Recherche Images Maps Play YouTube Actualités Gmail Drive Plus »
Connexion
Les utilisateurs de lecteurs d'écran peuvent cliquer sur ce lien pour activer le mode d'accessibilité. Celui-ci propose les mêmes fonctionnalités principales, mais il est optimisé pour votre lecteur d'écran.

Brevets

  1. Recherche avancée dans les brevets
Numéro de publicationUSRE34866 E
Type de publicationOctroi
Numéro de demandeUS 07/816,518
Date de publication21 févr. 1995
Date de dépôt31 déc. 1991
Date de priorité17 févr. 1987
État de paiement des fraisPayé
Numéro de publication07816518, 816518, US RE34866 E, US RE34866E, US-E-RE34866, USRE34866 E, USRE34866E
InventeursKenneth Kensey, Harold E. Clupper
Cessionnaire d'origineKensey Nash Corporation
Exporter la citationBiBTeX, EndNote, RefMan
Liens externes: USPTO, Cession USPTO, Espacenet
Device for sealing percutaneous puncture in a vessel
US RE34866 E
Résumé
A device and method for sealing a puncture or incision formed percutaneously in tissue separating two internal portions of the body of a living being, e.g., a puncture or incision in an artery, in the gall bladder, in the liver, in the heart, etc. The device comprises plug means having a holding portion which is adapted to engage portions of the tissue adjacent the puncture or incision to hold the plug means in place and a sealing portion formed of a foam material and extending through the puncture or incision to engage the tissue contiguous therewith to seal the puncture or incision from the flow of body fluid therethrough. In the preferred embodiment, the closure or plug means is formed of a biodegradable material.
Images(4)
Previous page
Next page
Revendications(46)
What is claimed is:
1. A closure device for sealing a puncture or incision formed percutaneously in tissue separating two internal portions of the body of a living being, .Iadd.said tissue having an inside and an outside portion, said puncture or incision including a first portion extending through said tissue from said inside portion to said outside portion and a second portion extending from said first portion of said puncture or incision to the surface of said skin, .Iaddend.said device comprising plug means arranged for placement at a predetermined position within the body of said being and having a first holding portion and a second sealing portion .[.adapted.]..Iadd., said first holding portion being preformed in a predetermined shape and being orientable into a first orientation to enable it to be extended in a first direction through said incision or puncture and thereafter orientable into a second and different orientation without changing from said predetermined shape so that it can be retracted in a second direction opposite to said first direction .Iaddend.to .[.engage.]. .Iadd.a position contiguous with the inside .Iaddend.portions of the tissue adjacent said puncture or incision .Iadd.without being pulled through said puncture or incision .Iaddend.to hold said plug means in place.Iadd., said second sealing portion being configured for location within said second portion of said puncture or incision, and being .Iaddend.formed of an expandable material which expands automatically in response to the ambient surroundings when in said .[.predetermined position and extending through said.]. .Iadd.second portion of .Iaddend.said puncture or incision to engage .[.the.]. tissue contiguous therewith to seal said puncture or incision from the flow of a body fluid therethrough .[.between said two internal portions.]..
2. The device of claim 1, wherein said expandable material comprises a collagen foam.
3. The device of claim 1, wherein said expandable material comprises a gelatinous foam.
4. The device of claim 1 wherein said tissue comprises .Iadd.the wall of .Iaddend.a blood vessel and wherein said second sealing portion .Iadd.is shaped to .Iaddend.extend.[.s fully.]. through said .Iadd.second portion of said .Iaddend.puncture or incision .[.in the wall of said blood vessel.]. to a point adjacent the skin of the being.
5. The device of claim 4 wherein said expandable material comprises a collagen foam.
6. The device of claim 4 wherein said expandable material comprises a gelatinous foam. .[.7. The device of claim 1 wherein said tissue comprises the gall bladder and wherein said second sealing portion extends fully through said puncture or incision in the wall of said gall bladder and into a cooperating puncture or incision in the liver of said being..]. .[.8. The device of claim 7, wherein said expandable material comprises a collagen foam..]. .[.9. The device of claim 7, wherein expandable material comprises a gelatinous foam..]. .[.10. The device of claim 1 wherein said tissue comprises the liver of said being and wherein said second sealing portion extends substantially into said puncture or incision in said liver..]. .[.11. The device of claim 10 wherein said expandable material comprises a collagen foam..]. .[.12. The device of claim 10 wherein said expandable material comprises a gelatinous foam..]. .[.13. The device of claim 1 wherein said tissue is the heart of said being and wherein said second sealing portion extends through said incision or puncture in said heart to a point closely adjacent the skin of said being..]. .[.14. The device of claim 13 wherein said expandable material comprises a collagen foam..]. .[.15. The device of claim 13 wherein said expandable material
comprises a gelatinous foam..]. 16. The device of claim 1 additionally
comprising retraction means. 17. The device of claim 16 wherein said retraction means comprises a filament secured to said holding portion.
The device of claim 17 wherein said holding portion toggles with
respect to the sealing portion. 19. The device of claim 18 wherein said filament and said .[.toggle.]. .Iadd.holding portion .Iaddend.are each formed of a biodegradable material. .[.20. The device of claim 1 wherein said tissue is a lung of said being and wherein said second sealing portion extends through said incision or puncture into said lung to a point closely adjacent the skin of said being..]. .[.21. The device of claim 20 wherein said expandable material comprises a collagen foam..]. .[.22. The device of claim 20 wherein said expandable material comprises a
gelatinous foam..]. 23. The method of sealing a small puncture or incision formed percutaneously in tissue separating two internal portions of the body of a living being by the use of plug means.Iadd., said tissue having an inside portion and an outside portion, said puncture or incision including a first portion extending through said tissue from said inside portion to said outside portion and a second portion extending from said first portion of said puncture or incision to the surface of said skin, said plug means .Iaddend.comprising a first holding portion and a second sealing portion.Iadd., said first holding portion being preformed in a predetermined shape, said second sealing portion being .Iaddend.formed of an expandable material which expands automatically in response to the ambient surroundings when in the body of said being, said method comprising .Iadd.orienting said first holding portion into a first orientation without changing said predetermined shape, inserting said first holding portion while in said first orientation .Iaddend..[.inserting said plug means.]. percutaneously into said puncture or incision .Iadd.in a first direction, orienting said first holding portion into a second orientation without changing said predetermined shape and retracting said first holding portion while in said second orientation in a second, opposite direction to said first direction .Iaddend.so that said first holding portion .[.engages.]. .Iadd.is pulled into a position contiguous with inside .Iaddend.portions of said tissue .Iadd.adjacent said puncture or incision and without being pulled through said puncture or incision .Iaddend.to hold said plug means in place and with said second sealing portion extending through said puncture or incision .[.expanding.]. .Iadd.so that said sealing portion is located within said second portion of said puncture or incision, whereupon said second portion expands automatically to engage .[.the.]. tissue contiguous therewith to seal said puncture or incision from the flow of a body fluid
therethrough .[.between said two internal portions.].. 24. The method of claim 23 wherein said tissue comprises .Iadd.the wall of .Iaddend.a blood vessel and wherein said second sealing portion is .[.arranged.]. .Iadd.shaped .Iaddend.so that its extends .[.fully.]. through said .Iadd.second portion of said .Iaddend.puncture or incision .[.in the wall
of said blood vessel.]. to a point adjacent the skin of the being. 25. The method of claim 24 wherein said expandable material comporises of a
collagen foam. 26. The method of claim 24 wherein said expandable material
comprises a gelatinous foam. 27. The method of sealing a small puncture or incision formed percutaneously in the gall bladder by use of plug means comprising a first holding portion and a second sealing portion formed of an expandable material, said method comprising inserting said plug means percutaneously into said puncture or incision so that said first holding portion engages portion of said gall bladder to hold said plug means in place and with said second sealing portion extending fully through said puncture or incision in the wall of said gall bladder and into a cooperating puncture or incision in the liver of said being to seal said
puncture or incision from the flow of a body fluid therethrough. 28. The method of claim 27 wherein said expandable material comprises a collagen
foam. 29. The method of claim 27 wherein said expandable material
comprises a gelatinous foam. 30. The method of claim 27 wherein said second sealing portion automatically expands in response to the ambient surroundings when in the body of said being in said puncture or incision.
1. The method of sealing a small puncture or incision formed percutaneously in the liver of a living being by the use of plug means comprising a first holding portion and a second sealing portion formed of an expandable material, said method comprising inserting said plug means percutaneously into said puncture or incision so that said first holding portion engages portions of said liver to hold said plug means in place and with said second sealing portion extending substantially into said puncture or incision in said liver to engage the tissue contiguous therewith to seal said puncture or incision from the flow of body fluid
therethrough. 32. The method of claim 31 wherein said expandable material
comprises a collagen foam. 33. The method of claim 31 wherein said
expandable material comprises a gelatinous foam. 34. The method of claim 31 wherein said second sealing portion automatically expands in response to the ambient surroundings when in the body of said being in said
puncture or incision. 35. The method of sealing a small puncture or incision formed percutaneously in the heart of a living being by use of plug means comprising a first holding portion and a second sealing portion formed of an expandable material, said method comprising inserting said plug means percutaneously into said puncture or incision so that first holding portion engages portions of said heart to hold said plug means in place and with said second sealing portion extending through said incision or puncture in said heart to a point closely adjacent the skin of said being and engaging the tissue contiguous therewith to said seal puncture
or incision from the flow of body fluid therethrough. 36. The method of
claim 35 wherein said expandable material comprises a collagen foam. 37. The method of claim 37 wherein said expandable material comprises a
gelatinous foam. 38. The method of claim 35 wherein said second sealing portion automatically expands in response to the ambient surroundings when
in the body of said being in said puncture or incision. 39. The method of sealing a small puncture or incision formed percutaneously in a lung of a living being by the use of plug means comprising a first holding portion and a second sealing portion formed of an expandable material, said method comprising inserting said plug means percutaneously into said puncture or incision so that said first holding portion engages portion of said lung to hold said plug means in place and with said second sealing portion extending fully through said puncture or incision in said lung to a point closely adjacent the skin of said being to engage the tissue contiguous therewith to seal said puncture or incision from the flow of a body fluid
therethrough. 40. The method of claim 39 wherein said expandable material
comprises a collagen foam. 41. The method of claim 39 wherein said
expandable material comprises a gelatinous foam. 42. The method of claim 39 wherein said second sealing portion automatically expands in response to the ambient surroundings when in the body of said being in said
puncture or incision. .Iadd.43. A method of sealing a small puncture or incision formed percutaneously in a blood vessel of the body of a living being by use of a plug means comprising first and second portions, said first portion being positioned distally of said second portion in use, at least one of said portions being formed of an expandable material, a flexible retraction means being operatively connected to said first portion of the plug means and extending beyond the being's skin after the plug means has been inserted percutaneously into said puncture or incision, said method comprising the steps of: inserting said plug means percutaneously into said puncture or incision; maneuvering said flexible retraction means from a location beyond the being's skin for adjusting the plug means after it has been inserted so that said plug means is in an orientation wherein said first portion is located within said blood vessel to act as a stop to prevent retraction of said plug means out of said puncture or incision and wherein said second portion engages a portion of the being's body located between the exterior surface of the blood vessel and the surface of the being's skin, said first and second portions cooperating for sealing said puncture or incision from the flow of blood passing through said blood vessel. .Iaddend. .Iadd.44. The method of claim 43, including the step of forming said second portion of said expandable material for expanding into engagement with portions of the being's body located between the exterior surface of the blood vessel and the surface
of the being's skin. .Iaddend. .Iadd.45. The method of claim 44 wherein said expansion of said second portion occurs automatically in response to
the presence of blood. .Iaddend. .Iadd.46. The method of claim 44 wherein said second portion promotes hemostasis and aids in holding said plug means in position for sealing the puncture or incision. .Iaddend.
.Iadd. The method of claim 43, including the step of forming said first and second portions of said plug means of materials which are absorbable within the body after a period of time sufficient for permitting effective closure of said incision or puncture. .Iaddend.
.Iadd.8. The method of claim 47, including the step of selecting the materials of said first and second portions of said plug means for causing said second portion to be absorbed within the body in a shorter period of
time than said first portion. .Iaddend. .Iadd.49. The method of claim 48 including the steps of forming said first portion and second portion of
different materials. .Iaddend. .Iadd.50. The method of claim 43, including the step of forming said plug means and flexible retraction means of a material which is absorbable within the body after a period of time sufficient for permitting effective closure of said incision or puncture. .Iaddend. .Iadd.51. The method of claim 43, including the steps of performing said first portion, prior to use of the plug means, in a configuration for permitting insertion of the first portion through the puncture or incision of the blood vessel to a position within said blood vessel when the first portion is in a first orientation relative to said second portion, and for permitting the first portion to bridge the puncture or incision within said blood vessel when said first portion is in a second orientation relative to said second portion for preventing the plug means from being pulled out of the blood vessel during the step of employing the retraction means to assist in locating the plug means for sealing the puncture or incision, and arranging said preformed first portion distally of said second portion in use for permitting said first portion to be positioned in the first orientation when the first portion is being inserted into the blood vessel through the puncture or incision, and then to be toggled relative to said second portion into said second
orientation when in the interior of the blood vessel. .Iaddend. .Iadd.52. The method of claim 51 including the step of forming said second portion of said expandable material for expanding into engagement with internal body tissue after said first portion has been inserted into the interior of the blood vessel, said second portion being arranged relative to said first portion for aiding in toggling said first portion into said second orientation upon expansion of said second portion. .Iaddend. .Iadd.53. The method of claim 52 wherein said expansion of said second portion occurs
automatically in response to the presence of blood. .Iaddend. .Iadd.54. The method of claim 43 wherein said second portion promotes hemostatis and aids in holding said plug means in position for sealing the puncture or
incision. .Iaddend. .Iadd.55. The method of claim 43 including the step of operatively connecting the flexible retraction means to the first portion by connecting the retraction means to the first portion and in a
location extending along said second portion. .Iaddend. .Iadd.56. The method of claim 55 including the step of positioning the retraction means
through the second portion. .Iaddend. .Iadd.57. A plug device for sealing a small puncture or incision formed percutaneously in a wall of a blood vessel of a living being, said device comprising a plug including a first portion and a second portion, said first portion being positioned distally of said second portion in use, and said device further including a flexible retraction means operatively coupled to the plug for extending beyond the being's skin after the plug has been inserted percutaneously into said puncture or incision in the wall of the blood vessel, one of said first and second portions of said plug being formed of an expandable material, said plug being configured to be inserted percutaneously into said puncture or incision such that retraction of said retraction means causes said first portion of said plug to move to a position within said blood vessel to act as a stop to prevent the retraction of said plug out of said puncture and said second portion of said plug being in engagement with internal tissue portions of the being's body located between the exterior surface of the wall of said blood vessel and the surface of the being's skin when said plug is positioned in said puncture or incision, said second portion of said plug being movable into engagement with said internal tissue portions for aiding in holding said plug in a position for sealing said puncture or incision from the flow of blood therethrough. .Iaddend. .Iadd.58. The plug device of claim 57 wherein said second portion of the plug is formed of an expandable material and is expanded into engagement with said internal tissue portions to retain said plug in said position for sealing said puncture or incision from the flow of blood
therethrough. .Iaddend. .Iadd.59. The plug device of claim 58 wherein said second portion of the plug comprises a material which expands automatically in response to the presence of blood. .Iaddend. .Iadd.60. The plug device of claim 59 wherein said second portion of the plug comprises a material which promotes hemostatis and aids in holding said plug device in said position. .Iaddend. .Iadd.61. The plug device of claim 58 wherein said second portion of the plug comprises a material which promotes hemostatis and aids in holding said plug device in said position. .Iaddend. .Iadd.62. The plug device of claim 57 wherein said first portion of said plug is configured to be positioned along the inner surface of the blood vessel to obstruct the flow of blood into the puncture or incision
from the blood vessel. .Iaddend. .Iadd.63. The plug device of claim 57 wherein the flexible retraction means is directly connected to the first portion of the plug and extends along the second portion of the plug. .Iaddend. .Iadd.64. The plug device of claim 63 wherein the flexible retraction means extends along the second portion of the plug by extending through the second portion. .Iaddend. .Iadd.65. The plug device of claim 57 wherein said first and second portions of said plug are formed of materials which are absorbable within the body after a period of time sufficient for permitting effective closure of said incision or puncture. .Iaddend. .Iadd.66. The plug device of claim 65 wherein the second portion of the plug is absorbed within the body in a shorter period of time then
said first portion. .Iaddend. .Iadd.67. The plug device of claim 66 wherein said first portion and said second portion of the plug are
constructed of different materials. .Iaddend. .Iadd.68. The plug device of claim 57 wherein said first portion of the plug is preformed in a configuration for permitting insertion of the first portion through the puncture or incision of the blood vessel to a position within said blood vessel when the first portion is in a first orientation relative to the second portion of the plug, and for permitting said first portion to bridge the puncture or incision within said blood vessel when said first portion is in a second orientation relative to said second portion for preventing the plug from being pulled out of the blood vessel, said preformed first portion being located distally of the second portion in use of the plug device for permitting the first portion to be positioned in the first orientation when the first portion is inserted into the blood vessel through the puncture or incision and then to be toggled relative to said second portion into said second orientation when in the interior of the blood vessel. .Iaddend. .Iadd.69. The plug device of claim 68 wherein the second portion of the plug is formed of an expandable material, said expandable material being positioned relative to the first portion for causing movement of the first portion into the second orientation upon expansion of the second portion. .Iaddend. .Iadd.70. The plug device of claim 69 wherein the second portion of the plug comprises a material which expands automatically in response to the presence of blood. .Iaddend.
Description

This invention relates generally to medical devices and more particularly to devices for sealing percutaneously formed punctures or incisions and is continuation-in-part of my copending U.S. patent application Ser. No. 07/015,267 filed on Feb. 17, 1987, now U.S. Pat. No. 4,744,364, entitled Device For Sealing Percutaneous Puncture In A Vessel, assigned to the same assignee as this invention and whose disclosure is incorporated by reference herein.

BACKGROUND OF THE INVENTION

As will be appreciated by those skilled in the art various surgical procedures are now being carried out intravascularly or intralumenally. For example in the treatment of vascular disease, such as atherosclerosis, it is a common practice to invade the artery to insert an instrument, e.g., a balloon or other type of catheter to carry out the procedure within the artery. Such procedures usually involve the percutaneous puncture of the artery so that in introducer sheath can be inserted into the artery and thereafter the instrument, e.g., catheter, itself can be inserted through the sheath to the operative position within the artery. Such procedures unavoidably present the problem of stopping the bleeding at the percutaneous puncture after the procedure has been completed and after the instrument (and any introducer sheaths used therewith) have been removed. At present such bleeding is stopped by the application of direct digital pressure over the puncture site by a trained physician or other suitably trained medical personnel. Such direct pressure has to be applied for a sufficiently long time for hemostasis to occurs that the opening is effectively closed against further bleeding. In the case of punctures into femoral or superficial femoral arteries the pressure may have to be applied for as long as forth-five minutes for hemostasis to occur. Not only is this direct digital pressure application procedure wasteful of time by highly skilled medical professionals, the procedure results in a substantial reduction, if not virtual arrest, of the flow of blood through the vessel. Since thrombosis is one of the major calamities that can occur in the immediate post operative period, any reduction in blood flow, such as caused by the application of digital pressure, is undesirable.

Applicator devices have been disclosed in the patent literature for inserting an absorbent plug or member into the vagina. Such devices basically comprises a tubular element adapted to be inserted into the vagina and having a plug of absorbent material located therein. The device also includes a plunger to push the plug out of the tubular element into the vagina. The plug also includes a thread or string attached to it to enable the plug to be retrieved from the vagina. Examples of such devices are shown in U.S. Pat. Nos. 1,191,736 (Roberson) and 1,794,221 (Washburn et al.).

While such devices are suitable for their intended purposes, there is no suggestion of their use, nor are they suitable for insertion into an opening in the wall of a blood vessel or other bodily lumen or duct to seal that opening.

The patent literature also includes devices for closing an opening in a blood vessel using sutures, see U.S. Pat. No. 4,587,909 (Gillis). Other means and techniques for closing a wound are disclosed in U.S. Pat. No. 4,606,337 (Zimmermann et al.).

None of the prior art teaches the use of simple means for effecting the closure of an opening, e.g., puncture, in the wall of a blood vessel, duct or lumen, by plugging the opening and without requiring sutures or the application of digital pressure.

A need also exists for devices and methods of sealing percutaneously formed punctures or incisions in other body tissues such as in the gall bladder, the liver, the heart, the lung, etc.

OBJECTS OF THE INVENTION

Accordingly, it is a general object of the instant invention to provide a device and methods of use which overcome the disadvantages of the prior art.

It is further object of the invention to provide a device and methods of use that is effective for closing off a puncture or other opening in a blood vessel, duct or lumen without the need for the application of digital pressure thereto and without resulting in any substantial reduction of blood flow through the vessel.

It is still a further object of the instant invention to provide an instrument which is simple in construction and whose method of use entails the ready insertion into a blood vessel, duct or lumen to position a closure therein for hemostatically sealing the puncture and without substantially blocking the flow of fluid through the vessel, duct or lumen.

It is yet a further object of the invention to provide a device and method of use for sealing percutaneously formed punctures or incisions in tissue separating two portions of the body of a living being from the flow of a body fluid therebetween.

SUMMARY OF THE INVENTION

These and other objects of the instant invention are achieved by providing a device and method for sealing a puncture or incision formed percutaneously in tissue separating two internal portions of the body of a living being, such as punctures or incisions in blood vessels, ducts or lumens, gall bladders, livers, hearts, etc. The device comprises a tubular body having an outlet at the distal end thereof and which is adapted to be inserted through the puncture or incision to expel a closure therefrom. The closure comprises a first holding portion adapted to engage portions of the tissue adjacent the puncture or incision to hold the closure in place and a second sealing portion formed of a foam material which is adapted to extend through the puncture or incision to engage the tissue contiguous with the puncture or incision to seal it from the flow of a body fluid therethrough between the two body portions.

BRIEF DESCRIPTION OF THE DRAWING

FIG. 1 is a side elevational view partially in section showing a portion of one device constructed in accordance with this invention about to be inserted into a conventional sheath extending through a percutaneous puncture into an artery;

FIG. 2 is a side elevational view of the device 20 in place in the sheath;

FIG. 3 is a side elevational view of the device 20 during the expulsion of its puncture sealing closure into the artery;

FIG. 4 is a side elevational view of the artery showing the sealing closure in place to close off the percutaneous puncture;

FIG. 5 is a reduced plan view of the device 20 of the subject invention;

FIG. 6 is a side elevational view of the device shown in FIG. 1 but including an alternative embodiment of the closure;

FIG. 7 is a sectional view taken along line 7--7 of FIG. 6;

FIG. 8 is a side elevational view of the embodiment of the device shown in FIG. 6 during the expulsion of its puncture sealing closure into an artery;

FIG. 9 is a side elevational view similar to that of FIG. 8 but showing the puncture sealing device in place within the puncture in the artery;

FIG. 10 is a sectional view taken along line 10--10 of FIG. 9;

FIG. 11 is a sectional view through the body of the being showing the sealing of a percutaneous incision or puncture in the gall bladder and liver; and

FIG. 12 is a sectional view through the body of the being showing the sealing of a wound in the lung and heart.

DESCRIPTION OF THE PREFERRED EMBODIMENT OF THE INVENTION

Referring now in greater detail to the various figures of the drawing wherein like reference characters refer to like parts, there is shown generally at 20 in FIG. 1 an instrument for effecting the closure of a puncture or other opening in a blood vessel, duct or lumen in a living being. The device 20 thus has particular utility when used in connection with intravascular procedures, such as angiographic dye injection, balloon angioplasty and other types of recanalization of atherosclerotic arteries, in-situ valvulectomy, etc. However, it should be appreciated that the device 20 can be used to hemostatically close a puncture or other opening in othe types of duct or lumens within the body. Thus, it is to be understood that while the description of the invention as contained herein is directed to closing off percutaneous punctures in arteries, the device 20 has much more wide-spread applications.

Before describing the instrument 20 itself a brief description of a typical, conventional, intravascular surgical procedure, e.g., catheter instrumentation of an artery, utilizing a percutaneous incision or puncture will be given to best appreciate the features of the device 20. In such a procedure a cannula of an instrument, such as an angiogrpahic needle (not shown), is inserted percutaneously through the skin into the artery, such as the femoral artery 24 at the situs for the instrument's insertion. The needle cannula is held in place and the flexible end of a mini-guidewire (not shown) is then passed through the cannula into the artery to the desired depth (i.e., longitudinal position therealong). Once the mini-guidewire is in place the needle cannula is removed leaving the guidewire in place. A conventional introducer sheath 26 and an arterial dilator (not shown) are then passed over the guidewire through the puncture 28 and into the artery 24. The guidewire and then the dilator are removed leaving the sheath 26 in place. The catheter (not shown) or other intravascular instrument (not shown) is then inserted through the introducer sheath 24 and threaded down the artery to the desired intravascular location, e.g., the situs of an atherosclerotic occlusion. Once the intravascular procedure (e.g., angioplasty) has been completed the catheter is removed. Thereafter the sheath is removed and the surgeon or other trained person applies digital pressure to the percutaneous puncture until hemostasis has occurred.

The device 20 effects the hemostatic closure of a percutaneous or other type of puncture, incision or opening in an artery or other body duct or lumen without necessitating the application of pressure thereto. Thus, once the catheter or other intravascular instrument has been removed but with the sheath 26 left in place, the device 20 of the subject invention is inserted through the sheath 26 into the artery 24 and operated to expel a closure member 30 (to be described later) into the artery. The closure is arranged to be drawn back into the puncture 28 to seal it. The sheath is removed and the closure left in place. Due to its construction the closure is ultimately absorbed by the surrounding tissue.

As can be seen in FIG. 1 the device 20 basically comprises a tubular body 32 having an outlet 34 at its distal end, the heretofore identified closure member 30 having a retraction filament 36 connected thereto, and pusher means 38. The tubular body is an elongate member preferably constructed of a sufficiently small outside diameter, e.g., 8 F (French), and somewhat flexible material, such as polyethylene or polyvinylchloride, to enable it to be inserted through the introducer sheath 26 into the artery 24, with the tubular body's outlet 34 within the artery distally of the puncture 28.

The closure member 30 is an expandable member which, when contracted or compressed is sufficiently compact to fit within the interior of the tubular body 30, but when unconstrained by the tubular body it expands to an enlarged configuration (See FIGS. 3 and 4) suitable for closing off the puncture 28 in the artery. Thus, closure member 30 is formed by a resilient, hemostatic material, which is preferably biodegradable, so that it need not be removed after placement. One particular effective material is a porous hemostatic absorbable gelatin sold by Johnson & Johnson, Inc. under the name Gelfoam.

The pusher means 38 basically comprises an elongated, cylindrical rod-like member, having a distal end 40. The pusher is also formed of a relatively flexible material, such as polyethylene or polyvinylchloride and is disposed within the interior of tubular body 32. The outside diameter of the pusher is slightly less than the inside diameter of the tubular body portion to enable the pusher to be manually moved (slid) down the longitudinal axis of the body portion 28, to push or force the closure 30 out of the outlet 34. Thus the pusher is arranged to be moved from a retracted position, like that shown in FIG. 2 to an extended position like that shown in FIG. 3 wherein its distal end 40 is located close to the outlet 34 of the body 32. When the pusher is moved to the extended position its distal end forces the closure member 30 out of the outlet 34.

The heretofore identified retraction filament 36 constitutes an elongated thread, preferably formed of a long, yet very thin, biodegradable material, such as an absorbable suture, and is fixedly secured to the proximal side 42 of the closure member 30 at the middle thereof. When the closure is in position within the tubular body the thread 36 extends down the length of the tubular body 32 between it and the pusher 38 so that the proximal end of the thread is located outside the device 20.

The thread 36 being long and thin does not interfere with the operation of the pusher expelling the closure member 32 out of outlet 34. Thus, during the expulsion of the closure into the artery the thread 36 slides down the tubular member with the closure. The thread 36 is sufficiently long that a substantial length extends outside of the proximal end of the device 20 even after the closure is in the artery.

In order to effecuate the movement of the pusher from the retracted to the extended position the tubular body includes a collar 44 having a flanged projection 46 arranged to be grasped by the fingers of the user of the device 20. In addition the proximal end 48 of the pusher 38 includes an enlarged cap 50 arranged to be engaged by the user's thumb. Thus, to effect the ejection of the closure member 30 all the user of the device 20 merely has to do is to grasp the projection 46 with his/her fingers while applying pressure to the cap 50 with his/her thumb. This action forces the pusher down the tubular body to the extended position.

As can be seen in FIGS. 3 and 4, when the closure member 30 is in its unconstrained state (such as when it is ejected into the artery) it assumes a configuration having an enlarged head portion 52 and an anchor portion 54. The head portion is of generally disk-like shape of relatively large diameter, e.g., 6-9 mm, yet relatively thin, e.g. 1-2mm. The head portion includes the rear (proximal) surface 42 and a front (distal) surface 56. The anchor portion 54 consists of a small diameter, e.g., 2-3 mm, hub-like projection from the proximal surface 50 at approximately the center thereof. The distal end of the retraction thread 36 is fixedly secured to the anchor portion 54. The resilient nature of the closure enables the enlarged head portion 52 to conform to the surface 58 of the interior of the artery 24 contiguous with the puncture 28 so that its proximal surface 42 intimately engages the artery surface 58 while the hub-like anchor portion 54 extends somewhat into the puncture 28 to hemostatically seal the puncture when the closure is pulled into place, as will be described hereinafter.

Thus, as shown in FIG. 3, after the tubular body 32 of device 20 has been inserted into the sheath 26 so that its outlet 34 is within the artery, the sheath 26 is withdrawn. The pusher is then extended or pushed down the tubular body as described heretofore so that its distal end portion 40 forces the closure 30 out of outlet 34. Once the closure 30 is outside the confines of the tubular body 32 it expands or enlarges to its disk-shaped configuration. After the closure is pushed out of the tubular member by the pusher, the tubular body is itself withdrawn from the puncture 28 in the artery and moved completely outside the body of the patient. This action leaves the closure 30 within the artery and with the retraction filament extending through the puncture 28 so that a substantially portion of the filament is outside the patient's body. The filament is then pulled by its proximal end to cause the closure to move toward the puncture 28, until its anchor portion 42 is somewhat within the puncture and its engagement surface 50 is in intimate engagement with the interior of the artery wall contiguous with the puncture. This action hemostatically seals the puncture. In order to hold the closure in place the thread 34 is held taut and is secured in position on the patients skin, such as by use of a strip of conventional tape 60. Alternatively, some other gripping means (not shown) can be used to slide down the filament into contact with the skin while together gripping the filament tightly to prevent it from slipping.

By virtue of the fact that the head portion 52 of the closure is thin and conforms to the interior surface of the artery, it does not block off or otherwise impede the flow of blood through the artery.

It should be noted at this juncture that the closure can be of any suitable shape and need not be of the disk-like shape shown herein, so long as once it is pulled into position at the situs of the puncture it serves to hemostatically seal that puncture without appreciably blocking the passageway. Moreover, in order to minimize the risks of thrombosis in the artery the front (distal) face 56 of the closure 30, which is exposed to the flow of blood through the artery, may be coated with a non-thrombogenic material. This feature serves to minimize the risk of thrombosis forming in the artery. The thrombogenic material used can comprise a waxy coating, such as coconut oil, on the closure's front surface 56.

As mentioned earlier the closure and its retraction filament are each preferably formed of an absorbable (e.g., biodegradable) material. This feature enables the closure to be left in place after hemostatis has occurred since it will be absorbed by the bodily tissues thereafter. Accordingly, the closure does not have to be removed after having served its purpose.

In order to accellerate hemostasis the nature forming the closures of the invention may include conventional clotting agents, such as tissue throboplastin.

In FIG. 6 there is shown an alternative embodiment of the closure utilized in a device 20 for sealing a percutaneous puncture or incision. The alternative embodiment of the closure is designated by the reference numeral 100 and basically comprises three components, namely, a holding member .[.102.]. .Iadd.106.Iaddend., a suture or filament 104, and a sealing member .[.106.]. .Iadd.102.Iaddend.. The holding member is an elongated body constructed like a toggle and is preferably formed of a biodegradable, thermoplastic polymer, such as polyglactide. This material will degrade within the body within a short period of time, e.g., approximately 45 days. The toggle is molded onto the distal end of the filament 104 which is slightly bulbous to hold the toggle in place thereon. The filament is also preferably formed of polyglactide (e.g., it will degrade within the body in approximately 90 days). The filament is quite flexible so that the toggle can pivot to various orientations with respect to it. Disposed promixally behind the toggle is the sealing member .[.106.]. .Iadd.102 .Iaddend.. That member basically comprises a cylindrical plug preferably formed of a compressed foam which is highly absorbent and which, when disposed within the body, swells in excess of its compressed diameter, e.g., swells to twice its compressed diameter. The plug is preferably formed of gelatin or collagen foam so that it also degrades quickly within the body, e.g., in approximately ten days or so. The filament extends fully through the plug.

The closure 100 is located within the device 20 adjacent the outlet 34 of the tubular portion 32 thereof. In particular, the foam plug or sealing portion 102 is located immediately adjacent the free end 40 of the plunger 38, with the toggle or holding portion 106 located at the distal end of the portion 102. The toggle is oriented so that its longitudinal axis is parallel to the longitudinal axis of the device 20. When so disposed the toggle compresses a portion of the distal end of the plug portion. The filament 104 extends backward from the toggle portion through the plug portion and through a central passageway in the plunger 38 to a point outside the device 20. The closure is introduced into the artery, or into a puncture or incision in any body tissue, such as the liver (FIG. 11), gall bladder (FIG. 11), lung (FIG. 12), heart (FIG. 12), etc., until the insertion device's outlet 34 is in the desired position.

In the case of the sealing of an artery, the outlet 34 of the device is positioned so that it is within the artery (See FIG. 8) and just slightly beyond the introducer sleeve 26. This placement is controlled by stops (not shown) on the device 25. The plunger 38 is then operated as described earlier to expel the closure 100. Once the closure is expelled, the device 20 is held in this position for a short period of time, e.g., 15 to 60 seconds, to allow the foam at the tip of the closure, i.e., the distal end of portion 102, to swell. This action effectively tips the toggle. The insertion device 20 is then removed in a similar manner as described earlier and the closure's filament 104 then retracted, that is, pulled in the direction of arrow 108 in FIG. 8. This action pulls the closure's plug portion 102 back through the puncture or incision 28 in the artery wall until its toggle portion 106 engages the inner surface of the arterial wall to stop further retraction. As the toggle comes into engagement with the arterial wall, it effects the compression of the distal end portion 110 of the plug portion 102. Moreover, the proximal end portion of the plug 102 extends into the puncture or incision in the subcutaneous tissue 22A to a point closely adjacent the skin 22. These actions effectively seal the puncture or incision from the passage of blood therethrough.

It should be noted that the engagement of the toggle with the inner surface of the artery wall can either be direct or indirect, the latter being through the interposed deformed distal end portion of the plug 102. In either event, the toggle serves to act as a stop precluding the closure 100 from being pulled out of sealing engagement with the puncture or incision 28.

In lieu of the use of the toggle/foam plug closure 100, one can utilize an alternative closure 200. The closure 200 basically comprises a preformed foam plug having an enlarged distal end portion 106 (See FIGS. 11 and 12) serving as the heretofore described holding member, a proximally located rod-like portion 102 (See FIGS. 11 and 12) serving as the heretofore described sealing member and a retraction filament 104 secured thereto. The closure 200 is preferably formed of a dense collagen foam with long collagen fiber reinforcement so that it has a high expansion ratio (wet-to-dry) and good mechanical wet strength.

The closure 200, like closures 30 and 100 is held within the tubular portion 32 of the insertion device 20 in a compressed state and with its holding portion 106 located immediately adjacent the outlet 34. For sealing punctures or incisions in arteries the device 20 is introduced into the artery in the manner as described heretofore. The pusher member 38 then pushes the foam closure out of the outlet, whereupon the holding portion 206 swells upon contact with the blood in the artery. The insertion device 20 is then removed so that the closure 200, now swollen, hangs up at the puncture or incision 28 within the arterial wall, i.e., the enlarged holding member portion 206 engages the inner surface of the arterial wall and the sealing portion 102 extends fully through the puncture or incision into the subcutaneous tissue 22A. The retraction of the filament fully seats the closure in place so that the sealing portion extends fully through the puncture or incision in the artery wall and with its proximal end located within the subcutaneous tissue closely adjacent the skin.

The advantage of the preformed foam closure as just described over the toggle/plug closure 100 is that it is considerably simpler in construction, assembly and cost.

As mentioned earlier, it is frequently desirable to be able to seal a puncture or incision in body organs or tissue other than blood vessels. For example, in cases where percutaneous transhepatic punctures are made into the gall bladder for purposes of introducing chemicals or mechanical instruments, there exists a very real risk of bile leakage into the peritoneum via the liver puncture site, thereby resulting in a dangerous possibility of peritonitis. The closures 30, 100 and 200, as described heretofore, can be utilized to seal such percutaneous punctures or incisions to eliminate the risks of bile leakage. For example, as shown in FIG. 11 an insertion device 20 with a closure 100 to 200 disposed therein is introduced through the puncture or incision 28 in the right lobe of the liver and through the puncture or incision in the gall bladder so that the devices outlet 34 extends just beyond its introducer sheath 26. The plunger 38 is then pressed to eject the closure so that the holding portion 106 thereof is located within the gall bladder and in engagement with the inner surface thereof, while the sealing portion 102 extends through the puncture or incision in the gall bladder and into the puncture or incision in the liver. Alternatively, the closure 100/200 may be left in the incision or puncture 28 in the liver alone, if that makes best sense from a medical/surgical standpoint.

The subject invention is also useful for effecting the sealing of percutaneous incisions or punctures in the heart, such as could result from a wound. In this connection, as shown in FIG. 12, a wound penetrating the left lung and left ventricle may be sealed by introducing the insertion device 20 with a closure 100/200 therein through the wound, through the puncture in the lung, and into the puncture in the left ventricle. The closure 100/200 is then ejected so that its holding portion 106 is located within the ventricle, while its sealing portion 102 extends through the puncture in the left ventricle wall and through the puncture in the left lung. In such applications, it is preferred that the closure member 100/200 be configured so that its sealing portion 102 is of a substantial length to extend not only through the puncture in the left ventricle, but also the puncture in the lung and through the wound in the skin to some exterior point closely adjacent the skin. Thus, the closure 100/200 acts as a tamponade.

As should be appreciated by those skilled in the art, the device and methods of this invention as well as the closure device mentioned in my copending U.S. patent application, can be utilized to seal a percutaneous incision or puncture in any body tissue or organ to prevent the flow of fluid through that puncture or incision from one body portion to another.

Without further elaboration the foregoing will so fully illustrate by invention that other may, by applying current or future knowledge, adopt the same for use under various conditions of service.

Citations de brevets
Brevet cité Date de dépôt Date de publication Déposant Titre
US1191736 *24 avr. 191618 juil. 1916Thomas Edgar RobersonApplicator.
US1794221 *9 sept. 192924 févr. 1931Lack Mfg CompanyApplicator
US2386590 *12 oct. 19409 oct. 1945Calhoun VernonCatamenial device
US3675639 *11 mai 197011 juil. 1972Hugo S CimberDevice for and method of temporary sterilizing a female
US3874388 *12 févr. 19731 avr. 1975Ochsner Med Found AltonShunt defect closure system
US4007743 *20 oct. 197515 févr. 1977American Hospital Supply CorporationOpening mechanism for umbrella-like intravascular shunt defect closure device
US4031569 *15 mars 197628 juin 1977Jacob H JohnNasal septum plug
US4154226 *27 mai 197715 mai 1979Coloplast International A/SMagnetically operated closure for an intestinal orifice
US4390018 *17 mai 198228 juin 1983Zukowski Henry JMethod for preventing loss of spinal fluid after spinal tap
US4537186 *2 sept. 198327 août 1985Verschoof Karel J HContraceptive device
US4587969 *28 janv. 198513 mai 1986Rolando GillisSupport assembly for a blood vessel or like organ
US4606337 *19 avr. 198319 août 1986Serapharm Gmbh & Co. KgResorptive sheet material for closing and healing wounds and method of making the same
US4650488 *16 mai 198417 mars 1987Richards Medical CompanyBiodegradable prosthetic device
US4710192 *17 oct. 19861 déc. 1987Liotta Domingo SDiaphragm and method for occlusion of the descending thoracic aorta
US4744364 *17 févr. 198717 mai 1988Intravascular Surgical Instruments, Inc.Device for sealing percutaneous puncture in a vessel
US4749689 *17 août 19877 juin 1988Koken Co., Ltd.Hemostatic agent composed of collagen/gelatin and protamine
SU782814A1 * Titre non disponible
Référencé par
Brevet citant Date de dépôt Date de publication Déposant Titre
US5674231 *20 oct. 19957 oct. 1997United States Surgical CorporationApparatus and method for vascular hole closure
US5716375 *21 févr. 199610 févr. 1998Quinton Instrument CompanyInsertion assembly and method of inserting a vessel plug into the body of a patient
US5725498 *12 sept. 199610 mars 1998Datascope Investment Corp.Device and method for sealing puncture wounds
US5728122 *7 juin 199517 mars 1998Datascope Investment Corp.Guide wire with releaseable barb anchor
US5741223 *12 sept. 199621 avr. 1998Datascope Investment Corp.Device and method for sealing puncture wounds
US5810846 *3 août 199522 sept. 1998United States Surgical CorporationVascular hole closure
US5830130 *5 oct. 19943 nov. 1998Datascope Investment Corp.Device and method for sealing puncture wounds
US5868778 *5 mai 19979 févr. 1999Vascular Solutions, Inc.Vascular sealing apparatus and method
US5871501 *12 janv. 199816 févr. 1999Datascope Investment Corp.Guide wire with releasable barb anchor
US629663216 août 19952 oct. 2001Boston Scientific CorporationBall-shaped fiber implant, and method and device for inserting the implant
US62995906 janv. 19999 oct. 2001Boston Scientific CorporationImplant, and method and device for inserting the implant
US632578921 déc. 19994 déc. 2001Datascope Investment CorporationDevice and method for sealing puncture wounds
US63502803 févr. 200026 févr. 2002Kensey Nash CorporationSurgical connector systems and methods of use
US63683415 août 19979 avr. 2002St. Jude Medical Puerto Rico, B.V.Insertion assembly and method of inserting a hemostatic closure device into an incision
US64027676 mars 200011 juin 2002Kensey Nash CorporationAnastomosis connection system and method of use
US648221427 avr. 200019 nov. 2002Medtronic, Inc.Intravascular seal with mesh reinforcement and method for using same
US658919929 mars 20008 juil. 2003Boston Scientific CorporationSystem for implanting a cross-linked polysaccharide fiber and methods of forming and inserting the fiber
US662350915 août 200123 sept. 2003Core Medical, Inc.Apparatus and methods for sealing vascular punctures
US662691921 juil. 199830 sept. 2003Lee L. SwanstromMethod and apparatus for attaching or locking an implant to an anatomic vessel or hollow organ wall
US662994711 juin 19997 oct. 2003Boston Scientific CorporationSystems and methods for delivering flowable substances for use as implants and surgical sealants
US666365525 mai 200116 déc. 2003Core Medical, Inc.Apparatus and methods for sealing vascular punctures
US666970724 janv. 200030 déc. 2003Lee L. SwanstromMethod and apparatus for attaching or locking an implant to an anatomic vessel or hollow organ wall
US67368156 sept. 200118 mai 2004Core Medical, Inc.Apparatus and methods for treating spinal discs
US674962211 oct. 200215 juin 2004Rex Medical, L.P.Vascular closure
US684631914 déc. 200025 janv. 2005Core Medical, Inc.Devices for sealing openings through tissue and apparatus and methods for delivering them
US7008439 *7 mars 19957 mars 2006Datascope Investments Corp.Device and method for sealing puncture wounds
US707423221 déc. 200111 juil. 2006Medtronic Angiolink, Inc.Advanced wound site management systems and methods
US708363524 avr. 20031 août 2006Ensure MedicalApparatus and methods for sealing vascular punctures
US719863123 janv. 20033 avr. 2007Medtronic Angiolink, Inc.Advanced wound site management systems and methods
US726767916 janv. 200311 sept. 2007Rex Medical, L.PVascular hole closure device
US731670422 mars 20048 janv. 2008Accessclosure, Inc.Occlusion member and tensioner apparatus and methods of their use for sealing a vascular puncture
US73319794 juin 200319 févr. 2008Access Closure, Inc.Apparatus and methods for sealing a vascular puncture
US73352205 nov. 200426 févr. 2008Access Closure, Inc.Apparatus and methods for sealing a vascular puncture
US73415955 juin 200211 mars 2008Rex Medical, L.PVascular hole closure device
US736118321 mai 200422 avr. 2008Ensure Medical, Inc.Locator and delivery device and method of use
US755331922 mars 200430 juin 2009Accessclosure, Inc.Auto-injector apparatus and methods for sealing a vascular puncture
US75977053 déc. 20036 oct. 2009St. Jude Medical Puerto Rico LlcVascular puncture seal anchor nest
US761843612 avr. 200517 nov. 2009St. Jude Medical Puerto Rico LlcTissue puncture closure device with scroll gear transmission tamping system
US76219373 déc. 200324 nov. 2009St. Jude Medical Puerto Rico LCVascular sealing device with high surface area sealing plug
US762262812 janv. 200624 nov. 2009Innovasa CorporationHemostatic wire guided bandage and method of use
US764522921 sept. 200412 janv. 2010Armstrong David NInstrument and method for endoscopic visualization and treatment of anorectal fistula
US76487139 juil. 200319 janv. 2010Incept LlcMethods of using in situ hydration of hydrogel articles for sealing or augmentation of tissue or vessels
US766216117 mai 200416 févr. 2010Rex Medical, L.PVascular hole closure device
US766216814 mai 200416 févr. 2010Rex Medical, L.P.Vascular closure
US774924818 sept. 20066 juil. 2010St. Jude Medical Puerto Rico LlcFlexible tamping device
US77539336 avr. 200513 juil. 2010Ensure Medical, Inc.Plug with detachable guidewire element and methods for use
US778098019 avr. 200624 août 2010Incept, LlcMethods of using in situ hydration of hydrogel articles for sealing or augmentation of tissue or vessels
US77901925 nov. 20047 sept. 2010Accessclosure, Inc.Apparatus and methods for sealing a vascular puncture
US780690424 févr. 20045 oct. 2010Integrated Vascular Systems, Inc.Closure device
US780691031 juil. 20065 oct. 2010Abbott LaboratoriesMulti-element biased suture clip
US781989518 avr. 200626 oct. 2010Integrated Vascular Systems, Inc.Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US78288174 août 20059 nov. 2010Integrated Vascular Systems, Inc.Apparatus and methods for delivering a closure device
US784150218 déc. 200730 nov. 2010Abbott LaboratoriesModular clip applier
US784206830 nov. 200130 nov. 2010Integrated Vascular Systems, Inc.Apparatus and methods for providing tactile feedback while delivering a closure device
US78507094 juin 200314 déc. 2010Abbott Vascular Inc.Blood vessel closure clip and delivery device
US785079712 mars 200914 déc. 2010Integrated Vascular Systems, Inc.Methods for manufacturing a clip and clip
US785481017 déc. 200321 déc. 2010Integrated Vascular Systems, Inc.Methods for manufacturing a clip and clip
US785782520 nov. 200328 déc. 2010Cook Biotech IncorporatedEmbolization device
US78672498 août 200311 janv. 2011Integrated Vascular Systems, Inc.Clip applier and methods of use
US786725331 août 200711 janv. 2011Kimberly-Clark Worldwide, Inc.Suture retention hub
US78790719 mai 20031 févr. 2011Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US78875559 juil. 200315 févr. 2011Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US788756314 juin 200515 févr. 2011Abbott Vascular Inc.Surgical staple
US789716721 juin 20061 mars 2011Cook IncorporatedImplantable graft to close a fistula
US79014283 oct. 20028 mars 2011Integrated Vascular Systems, Inc.Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US790590030 janv. 200315 mars 2011Integrated Vascular Systems, Inc.Clip applier and methods of use
US791887318 sept. 20065 avr. 2011Abbott Vascular Inc.Surgical staple
US793166917 mai 200226 avr. 2011Integrated Vascular Systems, Inc.Integrated vascular device with puncture site closure component and sealant and methods of use
US79428883 janv. 200617 mai 2011Rex Medical, L.P.Vascular hole closure device
US794289710 juil. 200317 mai 2011Boston Scientific Scimed, Inc.System for closing an opening in a body cavity
US79933658 juin 20049 août 2011Morris Innovative, Inc.Method and apparatus for sealing access
US7993367 *28 sept. 20079 août 2011Accessclosure, Inc.Apparatus and methods for sealing a vascular puncture
US80075128 oct. 200330 août 2011Integrated Vascular Systems, Inc.Plunger apparatus and methods for delivering a closure device
US80256402 juin 200927 sept. 2011Tyco Healthcare Group LpPressurized surgical valve
US80481084 févr. 20091 nov. 2011Abbott Vascular Inc.Vascular closure methods and apparatuses
US80575103 mai 200515 nov. 2011Ensure Medical, Inc.Plug with collet and apparatus and method for delivering such plugs
US807077223 janv. 20096 déc. 2011Rex Medical, L.P.Vascular hole closure device
US80755878 août 200513 déc. 2011Ensure Medical, Inc.Apparatus and methods for sealing vascular punctures
US807558929 nov. 200613 déc. 2011St. Jude Medical Puerto Rico LlcVascular sealing device with high surface area sealing plug
US80837667 juil. 200627 déc. 2011Rex Medical, LpSeptal defect closure device
US808376819 janv. 200527 déc. 2011Ensure Medical, Inc.Vascular plug having composite construction
US8088144 *5 oct. 20053 janv. 2012Ensure Medical, Inc.Locator and closure device and method of use
US81056228 août 200731 janv. 2012Incept LlcMethods of using in situ hydration of hydrogel articles for sealing or augmentation of tissue or vessels
US8118831 *14 janv. 200421 févr. 2012Radi Medical Systems AbClosure device and method for sealing a puncture in a blood vessel
US811883215 juin 200921 févr. 2012Morris Innovative, Inc.Method and apparatus for sealing access
US812864419 sept. 20036 mars 2012Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US812865213 nov. 20036 mars 2012St. Jude Medical Puerto Rico LlcMethod and apparatus for sealing an internal tissue puncture incorporating a block and tackle
US812865317 août 20076 mars 2012Rex Medical, L.P.Vascular hole closure device
US81373805 sept. 200820 mars 2012Transluminal Technologies, LlcClosure device, deployment apparatus, and method of deploying a closure device
US815781631 août 200717 avr. 2012Kimberly-Clark Worldwide, Inc.Gastropexy kit
US81778094 sept. 200915 mai 2012Curaseal Inc.Inflatable device for enteric fistula treatment
US81824974 oct. 201022 mai 2012Integrated Vascular Systems, Inc.Closure device
US819245613 juil. 20095 juin 2012Vascular Solutions, Inc.Metal vascular aperture closure device
US819245913 déc. 20105 juin 2012Abbott Vascular Inc.Blood vessel closure clip and delivery device
US820228312 nov. 201019 juin 2012Integrated Vascular Systems, Inc.Methods for manufacturing a clip and clip
US820229320 juin 200819 juin 2012Integrated Vascular Systems, Inc.Clip applier and methods of use
US820229420 déc. 201019 juin 2012Integrated Vascular Systems, Inc.Clip applier and methods of use
US820641628 sept. 200926 juin 2012Curaseal Inc.Inflatable device for enteric fistula treatment
US822145128 sept. 200917 juil. 2012Curaseal Inc.Inflatable device for enteric fistula treatment
US822668125 juin 200724 juil. 2012Abbott LaboratoriesMethods, devices, and apparatus for managing access through tissue
US823602627 mars 20067 août 2012Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US825202213 juil. 200928 août 2012Vascular Solutions, Inc.Metal vascular aperture closure device
US825739015 févr. 20074 sept. 2012Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US82626935 nov. 200411 sept. 2012Accessclosure, Inc.Apparatus and methods for sealing a vascular puncture
US830362415 mars 20106 nov. 2012Abbott Cardiovascular Systems, Inc.Bioabsorbable plug
US831349728 juin 200620 nov. 2012Abbott LaboratoriesClip applier and methods of use
US831782325 avr. 200827 nov. 2012Cook Biotech IncorporatedBodily lumen closure apparatus and method
US83233129 juin 20094 déc. 2012Abbott LaboratoriesClosure device
US833378731 déc. 200718 déc. 2012St. Jude Medical Puerto Rico LlcVascular closure device having a flowable sealing material
US834897127 août 20048 janv. 2013Accessclosure, Inc.Apparatus and methods for facilitating hemostasis within a vascular puncture
US837709426 sept. 201119 févr. 2013Curaseal Inc.Enteric fistula treatment devices
US838277216 avr. 201226 févr. 2013Kimberly-Clark Worldwide, Inc.Gastropexy kit
US83827944 janv. 200626 févr. 2013St. Jude Medical Puerto Rico LlcBalloon insertion apparatus and method of sealing a tissue puncture
US838279527 août 200926 févr. 2013St. Jude Medical Puerto Rico LlcVascular puncture seal anchor nest
US83986562 mars 201119 mars 2013Integrated Vascular Systems, Inc.Clip applier and methods of use
US839867629 oct. 200919 mars 2013Abbott Vascular Inc.Closure device
US839867728 mai 201019 mars 2013Boston Scientific Scimed, Inc.Closure device with textured surface
US84092489 juil. 20102 avr. 2013Core Medical, Inc.Plug with detachable guidewire element and methods for use
US846551612 mai 200418 juin 2013Oregon Health Science UniversityBodily lumen closure apparatus and method
US846551727 mai 201018 juin 2013St. Jude Medical Puerto Rico LlcFlexible tamping device
US84699954 juin 201225 juin 2013Abbott Vascular Inc.Blood vessel closure clip and delivery device
US84703627 sept. 201025 juin 2013Accessclosure, Inc.Methods for sealing a vascular puncture using a plug including unreactive precursors
US848609211 mars 200916 juil. 2013Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US84861081 févr. 200616 juil. 2013Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US849162917 oct. 201123 juil. 2013Rex MedicalVascular hole closure delivery device
US85012171 févr. 20116 août 2013Cook Medical Technologies LlcImplantable graft to close a fistula
US850659224 août 200913 août 2013St. Jude Medical, Inc.Method and system for sealing percutaneous punctures
US851237210 janv. 201220 août 2013Radi Medical Systems AbClosure device and method for sealing a puncture in a blood vessel
US851805713 sept. 201227 août 2013Abbott LaboratoriesClip applier and methods of use
US85180632 juil. 200827 août 2013Russell A. HouserArteriotomy closure devices and techniques
US85295876 juin 201210 sept. 2013Integrated Vascular Systems, Inc.Methods of use of a clip applier
US85353491 juil. 200817 sept. 2013Cook Biotech IncorporatedFistula grafts having a deflectable graft body portion
US855693028 juin 200615 oct. 2013Abbott LaboratoriesVessel closure device
US855693219 mai 201115 oct. 2013Abbott Cardiovascular Systems, Inc.Collapsible plug for tissue closure
US856844521 août 200729 oct. 2013St. Jude Medical Puerto Rico LlcExtra-vascular sealing device and method
US857993224 févr. 200412 nov. 2013Integrated Vascular Systems, Inc.Sheath apparatus and methods for delivering a closure device
US85799348 nov. 200712 nov. 2013Ensure Medical, Inc.Locator and delivery device and method of use
US858583618 juin 201219 nov. 2013Integrated Vascular Systems, Inc.Methods for manufacturing a clip and clip
US859076024 mai 200526 nov. 2013Abbott Vascular Inc.Surgical stapler
US859732428 déc. 20093 déc. 2013Rex Medical L.P.Vascular hole closure device
US859732529 nov. 20103 déc. 2013Integrated Vascular Systems, Inc.Apparatus and methods for providing tactile feedback while delivering a closure device
US86031164 août 201010 déc. 2013Abbott Cardiovascular Systems, Inc.Closure device with long tines
US86031363 mai 200710 déc. 2013Integrated Vascular Systems, Inc.Apparatus and methods for providing tactile feedback while delivering a closure device
US861718415 févr. 201131 déc. 2013Abbott Cardiovascular Systems, Inc.Vessel closure system
US86578528 mars 201325 févr. 2014Abbott Vascular Inc.Closure device
US86729536 juin 201118 mars 2014Abbott LaboratoriesTissue closure system and methods of use
US869091031 mars 20068 avr. 2014Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US870903812 juin 200329 avr. 2014Boston Scientific Scimed, Inc.Puncture hole sealing device
US872811918 févr. 201120 mai 2014Abbott Vascular Inc.Surgical staple
US874093430 mars 20063 juin 2014Rex Medical, L.P.Closure device for left atrial appendage
US874743910 juil. 200610 juin 2014P Tech, LlcMethod of using ultrasonic vibration to secure body tissue with fastening element
US875839627 avr. 200624 juin 2014Integrated Vascular Systems, Inc.Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US87583987 sept. 200724 juin 2014Integrated Vascular Systems, Inc.Apparatus and method for delivering a closure element
US87583992 août 201024 juin 2014Abbott Cardiovascular Systems, Inc.Expandable bioabsorbable plug apparatus and method
US87584008 nov. 201024 juin 2014Integrated Vascular Systems, Inc.Closure system and methods of use
US876479130 mai 20071 juil. 2014Cook Medical Technologies LlcImplantable graft to close a fistula
US878444725 avr. 200522 juil. 2014Abbott Vascular Inc.Surgical stapler
US880831014 févr. 200719 août 2014Integrated Vascular Systems, Inc.Resettable clip applier and reset tools
US88083293 avr. 201219 août 2014Bonutti Skeletal Innovations LlcApparatus and method for securing a portion of a body
US881490231 juil. 200626 août 2014Bonutti Skeletal Innovations LlcMethod of securing body tissue
US882060219 nov. 20102 sept. 2014Abbott LaboratoriesModular clip applier
US88215346 déc. 20102 sept. 2014Integrated Vascular Systems, Inc.Clip applier having improved hemostasis and methods of use
US884064031 déc. 200723 sept. 2014St. Jude Medical Puerto Rico LlcVascular closure device having an improved plug
US884091715 juil. 201323 sept. 2014Cook Medical Technologies LlcImplantable graft to close a fistula
US884568312 août 201330 sept. 2014St. Jude Medical, Inc.Method and system for sealing percutaneous punctures
US884568717 sept. 201330 sept. 2014Bonutti Skeletal Innovations LlcAnchor for securing a suture
US88456996 mars 201230 sept. 2014Bonutti Skeletal Innovations LlcMethod of securing tissue
US885222917 oct. 20037 oct. 2014Cordis CorporationLocator and closure device and method of use
US885223029 avr. 20107 oct. 2014Incept LlcApparatus and methods for sealing a vascular puncture
US885859418 déc. 200914 oct. 2014Abbott LaboratoriesCurved closure device
US88768612 nov. 20104 nov. 2014Transluminal Technologies, Inc.Closure device, deployment apparatus, and method of deploying a closure device
US887686214 avr. 20114 nov. 2014Phillips Medical LlcHemostatic device and its methods of use
US888881214 nov. 201118 nov. 2014Cordis CorporationPlug with collet and apparatus and methods for delivering such plugs
US889394717 déc. 200725 nov. 2014Abbott LaboratoriesClip applier and methods of use
US890593726 févr. 20099 déc. 2014Integrated Vascular Systems, Inc.Methods and apparatus for locating a surface of a body lumen
US890605927 juin 20089 déc. 2014Rex Medical, L.P.Vascular hole closure device
US891594114 juin 201223 déc. 2014Cook Medical Technologies LlcFistula closure devices and methods
US892044223 août 200630 déc. 2014Abbott Vascular Inc.Vascular opening edge eversion methods and apparatuses
US892046213 avr. 201130 déc. 2014Rex Medical, L.P.Vascular hole closure device
US892046313 avr. 201130 déc. 2014Rex Medical, L.P.Vascular hole closure device
US892663319 juin 20066 janv. 2015Abbott LaboratoriesApparatus and method for delivering a closure element
US892665414 avr. 20086 janv. 2015Cordis CorporationLocator and closure device and method of use
US892665610 janv. 20116 janv. 2015Integated Vascular Systems, Inc.Clip applier and methods of use
US894000228 sept. 201127 janv. 2015Kardium Inc.Tissue anchor system
US895128330 oct. 200710 févr. 2015Access Closure, Inc.Apparatus and methods for sealing a vascular puncture
US895638821 avr. 200817 févr. 2015Integrated Vascular Systems, Inc.Integrated vascular device with puncture site closure component and sealant
US896154131 oct. 200824 févr. 2015Cardio Vascular Technologies Inc.Vascular closure devices, systems, and methods of use
US89683617 nov. 20113 mars 2015Rex Medical, L.P.Vascular hole closure device
US897449321 févr. 201210 mars 2015Morris Innovative, Inc.Method and apparatus for sealing access
US898673029 mai 201324 mars 2015Incept, LlcMethods for sealing a vascular puncture
US899256721 sept. 200931 mars 2015Cardiovascular Technologies Inc.Compressible, deformable, or deflectable tissue closure devices and method of manufacture
US902309425 juin 20085 mai 2015Microvention, Inc.Self-expanding prosthesis
US90284484 mai 200912 mai 2015Covidien LpAccess seal with interstitial channels
US903973828 nov. 201126 mai 2015St. Jude Medical Puerto Rico LlcVascular sealing device with high surface area sealing plug
US905006820 mai 20139 juin 2015Abbott LaboratoriesClip applier and methods of use
US905008714 mai 20089 juin 2015Integrated Vascular Systems, Inc.Integrated vascular device with puncture site closure component and sealant and methods of use
US90607691 mai 200823 juin 2015Abbott Vascular Inc.Surgical stapler
US907251115 mars 20127 juil. 2015Kardium Inc.Medical kit for constricting tissue or a bodily orifice, for example, a mitral valve
US90893118 janv. 201028 juil. 2015Abbott Vascular Inc.Vessel closure devices and methods
US908967415 sept. 200628 juil. 2015Integrated Vascular Systems, Inc.Apparatus and methods for positioning a vascular sheath
US911385124 juil. 200825 août 2015Cook Biotech IncorporatedFistula plugs and apparatuses and methods for fistula plug delivery
US913194115 juin 201215 sept. 2015Curaseal Inc.Fistula treatment devices and methods
US914926221 juin 20076 oct. 2015Cook Biotech IncorporatedFistula grafts and related methods and systems useful for treating gastrointestinal fistulae
US914927621 mars 20116 oct. 2015Abbott Cardiovascular Systems, Inc.Clip and deployment apparatus for tissue closure
US91555309 nov. 201113 oct. 2015Transluminal Technologies, LlcSpecially designed magnesium-aluminum alloys and medical uses thereof in a hemodynamic environment
US91736448 janv. 20103 nov. 2015Abbott Vascular Inc.Closure devices, systems, and methods
US917990019 avr. 201010 nov. 2015Phillips Medical LlcHemostatic device and its methods of use
US919246823 janv. 201424 nov. 2015Kardium Inc.Method for anchoring a mitral valve
US920496413 juin 20138 déc. 2015Kardium Inc.Medical device, kit and method for constricting tissue or a bodily orifice, for example, a mitral valve
US921111615 juin 201215 déc. 2015Curaseal Inc.Fistula treatment devices and related methods
US92267363 juin 20105 janv. 2016Cook Biotech IncorporatedVolumetric grafts for treatment of fistulae and related methods and systems
US9226738 *2 avr. 20125 janv. 2016Rex Medical, L.P.Vascular hole closure delivery device
US924169629 oct. 200926 janv. 2016Abbott Vascular Inc.Closure device
US925434610 sept. 20129 févr. 2016St. Jude Medical Puerto Rico LlcVascular closure device having a flowable sealing material
US92717078 mars 20131 mars 2016Integrated Vascular Systems, Inc.Clip applier and methods of use
US928295331 déc. 200715 mars 2016St. Jude Medical Puerto Rico LlcSystems and methods for locating and closing a tissue puncture
US928296516 mai 200815 mars 2016Abbott LaboratoriesApparatus and methods for engaging tissue
US928919522 mars 200422 mars 2016Access Closure, Inc.Auto-retraction apparatus and methods for sealing a vascular puncture
US92954585 juil. 201329 mars 2016Rex Medical, L.P.Vascular hole closure delivery device
US92954693 juin 201329 mars 2016Abbott Vascular Inc.Blood vessel closure clip and delivery device
US931423022 août 201419 avr. 2016Abbott Vascular Inc.Closure device with rapidly eroding anchor
US932052231 août 201126 avr. 2016Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US933297630 nov. 201110 mai 2016Abbott Cardiovascular Systems, Inc.Tissue closure device
US93392615 juil. 201317 mai 2016Rex Medical, L.P.Vascular hole closure delivery device
US93454609 avr. 201024 mai 2016Cardiovascular Technologies, Inc.Tissue closure devices, device and systems for delivery, kits and methods therefor
US93642063 oct. 201114 juin 2016Access Closure, Inc.Apparatus and methods for sealing a vascular puncture
US936420921 déc. 201214 juin 2016Abbott Cardiovascular Systems, Inc.Articulating suturing device
US938696811 mai 201112 juil. 2016Access Closure, Inc.Apparatus and methods for sealing a vascular puncture
US938696923 févr. 201512 juil. 2016Incept, LlcMethods for sealing a vascular puncture
US93989143 sept. 201326 juil. 2016Integrated Vascular Systems, Inc.Methods of use of a clip applier
US94026252 mai 20082 août 2016Abbott Vascular Inc.Surgical stapler
US94148208 janv. 201016 août 2016Abbott Vascular Inc.Closure devices, systems, and methods
US94148243 juil. 201416 août 2016Abbott Vascular Inc.Closure devices, systems, and methods
US945681123 août 20064 oct. 2016Abbott Vascular Inc.Vascular closure methods and apparatuses
US94568132 avr. 20124 oct. 2016Cook Biotech IncorporatedVolumetric grafts for treatment of fistulae and related methods and systems
US945681521 août 20144 oct. 2016Cook Medical Technologies LlcImplantable graft to close a fistula
US94568163 nov. 20144 oct. 2016Transluminal Technologies, LlcClosure device, deployment apparatus, and method of deploying a closure device
US94630044 mai 201011 oct. 2016Incept, Llc.Biomaterials for track and puncture closure
US946300510 nov. 201211 oct. 2016Rex Medical, L.P.Vascular hole closure device
US946842813 juin 201218 oct. 2016Phillips Medical LlcHemostatic device and its methods of use
US948619120 mai 20118 nov. 2016Abbott Vascular, Inc.Closure devices
US949214812 déc. 200315 nov. 2016CARDINAL HEALTH SWITZERLAND 515 GmbHApparatus and methods for sealing vascular punctures
US949214912 nov. 200815 nov. 2016Cook Biotech IncorporatedFistula grafts and related methods and systems useful for treating gastrointestinal and other fistulae
US949819611 nov. 201322 nov. 2016Integrated Vascular Systems, Inc.Sheath apparatus and methods for delivering a closure device
US952648420 mai 201427 déc. 2016Cook Medical Technologies LlcImplantable graft to close a fistula
US953899631 janv. 200710 janv. 2017Cook Biotech IncorporatedFistula grafts and related methods and systems for treating fistulae
US95497159 août 201224 janv. 2017Cook Regentec LlcVial useable in tissue extraction procedures
US95547867 avr. 201431 janv. 2017Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US95725561 mai 200621 févr. 2017Cook Biotech IncorporatedVolumetric grafts for treatment of fistulae and related methods and systems
US957255715 oct. 201221 févr. 2017Kardium Inc.Method and device for closing holes in tissue
US95790913 avr. 200628 févr. 2017Integrated Vascular Systems, Inc.Closure system and methods of use
US957910330 avr. 201028 févr. 2017Endologix, Inc.Percutaneous method and device to treat dissections
US95856467 avr. 20147 mars 2017Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US958564712 nov. 20147 mars 2017Abbott LaboratoriesMedical device for repairing a fistula
US961581727 févr. 201511 avr. 2017Surgical Innovations LlcWound closure apparatus and method
US964260412 avr. 20129 mai 2017Phillips Medical LlcHemostatic system and its methods of use
US965560215 déc. 201123 mai 2017CARDINAL HEALTH SWITZERLAND 515 GmbHVascular plug having composite construction
US96872154 nov. 200927 juin 2017Cook Biotech IncorporatedVolumetric grafts for treatment of fistulae and related methods and systems
US968721628 juin 201627 juin 2017Incept, LlcMethods for sealing a vascular puncture
US97240814 juin 20138 août 2017Phillips Medical LlcHemostatic system and its methods of use
US97440386 oct. 201029 août 2017Kardium Inc.Medical device for constricting tissue or a bodily orifice, for example a mitral valve
US975048921 mai 20155 sept. 2017Terumo Puerto Rico, L.L.C.Vascular sealing device with high surface area sealing plug
US975710628 oct. 201312 sept. 2017Cook Medical Technologies LlcDegradable expanding closure plug
US977023823 févr. 200426 sept. 2017P Tech, LlcMagnetic positioning apparatus
US978215513 déc. 201410 oct. 2017Rex Medical, L.P.Vascular hole closure device
US20020072768 *30 nov. 200113 juin 2002Ginn Richard S.Apparatus and methods for providing tactile feedback while delivering a closure device
US20020133193 *17 mai 200219 sept. 2002Ginn Richard S.Integrated vascular device with puncture site closure component and sealant and methods of use
US20030014075 *16 juil. 200116 janv. 2003Microvention, Inc.Methods, materials and apparatus for deterring or preventing endoleaks following endovascular graft implanation
US20030078598 *3 oct. 200224 avr. 2003Integrated Vascular Systems, Inc.Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US20030109890 *23 janv. 200312 juin 2003Glenn KannerAdvanced wound site management systems and methods
US20030144695 *16 janv. 200331 juil. 2003Mcguckin James F.Vascular hole closure device
US20040009205 *9 juil. 200315 janv. 2004Incept LlcMethods of using in situ hydration of hydrogel articles for sealing or augmentation of tissue or vessels
US20040009289 *9 juil. 200315 janv. 2004Carley Michael T.Closure device and methods for making and using them
US20040073236 *19 sept. 200315 avr. 2004Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US20040073255 *8 oct. 200315 avr. 2004Ginn Richard SPlunger apparatus and methods for delivering a closure device
US20040083002 *22 oct. 200329 avr. 2004Belef William MartinMethods for treating spinal discs
US20040122349 *20 déc. 200224 juin 2004Lafontaine Daniel M.Closure device with textured surface
US20040127940 *12 déc. 20031 juil. 2004Ginn Richard S.Apparatus and methods for sealing vascular punctures
US20040153122 *30 janv. 20035 août 2004Integrated Vascular Systems, Inc.Clip applier and methods of use
US20040204741 *14 janv. 200414 oct. 2004Radi Medical Systems AbClosure device and method for sealing a puncture in a blood vessel
US20040267193 *22 mars 200430 déc. 2004Accessclosure, Inc.Auto-injector apparatus and methods for sealing a vascular puncture
US20040267307 *22 mars 200430 déc. 2004Access Closure, Inc.Occlusion member and tensioner apparatus and methods of their use for sealing a vascular puncture
US20040267308 *22 mars 200430 déc. 2004Accessclosure, Inc.Auto-retraction apparatus and methods for sealing a vascular puncture
US20050033326 *17 mai 200410 févr. 2005Briganti Richard T.Vascular hole closure device
US20050049637 *8 juin 20043 mars 2005Morris Edward J.Method and apparatus for sealing access
US20050055049 *14 mai 200410 mars 2005Mcguckin James F.Vascular closure
US20050070759 *21 sept. 200431 mars 2005Armstrong David N.Instrument and method for endoscopic visualization and treatment of anorectal fistula
US20050085854 *17 oct. 200321 avr. 2005Ensure Medical, Inc.Locator and closure device and method of use
US20050085856 *21 mai 200421 avr. 2005Ensure Medical, Inc.Locator and delivery device and method of use
US20050119695 *3 janv. 20052 juin 2005Carley Michael T.Closure device and methods for making and using them
US20050125030 *3 déc. 20039 juin 2005Forsberg Andrew T.Vascular puncture seal anchor nest
US20050125031 *3 déc. 20039 juin 2005Pipenhagen Catherine A.Vascular sealing device with high surface area sealing plug
US20050149117 *24 déc. 20037 juil. 2005Farhad KhosraviApparatus and methods for delivering sealing materials during a percutaneous procedure to facilitate hemostasis
US20050155608 *12 mai 200421 juil. 2005Cook IncorporatedBodily lumen closure apparatus and method
US20050159776 *21 janv. 200521 juil. 2005Cook IncorporatedImplantable graft to close a fistula
US20050177189 *6 avr. 200511 août 2005Ginn Richard S.Plug with detachable guidewire element and methods for use
US20050216057 *25 avr. 200529 sept. 2005James ColemanSurgical stapler
US20050267521 *13 mai 20041 déc. 2005St. Jude Medical Puerto Rico B.V.Collagen sponge for arterial sealing
US20050267528 *19 janv. 20051 déc. 2005Ensure Medical, Inc.Vascular plug having composite construction
US20050267530 *14 juin 20051 déc. 2005Christy CumminsSurgical staple
US20050273137 *8 août 20058 déc. 2005Core Medical, Inc.Apparatus and methods for sealing vascular punctures
US20050274768 *24 mai 200515 déc. 2005Christy CumminsSurgical stapler
US20060058844 *13 sept. 200416 mars 2006St. Jude Medical Puerto Rico B.V.Vascular sealing device with locking system
US20060074447 *21 janv. 20056 avr. 2006Cook IncorporatedImplantable graft to close a fistula
US20060142798 *27 déc. 200429 juin 2006Holman Thomas JDevice and method for closing an opening in a body cavity or lumen
US20060144479 *17 déc. 20036 juil. 2006Integrated Vascular Systems, Inc.Methods for manufacturing a clip and clip
US20060155327 *3 janv. 200613 juil. 2006Briganti Richard TVascular hole closure device
US20060167484 *27 mars 200627 juil. 2006Carley Michael TClosure device and methods for making and using them
US20060190014 *31 janv. 200624 août 2006Ginn Richard SIntegrated vascular device with puncture site closure component and sealant and methods of use
US20060190038 *1 févr. 200624 août 2006Carley Michael TClosure device and methods for making and using them
US20060193899 *19 avr. 200631 août 2006Incept LlcMethods of using in situ hydration of hydrogel articles for sealing or augmentation of tissue or vessels
US20060195123 *18 avr. 200631 août 2006Ginn Richard SVascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US20060195124 *27 avr. 200631 août 2006Ginn Richard SVascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US20060229674 *12 avr. 200512 oct. 2006St. Jude Medical Puerto Rico B.V.Tissue puncture closure device with scroll gear transmission tamping system
US20060253037 *5 oct. 20059 nov. 2006Ensure Medical, Inc.Locator and closure device and method of use
US20060276839 *7 juil. 20067 déc. 2006Rex MedicalSeptal defect closure device
US20070010854 *18 sept. 200611 janv. 2007Christy CumminsSurgical Staple
US20070021778 *19 juin 200625 janv. 2007Abbott Laboratories Abbott Vascular DevicesApparatus and method for delivering a closure element
US20070031508 *21 juin 20068 févr. 2007Armstrong David NImplantable graft to close a fistula
US20070032824 *4 août 20058 févr. 2007St. Jude Medical Puerto Rico B.V.Tissue puncture closure device with track plug
US20070038244 *11 oct. 200615 févr. 2007Morris Edward JMethod and apparatus for sealing access
US20070038245 *11 oct. 200615 févr. 2007Morris Edward JDilator
US20070060950 *27 oct. 200415 mars 2007Farhad KhosraviApparatus and methods for delivering sealing materials during a percutaneous procedure to facilitate hemostasis
US20070073345 *29 nov. 200629 mars 2007St. Jude Medical Puerto Rico B.V.Vascular sealing device with high surface area sealing plug
US20070129757 *1 déc. 20067 juin 2007Cook IncorporatedDevices, systems, and methods for occluding a defect
US20070156084 *4 janv. 20065 juil. 2007St. Jude Medical Puerto Rico B.V.Balloon insertion apparatus and method of sealing a tissue puncture
US20070198057 *21 févr. 200623 août 2007Daniel GelbartMethod and device for closing holes in tissue
US20070198059 *31 janv. 200723 août 2007Patel Umesh HFistula grafts and related methods and systems for treating fistulae
US20070203506 *23 août 200630 août 2007Sibbitt Wilmer L JrVascular closure methods and apparatuses
US20070233278 *30 mai 20074 oct. 2007Cook IncorporatedImplantable graft to close a fistula
US20070250080 *14 févr. 200725 oct. 2007Integrated Vascular Systems, Inc.Resettable clip applier and reset tools
US20070270891 *30 mars 200622 nov. 2007Mcguckin James F JrClosure device for left atrial appendage
US20070270904 *3 mai 200722 nov. 2007Integrated Vascular Systems, Inc.Apparatus and Methods for Providing Tactile Feedback while Delivering a Closure Device
US20070276416 *15 févr. 200729 nov. 2007Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US20070293880 *17 août 200720 déc. 2007Rex MedicalVascular hole closure device
US20080004636 *28 juin 20063 janv. 2008Abbott LaboratoriesClip applier and methods of use
US20080004657 *1 mai 20063 janv. 2008Obermiller F JVolumetric grafts for treatment of fistulae and related methods and systems
US20080017201 *8 août 200724 janv. 2008Incept LlcMethods of using in situ hydration of hydrogel articles for sealing or augmentation of tissue or vessels
US20080027477 *21 juin 200731 janv. 2008Obermiller F JFistula grafts and related methods and systems useful for treating gastrointestinal fistulae
US20080065151 *8 nov. 200713 mars 2008Ginn Richard SLocator and delivery device and method of use
US20080065152 *7 sept. 200713 mars 2008Abbott LaboratoriesApparatus and method for delivering a closure element
US20080071311 *18 sept. 200620 mars 2008St. Jude Medical Puerto Rico B.V.Flexible tamping device
US20080077178 *19 mars 200727 mars 2008Datascope Investment Corp.Device and method for sealing puncture wounds
US20080097521 *30 oct. 200724 avr. 2008Accessclosure, Inc.Apparatus and methods for sealing a vascular puncture
US20080109030 *31 oct. 20078 mai 2008Houser Russell AArteriotomy closure devices and techniques
US20080114394 *31 oct. 200715 mai 2008Houser Russell AArteriotomy Closure Devices and Techniques
US20080210737 *21 avr. 20084 sept. 2008Integrated Vascular Systems, Inc.Integrated vascular device with puncture site closure component and sealant and methods of use
US20080215087 *25 avr. 20084 sept. 2008Dusan PavcnikBodily lumen closure apparatus and method
US20080221615 *14 avr. 200811 sept. 2008Ginn Richard SLocator and closure device and method of use
US20080221616 *14 mai 200811 sept. 2008Integrated Vascular Systems, Inc.Integrated vascular device with puncture site closure component and sealant and methods of use
US20080245374 *7 avr. 20089 oct. 2008Agnew Charles WFistula plugs having increased column strength and fistula plug delivery apparatuses and methods
US20080269802 *2 mai 200830 oct. 2008Abbott Vascular Inc.Surgical stapler
US20080312686 *9 juin 200818 déc. 2008Abbott LaboratoriesAntimicrobial closure element and closure element applier
US20080319475 *25 juin 200725 déc. 2008Abbott LaboratoriesMethods, Devices, and Apparatus for Managing Access Through Tissue
US20080319525 *25 juin 200825 déc. 2008Microvention, Inc.Self-Expanding Prosthesis
US20090005777 *2 juil. 20081 janv. 2009Vascular Closure Systems, Inc.Arteriotomy closure devices and techniques
US20090012558 *1 juil. 20088 janv. 2009Steve ChenFistula grafts having a deflectable graft body portion
US20090024106 *17 juil. 200722 janv. 2009Morris Edward JMethod and apparatus for maintaining access
US20090054926 *21 août 200726 févr. 2009St. Jude Medical Puerto Rico B.V.Extra-vascular sealing device and method
US20090062742 *31 août 20075 mars 2009John Anthony RotellaBlunted Safety Needle
US20090062743 *31 août 20075 mars 2009John Anthony RotellaGastropexy Kit
US20090062853 *31 août 20075 mars 2009Mcmichael Donald JaySuture Retention Hub
US20090069844 *5 sept. 200812 mars 2009Transluminal Technologies, LlcClosure Device, Deployment Apparatus, and Method of Deploying a Closure Device
US20090088723 *3 juil. 20082 avr. 2009Accessclosure, Inc.Apparatus and methods for treating pseudoaneurysms
US20090088793 *28 sept. 20072 avr. 2009Accessclosure, Inc.Apparatus and methods for sealing a vascular puncture
US20090125119 *12 nov. 200814 mai 2009Obermiller F JosephFistula grafts and related methods and systems useful for treating gastrointestinal and other fistulae
US20090143789 *31 oct. 20084 juin 2009Houser Russell AVascular closure devices, systems, and methods of use
US20090157101 *17 déc. 200718 juin 2009Abbott LaboratoriesTissue closure system and methods of use
US20090157102 *17 déc. 200718 juin 2009Abbott LaboratoriesClip applier and methods of use
US20090157103 *18 déc. 200718 juin 2009Abbott LaboratoriesModular clip applier
US20090171281 *31 déc. 20072 juil. 2009Pipenhagen Catherine ASystems and methods for locating and closing a tissue puncture
US20090171282 *31 déc. 20072 juil. 2009Pipenhagen Catherine AVascuar closure device having a flowable sealing material
US20090177212 *11 mars 20099 juil. 2009Integrated Vascular Systems, Inc.Closure device and methods for making and using them
US20090177213 *12 mars 20099 juil. 2009Integrated Vascular Systems, Inc.Methods For Manufacturing A Clip And Clip
US20090187213 *27 juin 200823 juil. 2009Mcguckin Jr James FVascular hole closure device
US20090187215 *18 déc. 200823 juil. 2009Abbott LaboratoriesMethods and apparatus to reduce a dimension of an implantable device in a smaller state
US20090287244 *16 mai 200819 nov. 2009Abbott Laboratories Vascular Enterprises LimitedApparatus and methods for engaging tissue
US20090312790 *27 août 200917 déc. 2009St. Jude Medical Puerto Rico LlcVascular puncture seal anchor nest
US20090326468 *2 juin 200931 déc. 2009Tyco Healthcare Group LpPressurized surgical valve
US20100049246 *4 nov. 200925 févr. 2010Obermiller F JosephVolumetric grafts for treatment of fistulae and related methods and systems
US20100076463 *1 avr. 200925 mars 2010Akshay MavaniImplantable fistula closure device
US20100082056 *1 avr. 20091 avr. 2010Akshay MavaniImplantable fistula closure device
US20100114156 *29 oct. 20096 mai 2010Abbott Vascular Inc.Closure device
US20100114159 *29 oct. 20096 mai 2010Abbott Vascular Inc.Closure device
US20100119451 *18 janv. 201013 mai 2010Incept, LlcMethods of using in situ hydration of hydrogel articles for sealing or augmentation of tissue or vessels
US20100160958 *9 juin 200924 juin 2010Abbott LaboratoriesClosure Device
US20100179572 *8 janv. 201015 juil. 2010Abbott Vascular Inc.Closure devices, systems, and methods
US20100179590 *8 janv. 201015 juil. 2010Abbott Vascular Inc.Vessel closure devices and methods
US20100185234 *15 janv. 201022 juil. 2010Abbott Vascular Inc.Closure devices, systems, and methods
US20100211000 *24 août 200919 août 2010Killion Douglas PMethod and system for sealing percutaneous punctures
US20100217132 *26 févr. 200926 août 2010Abbott LaboratoriesMethods and apparatus for locating a surface of a body lumen
US20100234883 *27 mai 201016 sept. 2010St. Jude Medical Puerto Rico LlcFlexible tamping device
US20100234884 *28 mai 201016 sept. 2010Boston Scientific Scimed, Inc.Closure device with textured surface
US20100249827 *28 sept. 200930 sept. 2010Akshay MavaniInflatable device for enteric fistula treatment
US20100249828 *28 sept. 200930 sept. 2010Akshay MavaniInflatable device for enteric fistula treatement
US20100274280 *29 avr. 201028 oct. 2010Incept, LlcApparatus and methods for sealing a vascular puncture
US20100274281 *9 juil. 201028 oct. 2010Ensure Medical, Inc.Plug with detachable guidewire element and methods for use
US20100280546 *4 mai 20104 nov. 2010Patrick CampbellBiomaterials for track and puncture closure
US20100280588 *30 avr. 20104 nov. 2010Endologix, Inc.Percutaneous method and device to treat dissections
US20100305588 *28 déc. 20092 déc. 2010Briganti Richard TVascular hole closure device
US20100312259 *9 avr. 20109 déc. 2010Houser Russell ATissue closure devices, device and systems for delivery, kits and methods therefor
US20110009900 *13 juil. 200913 janv. 2011Tom HolmanMetal vascular aperture closure device
US20110009901 *13 juil. 200913 janv. 2011Tom HolmanMetal vascular aperture closure device
US20110029013 *12 août 20103 févr. 2011Mcguckin James FVascular Hole Closure Device
US20110046665 *2 nov. 201024 févr. 2011Transluminal Technologies, LlcClosure Device, Deployment Apparatus, and Method of Deploying a Closure Device
US20110054492 *26 août 20093 mars 2011Abbott LaboratoriesMedical device for repairing a fistula
US20110060355 *12 nov. 201010 mars 2011Integrated Vacular Systems, Inc.Methods for manufacturing a clip and clip
US20110066164 *19 nov. 201017 mars 2011Abbott LaboratoriesModular clip applier
US20110066183 *7 sept. 201017 mars 2011Incept, LlcApparatus and methods for sealing a vascular puncture
US20110071565 *29 nov. 201024 mars 2011Integrated Vascular Systems, Inc.Apparatus and methods for providing tactile feedback while delivering a closure device
US20110106148 *8 nov. 20105 mai 2011Integrated Vascular Systems, Inc.Closure system and methods of use
US20110125289 *1 févr. 201126 mai 2011Cook Biotech IncorporatedImplantable Graft to Close a Fistula
US20110137338 *19 avr. 20109 juin 2011Victor Matthew PhillipsHemostatic Device and Its Methods of Use
US20110137340 *14 févr. 20119 juin 2011Abbott Vascular Inc.Surgical staple
US20110144663 *13 déc. 201016 juin 2011Abbott Vascular Inc.Blood Vessel Closure Clip and Delivery Device
US20110144668 *4 oct. 201016 juin 2011Integrated Vascular Systems, Inc.Closure device
US20110144691 *18 févr. 201116 juin 2011Abbott Vascular Inc.Surgical staple
US20110166584 *10 janv. 20117 juil. 2011Integrated Vascular Systems, Inc.Clip applier and methods of use
US20110224719 *15 mars 201015 sept. 2011Abbott Cardiovascular Systems, Inc.Bioabsorbable plug
US20110230897 *2 mars 201122 sept. 2011Integrated Vascular Systems, Inc.Clip applier and methods of use
US20120232583 *2 avr. 201213 sept. 2012Defonzo Stephan AVascular hole closure delivery device
US20120330352 *23 juin 201227 déc. 2012Accessclosure, Inc.Transapical closure devices and methods for use
US20150112288 *22 déc. 201423 avr. 2015Kci Licensing, Inc.Targeted delivery of magnetically tagged active agents in combination with negative pressure wound therapy
US20150209018 *4 avr. 201530 juil. 2015Rex Medical, L.P.Vascular hole closure delivery device
USD61114418 oct. 20072 mars 2010Abbott LaboratoriesApparatus for delivering a closure element
WO2008010738A2 *24 janv. 200724 janv. 2008Uros BabicPatent foramen ovale occluder with suture based anchor
WO2008010738A3 *24 janv. 200730 avr. 2009Uros BabicPatent foramen ovale occluder with suture based anchor
Classifications
Classification aux États-Unis606/213
Classification internationaleA61F2/06, A61F2/04, A61F2/02, A61F2/24, A61F2/00, A61B17/00
Classification coopérativeA61F2002/30062, A61F2/04, A61F2210/0061, A61F2210/0004, A61B17/0057, A61B2017/00659, A61F2002/30075, A61F2/06, A61B2017/00654, A61B2017/00004, A61B2017/00637
Classification européenneA61B17/00P
Événements juridiques
DateCodeÉvénementDescription
5 oct. 1992ASAssignment
Owner name: KENSEY NASH CORPORATION, PENNSYLVANIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:CLUPPER, HAROLD E.;REEL/FRAME:006273/0282
Effective date: 19920925
19 juin 1997FPAYFee payment
Year of fee payment: 8
18 juin 2001FPAYFee payment
Year of fee payment: 12