CN101431949B - 生物组织的闭合装置 - Google Patents
生物组织的闭合装置 Download PDFInfo
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- A—HUMAN NECESSITIES
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- 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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Abstract
本发明公开了用于闭合生物组织的装置和方法。公开了动脉切口的闭合和止血的装置和方法。公开了一种可在组织中的开口上提供横向张力并施加能量以封闭该组织的装置。本发明还公开了使用该装置的方法。
Description
技术领域
本发明涉及闭合生物组织中的开口的领域及其操作方法。
背景技术
目前,许多诊断和介入脉管操作是横穿管腔(translumenally)进行的,其中,导管在便于进入的位置-例如股动脉、肱动脉或锁骨下动脉处-引入脉管系统并被引导通过脉管系统到达目标位置以执行治疗或诊断。当不再需要脉管进入时,必须从脉管入口取出导管和其它脉管进入装置,并且必须在穿孔位置处止血。
用于止血的一种常用方法是通常通过手动按压而在穿孔位置附近和上游施加外力。这种方法费时,在止血前常常需要一个半小时或更长时间的按压。对于病人而言,这种过程不舒服并且经常需要使用止痛剂。过度的压力也会产生血管完全闭塞的危险,导致局部缺血和/或血栓形成。
在手压止血后,病人需要躺着休息6到8个小时进行观察,以确保持续止血。在此期间,从脉管进入伤口处的出血可重新开始,可能导致严重的并发症。这些并发症可能需要输血和/或外科手术的介入。
生物可吸收的紧固件也已经用于止血。通常,这些方法依赖于凝血酶原和生物可吸收的材料例如胶原质在穿孔位置的表面动脉壁处的布置。该方法通常难以确定叠置组织的界面和血管外膜表面的位置。植入的紧固件距离预期位置太远会导致止血失效。但是,如果紧固件塞入脉管内腔,则可能在紧固件上形成血栓。血栓会使下游发生栓塞和/或阻塞血栓位置处的正常的血液流动。植入的紧固件也可能引起感染以及植入物的自免疫反应/排斥。
缝合方法也被用于在脉管进入后进行止血。缝合实施装置通过组织管道被导入,该装置的远端部位于脉管穿孔处。装置中的针牵动缝线穿过穿孔的相对侧上的血管壁,并且缝线直接固定在血管壁的外膜表面上以闭合脉管进入伤口。
为获得成功,需要在精确控制下执行缝合方法。针需要被正确地引导穿过脉管壁,以便将缝线很好地固定在组织中以实现紧密闭合。缝合方法也需要外科医生的额外操作。
在Weng等人的美国专利No.6,56,136中,使用高强度聚焦超声(HIFU)进行止血封闭(seal)。在使用声能进行止血封闭的商业装置中,声能转换器(acoustic transducer)被保持在动脉切口附近,声能被传输至目标位置以热封闭所述开口。在施用声能之前,将所有的其它外科工具从动脉开口处移走。由于动脉切口处的声能转换器缺少明确的瞄准目标,所以转换器的声能也许不能成功地封闭目标动脉切口,和/或会无意地影响周围组织。此外,动脉切口近似为柱状,这增加了在能量施用过程中动脉切口的壁分离过大以至无法密封在一起的可能性。
由于上述方法和装置的不足,需要一种更可靠的脉管闭合方法和装置。还需要一种不会植入外来物并且自密封的脉管闭合装置和方法。还需要一种不需要或者几乎不需要额外步骤来闭合脉管位置的脉管闭合装置和方法。此外,需要一种使用能量来实现止血封闭的脉管闭合装置,其中所述能量精确瞄准(aim)到脉管位置。另外,需要一种使用能量来实现脉管开口的止血封闭的脉管闭合装置,其中脉管开口的壁在施用能量之前就被设置在一起。
发明内容
公开了一种用于闭合生物组织中的开口的装置。该装置具有张紧器和封闭器(seal applier)。张紧器构造成张紧所述开口。张紧器可具有第一细长构件和第二细长构件。第一细长构件可构造成从第二细长构件偏离开。第二细长构件构造成从第一细长构件偏离开。
封闭器可以具有射频转换器、声能(例如,超声波)转换器、电阻加热器、微波加热器、感应加热器、孔(例如,显微孔隙)、网状物(web),或者它们的组合。网状物可具有第一纤维和第二纤维。第一纤维可以与第二纤维交叉。网状物可由生物可吸收的材料制成。网状物能够可拆卸地附装在所述装置上。
此外,公开了一种脉管闭合装置。该脉管闭合装置使用能量来实现止血封闭。该装置构造成向动脉切口传送能量。该装置构造成使能量精确地瞄准动脉切口。
还公开了一种用于闭合生物组织中的开口的装置。所述开口具有内壁。所述装置具有壁操纵器以及封闭器。壁操纵器构造成使所述壁的第一部分靠近所述壁的第二部分。
公开了一种用于闭合生物组织中的开口的方法。所述开口具有内壁。所述方法包括张紧所述开口并向所述开口施用封闭物(sealer)。张紧所述开口可包括使所述壁的第一部分靠近所述壁的第二部分。所述壁的第一部分可距离所述壁的第二部分不到约0.51mm。所述壁的第一部分可距离所述壁的第二部分不到约0.38mm。所述壁的第一部分可距离所述壁的第二部分超过约0.25mm。封闭物可包括能量,例如声能(例如,超声波)、射频能量、传导热能、液体粘合剂,或它们的组合。
所述方法还可包括使封闭物瞄准所述开口。瞄准可包括将瞄准装置展开(deploy)在所述开口内。瞄准装置可位于皮肤表面上或靠近皮肤表面。所述方法还可包括将网状物布置在所述开口内。所述方法还可包括将网状物留在所述开口内至少到所述网状物完全被生物吸收为止。
还公开了一种用于闭合生物组织中的开口的方法。所述开口具有内壁。所述方法包括使所述壁的第一部分靠近所述壁的第二部分并向所述开口施用封闭物。
附图说明
图1示出闭合装置的远端部的一实施例。
图2示出以第二扩张器金属丝(expander wire)为中心的图1的近视图。
图3-6示出闭合装置的远端部的各种实施例。
图7示出处于缩进构型的闭合装置的远端部的实施例。
图8和9是处于缩进构型的闭合装置的实施例的透视视图。
图10是处于缩进构型的闭合装置的实施例的透视视图。
图11至13示出将闭合装置的一实施例从缩进构型改变成伸展构型的方法。
图14示出图11的闭合装置的远端部的近视图。
图15示出图13的闭合装置的远端部的近视图。
图16和17示出用于将扩张器金属丝布置到显示为内腔壁的透视部分的动脉切口中的方法。
图18示出图17的用于将扩张器金属丝布置到显示为内腔壁的透视部分的动脉切口中的方法的远视图。
图19至22示出在显示为内腔壁的透视部分的动脉切口中使用闭合装置的方法的各种实施例的近视图。
图23示出使用具有外部转换器的闭合装置的方法的一实施例的剖视图。
图24示出图23的实施例的截切透视图。
具体实施方式
图1示出处于伸展(即张开)构型的用于闭合生物组织例如在动脉切口上实现止血的闭合装置2。图2示出图1的闭合装置的远端部的近视图。
闭合装置2可具有传送导件(delivery guide)4。传送导件4可以是一种管状构件,例如闭合装置2的外径向侧上的导管或护套。传送导件4可以是中空的。在一种构型中,传送导件4可位于闭合装置2的近端。在另一种构型中,传送导件4可占据闭合装置2的整个长度。传送导件4可具有低摩擦的内表面。传送导件4可构造成接纳内部构件6。传送导件4可 以具有位于该传送导件4的远端部的远端孔口8。
传送导件4可具有位于近端的手柄(未示出)。所述手柄有助于传送导件4和内部构件6的操纵以及闭合装置2的操作。
闭合装置2可具有内部构件6。内部构件6可构造成可滑动地或固定地附装在传送导件4的内侧。内部构件6可具有构件纵向轴线10。传送导件4的远端孔口8相对于构件纵向轴线10可成非直角的角度。
内部件6可具有第一金属丝口(未示出)和第二金属丝口12b。金属丝口12a和12b可以是沿着构件纵向轴线10的整个长度(例如,从远端部到位于近端部的手柄)的通道。金属丝口12a和12b可以在内部构件6的远端部或靠近该远端部处具有开口。
内部构件6可以具有封闭物通道(未示出)。封闭物通道可具有能量导管和/或流体导管。封闭物通道可构造成将能量(例如,用于组织粘合,和/或增强细胞生长,和/或蛋白质例如外膜蛋白质和/或胶原质的变性和重新凝固)和/或液体封闭剂(例如,止血剂和/或组织粘合剂和/或空间填充剂,例如聚乙二醇(PEG))传送到位于内部构件6的远端的封闭物口14,和/或传送到一个或多个细长构件,例如第一和/或第二扩张器金属丝16a和/或16b。
附加封闭物传送装置18可附装至封闭物口14。动脉切口在其自身附近的组织的自然愈合会引起自然封闭。附加封闭可以是自然封闭以外的任何封闭作用,包括促进、最大化和/或增强自然封闭效率的方法。附加封闭物传送装置18或其它传送装置可构造成传送封闭物,例如能量,比如声学或射频(RF)能量、微波能量,和/或生物相容的粘合剂液体。附加封闭物传送装置18可以是声能转换器,例如高强度聚焦超声(HIFU)转换器或图像引导HIFU(image guided HIFU)。附加封闭物传送装置18可以形成回路,该回路从封闭物口14延伸出来并回到该封闭物口。附加封闭物传送装置18可以是用于输送液体封闭物的喷管(未示出)。附加封闭物传送装置18可以是各种单独的附加封闭物传送装置18(例如声能转换器和喷管)的组合。
第一扩张器金属丝16a和第二扩张器金属丝16b能够可滑动地和/或可转动地和/或固定地分别附装到第一金属丝口12a和第二金属丝口12b。扩张器金属丝16a和16b可分别从金属丝口12a和12b向远端伸出。第一和第二扩张器金属丝16a和16b可以分别具有第一和第二扩张器金属丝延伸部20a和20b,以及第一和第二扩张器金属丝端部22a和22b。
如图2中关于第二扩张器金属丝16b所例示的,扩张器金属丝延伸部20a和20b可沿径向延伸远离构件纵向轴线10。第一和第二扩张器金属丝端部22a和22b可分别成角度地从第一和第二扩张器金属丝延伸部20a和20b延伸出。第一和第二扩张器金属丝端部22a和22b可具有端部纵向轴线24a和24b。第一和第二端部纵向轴线24a和24b可基本上与构件纵向轴线10平行。第一和第二扩张器金属丝端部22a和22b的远端部可分别具有第一足部(未示出)和第二足部26b。足部26a和26b可比扩张器金属丝端部22a和22b的主要部分更进一步地沿径向从构件纵向轴线10伸出。
扩张器金属丝16a和16b可具有金属丝直径28。金属丝直径28可以横向(即,大致垂直)于端部纵向轴线24a和24b。金属丝直径28可以为大约0.1mm(0.005in.)到大约1.2mm(0.050in.),例如大约0.38mm(0.015in.)。
从构件纵向轴线10附近到扩张器金属丝端部22a或22b的径向外侧附近的距离可为封闭半径30。封闭半径30可以为大约0.51mm(0.020in.)到大约5.08mm(0.200in.)mm,例如大约2.0mm(0.080in.)。
扩张器金属丝端部22a和22b可具有端部长度32。端部长度可为大约0.51mm(0.020in.)到大约25mm(1.0in.),例如大约4.06mm(0.160in.)。
扩张器金属丝延伸部20a和20b可具有延伸部长度34。延伸部长度可为大约2.54mm(0.100in.)到大约25mm(1.0in.),例如大约9.65mm(0.380in.)。
图3示出可具有附加封闭物传送装置18的闭合装置2,所述附加封闭物传送装置18可从封闭物口14伸出。附加封闭物传送装置18可沿着构件 纵向轴线10延伸,其延伸距离与第一和/或第二扩张器金属丝16a和/或16b的远端部在平行于构件纵向轴线10的方向上延伸的距离大致相等。
附加封闭物传送装置18可构造成传输射频能量。例如,附加封闭物传送装置18可以与导线(例如,来自内部构件的内部)电气连通。第一和/或第二扩张器金属丝16a和/或16b可构造成传输射频能量。例如,第一和/或第二扩张器金属丝16a和/或16b可以与导线(例如,来自内部构件6的内部)电气连通。
附加封闭物传送装置18可构造成传输微波能量。例如,附加封闭物传送装置18可以与导波件(例如,来自内部构件的内部)电气连通。第一和/或第二扩张器金属丝16a和/或16b可构造成传输微波能量。例如,第一和/或第二扩张器金属丝16a和/或16b可以与导波件(例如,来自内部构件6的内部)电气连通。
图4示出不具有附加封闭物传送装置18的闭合装置2。第一和/或第二扩张器金属丝16a和/或16b可构造成传输一种或多种封闭物,例如能量。第一和/或第二扩张器金属丝16a和/或16b可附装在例如位于内部构件6的内部的声能致动器上。第一和/或第二扩张器金属丝16a和/或16b可以与单根导线或用于每根扩张器金属丝16a和16b的导线电气连通。
图5示出不具有附加封闭物传送装置18的闭合装置2。第一和/或第二扩张器金属丝16a和/或16b可构造成传输物理封闭物,例如液体粘合封闭剂。第一和/或第二扩张器金属丝16a和/或16b可以是中空的。第一和/或第二扩张器金属丝16a和/或16b可在其表面上具有输出孔36(例如,显微孔和/或肉眼可见的开口),以便例如传送液体粘合封闭剂,或任意抗生素、麻醉剂、脉管限制器(vaso-restrictor)、PEG,或者前面所列的任意其它制剂或者它们的组合。输出孔36可以位于第一和/或第二扩张器金属丝端部22a和/或22b上。输出孔36可以位于第一和/或第二扩张器金属丝16a和/或16b的面向构件纵向轴线10的侧面上。输出孔36可以沿例如与构件纵向轴线10平行的线排列。第一和/或第二扩张器金属丝16a和/或16b可以在近端以流体连通的方式附装到储液器,和/或泵,和/或保持和/或输出 封闭物例如液体粘合封闭剂的阀上。
图6示出可具有网状物38的闭合装置2,所述网状物38可以附装在第一和第二扩张器金属丝16a和16b上。网状物38可以固定地或可拆卸地附装在第一和第二扩张器金属丝端部22a和22b上。网状物38可以是两束或多束某种材料的交叉的纤维或线丝。网状物38可以是网(mesh)。网状物38可以是多孔表面。网状物38可以由金属和/或导电聚合物制成。网状物38可以由可再吸收的聚合物制成。网状物38可构造成传输射频能量,或者可以被感应加热。例如,网状物38可以与导线(例如,经由第一和/或者第二扩张器金属丝端部22a和/或22b,来自内部构件6的内部、和/或沿着传送导件4的外部、和/或来自不是闭合装置2的一部分的另一工具)电气连通,和/或具有在其中感应出的电流(例如,来自外部感应线圈)。如图5所示,网状物38可以与输出孔36流体连通。网状物38的纤维或线丝可以是中空的和/或具有孔或孔隙(未示出)。网状物38可构造成传输物理封闭物,例如液体粘合封闭剂。
图7示出可具有缩进(即,压缩)构型的闭合装置。内部构件6(未示出)可以缩进到传送导件4内。第一扩张器金属丝16a和/或第二扩张器金属丝16b可以缩进到传送导件4内。第一扩张器金属丝16a和/或第二扩张器金属丝16b的远端部可位于远端孔口的近端。
图8和图9示出处于缩进构型的可用于检查远端孔口8处的流体压力的闭合装置2。闭合装置2可在传送导件4和/或内部构件6(未示出)中具有压力检查口40。当扩张器金属丝端部22a和22b处于缩进构型时,压力检查口40可位于扩张器金属丝端部22a和22b的远端。当闭合装置2处于缩进位置时,压力检查口40可以与远端孔口8流体连通。压力检查口40可以与传送导件4的外壁流体连通。压力检查口40可以与压力检查腔42流体连通。压力检查腔42可以与位于传送导件4的手柄(未示出)之上或附近的传感器或孔口流体连通,例如,可以观测到血流的外腔,所述血流例如来自外管的端部或孔口和/或通过透明或半透明的窗口进行观测。
图10示出处于缩进构型的闭合装置2,该闭合装置2可具有与扩张器 金属丝端部22a和22b的远端部对齐的压力检查口40,例如,正好与远端对齐线43对齐。
在使用闭合装置2时,传送导件4的远端部可以穿插过血管壁,直到血液的“瞬流(flash)”进入压力检查口40,向上流过压力检查腔42,然后被位于手柄之上或附近的传感器或孔口观测到。一旦观测到血液“瞬流”,则可使传送导件4沿近端方向缓慢移动,直到“瞬流”停止。“瞬流”的停止可作为传送导件的远端位置的指示(即,压力检查口40可以被内腔壁54阻塞)。
闭合装置2和/或此处所述的其它装置或设备的任意元件或所有元件可以由以下材料制成,例如:一种或多种不锈钢合金,镍钛合金(例如镍钛诺),钴铬合金(例如,Elgin Specialty Metals,Elgin,IL的ELGILOY ;Carpenter Metals Corp.,Wyomissing,PA的CONICHROME ),钼合金(例如钼TZM合金,例如如2003年10月9日公开的国际公开No.WO03/082363 A2中所公开的,其整体结合于此作为参考),钨铼合金(例如如国际公开No.WO 03/082363中所公开的),聚合物例如聚酯(例如,E.I.Du Pont de Nemours and Company,Wilmington,DE的DACRON )、聚丙烯、聚四氟乙烯(PTFE)、膨胀PTFE(ePTFE)、聚醚醚酮(PEEK)、尼龙、聚醚嵌段共聚酰胺聚合物(例如,ATOFINA,Paris,France的PEBAX )、脂肪族聚醚型荆氨酯(例如的ThermedicsPolymer Products,Wilmington,MA的TECOFLEX )、聚氯乙烯(PVC)、聚亚安酯、热塑性塑料、氟化乙烯丙烯(FEP)、可吸收或可再吸收聚合物例如聚乙醇酸(PGA)、聚乳酸(PLA)、聚二恶烷酮以及伪聚氨酪氨酸基酸,挤压胶原质,硅树脂,锌,回声的(echogenic)、放射性的、不透射线的材料或它们的组合。不透射线的材料的示例为硫酸钡、氧化锌、钛、不锈钢、镍钛合金、钽和金。
闭合装置2和/或此处所述的其它装置或设备的任意元件或所有元件可以是或者具有用于细胞向内生长的基质,或者与织物例如用作细胞向内生长的基质的遮盖物(未示出)一起使用。所述基质和/或织物可以是例如聚 酯(例如,E.I.Du Pont de Nemours and Company,Wilmington,DE的DACRON )、聚丙烯、PTFE、ePTFE、尼龙、挤压胶原质、硅树脂或它们的组合。
闭合装置2和/或此处所述的其它装置或设备和/或织物可以用本领域技术人员已知的制剂传送基质和/或治疗剂和/或诊断剂来充填和/或者覆盖。这些基质中的制剂可包括放射性材料;不透射线的材料;细胞形成剂;细胞毒素剂;细胞生长抑制剂;血栓形成剂,例如聚亚安酯、与三氧化二铋混合的醋酸纤维素和乙烯-乙烯醇共聚物;滑的亲水材料;磷酸胆碱(phosphor cholene);消炎剂,例如非类固醇消炎剂(NSAIDs)如环加氧酶-1(COX-1)抑制剂(例如乙酰水杨酸,例如Bayer AG,Leverkusen,Germany的ASPIRIN ;布洛芬,例如Wyeth,Collegeville,PA的ADVIL ;消炎痛;扑湿痛)、COX-2抑制剂(例如,Merck & Co.,Inc.,WhitehouseStation,NJ的VIOXX ;Pharmacia Corp.,Peapack,NJ的CELEBREX ;COX-1抑制剂);免疫抑制剂,例如Sirolimus(Wyeth,Collegeville,PA的RAPAMUNE ),或在炎症反应过程中较早地起作用的基质金属蛋白(MMP)抑制剂(例如,四环素和四环素衍生物)。其它制剂的示例可见:Walton等,Inhibition of Prostoglandin E2 Synthesis in Abdominal AorticAneurysms,Circulation,1999年7月6日,第48-54页;Tambiah等,Provocation of Experimental Aortic Inflammation Mediators andChlamydia Pneumoniae,Brit.J.Surgery 88(7),第935-940页;Franklin等,Uptake of Tetracycline by Aortic Aneurysm Wall and Its Effect onInflammation and Proteolysis,Brit.J.Surgery 86(6),第771-775页;Xu等,Sp1 Increases Expression of Cyclooxygenase-2 in Hypoxic VascularEndothelium,J.Biological Chemistry 275(32),第24583-24589页;以及Pyo等,Targeted Gene Disruption of Matrix Metalloproteinase-9(Gelatinase B)Suppresses Development of Experimental AbdominalAortic Aneurysms,J.Clinical Investigation 105(11),第1641-1649页,这些文章整体结合于此作为参考。
制造方法
闭合装置2的元件可以例如通过熔化、螺纹连接、粘接、焊接、软钎焊、摩擦或者使用干涉配合或压配合例如弯边、咬合或它们的组合方法来直接附装。元件可以是一体式的,例如由单一的工件或材料模制、冲切、激光切割、电火花加工(EDM)或者冲压而成。也可使用本领域普通技术人员已知的任意其它方法。
一体式的部件可以由预成型的弹性材料例如弹性合金(例如镍钛诺、ELGILOY )制成,如本领域普通技术人员所已知,所述弹性材料被预成型并被偏压成后期展开形状(post-deployment shape),然后被压缩成展开形状(deployment shape)。
扩张器金属丝16a和16b可由预成型的弹性材料例如弹性合金(例如镍钛诺、ELGILOY )制成,所述弹性材料被预成型并被偏压至后期展开形状,然后被压缩成展开形状。后期展开形状可以是图2和本文其它地方所示的构型。
闭合装置2的任何元件或者组装后的闭合装置2整体可以通过本领域普通技术人员已知的浸涂、刷涂或喷涂方法进行涂覆。例如,扩张器金属丝16a和16b可以被喷涂、浸涂或刷涂。
用于涂覆脉管用医疗装置的方法的一个示例在Ding等人的美国专利No.6,358,556中公开,其整体结合于此作为参考。本领域普通技术人员已知的延时释放涂覆方法也可用于延迟涂层——例如扩张器金属丝16a和16b上的涂层——中的制剂的释放。
使用方法
图11至13示出用于将闭合装置2从第一构型改变成第二构型的方法。图14和15也分别示出图11和13的闭合装置2的远端部的近视图。如图11和14所示,闭合装置2可处于完全缩进构型。内部构件6和扩张器金属丝16a和16b可隐藏在传送导件4内。
如图12所示,闭合装置2可处于部分展开构型。如箭头44所示,内部构件6可以被推动或拉动而相对于传送导件4向远端平移,和/或如箭头46所示,传送导件4可以被推动或拉动而相对于传送导件4向近端平移。
传送导件4可限制(例如,通过干涉配合)扩张器金属丝16a和16b张开远离构件纵向轴线10。如箭头47所示,扩张器金属丝16a和16b可相对于传送导件4向远端移动。扩张器金属丝16a和16b可附装在内部构件6上,使得当内部构件6被推动时该内部构件6推动扩张器金属丝16a和16b。
如图13和15所示,闭合装置2可处于完全展开构型。如箭头48所示,内部构件6可被推动或拉动而相对于传送导件4向远端平移,直到内部构件6关于附加封闭物传送装置到达一止挡装置(未示出)。该止挡装置可以是传送导件4和内部构件6之间的干涉配合。如箭头50所示,传送导件4可被推动或拉动而相对于传送导件4向近端平移,直到传送导件4到达所述止挡装置。
如箭头51所示,扩张器金属丝16a和16b可相对于扩张器金属丝16a和16b离开金属丝口12a和12b的位置向远端移动。扩张器金属丝16a和16b离开相应的金属丝口12a和12b的位置可移动超出远端孔口8和传送导件4。如箭头51所示,扩张器金属丝16a和16b可沿径向张开远离构件纵向轴线10。
图16示出闭合装置2,该闭合装置可以如箭头所示插入组织中的开口,例如内腔壁54中的动脉切口52。当闭合装置2插入动脉切口52时,闭合装置2可处于缩进构型。在插入闭合装置2后,闭合装置2的远端部可位于动脉切口52之内或之外并且处于动脉切口52的远端。内腔壁54可具有内腔壁表面56,并且可包围内腔57。
动脉切口52可具有动脉切口直径58。动脉切口直径58可为大约0.5mm(0.020in.)到大约40mm(1.5in.),然而更窄的范围为大约1.0mm(0.040in.)到大约10.2mm(0.400in.),例如大约2.54mm(0.100in.)。当处于缩进构型时,闭合装置2的直径可小于动脉切口直径58。
内腔壁54具有内腔壁厚度60。内腔壁厚度60可为大约0.51mm(0.020in.)到大约5.08mm(0.200in.),例如大约1.0mm(0.040in.)。
图17和18示出在闭合装置2被插入动脉切口52后张开闭合装置2。传送导件4可相对于内部构件6向近端移动。如箭头62所示,扩张器金属丝16a和16b可张开远离构件纵向轴线10。扩张器金属丝端部22a和22b可位于动脉切口52内。扩张器金属丝端部22a和22b可抵靠着动脉切口52例如横向地张开。例如在张开过程中,动脉切口52可响应由扩张器金属丝端部22a和22b施加的张力而改变形状。足部26a和26b可与动脉切口52和/或内腔壁表面56压配合和/或干涉配合。
动脉切口52可具有动脉切口宽度64和动脉切口高度66。动脉切口宽度64可大约为动脉切口52的周长的一半。动脉切口宽度64可为大约1.0mm(0.040in.)到大约10.2mm(0.400in.),例如大约4.06mm(0.160in.)。
动脉切口高度66可大约等于金属丝直径28。动脉切口高度66可小于大约0.51mm(0.020in.),更窄地,小于大约0.38mm(0.015in.)。动脉切口高度66可为大约0.1mm(0.005in.)到大约1.3mm(0.050in.),例如大约0.38mm(0.015in.)。动脉切口高度66可以足够小以使得在动脉开口52上能够实现细胞生长、血液凝结、声封闭、热封闭、粘结、增强的自封闭和它们的组合。
图19示出用于向张紧的动脉切口52施用能量(例如,声能)的方法。闭合装置2具有附加封闭物传送装置18。附加封闭物传送装置18可以是声能(例如,超声波)转换器。例如,由于扩张器金属丝16a和16b可在动脉切口52内部的相对侧上产生相对力,所以附加封闭物传送装置18可自动瞄准和自动对中(例如,沿着构件纵向轴线10与动脉切口52的大致中央部对准)。附加封闭物传送装置18可以向动脉切口52传输声能。
图20示出用于向张紧的动脉切口52施用能量(例如,射频或微波)的方法。附加封闭物传送装置18可以伸进动脉切口52的大致中央部。附加封闭物传送装置18可以是射频转换器。第一和/或第二扩张器金属丝16a和16b可以是射频或微波转换器(例如,微波天线)。例如,第一和/或第 二扩张器金属丝16a和/或16b可以是第一射频极,而附加封闭物传送装置18可以是第二射频极。
图21示出使用网状物38向张紧的动脉切口52中施用封闭物(例如,能量或液体)的方法。网状物38可以是射频转换器和/或电阻加热器和/或感应加热器和/或微波加热器。网状物38可以是中空的并具有孔或孔隙(未示出)。网状物38可以与中空的第一和/或第二扩张器金属丝16a和/或16b流体连通。网状物38可以将流体例如封闭物传输到动脉切口52中。
一旦网状物38将封闭物施用到张紧的动脉切口52上,则当移走闭合装置2的剩余部分时可将网状物从扩张器金属丝端部22a和22b上卸下,并且将网状物留在动脉切口52中。网状物38可被动脉切口52周围的组织吸收。
图22示出用于将液体封闭物施用到张紧的动脉切口52中的方法。如箭头所示,液体封闭物可以从输出孔36流入动脉切口52内。用于充填和封闭动脉切口52的液体封闭物(例如,生物相容的粘合剂、生物相容的环氧化物、PEG)都是本领域普通技术人员已知的。封闭物可用作粘合剂。粘合剂能用作填充剂,例如PEG。封闭物是生物可吸收的。
动脉切口52可以通过能量部分地或完全地封闭。流体流动可基本和/或完全停止(即,止血)。穿过动脉切口52的流体流动可以通过能量部分地或完全地封闭。
附加封闭物传送装置18和/或网状物38和/或扩张器金属丝端部22a和22b可以是电阻加热器元件。封闭物可以是通过传导和/或对流和/或辐射加热而传递的直接的热量。附加封闭物传送装置18可以通过传导直接加热动脉切口。
任意比例的能量的任意组合可施用在动脉切口52上。例如,可以在开始时对张紧的动脉切口52施用射频或其它热能。然后,可停止射频或其它热能并对张紧的动脉切口52施用声能。
电阻热能(即,由电阻产生的热量)和声能可以同时并以任意比例地施用在动脉切口52上。射频能量和电阻热能可以同时并以任意比例地施用 在动脉切口52上。声能和射频能量可以同时并以任意比例地施用在动脉切口52上。声能和感应能量可以同时并以任意比例地施用在动脉切口52上。电阻热能、声能、射频能量、感应能量和/或微波能量可以同时并以任意比例地施用在动脉切口52上。
图23和24示出具有皮肤68的处置区域,皮肤68与血管70被皮下组织72(例如,脂肪、肌肉、其它血管)隔开。外部转换器74可以接触或靠近皮肤68。本领域普通技术人员所知的凝胶或其它接触附件可以用来增强外部转换器74和皮肤68之间的能量传导。
在基本封闭动脉切口之后,内腔壁54中的扩张器金属丝16a和16b和/或附加封闭物传送装置18移走时穿过的孔可非常小,从而从这些孔的出血可以忽略。由于闭合装置2从动脉切口52移走,因此可以执行封闭(例如,加热),以便闭合因闭合装置2的移走而在内腔壁54中形成的孔。
外部转换器74可以是:声能转换器,例如超声波成像仪、HIFU、图像引导HIFU;放射转换器,例如X射线成像仪;磁成像仪,例如磁共振成像仪(MRI);上述成像仪的治疗版,或者它们的组合。
外部转换器74可用来向动脉切口52传送能量波76。能量波76可从动脉切口52和/或扩张器金属丝端部22a和22b反射回来、传递通过和/或产生谐振。反射和/或传递和/或谐振的能量波76可以被外部转换器74接收并用于检测动脉切口52以及扩张器金属丝端部22a和22b的状态(例如,形态、结构)和位置。外部转换器74可以追踪动脉切口52以及扩张器金属丝端部22a和22b的位置。
扩张器金属丝端部22a和22b可以具有增强外部转换器74的检测扩张器金属丝端部22a和22b的能力的材料或构造。例如,扩张器金属丝端部22a和22b可以具有回声的和/或不透射线的的材料和/或构造,例如前面所列出的不透射线的材料。第一和第二扩张器金属丝端部22a和22b可以框住(frame)动脉切口52的位置并且提供图像引导外部转换器74(例如,图像引导HIFU)的目标。能量波76可以是治疗能量,例如,用于封闭动脉切口52的能量。能量波76可以聚焦在动脉切口52上,并且可向周围的 组织传递极低的能量。例如,能量波76可以是相控阵发出的治疗用超声波,从而能量波76的节点位于动脉切口52处。
闭合装置2可以从动脉切口52移走。该闭合装置2可以直接从动脉切口撤回,例如,沿着与端部纵向轴线24a和24b平行的方向撤回。当第一和第二扩张器金属丝16a和16b处于张开构型时,闭合装置2可以从动脉切口52撤回。
在闭合装置从动脉切口52和/或皮下组织轨迹撤回之前,内部构件6可以缩进到传送导件4中,其中扩张器金属丝16a和16可完全或不完全地缩进第一和第二金属丝口12a和12b中。传送导件4可相对于内部构件6向远端移动,与图11至16所示的方法相反,并且将闭合装置2变成缩进构型。然后,闭合装置2可以从动脉切口移开,而扩张器金属丝16a和16b处于张开或缩进构型。
如果动脉切口52由使用中空构件例如导管的手术程序形成,或者在执行本文所述的方法之前动脉切口52中已有导管,那么已经展开的导管可以用作传送导件4,或者用作传送导件4的护套。
本文所示和所述的闭合装置和方法可以整体使用,和/或与在2004年5月12日提交的美国专利申请No.10/844,247中所示和所述的进入与闭合装置和方法组合使用,美国专利申请No.10/844,247整体结合于此作为参考。例如,动脉切口52可以与内腔成一定角度,其中,该角度可为大约20°到大约90°,更窄的范围是从大约30°到大约60°,例如大约45°,或者采用如美国专利申请No.10/844,247中所述的形式。同样,例如,动脉切口52可以具有如美国专利申请No.10/844,247中所述的形状。本文所述的装置和方法可以结合如美国专利申请No.10/844,247中所述的附加闭合装置例如张紧器、夹子、套索钉(toggle)、缝线以及它们的组合来使用。
本领域技术人员可清楚地认识到,在不脱离本发明的精神和范围的情况下可以对本公开内容进行各种变化和修改并且可采用等同物。与任何实施例一起示出的元件对于该特定实施例都是示例性的,并且可用于本公开内容中的其它实施例。
Claims (28)
1.一种用于闭合开口的系统,所述开口位于脉管壁的外表面和内表面之间,所述系统包括:
张紧元件,所述张紧元件构造成进入所述开口中并沿横向张紧所述开口,使得所述开口沿纵向塌缩;和
用于向所述开口施用封闭物的封闭器。
2.如权利要求1所述的系统,其特征在于,所述系统构造成使所述开口的第一部分靠近至距离所述开口的第二部分不到0.51mm的位置。
3.如权利要求1所述的系统,其特征在于,所述系统构造成使所述开口的第一部分靠近至距离所述开口的第二部分不到0.38mm的位置。
4.如权利要求1所述的系统,其特征在于,所述系统构造成使所述开口的第一部分靠近至距离所述开口的第二部分超过0.25mm的位置。
5.如权利要求1所述的系统,其特征在于,所述封闭物包括能量。
6.如权利要求5所述的系统,其特征在于,所述能量包括声能。
7.如权利要求6所述的系统,其特征在于,所述能量还包括射频能量。
8.如权利要求5所述的系统,其特征在于,所述能量包括射频能量。
9.如权利要求5所述的系统,其特征在于,所述能量包括传导热能量。
10.如权利要求5所述的系统,其特征在于,所述能量包括感应热能量。
11.如权利要求5所述的系统,其特征在于,所述能量包括微波热能量。
12.如权利要求1所述的系统,其特征在于,所述封闭物包括粘合剂。
13.如权利要求1所述的系统,其特征在于,所述封闭物包括填充剂。
14.如权利要求1所述的系统,其特征在于,所述封闭物包括液体。
15.如权利要求12所述的系统,其特征在于,所述粘合剂包括液体粘合剂。
16.如权利要求1所述的系统,其特征在于,该系统还包括用于使所述封闭物瞄准所述开口的瞄准装置。
17.如权利要求16所述的系统,其特征在于,所述瞄准装置可展开到所述开口内。
18.如权利要求1所述的系统,其特征在于,该系统还包括可展开到所述开口内的网状物。
19.如权利要求18所述的系统,其特征在于,所述网状物构造成在闭合所述开口后留在所述开口内至少一段延长时间。
20.如权利要求19所述的系统,其特征在于,所述网状物是可被生物吸收的。
21.如权利要求1所述的系统,其特征在于,所述开口是动脉切口。
22.如权利要求1所述的系统,其特征在于,该系统还包括:可插入所述开口内的中空构件,其中该中空构件构造成通过其执行第一手术程序,并且其中该中空构件构造成执行所述张紧。
23.一种用于闭合生物组织中的开口的系统,包括:
闭合装置,所述闭合装置构造成插入所述开口中,并通过在所述闭合装置设置在所述开口内时沿横向抻开所述开口来使所述开口的第一部分沿纵向靠近所述开口的第二部分,其中所述开口位于脉管壁的外表面和内表面之间;以及
用于向所述开口施用封闭物的封闭器。
24.如权利要求23所述的系统,其特征在于,所述系统构造成使所述开口的第一部分靠近至距离所述开口的第二部分不到0.51mm的位置。
25.如权利要求24所述的系统,其特征在于,所述系统构造成使所述开口的第一部分靠近至距离所述开口的第二部分不到0.38mm的位置。
26.如权利要求25所述的系统,其特征在于,所述系统构造成使所述开口的第一部分靠近至距离所述开口的第二部分超过0.25mm的位置。
27.一种用于闭合开口的系统,所述开口位于脉管壁的外表面和内表面之间,所述系统包括:
构造成插入所述开口的第一细长构件;和
构造成插入所述开口的第二细长构件;
其中所述第一和第二细长构件构造成使所述开口张开而将所述开口的形状改变为使得所述开口闭合的构型。
28.如权利要求27所述的系统,其特征在于,所述开口是动脉切口。
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Families Citing this family (56)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6626899B2 (en) | 1999-06-25 | 2003-09-30 | Nidus Medical, Llc | Apparatus and methods for treating tissue |
US7993365B2 (en) * | 2001-06-08 | 2011-08-09 | Morris Innovative, Inc. | Method and apparatus for sealing access |
US20060004408A1 (en) * | 2001-06-08 | 2006-01-05 | Morris Edward J | Method and apparatus for sealing access |
US7972330B2 (en) * | 2003-03-27 | 2011-07-05 | Terumo Kabushiki Kaisha | Methods and apparatus for closing a layered tissue defect |
US8021362B2 (en) * | 2003-03-27 | 2011-09-20 | Terumo Kabushiki Kaisha | Methods and apparatus for closing a layered tissue defect |
US7976539B2 (en) * | 2004-03-05 | 2011-07-12 | Hansen Medical, Inc. | System and method for denaturing and fixing collagenous tissue |
US20050267520A1 (en) * | 2004-05-12 | 2005-12-01 | Modesitt D B | Access and closure device and method |
US7678133B2 (en) * | 2004-07-10 | 2010-03-16 | Arstasis, Inc. | Biological tissue closure device and method |
AU2006247355B2 (en) * | 2005-05-12 | 2013-01-10 | Arstasis, Inc. | Access and closure device and method |
US7837619B2 (en) * | 2005-08-19 | 2010-11-23 | Boston Scientific Scimed, Inc. | Transeptal apparatus, system, and method |
US7998095B2 (en) * | 2005-08-19 | 2011-08-16 | Boston Scientific Scimed, Inc. | Occlusion device |
US8062309B2 (en) * | 2005-08-19 | 2011-11-22 | Boston Scientific Scimed, Inc. | Defect occlusion apparatus, system, and method |
WO2008152617A2 (en) | 2007-06-15 | 2008-12-18 | Zerusa Limited | A closure device |
WO2009032695A1 (en) * | 2007-08-29 | 2009-03-12 | Trinity Orthopedics, Llc | Annulus fibrosus repair device and methods |
US20090105744A1 (en) * | 2007-10-17 | 2009-04-23 | Modesitt D Bruce | Methods for forming tracts in tissue |
JP5320403B2 (ja) * | 2007-11-05 | 2013-10-23 | エルベ・エレクトロメディティン・ゲゼルシャフト・ミット・ベシュレンクテル・ハフツング | 血管をシールするための手術器具 |
US8317808B2 (en) | 2008-02-18 | 2012-11-27 | Covidien Lp | Device and method for rolling and inserting a prosthetic patch into a body cavity |
US9044235B2 (en) | 2008-02-18 | 2015-06-02 | Covidien Lp | Magnetic clip for implant deployment device |
US9393002B2 (en) | 2008-02-18 | 2016-07-19 | Covidien Lp | Clip for implant deployment device |
US9034002B2 (en) | 2008-02-18 | 2015-05-19 | Covidien Lp | Lock bar spring and clip for implant deployment device |
US9301826B2 (en) | 2008-02-18 | 2016-04-05 | Covidien Lp | Lock bar spring and clip for implant deployment device |
WO2009104182A2 (en) * | 2008-02-18 | 2009-08-27 | Polytouch Medical Ltd | A device and method for deploying and attaching a patch to a biological tissue |
US9398944B2 (en) | 2008-02-18 | 2016-07-26 | Covidien Lp | Lock bar spring and clip for implant deployment device |
US8758373B2 (en) * | 2008-02-18 | 2014-06-24 | Covidien Lp | Means and method for reversibly connecting a patch to a patch deployment device |
US8808314B2 (en) * | 2008-02-18 | 2014-08-19 | Covidien Lp | Device and method for deploying and attaching an implant to a biological tissue |
US9393093B2 (en) | 2008-02-18 | 2016-07-19 | Covidien Lp | Clip for implant deployment device |
US9833240B2 (en) | 2008-02-18 | 2017-12-05 | Covidien Lp | Lock bar spring and clip for implant deployment device |
US8118832B1 (en) | 2008-06-16 | 2012-02-21 | Morris Innovative, Inc. | Method and apparatus for sealing access |
WO2010011695A1 (en) * | 2008-07-21 | 2010-01-28 | Arstasis, Inc. | Devices, methods, and kits for forming tracts in tissue |
WO2010011696A1 (en) | 2008-07-21 | 2010-01-28 | Arstasis, Inc. | Devices and methods for forming tracts in tissue |
CA2730547C (en) * | 2008-10-20 | 2013-08-06 | Polytouch Medical Ltd. | A device for attaching a patch to a biological tissue |
JP2010125157A (ja) * | 2008-11-28 | 2010-06-10 | Olympus Corp | 超音波切開装置 |
CN102802541A (zh) * | 2009-05-15 | 2012-11-28 | 阿尔斯塔西斯公司 | 在组织中形成管道的装置、方法和成套用具 |
DE102009032972A1 (de) * | 2009-07-14 | 2011-01-20 | Erbe Elektromedizin Gmbh | Vorrichtung zur Herstellung von Anastomosen |
CN102596078B (zh) | 2009-08-11 | 2015-07-01 | 奥林巴斯医疗株式会社 | 治疗用处理器具、治疗用处理装置及治疗处理方法 |
CA2769666C (en) * | 2009-08-17 | 2018-02-13 | Arie Levy | Means and method for reversibly connecting an implant to a deployment device |
WO2011021083A1 (en) * | 2009-08-17 | 2011-02-24 | PolyTouch Medical, Inc. | Articulating patch deployment device and method of use |
JP2013505114A (ja) * | 2009-09-22 | 2013-02-14 | アルスタシス,インコーポレイテッド | 組織内に管を形成する装置、方法、及びキット |
CN102665584A (zh) * | 2009-11-27 | 2012-09-12 | 奥林巴斯医疗株式会社 | 治疗用处理器具、治疗用处理装置及治疗处理方法 |
EP2519161B1 (en) | 2009-12-30 | 2020-04-29 | Vivasure Medical Limited | Closure system |
CA2786536A1 (en) | 2010-01-11 | 2011-07-14 | Arstasis, Inc. | Device for forming tracts in tissue |
US20110208179A1 (en) * | 2010-02-25 | 2011-08-25 | Tyco Healthcare Group Lp | Patient Isolation in a Microwave-Radio Frequency Generator |
EP2819586A2 (en) | 2012-02-29 | 2015-01-07 | Vivasure Medical Limited | Percutaneous perforation closure systems, devices, and methods |
US20130317438A1 (en) | 2012-05-25 | 2013-11-28 | Arstasis, Inc. | Vascular access configuration |
US20130317481A1 (en) | 2012-05-25 | 2013-11-28 | Arstasis, Inc. | Vascular access configuration |
US9850013B2 (en) | 2013-03-15 | 2017-12-26 | Vivasure Medical Limited | Loading devices and methods for percutaneous perforation closure systems |
WO2016096932A1 (en) | 2014-12-15 | 2016-06-23 | Vivasure Medical Limited | Closure apparatus with flexible sealable member and flexible support member |
WO2016096930A1 (en) | 2014-12-15 | 2016-06-23 | Vivasure Medical Limited | Implantable sealable member with mesh layer |
EP3389505A1 (en) | 2015-12-15 | 2018-10-24 | Vivasure Medical Limited | Arteriotomy closure apparatus with slotted shoe for advantageous pressure distribution |
TWI613990B (zh) * | 2016-12-08 | 2018-02-11 | 南臺科技大學 | 止血方法 |
TWI618525B (zh) * | 2016-12-13 | 2018-03-21 | 奇美醫療財團法人奇美醫院 | 股動脈加壓止血器 |
CN108720885B (zh) * | 2017-04-20 | 2021-02-05 | 南台科技大学 | 止血装置 |
DE102018104549A1 (de) * | 2018-02-28 | 2019-08-29 | Venock Medical Gmbh | Vorrichtung und Verfahren zum Verschließen einer Gewebsöffnung |
US10820981B2 (en) * | 2018-05-07 | 2020-11-03 | Arthrex, Inc. | Surgical tools and joint kinematic reconstruction techniques |
EP3900675A1 (en) * | 2020-04-23 | 2021-10-27 | Sofradim Production | Kits for surgical repair of soft tissue defects and components, packaging, and methods of use thereof |
US11771416B2 (en) | 2020-07-14 | 2023-10-03 | Arthrex, Inc. | Surgical tools and associated graft augmentation techniques |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5364389A (en) * | 1992-11-25 | 1994-11-15 | Premier Laser Systems, Inc. | Method and apparatus for sealing and/or grasping luminal tissue |
US5709224A (en) * | 1995-06-07 | 1998-01-20 | Radiotherapeutics Corporation | Method and device for permanent vessel occlusion |
US6179832B1 (en) * | 1997-09-11 | 2001-01-30 | Vnus Medical Technologies, Inc. | Expandable catheter having two sets of electrodes |
Family Cites Families (236)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3730185A (en) | 1971-10-29 | 1973-05-01 | Cook Inc | Endarterectomy apparatus |
US4006747A (en) | 1975-04-23 | 1977-02-08 | Ethicon, Inc. | Surgical method |
US4774949A (en) | 1983-06-14 | 1988-10-04 | Fogarty Thomas J | Deflector guiding catheter |
US4744364A (en) | 1987-02-17 | 1988-05-17 | Intravascular Surgical Instruments, Inc. | Device for sealing percutaneous puncture in a vessel |
US4890611A (en) | 1988-04-05 | 1990-01-02 | Thomas J. Fogarty | Endarterectomy apparatus and method |
US4921484A (en) | 1988-07-25 | 1990-05-01 | Cordis Corporation | Mesh balloon catheter device |
US5620461A (en) | 1989-05-29 | 1997-04-15 | Muijs Van De Moer; Wouter M. | Sealing device |
US4962755A (en) | 1989-07-21 | 1990-10-16 | Heart Tech Of Minnesota, Inc. | Method for performing endarterectomy |
US5571169A (en) | 1993-06-07 | 1996-11-05 | Endovascular Instruments, Inc. | Anti-stenotic method and product for occluded and partially occluded arteries |
US5662701A (en) | 1989-08-18 | 1997-09-02 | Endovascular Instruments, Inc. | Anti-stenotic method and product for occluded and partially occluded arteries |
US5391183A (en) | 1990-09-21 | 1995-02-21 | Datascope Investment Corp | Device and method sealing puncture wounds |
JPH07108368B2 (ja) * | 1990-11-02 | 1995-11-22 | 住友精化株式会社 | 混合ガス中の水分除去方法 |
US5183464A (en) | 1991-05-17 | 1993-02-02 | Interventional Thermodynamics, Inc. | Radially expandable dilator |
US5358507A (en) | 1991-07-26 | 1994-10-25 | Pat O. Daily | Thromboendarterectomy suction dissector |
US6818008B1 (en) | 1992-01-07 | 2004-11-16 | Cch Associates, Inc. | Percutaneous puncture sealing method |
AU3727993A (en) | 1992-02-21 | 1993-09-13 | Diasonics Inc. | Ultrasound intracavity system for imaging therapy planning and treatment of focal disease |
US5993389A (en) | 1995-05-22 | 1999-11-30 | Ths International, Inc. | Devices for providing acoustic hemostasis |
CA2134071C (en) * | 1992-04-23 | 1999-04-27 | Sew Wah Tay | Apparatus and method for sealing vascular punctures |
US5810810A (en) * | 1992-04-23 | 1998-09-22 | Scimed Life Systems, Inc. | Apparatus and method for sealing vascular punctures |
US6063085A (en) | 1992-04-23 | 2000-05-16 | Scimed Life Systems, Inc. | Apparatus and method for sealing vascular punctures |
US5368601A (en) | 1992-04-30 | 1994-11-29 | Lasersurge, Inc. | Trocar wound closure device |
CA2106127A1 (en) | 1992-09-23 | 1994-03-24 | Peter W.J. Hinchliffe | Instrument for closing trocar puncture wounds |
US5489288A (en) | 1992-10-09 | 1996-02-06 | Advanced Surgical, Inc. | Device and method for applying large-diameter ligating loop |
US5415657A (en) | 1992-10-13 | 1995-05-16 | Taymor-Luria; Howard | Percutaneous vascular sealing method |
US6398782B1 (en) | 1992-10-13 | 2002-06-04 | Edwards Lifesciences Corporation | Bipolar vascular sealing apparatus and methods |
US5336221A (en) * | 1992-10-14 | 1994-08-09 | Premier Laser Systems, Inc. | Method and apparatus for applying thermal energy to tissue using a clamp |
US5383897A (en) * | 1992-10-19 | 1995-01-24 | Shadyside Hospital | Method and apparatus for closing blood vessel punctures |
US5304184A (en) | 1992-10-19 | 1994-04-19 | Indiana University Foundation | Apparatus and method for positive closure of an internal tissue membrane opening |
US5467786A (en) | 1992-12-10 | 1995-11-21 | William C. Allen | Method for repairing tears and incisions in soft tissue |
US5417699A (en) | 1992-12-10 | 1995-05-23 | Perclose Incorporated | Device and method for the percutaneous suturing of a vascular puncture site |
US6036699A (en) | 1992-12-10 | 2000-03-14 | Perclose, Inc. | Device and method for suturing tissue |
DE4310555C1 (de) | 1993-03-31 | 1993-12-09 | Strobel & Soehne Gmbh & Co J | Chirurgische Nähmaschine |
JPH08509147A (ja) * | 1993-04-23 | 1996-10-01 | シメッド ライフ システムズ インコーポレイテッド | 血管穿刺を密封するための装置及び方法 |
US5503634A (en) | 1993-04-28 | 1996-04-02 | Christy; William J. | Surgical stab wound closure device and method |
US5527321A (en) | 1993-07-14 | 1996-06-18 | United States Surgical Corporation | Instrument for closing trocar puncture wounds |
US5391182A (en) | 1993-08-03 | 1995-02-21 | Origin Medsystems, Inc. | Apparatus and method for closing puncture wounds |
US5462561A (en) | 1993-08-05 | 1995-10-31 | Voda; Jan K. | Suture device |
US5474568A (en) | 1993-10-08 | 1995-12-12 | United States Surgical Corporation | Instrument for closing trocar puncture wounds |
US5470338A (en) | 1993-10-08 | 1995-11-28 | United States Surgical Corporation | Instrument for closing trocar puncture wounds |
US5437665A (en) | 1993-10-12 | 1995-08-01 | Munro; Malcolm G. | Electrosurgical loop electrode instrument for laparoscopic surgery |
US5439469A (en) | 1993-11-05 | 1995-08-08 | Advanced Surgical, Inc. | Wound closure device |
US5527322A (en) | 1993-11-08 | 1996-06-18 | Perclose, Inc. | Device and method for suturing of internal puncture sites |
US5476470A (en) | 1994-04-15 | 1995-12-19 | Fitzgibbons, Jr.; Robert J. | Trocar site suturing device |
WO1995032669A1 (en) | 1994-06-01 | 1995-12-07 | Perclose, Inc. | Apparatus and method for advancing surgical knots |
WO1995032671A1 (en) | 1994-06-01 | 1995-12-07 | Perclose, Inc. | Method and device for providing vascular hemostasis |
US6033401A (en) | 1997-03-12 | 2000-03-07 | Advanced Closure Systems, Inc. | Vascular sealing device with microwave antenna |
US6302898B1 (en) * | 1994-06-24 | 2001-10-16 | Advanced Closure Systems, Inc. | Devices for sealing punctures in body vessels |
US5582616A (en) * | 1994-08-05 | 1996-12-10 | Origin Medsystems, Inc. | Surgical helical fastener with applicator |
US5451230A (en) | 1994-10-11 | 1995-09-19 | Steinert; Roger F. | Cataract disassembly |
US5496332A (en) | 1994-10-20 | 1996-03-05 | Cordis Corporation | Wound closure apparatus and method for its use |
US5695504A (en) | 1995-02-24 | 1997-12-09 | Heartport, Inc. | Devices and methods for performing a vascular anastomosis |
US5837313A (en) | 1995-04-19 | 1998-11-17 | Schneider (Usa) Inc | Drug release stent coating process |
ATE222076T1 (de) | 1995-06-07 | 2002-08-15 | Medtronic Inc | Wundverschlussvorrichtung |
US6132438A (en) | 1995-06-07 | 2000-10-17 | Ep Technologies, Inc. | Devices for installing stasis reducing means in body tissue |
US5702438A (en) * | 1995-06-08 | 1997-12-30 | Avitall; Boaz | Expandable recording and ablation catheter system |
US5902311A (en) | 1995-06-15 | 1999-05-11 | Perclose, Inc. | Low profile intraluminal suturing device and method |
US5700273A (en) | 1995-07-14 | 1997-12-23 | C.R. Bard, Inc. | Wound closure apparatus and method |
US5846253A (en) | 1995-07-14 | 1998-12-08 | C. R. Bard, Inc. | Wound closure apparatus and method |
US6117144A (en) | 1995-08-24 | 2000-09-12 | Sutura, Inc. | Suturing device and method for sealing an opening in a blood vessel or other biological structure |
AU6858896A (en) | 1995-08-24 | 1997-03-19 | Nobles-Lai Engineering, Inc. | Method and apparatus for suturing |
US5653717A (en) | 1995-08-28 | 1997-08-05 | Urohealth Systems, Inc. | Wound closure device |
US6071300A (en) | 1995-09-15 | 2000-06-06 | Sub-Q Inc. | Apparatus and method for percutaneous sealing of blood vessel punctures |
US5645566A (en) | 1995-09-15 | 1997-07-08 | Sub Q Inc. | Apparatus and method for percutaneous sealing of blood vessel punctures |
IL124037A (en) * | 1995-10-13 | 2003-01-12 | Transvascular Inc | Device and system for interstitial transvascular intervention |
US6302875B1 (en) | 1996-10-11 | 2001-10-16 | Transvascular, Inc. | Catheters and related devices for forming passageways between blood vessels or other anatomical structures |
US6524326B1 (en) * | 1995-12-07 | 2003-02-25 | Loma Linda University Medical Center | Tissue opening locator and everter and method |
US5772673A (en) | 1996-03-07 | 1998-06-30 | United States Surgical Corporation | Apparatus for applying surgical clips |
US6152918A (en) | 1996-04-05 | 2000-11-28 | Eclipse Surgical Technologies, Inc. | Laser device with auto-piercing tip for myocardial revascularization procedures |
US6468228B1 (en) | 1996-06-18 | 2002-10-22 | Vance Products Incorporated | Surgical tissue morcellator |
US5954713A (en) | 1996-07-12 | 1999-09-21 | Newman; Fredric A. | Endarterectomy surgical instruments and procedure |
US5766183A (en) | 1996-10-21 | 1998-06-16 | Lasersurge, Inc. | Vascular hole closure |
US5758665A (en) * | 1996-11-14 | 1998-06-02 | Suval; William D. | Method for treating varicose veins |
US6036721A (en) | 1996-11-16 | 2000-03-14 | Cap Incorporated | Puncture closure |
US5782861A (en) | 1996-12-23 | 1998-07-21 | Sub Q Inc. | Percutaneous hemostasis device |
US6371975B2 (en) | 1998-11-06 | 2002-04-16 | Neomend, Inc. | Compositions, systems, and methods for creating in situ, chemically cross-linked, mechanical barriers |
US6733515B1 (en) | 1997-03-12 | 2004-05-11 | Neomend, Inc. | Universal introducer |
US6475182B1 (en) | 1997-03-12 | 2002-11-05 | Olexander Hnojewyj | Fluidic media introduction apparatus |
CA2284720C (en) | 1997-04-11 | 2006-09-12 | Transvascular, Inc. | Methods and apparatus for transmyocardial direct coronary revascularization |
US5830232A (en) | 1997-04-14 | 1998-11-03 | Hasson; Harrith M. | Device for closing an opening in tissue and method of closing a tissue opening using the device |
US5984948A (en) | 1997-04-14 | 1999-11-16 | Hasson; Harrith M. | Device for closing an opening in tissue and method of closing a tissue opening using the device |
US5941897A (en) | 1997-05-09 | 1999-08-24 | Myers; Gene E. | Energy activated fibrin plug |
US6071292A (en) | 1997-06-28 | 2000-06-06 | Transvascular, Inc. | Transluminal methods and devices for closing, forming attachments to, and/or forming anastomotic junctions in, luminal anatomical structures |
EP0895753A1 (en) | 1997-07-31 | 1999-02-10 | Academisch Ziekenhuis Utrecht | Temporary vascular seal for anastomosis |
US5954732A (en) | 1997-09-10 | 1999-09-21 | Hart; Charles C. | Suturing apparatus and method |
US6258084B1 (en) * | 1997-09-11 | 2001-07-10 | Vnus Medical Technologies, Inc. | Method for applying energy to biological tissue including the use of tumescent tissue compression |
US6338712B2 (en) * | 1997-09-17 | 2002-01-15 | Origin Medsystems, Inc. | Device to permit offpump beating heart coronary bypass surgery |
US6592552B1 (en) * | 1997-09-19 | 2003-07-15 | Cecil C. Schmidt | Direct pericardial access device and method |
US5868762A (en) | 1997-09-25 | 1999-02-09 | Sub-Q, Inc. | Percutaneous hemostatic suturing device and method |
US5928246A (en) * | 1997-10-15 | 1999-07-27 | Bsc Northwest Technology Center, Inc. | Stent securing catheter |
US6159232A (en) | 1997-12-16 | 2000-12-12 | Closys Corporation | Clotting cascade initiating apparatus and methods of use and methods of closing wounds |
US5972005A (en) | 1998-02-17 | 1999-10-26 | Advanced Cardiovascular Systems, Ind. | Wound closure assembly and method of use |
US6010514A (en) * | 1998-03-17 | 2000-01-04 | Burney; Bryan T. | Suturing assembly and method of use |
US6042601A (en) | 1998-03-18 | 2000-03-28 | United States Surgical Corporation | Apparatus for vascular hole closure |
US20010045575A1 (en) | 1998-05-01 | 2001-11-29 | Mark Ashby | Device and method for facilitating hemostasis of a biopsy tract |
US5980539A (en) | 1998-05-06 | 1999-11-09 | X-Site L.L.C. | Device and method for suturing blood vessels and the like |
US6936053B1 (en) | 1998-07-02 | 2005-08-30 | Jeffrey N. Weiss | Ocular implant needle |
US7335220B2 (en) | 2004-11-05 | 2008-02-26 | Access Closure, Inc. | Apparatus and methods for sealing a vascular puncture |
US6143004A (en) | 1998-08-18 | 2000-11-07 | Atrion Medical Products, Inc. | Suturing device |
US6458147B1 (en) | 1998-11-06 | 2002-10-01 | Neomend, Inc. | Compositions, systems, and methods for arresting or controlling bleeding or fluid leakage in body tissue |
US6994686B2 (en) | 1998-08-26 | 2006-02-07 | Neomend, Inc. | Systems for applying cross-linked mechanical barriers |
US6093173A (en) | 1998-09-09 | 2000-07-25 | Embol-X, Inc. | Introducer/dilator with balloon protection and methods of use |
EP1112043B1 (en) | 1998-09-10 | 2006-04-05 | Percardia, Inc. | Tmr shunt |
US7279001B2 (en) | 1998-11-06 | 2007-10-09 | Neomend, Inc. | Systems, methods, and compositions for achieving closure of vascular puncture sites |
US6949114B2 (en) | 1998-11-06 | 2005-09-27 | Neomend, Inc. | Systems, methods, and compositions for achieving closure of vascular puncture sites |
KR20010040761A (ko) * | 1998-12-09 | 2001-05-15 | 쿡 인코포레이티드 | 중공의 만곡형 초탄성 의료용 니들 |
US7001400B1 (en) | 1999-03-04 | 2006-02-21 | Abbott Laboratories | Articulating suturing device and method |
US6136010A (en) | 1999-03-04 | 2000-10-24 | Perclose, Inc. | Articulating suturing device and method |
US6964668B2 (en) | 1999-03-04 | 2005-11-15 | Abbott Laboratories | Articulating suturing device and method |
US20040092964A1 (en) | 1999-03-04 | 2004-05-13 | Modesitt D. Bruce | Articulating suturing device and method |
US7235087B2 (en) | 1999-03-04 | 2007-06-26 | Abbott Park | Articulating suturing device and method |
US6981983B1 (en) | 1999-03-31 | 2006-01-03 | Rosenblatt Peter L | System and methods for soft tissue reconstruction |
US6146397A (en) | 1999-04-06 | 2000-11-14 | Harkrider, Jr.; William W. | Endarterectomy loop |
US20040044350A1 (en) | 1999-04-09 | 2004-03-04 | Evalve, Inc. | Steerable access sheath and methods of use |
EP1196092A1 (en) | 1999-06-18 | 2002-04-17 | Radi Medical Systems Ab | A tool, a sealing device, a system and a method for closing a wound |
US6565583B1 (en) | 1999-07-08 | 2003-05-20 | Acumen Vascular, Inc. | Endarterectomy apparatus and method |
US6206895B1 (en) | 1999-07-13 | 2001-03-27 | Scion Cardio-Vascular, Inc. | Suture with toggle and delivery system |
US7341595B2 (en) | 1999-09-13 | 2008-03-11 | Rex Medical, L.P | Vascular hole closure device |
CA2381818C (en) | 1999-09-13 | 2009-08-04 | Rex Medical, L.P. | Vascular closure |
US6190396B1 (en) | 1999-09-14 | 2001-02-20 | Perclose, Inc. | Device and method for deploying and organizing sutures for anastomotic and other attachments |
US6171317B1 (en) | 1999-09-14 | 2001-01-09 | Perclose, Inc. | Knot tying device and method |
US6423051B1 (en) * | 1999-09-16 | 2002-07-23 | Aaron V. Kaplan | Methods and apparatus for pericardial access |
US6656136B1 (en) | 1999-10-25 | 2003-12-02 | Therus Corporation | Use of focused ultrasound for vascular sealing |
WO2001034035A1 (en) | 1999-11-05 | 2001-05-17 | Onux Medical, Inc. | Apparatus and method for approximating and closing the walls of a hole or puncture in a physiological shell structure |
US6641592B1 (en) | 1999-11-19 | 2003-11-04 | Lsi Solutions, Inc. | System for wound closure |
US6203554B1 (en) | 1999-11-23 | 2001-03-20 | William Roberts | Apparatus, kit and methods for puncture site closure |
US6626855B1 (en) | 1999-11-26 | 2003-09-30 | Therus Corpoation | Controlled high efficiency lesion formation using high intensity ultrasound |
AU2598201A (en) | 1999-12-23 | 2001-07-03 | Therus Corporation | Ultrasound transducers for imaging and therapy |
US6461383B1 (en) * | 1999-12-30 | 2002-10-08 | Advanced Cardiovascular Systems, Inc. | Ultrasonic catheter vascular stent system and method |
ATE302568T1 (de) * | 2000-01-05 | 2005-09-15 | Integrated Vascular Sys Inc | Vorrichtung zum schliessen einer punktionswunde |
US6780197B2 (en) | 2000-01-05 | 2004-08-24 | Integrated Vascular Systems, Inc. | Apparatus and methods for delivering a vascular closure device to a body lumen |
US6942674B2 (en) | 2000-01-05 | 2005-09-13 | Integrated Vascular Systems, Inc. | Apparatus and methods for delivering a closure device |
US6197042B1 (en) | 2000-01-05 | 2001-03-06 | Medical Technology Group, Inc. | Vascular sheath with puncture site closure apparatus and methods of use |
US7077848B1 (en) | 2000-03-11 | 2006-07-18 | John Hopkins University | Sutureless occular surgical methods and instruments for use in such methods |
US6802822B1 (en) | 2000-03-31 | 2004-10-12 | 3M Innovative Properties Company | Dispenser for an adhesive tissue sealant having a flexible link |
US6533795B1 (en) | 2000-04-11 | 2003-03-18 | Opus Medical, Inc | Dual function suturing apparatus and method |
DE10026172A1 (de) * | 2000-05-26 | 2001-11-29 | Roche Diagnostics Gmbh | System zur Entnahme von Körperflüssigkeit |
WO2005009250A1 (en) * | 2003-06-30 | 2005-02-03 | Magenta Medical Corporation | Methods and apparatus for forming anastomotic sites |
US6846321B2 (en) | 2000-06-21 | 2005-01-25 | Cardiodex, Ltd. | Mechanical method and apparatus for enhancing hemostatis following arterial catheterization |
WO2002005865A2 (en) | 2000-07-14 | 2002-01-24 | 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 |
WO2002017831A2 (en) | 2000-08-30 | 2002-03-07 | John Hopkins University | Devices for intraocular drug delivery |
JP2004511275A (ja) | 2000-09-01 | 2004-04-15 | アンジオリンク・コーポレイション | 創傷サイトの管理ならびに創傷閉塞デバイス |
US20040093024A1 (en) * | 2000-09-01 | 2004-05-13 | James Lousararian | Advanced wound site management systems and methods |
US7074232B2 (en) | 2000-09-01 | 2006-07-11 | Medtronic Angiolink, Inc. | Advanced wound site management systems and methods |
US6767356B2 (en) | 2000-09-01 | 2004-07-27 | Angiolink Corporation | Advanced wound site management systems and methods |
US7029481B1 (en) | 2000-11-06 | 2006-04-18 | Abbott Laboratories | Systems, devices and methods for suturing patient tissue |
ATE495703T1 (de) * | 2000-11-28 | 2011-02-15 | Intuitive Surgical Operations | Endoskopischer stabilisator für das schlagende herz und gefässokklusionsverschluss |
US6840952B2 (en) | 2000-12-07 | 2005-01-11 | Mark B. Saker | Tissue tract sealing device |
US6695867B2 (en) | 2002-02-21 | 2004-02-24 | Integrated Vascular Systems, Inc. | Plunger apparatus and methods for delivering a closure device |
US7905900B2 (en) | 2003-01-30 | 2011-03-15 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US6623510B2 (en) | 2000-12-07 | 2003-09-23 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US6846319B2 (en) | 2000-12-14 | 2005-01-25 | Core Medical, Inc. | Devices for sealing openings through tissue and apparatus and methods for delivering them |
US6896692B2 (en) | 2000-12-14 | 2005-05-24 | Ensure Medical, Inc. | Plug with collet and apparatus and method for delivering such plugs |
US6890343B2 (en) | 2000-12-14 | 2005-05-10 | Ensure Medical, Inc. | Plug with detachable guidewire element and methods for use |
US6969397B2 (en) | 2000-12-14 | 2005-11-29 | Ensure Medical, Inc. | Guide wire element for positioning vascular closure devices and methods for use |
US6524321B2 (en) | 2001-01-03 | 2003-02-25 | Nozomu Kanesaka | Closure device for puncture in vessel |
EP1363700A4 (en) * | 2001-01-11 | 2005-11-09 | Rita Medical Systems Inc | INSTRUMENT AND METHOD FOR BONE TREATMENT |
ATE303100T1 (de) | 2001-01-12 | 2005-09-15 | Radi Medical Systems | Mit positionsanzeigeeinrichtung versehene verschliessungsvorrichtung für die arterienwand |
US6454777B1 (en) | 2001-02-27 | 2002-09-24 | David T. Green | Apparatus and method for suturing a blood vessel |
US7041119B2 (en) | 2001-02-27 | 2006-05-09 | Green David T | Apparatus for suturing a blood vessel |
US6743195B2 (en) | 2001-03-14 | 2004-06-01 | Cardiodex | Balloon method and apparatus for vascular closure following arterial catheterization |
US7025776B1 (en) | 2001-04-24 | 2006-04-11 | Advanced Catheter Engineering, Inc. | Arteriotomy closure devices and techniques |
FR2824253B1 (fr) | 2001-05-04 | 2005-02-18 | Francis Navarro | Intrument permettant de fermer par suture sous-cutanee un orifice realise dans la paroi abdominale d'un patient |
US6863680B2 (en) | 2001-11-08 | 2005-03-08 | Sub-Q, Inc. | System and method for delivering hemostasis promoting material to a blood vessel puncture site by fluid pressure |
US7008440B2 (en) | 2001-11-08 | 2006-03-07 | Sub-Q, Inc. | System and method for delivering hemostasis promoting material to a blood vessel puncture site by fluid pressure |
US7029489B1 (en) | 2001-05-18 | 2006-04-18 | Sub-Q, Inc. | System and method for delivering hemostasis promoting material to a blood vessel puncture site |
US6457182B1 (en) | 2001-06-08 | 2002-10-01 | The United States Of America As Represented By The Secretary Of The Army | Protective glove |
JP4170897B2 (ja) | 2001-06-08 | 2008-10-22 | モリス イノヴェイティヴ リサーチ, インコーポレイテッド | 生体刺入口を封印するための方法および装置 |
JP4159805B2 (ja) | 2001-06-15 | 2008-10-01 | ラディ・メディカル・システムズ・アクチェボラーグ | 閉鎖方法用の突き押し機構 |
US6773699B1 (en) | 2001-10-09 | 2004-08-10 | Tissue Adhesive Technologies, Inc. | Light energized tissue adhesive conformal patch |
US6939364B1 (en) | 2001-10-09 | 2005-09-06 | Tissue Adhesive Technologies, Inc. | Composite tissue adhesive |
US6893431B2 (en) | 2001-10-15 | 2005-05-17 | Scimed Life Systems, Inc. | Medical device for delivering patches |
US7037322B1 (en) | 2001-11-08 | 2006-05-02 | Sub-Q, Inc. | System and method for delivering hemostasis promoting material to a blood vessel puncture with a staging tube |
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 |
US20030093114A1 (en) | 2001-11-13 | 2003-05-15 | Melvin Levinson | Method for effecting hemostasis |
US7609673B2 (en) * | 2002-02-08 | 2009-10-27 | Telefonaktiebolaget Lm Ericsson (Publ) | Packet-based conversational service for a multimedia session in a mobile communications system |
WO2003057272A2 (en) | 2001-12-26 | 2003-07-17 | Yale University | Vascular access device |
US7247162B1 (en) | 2002-01-14 | 2007-07-24 | Edwards Lifesciences Corporation | Direct access atherectomy devices |
EP1330986B1 (en) * | 2002-01-25 | 2009-12-09 | Terumo Kabushiki Kaisha | Vascular incision apparatus |
US7967839B2 (en) * | 2002-05-20 | 2011-06-28 | Rocky Mountain Biosystems, Inc. | Electromagnetic treatment of tissues and cells |
EP1371333B1 (en) | 2002-06-12 | 2004-05-19 | Radi Medical Systems Ab | Closure device |
US7494460B2 (en) | 2002-08-21 | 2009-02-24 | Medtronic, Inc. | Methods and apparatus providing suction-assisted tissue engagement through a minimally invasive incision |
JP2006508776A (ja) * | 2002-09-20 | 2006-03-16 | フローメディカ,インコーポレイテッド | 腎臓内カテーテルを介する選択的物質送達のための方法および装置 |
US7662128B2 (en) * | 2002-12-23 | 2010-02-16 | Salcudean Septimiu E | Steerable needle |
US7008442B2 (en) | 2003-01-20 | 2006-03-07 | Medtronic Vascular, Inc. | Vascular sealant delivery device and sheath introducer and method |
US7322976B2 (en) | 2003-03-04 | 2008-01-29 | Cardiva Medical, Inc. | Apparatus and methods for closing vascular penetrations |
US7293562B2 (en) * | 2003-03-27 | 2007-11-13 | Cierra, Inc. | Energy based devices and methods for treatment of anatomic tissue defects |
US8021362B2 (en) * | 2003-03-27 | 2011-09-20 | Terumo Kabushiki Kaisha | Methods and apparatus for closing a layered tissue defect |
US7165552B2 (en) * | 2003-03-27 | 2007-01-23 | Cierra, Inc. | Methods and apparatus for treatment of patent foramen ovale |
US6939348B2 (en) | 2003-03-27 | 2005-09-06 | Cierra, Inc. | Energy based devices and methods for treatment of patent foramen ovale |
US7186251B2 (en) * | 2003-03-27 | 2007-03-06 | Cierra, Inc. | Energy based devices and methods for treatment of patent foramen ovale |
US7850654B2 (en) | 2003-04-24 | 2010-12-14 | St. Jude Medical Puerto Rico B.V. | Device and method for positioning a closure device |
US20040220604A1 (en) | 2003-04-30 | 2004-11-04 | Fogarty Thomas J. | Tissue separation apparatus and method |
US7331979B2 (en) | 2003-06-04 | 2008-02-19 | Access Closure, Inc. | Apparatus and methods for sealing a vascular puncture |
US9289195B2 (en) | 2003-06-04 | 2016-03-22 | Access Closure, Inc. | Auto-retraction apparatus and methods for sealing a vascular puncture |
WO2004112615A2 (en) | 2003-06-16 | 2004-12-29 | Galdonik Jason A | Temporary hemostatic plug apparatus and method of use |
US6944517B2 (en) * | 2003-07-03 | 2005-09-13 | Brooks Automation, Inc. | Substrate apparatus calibration and synchronization procedure |
US20050049634A1 (en) | 2003-08-07 | 2005-03-03 | Scimed Life Systems, Inc. | Medical closure device |
EP2345371B1 (en) | 2003-08-14 | 2014-07-16 | Loma Linda University Medical Center | Vascular wound closure device |
US7762977B2 (en) | 2003-10-08 | 2010-07-27 | Hemosphere, Inc. | Device and method for vascular access |
US8337522B2 (en) | 2003-10-15 | 2012-12-25 | St. Jude Medical Puerto Rico Llc | Vascular sealing device with locking hub |
US20050085773A1 (en) | 2003-10-15 | 2005-04-21 | Forsberg Andrew T. | Method and apparatus for locating vascular punctures |
US7931670B2 (en) | 2003-10-15 | 2011-04-26 | St. Jude Medical Puerto Rico Llc | Tissue puncture closure device with automatic tamping |
US7361183B2 (en) | 2003-10-17 | 2008-04-22 | Ensure Medical, Inc. | Locator and delivery device and method of use |
US8007514B2 (en) | 2003-10-17 | 2011-08-30 | St. Jude Medical Puerto Rico Llc | Automatic suture locking device |
US8852229B2 (en) | 2003-10-17 | 2014-10-07 | Cordis Corporation | Locator and closure device and method of use |
US20050090860A1 (en) | 2003-10-23 | 2005-04-28 | Paprocki Loran J. | Segmented plug for tissue tracts |
CA2543295A1 (en) * | 2003-10-23 | 2005-05-06 | Trans1 Inc. | Tools and tool kits for performing minimally invasive procedures on the spine |
US20050096697A1 (en) | 2003-11-04 | 2005-05-05 | Forsberg Andrew T. | Vascular insertion sheath with stiffened tip |
US7731726B2 (en) * | 2003-12-03 | 2010-06-08 | St. Jude Medical Puerto Rico Llc | Suture based vascular closure apparatus and method incorporating a pre-tied knot |
US7597705B2 (en) | 2003-12-03 | 2009-10-06 | St. Jude Medical Puerto Rico Llc | Vascular puncture seal anchor nest |
US7390328B2 (en) | 2003-12-19 | 2008-06-24 | Abbott Laboratories | Device and method for suturing of internal puncture sites |
US20060064101A1 (en) * | 2004-02-12 | 2006-03-23 | Arthrocare Corporation | Bone access system |
JP4700384B2 (ja) * | 2004-04-07 | 2011-06-15 | オリンパス株式会社 | 医療用結紮縫合装置及び医療用結紮縫合システム |
US7993366B2 (en) | 2004-05-27 | 2011-08-09 | Cardiva Medical, Inc. | Self-tensioning vascular occlusion device and method for its use |
US9017374B2 (en) | 2004-04-09 | 2015-04-28 | Cardiva Medical, Inc. | Device and method for sealing blood vessels |
US7572274B2 (en) | 2004-05-27 | 2009-08-11 | Cardiva Medical, Inc. | Self-tensioning vascular occlusion device and method for its use |
US20050234507A1 (en) | 2004-04-16 | 2005-10-20 | Jeff Geske | Medical tool for access to internal tissue |
CA2501664A1 (en) * | 2004-04-22 | 2005-10-22 | Briggs And Stratton Corporation | Engine oil heater |
US20050267520A1 (en) | 2004-05-12 | 2005-12-01 | Modesitt D B | Access and closure device and method |
JP5178194B2 (ja) * | 2004-06-14 | 2013-04-10 | ロックス メディカル, インコーポレイテッド | 動脈−静脈フィステル生成のためのデバイス、システム、および方法 |
US7678133B2 (en) * | 2004-07-10 | 2010-03-16 | Arstasis, Inc. | Biological tissue closure device and method |
EP1791476B1 (en) * | 2004-09-20 | 2015-12-23 | Endoevolution, Llc | Apparatus for minimally invasive suturing |
US7182763B2 (en) | 2004-11-23 | 2007-02-27 | Instrasurgical, Llc | Wound closure device |
JP4366306B2 (ja) | 2004-12-17 | 2009-11-18 | テルモ株式会社 | 生体内組織閉鎖具および生体内組織閉鎖装置 |
US8162905B2 (en) | 2004-12-17 | 2012-04-24 | W. L. Gore & Associates, Inc. | Delivery system |
US20060235449A1 (en) | 2005-04-19 | 2006-10-19 | Vascular Architects, Inc., A Delaware Corporation | Vascular intimal lining removal assembly |
AU2006247355B2 (en) | 2005-05-12 | 2013-01-10 | Arstasis, Inc. | Access and closure device and method |
US8038687B2 (en) | 2005-05-17 | 2011-10-18 | St. Jude Medical Puerto Rico Llc | Suture loop closure device |
US8682411B2 (en) * | 2007-01-22 | 2014-03-25 | Cvdevices, Llc | Devices, systems and methods for epicardial cardiac monitoring system |
US20080097347A1 (en) * | 2006-09-22 | 2008-04-24 | Babak Arvanaghi | Bendable needle assembly |
US20080114364A1 (en) * | 2006-11-15 | 2008-05-15 | Aoi Medical, Inc. | Tissue cavitation device and method |
US20090312786A1 (en) * | 2008-06-12 | 2009-12-17 | Terumo Medical Corporation | Guide Sheath Dilator And Method Of Using The Same |
CN102802541A (zh) * | 2009-05-15 | 2012-11-28 | 阿尔斯塔西斯公司 | 在组织中形成管道的装置、方法和成套用具 |
JP2013505114A (ja) * | 2009-09-22 | 2013-02-14 | アルスタシス,インコーポレイテッド | 組織内に管を形成する装置、方法、及びキット |
CA2786536A1 (en) * | 2010-01-11 | 2011-07-14 | Arstasis, Inc. | Device for forming tracts in tissue |
-
2004
- 2004-07-10 US US10/888,682 patent/US7678133B2/en not_active Expired - Fee Related
-
2005
- 2005-06-30 AU AU2005272102A patent/AU2005272102A1/en not_active Abandoned
- 2005-06-30 CA CA2840690A patent/CA2840690A1/en not_active Abandoned
- 2005-06-30 JP JP2007520363A patent/JP5060291B2/ja not_active Expired - Fee Related
- 2005-06-30 CN CN2005800293656A patent/CN101431949B/zh not_active Expired - Fee Related
- 2005-06-30 WO PCT/US2005/023107 patent/WO2006017023A2/en active Application Filing
- 2005-06-30 EP EP05787529A patent/EP1778102A4/en not_active Withdrawn
- 2005-06-30 CA CA2573065A patent/CA2573065C/en not_active Expired - Fee Related
- 2005-06-30 CN CN201310740443.XA patent/CN103815936A/zh active Pending
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2007
- 2007-01-02 IL IL180497A patent/IL180497A0/en unknown
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2010
- 2010-01-07 JP JP2010002400A patent/JP2010115505A/ja not_active Withdrawn
- 2010-01-25 US US12/693,395 patent/US20100125296A1/en not_active Abandoned
-
2013
- 2013-08-22 JP JP2013171952A patent/JP2013255831A/ja active Pending
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5364389A (en) * | 1992-11-25 | 1994-11-15 | Premier Laser Systems, Inc. | Method and apparatus for sealing and/or grasping luminal tissue |
US5709224A (en) * | 1995-06-07 | 1998-01-20 | Radiotherapeutics Corporation | Method and device for permanent vessel occlusion |
US6179832B1 (en) * | 1997-09-11 | 2001-01-30 | Vnus Medical Technologies, Inc. | Expandable catheter having two sets of electrodes |
Also Published As
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IL180497A0 (en) | 2007-06-03 |
CA2840690A1 (en) | 2006-02-16 |
JP2010115505A (ja) | 2010-05-27 |
CA2573065C (en) | 2014-04-08 |
JP5060291B2 (ja) | 2012-10-31 |
EP1778102A2 (en) | 2007-05-02 |
US7678133B2 (en) | 2010-03-16 |
WO2006017023A2 (en) | 2006-02-16 |
CA2573065A1 (en) | 2006-02-16 |
US20060009802A1 (en) | 2006-01-12 |
JP2013255831A (ja) | 2013-12-26 |
US20100125296A1 (en) | 2010-05-20 |
CN101431949A (zh) | 2009-05-13 |
EP1778102A4 (en) | 2010-12-08 |
JP2008505697A (ja) | 2008-02-28 |
AU2005272102A1 (en) | 2006-02-16 |
CN103815936A (zh) | 2014-05-28 |
WO2006017023A3 (en) | 2009-04-02 |
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