, if the tubular body 210 is not sufficiently rigid or under other circumstances in which support for the tubular body 210 might be desirable. The support member 340 can be configured to inhibit the plurality of longitudinal extensions 335, which may extend from the distal end region 330 b of the cover member 330, from expanding prematurely prior to the closure element 10 being deployed.
  • [0060]
    The support member 340 can be formed as a substantially rigid, semi-rigid, or flexible tubular member, having a proximal end region 340 a and a distal end region 340 b. An outer periphery 342 b of the support member 340 can define a lumen 344 that extends substantially between the proximal end region 340 a and the distal end region 340 b, the lumen 334 may be configured to slidably receive and support at least a portion of the tubular body 210 of the locator assembly 200. The support member 340, in turn, can be at least partially slidably disposed within the lumen 314 of the carrier member 310 such that the tubular body 210 of the locator assembly 200 may be coupled with, and/or slidable relative to, the carrier member 310. The support member 340 can have a predetermined length and/or a predetermined cross-section, both of which can be of any suitable dimension, and the cross-section can be substantially uniform. Although shown and described as being substantially separate for purposes of illustration, it will be appreciated that the carrier member 310, the pusher member 320, the cover member 330, and/or the support member 340 can be provided, in whole or in part, as one or more integrated assemblies.
  • [0061]
    In operation, the distal end region 210 b of the locator assembly 200 may be positioned as desired and transitioned from the unexpanded state to the expanded state. While the locator control system the distal end region 210 b is in the expanded state, a distally-directed axial force can be applied to the triggering system 400 via the switching system 450. The pusher block 420 may then be freed to allow the tube set 305 to slide within the housing 380 distally from an initial predetermined position to a first predetermined position.
  • [0062]
    In the initial predetermined position, the carrier member 310, the pusher member 320, the cover member 330, and/or the support member 340 can be coupled such that the carrier block 410, the pusher block 420, the cover block 430, and/or the support block 440 may be coupled. As a result, the carrier member 310, the pusher member 320, the cover member 330, and/or the support member 340 each can slide distally from the initial predetermined position to the first predetermined position in response to the axial force.
  • [0063]
    To continue distally from the first predetermined position, the carrier member 310 and the pusher member 320 can be decoupled from the cover member 330 and the support member 340. The carrier member 310 and the pusher member 320 remain coupled with the cover member 330 and the support member 340. As the axial force increases to a level that is greater than or substantially equal to the combined static force between the components, the carrier member 310 and the pusher member 320 may become uncoupled from the cover member 330 and the support member 340 thereby allowing the carrier member 310 and the pusher member 320 to proceed distally toward a second predetermined position.
  • [0064]
    In the second predetermined position, the carrier block 410 can engage the carrier stop 460 c. Whereby, the carrier stop 460 c can receive, and substantially inhibit further movement of, the carrier block 410 and, therefore, the carrier member 310. To continue distally from the second predetermined position, the pusher member 320 can be decoupled from the carrier member 310.
  • [0065]
    As the axial force increases to a level that is greater than or substantially equal to the static force, the pusher member 320 may be decoupled from the carrier member 310 allowing the pusher member 320 to proceed distally to deploy the closure element 10 and to activate a locator release system 490 such that the distal end region 210 b, the expansion elements 230, and/or the substantially flexible members 230 of the locator assembly 200 transition from the expanded state to the unexpanded state. The axial force that is applied to overcome the static force associated with the first predetermined position can be sufficient to overcome the static forces associated with the subsequent predetermined positions, to deploy the closure element 10, and to activate the locator release system 490 such that the triggering system 400 may operate in one substantially-continuous motion.
  • [0066]
    The triggering system 400 can include an energy storing element (not shown), which can be disposed substantially between the housing 380 and the blocks 410, 420, 430, and 440 and which can be configured to store potential energy for moving the tube set 305 from the initial predetermined position through the other predetermined positions, deploying the closure element 10, and/or activating the locator release system 490. The energy-storing element can be configured store the potential energy when the tube set 305 is in the initial predetermined position and to release the potential energy, when activated, such that the tube set 305 may travel through the predetermined positions at a substantially constant and continuous rate. For example, the energy-storing element can include one or more springs (not shown). Each of the springs can be in a compressed state when the tube set 305 is in the initial predetermined position and may be released from the compressed state when the switching system 450 of the triggering system 400 is activated.
  • [0067]
    When the apparatus 100 is properly assembled, the tubular body 210 of the locator assembly 200 can be at least partially disposed within the tube set 305 of the carrier assembly 300 such that the distal end region 210 b of the tubular body 210 may extend beyond the distal end regions 310 b, 320 b, 330 b, and/or 340 b. One example of an assembled tube set is illustrated in FIG. 6A. Further, the proximal end region 210 a of the tubular body 210 and the proximal end regions 310 a, 320 a, 330 a, and/or 340 a of the tube set 305 are at least partially disposed within, and slidable relative to, the housing 380.
  • [0068]
    FIG. 6B illustrates the carrier member 310 in more detail. The carrier member 310 can be configured to receive and/or support the closure element 10. While being disposed on the carrier member 310, the closure element 10 can be deformed from the natural, relaxed configuration (shown in FIGS. 1B and 1D) to a deflected or expanded state (shown in FIG. 1C).
  • [0069]
    FIG. 6B illustrates how the closure element 10 may be disposed substantially about, and/or supported by, an outer periphery 312 b of the carrier member 310. The closure element 10 can be substantially in axial alignment with the carrier member 310 with the tines 16 pointed substantially distally.
  • [0070]
    In one configuration, the carrier member 310 can be formed as a substantially rigid, semi-rigid, or flexible tubular member. The carrier member 310 can have a proximal end region 310 a and a distal end region 310 b and can include a predetermined length 318 a and/or a predetermined cross-section 318 b, both of which can be of any suitable dimension. The carrier member 310 also can define a lumen 314 that may extend substantially between the proximal end region 310 a and the distal end region 310 b and that may be configured to slidably receive at least a portion of the tubular body 210 of the locator assembly 200. Although the cross-section 318 b of the carrier member 310 generally is substantially uniform, the distal end region 310 b of the carrier member 310 may have a cross-section that increases distally, as illustrated in FIGS. 6A-6B, for substantially uniformly expanding the closure element 10 when the closure element 10 is deployed.
  • [0071]
    To deploy the closure element 10 without expanding the closure element 10 prior to deployment, the distal end region 310 b can be formed with a cross-section (not shown) that is substantially uniform. Although shown and described as having the cross-section that increases distally for expanding the closure element 10, it will be understood that the distal end region 310 b of the carrier member 310 may be provided with the substantially-uniform cross-section and that the closure element 10 may be deployed without being expanded prior to deployment.
  • [0072]
    FIG. 6C illustrates the pusher member 320 in more detail. The pusher member 320 may be configured to distally deploy the closure element 10. In particular, the pusher member 320 may include a proximal end region 320 a and a distal end region 320 b. In addition, the pusher member 320 may be coupled with and slidable relative to the carrier member 310. The pusher member 320 may include a predetermined length 328 a and/or a predetermined cross-section 328 b, both of which may be of any suitable dimension and may be configured to slidably receive the carrier member 310 such that the distal end region 320 b of the pusher member 320 may be offset proximally from the distal end region 310 b of the carrier member 310. As desired, the predetermined length 328 a of the pusher member 320 can be greater than or substantially equal to the predetermined length 318 a of the carrier member 310. The predetermined length 328 a of the pusher member 320, however, may be less than the predetermined length 318 a of the carrier member 310 such that the carrier member 310 and the pusher member 320 may at least partially define a space 370 distal to the distal end region 320 b of the pusher member 320 and along the periphery 312 b of the carrier member 310.
  • [0073]
    In FIG. 6D, the closure element 10 is shown disposed on the carrier member 310. As the carrier member 310 is received within the pusher member 320, the distal end 320 b of the pusher member 320 may be urged distally. Thereby, reducing the distance between the distal end 320 b of the pusher member 320 and the distal end 310 b of the carrier member 310. At some point, the distal end 320 b of the pusher member 320 may come into contact with the closure element 10. Thereafter, further advancing the pusher member 320 may urge the closure element 10 toward the distal end 310 b of the carrier member 310.
  • [0074]
    The cross-section 328 b of the pusher member 320 can be substantially uniform and the distal end region 320 b of the pusher member 320 can include one or more longitudinal extensions 325, which may extend distally from the pusher member 320 and along the periphery 312 b of the carrier member 310 as shown in FIG. 6C. The longitudinal extensions 325 can be biased such that the longitudinal extensions 325 may extend generally in parallel with common longitudinal axis 350. The longitudinal extensions 325 may be sufficiently flexible to expand radially, and yet sufficiently rigid to inhibit buckling, as the distal end region 320 b is directed distally along the carrier member 310 and engages the distally-increasing cross-section of the distal end region 310 b of the carrier member 310 to deploy the closure element 10.
  • [0075]
    FIG. 6E illustrates the cover member 330 in more detail. A cover member 330 may be configured to retain the closure element 10 (best shown in FIG. 6A) substantially within the carrier assembly 300 prior to deployment as shown in FIG. 6D. Being coupled with, and/or slidable relative to, the pusher member 320, the cover member 330 may include a proximal end region 330 a and/or a distal end region 330 b and may include a predetermined length 338 a and/or a predetermined cross-section 338 b, both of which can be of any suitable dimension.
  • [0076]
    The cover member 330 can be formed as a substantially rigid, semi-rigid, or flexible tubular member. The cover member 330 can have an inner periphery 332 a and/or an outer periphery 332 b and/or can define a lumen 334. The lumen 334 can extend substantially between the proximal and distal end regions 330 a, 330 b of the cover member 330 and/or can be configured to slidably receive at least a portion of the pusher member 320. When the cover member 330 is properly positioned within the carrier assembly 300, the distal end region 330 b can be configured to extend over the space 360, to provide space for receiving and retaining the closure element 10. The cross-section 338 b of the cover member 330 can be substantially uniform. The distal end region 330 b of the cover member 330 can include one or more longitudinal extensions 335, which may extend distally from the cover member 330 and along an outer periphery 322 b of the pusher member 320 as shown in FIG. 6D.
  • [0077]
    Turning again to FIG. 6A, although the longitudinal extensions 335 can extend generally in parallel with common longitudinal axis 350, the longitudinal extensions 335 can be biased such that the plurality of longitudinal extensions 335 extend substantially radially inwardly. The inward extension of the longitudinal extensions 335 can partially close the lumen 334 substantially adjacent to the distal end region 330 b (FIG. 6D) of the cover member 330. The longitudinal extensions 335 can be sufficiently flexible to expand radially to permit the distal end region 310 b (FIG. 6E) of the carrier member 310 to move distally past the cover member 330 such that the distal end region 330 b no longer extends over the space 360. As the carrier member 310 moves past the distal end region 330 b, the carrier member 310 may move the closure element 10 toward deployment.
  • [0078]
    The invention is susceptible to various modifications and alternative means, and specific examples thereof have been shown by way of example in the drawings and are herein described in detail. It should be understood, however, that the invention is not to be limited to the particular devices or methods disclosed, but to the contrary, the invention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the claims.
Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US1088393 *Sep 20, 1913Feb 24, 1914Oscar E BackusButton.
US1331401 *Sep 12, 1919Feb 17, 1920Clay Summers HenryButton-fastening
US2108206 *Mar 9, 1937Feb 15, 1938Lillian Pearl MeckerTenaculum
US2583625 *Oct 29, 1946Jan 29, 1952Thomas & Betts CorpMethod of and tool for crimping tubes
US2969887 *Apr 8, 1959Jan 31, 1961American Thermos Products CompThreaded pouring lip stopper combination for vacuum bottle
US3015403 *Apr 8, 1959Jan 2, 1962American Thermos Products CompThreaded stopper expanding pouring lip combination for vacuum bottle
US3120230 *Oct 24, 1960Feb 4, 1964Jack H SandersSurgical clamp
US3494533 *Oct 10, 1966Feb 10, 1970United States Surgical CorpSurgical stapler for stitching body organs
US3944114 *Mar 14, 1975Mar 16, 1976Koninklijke Emballage Industrie Van Leer B.V.Screw threaded plastic plug
US4011872 *Mar 28, 1975Mar 15, 1977Olympus Optical Co., Ltd.Electrical apparatus for treating affected part in a coeloma
US4014492 *Jun 11, 1975Mar 29, 1977Senco Products, Inc.Surgical staple
US4192315 *Dec 16, 1977Mar 11, 1980Aesculap-Werke Aktiengesellschaft Vormals Jetter & ScheererClip for surgical purposes
US4317445 *Mar 31, 1980Mar 2, 1982Baxter Travenol Laboratories, Inc.Catheter insertion unit with separate flashback indication for the cannula
US4318401 *Apr 24, 1980Mar 9, 1982President And Fellows Of Harvard CollegePercutaneous vascular access portal and catheter
US4368736 *Nov 17, 1980Jan 18, 1983Kaster Robert LAnastomotic fitting
US4428376 *Jun 14, 1982Jan 31, 1984Ethicon Inc.Plastic surgical staple
US4501276 *Jul 16, 1982Feb 26, 1985Illinois Tool Works Inc.Fetal electrode apparatus
US4505273 *Feb 9, 1983Mar 19, 1985Intermedicat GmbhSurgical staple
US4505274 *Oct 12, 1982Mar 19, 1985Propper Manufacturing Co., Inc.Suture clip
US4635634 *Jul 12, 1985Jan 13, 1987Santos Manuel VSurgical clip applicator system
US4719917 *Feb 17, 1987Jan 19, 1988Minnesota Mining And Manufacturing CompanySurgical staple
US4724840 *Feb 3, 1982Feb 16, 1988Ethicon, Inc.Surgical fastener applier with rotatable front housing and laterally extending curved needle for guiding a flexible pusher
US4997436 *Dec 7, 1989Mar 5, 1991Oberlander Michael AArthroscopic clip insertion tool
US4997439 *Jan 26, 1990Mar 5, 1991Chen Fusen HSurgical closure or anastomotic device
US5002562 *Apr 18, 1990Mar 26, 1991Oberlander Michael ASurgical clip
US5092941 *Nov 6, 1989Mar 3, 1992Gac International, Inc.Method for imparting shapes to shape memory alloy wires
US5100418 *Dec 15, 1989Mar 31, 1992Inbae YoonSuture tie device system and applicator therefor
US5176648 *Dec 13, 1991Jan 5, 1993Unisurge, Inc.Introducer assembly and instrument for use therewith
US5176691 *Sep 11, 1990Jan 5, 1993Pierce Instruments, Inc.Knot pusher
US5192287 *Apr 5, 1991Mar 9, 1993American Cyanamid CompanySuture knot tying device
US5192288 *May 26, 1992Mar 9, 1993Origin Medsystems, Inc.Surgical clip applier
US5192300 *Jan 28, 1992Mar 9, 1993Quinton Instrument CompanyInsertion assembly and method of inserting a vessel plug into the body of a patient
US5192301 *Sep 3, 1991Mar 9, 1993Nippon Zeon Co., Ltd.Closing plug of a defect for medical use and a closing plug device utilizing it
US5192302 *Oct 28, 1991Mar 9, 1993Kensey Nash CorporationPlug devices for sealing punctures and methods of use
US5192602 *May 14, 1991Mar 9, 1993Spencer Victor VLouvered filter and paint arrestor
US5275616 *Dec 18, 1992Jan 4, 1994Quinton Instrument CompanyInsertion assembly and method of inserting a vessel plug into the body of a patient
US5282808 *Feb 4, 1993Feb 1, 1994Origin Medsystems, Inc.Closure prevention apparatus for surgical clip applier
US5290243 *Jul 16, 1992Mar 1, 1994Technalytics, Inc.Trocar system
US5290310 *Jul 13, 1992Mar 1, 1994Howmedica, Inc.Hemostatic implant introducer
US5383896 *May 25, 1993Jan 24, 1995Gershony; GaryVascular sealing device
US5383905 *Oct 9, 1992Jan 24, 1995United States Surgical CorporationSuture loop locking device
US5392978 *Oct 15, 1993Feb 28, 1995United States Surgical CorporationSurgical staple and endoscopic stapler
US5486195 *Jul 26, 1993Jan 23, 1996Myers; GeneMethod and apparatus for arteriotomy closure
US5492119 *Dec 22, 1993Feb 20, 1996Heart Rhythm Technologies, Inc.Catheter tip stabilizing apparatus
US5591205 *Jun 6, 1995Jan 7, 1997Quinton Instrument CompanyInsertion assembly and method of inserting a vessel plug into the body of a patient
US5593412 *May 2, 1995Jan 14, 1997Cordis CorporationStent delivery method and apparatus
US5601602 *Nov 16, 1994Feb 11, 1997Quinton Instrument CompanyInsertion assembly and method of inserting a vessel plug into the body of a patient
US5716375 *Feb 21, 1996Feb 10, 1998Quinton Instrument CompanyInsertion assembly and method of inserting a vessel plug into the body of a patient
US5720755 *Oct 2, 1995Feb 24, 1998Dakov; PepiTubular suturing device and methods of use
US5855312 *Jul 25, 1996Jan 5, 1999Toledano; HavivFlexible annular stapler for closed surgery of hollow organs
US5855576 *Dec 12, 1996Jan 5, 1999Board Of Regents Of University Of NebraskaMethod for volumetric tissue ablation
US5858082 *Sep 15, 1997Jan 12, 1999Cruz; Hector GonzaloSelf-interlocking reinforcement fibers
US5860991 *Aug 22, 1997Jan 19, 1999Perclose, Inc.Method for the percutaneous suturing of a vascular puncture site
US5861005 *Feb 11, 1997Jan 19, 1999X-Site, L.L.C.Arterial stapling device
US5868755 *Jan 16, 1997Feb 9, 1999Atrion Medical Products, Inc.Sheath retractor mechanism and method
US5871474 *Apr 2, 1997Feb 16, 1999General Surgical Innovations, Inc.Screw-type skin seal with inflatable membrane
US5871501 *Jan 12, 1998Feb 16, 1999Datascope Investment Corp.Guide wire with releasable barb anchor
US5871525 *Oct 23, 1995Feb 16, 1999Ep Technologies, Inc.Steerable ablation catheter system
US6009877 *Feb 19, 1998Jan 4, 2000Edwards; Stuart D.Method for treating a sphincter
US6019779 *Oct 9, 1998Feb 1, 2000Intratherapeutics Inc.Multi-filar coil medical stent
US6022372 *Oct 14, 1998Feb 8, 2000X-Site, L.L.C.Arterial stapling device
US6024747 *Jul 30, 1998Feb 15, 2000X-Site L.L.C.Device and method for suturing blood vessels and the like
US6024750 *Aug 14, 1997Feb 15, 2000United States SurgicalUltrasonic curved blade
US6030364 *Oct 3, 1997Feb 29, 2000Boston Scientific CorporationApparatus and method for percutaneous placement of gastro-intestinal tubes
US6030413 *Aug 29, 1991Feb 29, 2000Endovascular Technologies, Inc.Artificial graft and implantation method
US6179849 *Jun 10, 1999Jan 30, 2001Vascular Innovations, Inc.Sutureless closure for connecting a bypass graft to a target vessel
US6193734 *Jan 5, 1999Feb 27, 2001Heartport, Inc.System for performing vascular anastomoses
US6334865 *Jul 27, 1999Jan 1, 2002Fusion Medical Technologies, Inc.Percutaneous tissue track closure assembly and method
US6348064 *Sep 11, 2000Feb 19, 2002Angiolink CorporationWound site management and wound closure device
US6506210 *Sep 11, 2000Jan 14, 2003Angiolink CorporationWound site management and wound closure device
US6517498 *Jul 20, 2000Feb 11, 2003Senorx, Inc.Apparatus and method for tissue capture
US6517569 *Mar 20, 2001Feb 11, 2003Endocare, Inc.Insertion device for stents and methods for use
US6676671 *Mar 2, 2001Jan 13, 2004United States SurgicalStapling apparatus and method for heart valve replacement
US6679904 *Oct 15, 1997Jan 20, 2004Malachy GleesonDevice for closure of puncture wound
US6689051 *May 21, 2001Feb 10, 2004Olympus CorporationEndoscope hood for mucous membrane resection
US6689147 *Jun 13, 2000Feb 10, 2004J. Kenneth Koster, Jr.Anastomosis punch device and method
US6695867 *Feb 21, 2002Feb 24, 2004Integrated Vascular Systems, Inc.Plunger apparatus and methods for delivering a closure device
US6846319 *Dec 14, 2000Jan 25, 2005Core Medical, Inc.Devices for sealing openings through tissue and apparatus and methods for delivering them
US6989003 *Aug 31, 2001Jan 24, 2006Conmed CorporationObturator and cannula for a trocar adapted for ease of insertion and removal
US6989016 *Oct 20, 2003Jan 24, 2006Medtronic Angiolink, Inc.Vascular suction cannula, dilator and surgical stapler
US7001398 *Jul 9, 2003Feb 21, 2006Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US7001400 *Aug 29, 2000Feb 21, 2006Abbott LaboratoriesArticulating suturing device and method
US7163551 *Aug 8, 2002Jan 16, 2007Thomas AnthonySurgical stapling device
US7169158 *Oct 18, 2001Jan 30, 2007Tyco Healthcare Group LpAnastomosis instrument and method for performing same
US7169164 *Sep 21, 2001Jan 30, 2007Atritech, Inc.Apparatus for implanting devices in atrial appendages
US20020026215 *Sep 19, 2001Feb 28, 2002Redmond Russell J.Percutaneous tissue track closure assembly and method
US20030004543 *Oct 15, 1997Jan 2, 2003Malachy GleesonDevice for closure of puncture wound
US20030009180 *Jun 5, 2002Jan 9, 2003Hinchliffe Peter W.J.Vascular hole closure device
US20030032981 *Jun 21, 2002Feb 13, 2003Glenn KannerAdvanced wound site management systems and methods
US20040009289 *Jul 9, 2003Jan 15, 2004Carley Michael T.Closure device and methods for making and using them
US20060020270 *Feb 1, 2005Jan 26, 2006Ronald JabbaClip applier and methods of use
US20060030867 *Oct 12, 2005Feb 9, 2006Reza ZadnoDevice and method for repairing tissue
US20070010853 *Sep 15, 2006Jan 11, 2007Integrated Vascular Systems, Inc.Apparatus and methods for positioning a vascular sheath
US20070010854 *Sep 18, 2006Jan 11, 2007Christy CumminsSurgical Staple
US20070021778 *Jun 19, 2006Jan 25, 2007Abbott Laboratories Abbott Vascular DevicesApparatus and method for delivering a closure element
US20080004636 *Jun 28, 2006Jan 3, 2008Abbott LaboratoriesClip applier and methods of use
US20080045979 *Aug 18, 2006Feb 21, 2008Abbott LaboratoriesArticulating suture device and method
USRE31855 *Nov 22, 1982Mar 26, 1985Cook, Inc.Tear apart cannula
USRE34866 *Dec 31, 1991Feb 21, 1995Kensey Nash CorporationDevice for sealing percutaneous puncture in a vessel
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US7806904Feb 24, 2004Oct 5, 2010Integrated Vascular Systems, Inc.Closure device
US7819895Apr 18, 2006Oct 26, 2010Integrated Vascular Systems, Inc.Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US7841502Dec 18, 2007Nov 30, 2010Abbott LaboratoriesModular clip applier
US7842068Nov 30, 2010Integrated Vascular Systems, Inc.Apparatus and methods for providing tactile feedback while delivering a closure device
US7850709Jun 4, 2003Dec 14, 2010Abbott Vascular Inc.Blood vessel closure clip and delivery device
US7850797Dec 14, 2010Integrated Vascular Systems, Inc.Methods for manufacturing a clip and clip
US7854810Dec 17, 2003Dec 21, 2010Integrated Vascular Systems, Inc.Methods for manufacturing a clip and clip
US7857828Feb 1, 2005Dec 28, 2010Integrated Vascular Systems, Inc.Clip applier and methods of use
US7867249Aug 8, 2003Jan 11, 2011Integrated Vascular Systems, Inc.Clip applier and methods of use
US7879071May 9, 2003Feb 1, 2011Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US7887555Jul 9, 2003Feb 15, 2011Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US7887563Jun 14, 2005Feb 15, 2011Abbott Vascular Inc.Surgical staple
US7901428Mar 8, 2011Integrated Vascular Systems, Inc.Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US7905900Mar 15, 2011Integrated Vascular Systems, Inc.Clip applier and methods of use
US7918873Sep 18, 2006Apr 5, 2011Abbott Vascular Inc.Surgical staple
US7931669Apr 26, 2011Integrated Vascular Systems, Inc.Integrated vascular device with puncture site closure component and sealant and methods of use
US8007512Aug 30, 2011Integrated Vascular Systems, Inc.Plunger apparatus and methods for delivering a closure device
US8128644Sep 19, 2003Mar 6, 2012Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US8182497May 22, 2012Integrated Vascular Systems, Inc.Closure device
US8192459Jun 5, 2012Abbott Vascular Inc.Blood vessel closure clip and delivery device
US8202283Jun 19, 2012Integrated Vascular Systems, Inc.Methods for manufacturing a clip and clip
US8202293Jun 20, 2008Jun 19, 2012Integrated Vascular Systems, Inc.Clip applier and methods of use
US8202294Dec 20, 2010Jun 19, 2012Integrated Vascular Systems, Inc.Clip applier and methods of use
US8226681Jul 24, 2012Abbott LaboratoriesMethods, devices, and apparatus for managing access through tissue
US8236026Aug 7, 2012Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US8257390Sep 4, 2012Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US8303624Mar 15, 2010Nov 6, 2012Abbott Cardiovascular Systems, Inc.Bioabsorbable plug
US8313497Nov 20, 2012Abbott LaboratoriesClip applier and methods of use
US8323312Jun 9, 2009Dec 4, 2012Abbott LaboratoriesClosure device
US8398656Mar 2, 2011Mar 19, 2013Integrated Vascular Systems, Inc.Clip applier and methods of use
US8398676Mar 19, 2013Abbott Vascular Inc.Closure device
US8469995Jun 4, 2012Jun 25, 2013Abbott Vascular Inc.Blood vessel closure clip and delivery device
US8486092Mar 11, 2009Jul 16, 2013Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US8486108Feb 1, 2006Jul 16, 2013Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US8518057Sep 13, 2012Aug 27, 2013Abbott LaboratoriesClip applier and methods of use
US8529587Jun 6, 2012Sep 10, 2013Integrated Vascular Systems, Inc.Methods of use of a clip applier
US8556930Jun 28, 2006Oct 15, 2013Abbott LaboratoriesVessel closure device
US8579932Feb 24, 2004Nov 12, 2013Integrated Vascular Systems, Inc.Sheath apparatus and methods for delivering a closure device
US8585836Jun 18, 2012Nov 19, 2013Integrated Vascular Systems, Inc.Methods for manufacturing a clip and clip
US8590760May 24, 2005Nov 26, 2013Abbott Vascular Inc.Surgical stapler
US8597325Nov 29, 2010Dec 3, 2013Integrated Vascular Systems, Inc.Apparatus and methods for providing tactile feedback while delivering a closure device
US8603116Aug 4, 2010Dec 10, 2013Abbott Cardiovascular Systems, Inc.Closure device with long tines
US8603136May 3, 2007Dec 10, 2013Integrated Vascular Systems, Inc.Apparatus and methods for providing tactile feedback while delivering a closure device
US8657852Mar 8, 2013Feb 25, 2014Abbott Vascular Inc.Closure device
US8672953Jun 6, 2011Mar 18, 2014Abbott LaboratoriesTissue closure system and methods of use
US8690910Mar 31, 2006Apr 8, 2014Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US8728119Feb 18, 2011May 20, 2014Abbott Vascular Inc.Surgical staple
US8758396Apr 27, 2006Jun 24, 2014Integrated Vascular Systems, Inc.Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US8758398Sep 7, 2007Jun 24, 2014Integrated Vascular Systems, Inc.Apparatus and method for delivering a closure element
US8758399Aug 2, 2010Jun 24, 2014Abbott Cardiovascular Systems, Inc.Expandable bioabsorbable plug apparatus and method
US8758400Nov 8, 2010Jun 24, 2014Integrated Vascular Systems, Inc.Closure system and methods of use
US8784447Apr 25, 2005Jul 22, 2014Abbott Vascular Inc.Surgical stapler
US8808310Feb 14, 2007Aug 19, 2014Integrated Vascular Systems, Inc.Resettable clip applier and reset tools
US8820602Nov 19, 2010Sep 2, 2014Abbott LaboratoriesModular clip applier
US8821534Dec 6, 2010Sep 2, 2014Integrated Vascular Systems, Inc.Clip applier having improved hemostasis and methods of use
US8858594Dec 18, 2009Oct 14, 2014Abbott LaboratoriesCurved closure device
US8893947Dec 17, 2007Nov 25, 2014Abbott LaboratoriesClip applier and methods of use
US8905937Feb 26, 2009Dec 9, 2014Integrated Vascular Systems, Inc.Methods and apparatus for locating a surface of a body lumen
US8915933Nov 2, 2012Dec 23, 2014Medtronic Vascular, Inc.Suturing device having a retractable distal tip and method for sealing an opening in a blood vessel or other biological structure
US8920442Aug 23, 2006Dec 30, 2014Abbott Vascular Inc.Vascular opening edge eversion methods and apparatuses
US8926633Jun 19, 2006Jan 6, 2015Abbott LaboratoriesApparatus and method for delivering a closure element
US8926656Jan 10, 2011Jan 6, 2015Integated Vascular Systems, Inc.Clip applier and methods of use
US8932324Sep 14, 2009Jan 13, 2015Abbott Vascular Inc.Redundant tissue closure methods and apparatuses
US8956388Apr 21, 2008Feb 17, 2015Integrated Vascular Systems, Inc.Integrated vascular device with puncture site closure component and sealant
US9050068May 20, 2013Jun 9, 2015Abbott LaboratoriesClip applier and methods of use
US9050087May 14, 2008Jun 9, 2015Integrated Vascular Systems, Inc.Integrated vascular device with puncture site closure component and sealant and methods of use
US9060769May 1, 2008Jun 23, 2015Abbott Vascular Inc.Surgical stapler
US9089311Jan 8, 2010Jul 28, 2015Abbott Vascular Inc.Vessel closure devices and methods
US9089674Sep 15, 2006Jul 28, 2015Integrated Vascular Systems, Inc.Apparatus and methods for positioning a vascular sheath
US9125656May 22, 2012Sep 8, 2015Insightra Medical, Inc.Devices and methods for securing tissue
US9149276 *Mar 21, 2011Oct 6, 2015Abbott Cardiovascular Systems, Inc.Clip and deployment apparatus for tissue closure
US9173644Jan 8, 2010Nov 3, 2015Abbott Vascular Inc.Closure devices, systems, and methods
US9241696Oct 29, 2009Jan 26, 2016Abbott Vascular Inc.Closure device
US9265502May 21, 2013Feb 23, 2016Insightra Medical, Inc.Delivery assembly for resilient tissue clamp
US9271707Mar 8, 2013Mar 1, 2016Integrated Vascular Systems, Inc.Clip applier and methods of use
US9282965May 16, 2008Mar 15, 2016Abbott LaboratoriesApparatus and methods for engaging tissue
US9295469Jun 3, 2013Mar 29, 2016Abbott Vascular Inc.Blood vessel closure clip and delivery device
US9314230Aug 22, 2014Apr 19, 2016Abbott Vascular Inc.Closure device with rapidly eroding anchor
US9320522Aug 31, 2011Apr 26, 2016Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US9332976Nov 30, 2011May 10, 2016Abbott Cardiovascular Systems, Inc.Tissue closure device
US9364209Dec 21, 2012Jun 14, 2016Abbott Cardiovascular Systems, Inc.Articulating suturing device
US9398914Sep 3, 2013Jul 26, 2016Integrated Vascular Systems, Inc.Methods of use of a clip applier
US9402625May 2, 2008Aug 2, 2016Abbott Vascular Inc.Surgical stapler
US20120245603 *Sep 27, 2012Abbott Cardiovascular SystemsClip for tissue closure
US20140039549 *Apr 23, 2012Feb 6, 2014Novogate Medical LtdTissue closure device and method of deliver and uses thereof
CN103932748A *May 13, 2014Jul 23, 2014吴伟Medical suture clip
EP2713906A1 *May 29, 2012Apr 9, 2014Insightra Medical, Inc.Devices and methods for securing tissue
EP2713906A4 *May 29, 2012Dec 10, 2014Insightra Medical IncDevices and methods for securing tissue
WO2014210019A1 *Jun 24, 2014Dec 31, 2014Boston Scientific Scimed, Inc.Hemostasis device with one way trap
Classifications
U.S. Classification606/142, 606/213
International ClassificationA61B17/10, A61B17/08
Cooperative ClassificationA61B2017/00867, A61B17/0057, A61B17/068, A61B17/083, A61B17/0644, A61B2017/00004
European ClassificationA61B17/08C, A61B17/00P, A61B17/064D, A61B17/068
Legal Events
DateCodeEventDescription
Jul 16, 2008ASAssignment
Owner name: ABBOTT LABORATORIES, ILLINOIS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:REYES, STEVEN;BARON, SCOTT;REEL/FRAME:021244/0028;SIGNING DATES FROM 20071017 TO 20071102