Patent Publication Number: US-9414820-B2

Title: Closure devices, systems, and methods

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This patent application claims the benefit of and priority to U.S. Provisional Patent Application Ser. No. 61/143,751, entitled “Vessel Closure Devices and Methods,” filed Jan. 9, 2009, the disclosure of which is incorporated herein by reference in its entirety. 
    
    
     BACKGROUND 
     1. Technical Field 
     The present disclosure relates generally to medical devices and their methods of use. In particular, the present disclosure relates to vessel closure systems and devices and corresponding methods of use. 
     2. The Technology 
     Catheterization and interventional procedures, such as angioplasty or stenting, generally are performed by inserting a hollow needle through a patient&#39;s skin and tissue into the vascular system. A guidewire may be advanced through the needle and into the patient&#39;s blood vessel accessed by the needle. The needle is then removed, enabling an introducer sheath to be advanced over the guidewire into the vessel, e.g., in conjunction with or subsequent to a dilator. 
     A catheter or other device may then be advanced through a lumen of the introducer sheath and over the guidewire into a position for performing a medical procedure. Thus, the introducer sheath may facilitate introducing various devices into the vessel, while minimizing trauma to the vessel wall and/or minimizing blood loss during a procedure. 
     Upon completing the procedure, the devices and introducer sheath are removed, leaving a puncture site in the vessel wall. Traditionally, external pressure would be applied to the puncture site until clotting and wound sealing occur; however, the patient must remain bedridden for a substantial period after clotting to ensure closure of the wound. This procedure may also be time consuming and expensive, requiring as much as an hour of a physician&#39;s or nurse&#39;s time. It is also uncomfortable for the patient and requires that the patient remain immobilized in the operating room, catheter lab, or holding area. In addition, a risk of hematoma exists from bleeding before hemostasis occurs. Although some closure systems may be available, they provide limited control to flexibility to the operator, which may lead to improper or undesirable closure of the puncture site. 
     BRIEF SUMMARY 
     A closure system is provided that may include a plurality of needle carriers each having a distal end and a proximal end and a plurality of detachable needles in which at least one of the detachable needles is detachably coupled to the distal end of one of the needle carriers. The detachable needle may be configured to resist proximal movement when deployed in a vessel wall. The closure system may further include at least one suture secured to each of the detachable needles and a guide member having a plurality of first lumens defined therein that extend distally from a proximal end of the guide member toward a distal end of the guide member in which each of the first lumens is sized to receive one of the needle carriers and one of the detachable needles coupled to the needle carrier. The first lumens may be further configured to direct the needle carrier and the detachable needle radially outward and distally away from the guide member. An outer housing may have a distal end and a proximal end in which a second lumen is defined between the distal end of the outer housing and the proximal end of the outer housing. The second lumen may be configured to receive at least a portion of the guide member. An anchor member may be configured to be at least partially disposed within the second lumen. The anchor member may comprise an anchor portion and an elongate portion disposed in the inner lumen in an initial configuration and configured to move to an expanded configuration once when positioned distally from the distal end of the outer housing. 
     A closure system may include a plurality of needle carriers having a distal end and a proximal end. A plurality of detachable needles in which at least one of the detachable needles is detachably coupled to the distal end of each of the needle carriers with a slip fit to allow the detachable carriers and the detachable needles to move together when moving in a distal direction to allow the detachable needles to detach from the needle carriers when the needle carriers are drawn in a proximal direction. At least one suture may be secured to each of the detachable needles. A guide member has a plurality of first lumens defined therein extending distally from a proximal end of the guide member toward a distal end of the guide member in which each of the first lumens is sized to receive one of the needle carriers and one of the detachable needles coupled to the needle carriers the first lumens being further configured to direct the needle carrier and the detachable needle radially outward and distally away from the guide member. An outer housing may have a distal end and a proximal end, wherein a second lumen is defined between the distal end of the outer housing and the proximal end of the outer housing, the second lumen being configured to receive at least a portion of the guide member. An anchor member may be configured to be at least partially disposed within the second lumen. The anchor member may include an anchor portion disposed in the inner lumen in an initial configuration and configured to move to an expanded configuration once when positioned distally from the distal end of the outer housing. 
     A method of closing a puncture in a vessel includes advancing a distal end of a first member into proximity with a puncture in a vessel wall, the first member having a first lumen defined therein. An anchor member may then be advanced through the first lumen and distally from the distal end of the first member and expanding the anchor member distally of the puncture in the vessel. The anchor member may then be drawn proximally into engagement with a posterior side of the vessel wall. A guide member may then be advanced through the first lumen and distally from the distal end of the first member to expose openings in the guide member, each of the openings being in communication with one of a plurality of needle carrier lumens defined in the guide member. Needle carriers and needles coupled to the needle carriers may then be advanced through the needle carrier lumens to move the needles radially outward and distally away from a distal end of the guide member to pass the needles at least partially through the vessel wall, wherein sutures are further coupled to the needles. Thereafter, the needle carriers may be retracted into the guide member to detach the needles from the needle carriers and the guide member may be retracted into the first lumen. Tension may then be established in the sutures with a constrictor to move the needles toward each other to thereby close the puncture. 
     These and other advantages and features of the present disclosure will become more fully apparent from the following description and appended claims, or may be learned by the practice of the disclosure as set forth hereinafter. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       To further clarify at least some of the advantages and features of the present disclosure, a more particular description of the disclosure will be rendered by reference to specific embodiments thereof which are illustrated in the appended drawings. It is appreciated that these drawings depict only illustrated embodiments of the disclosure and are therefore not to be considered limiting of its scope. The disclosure will be described and explained with additional specificity and detail through the use of the accompanying drawings in which: 
         FIG. 1A  illustrates a side view of a closure system according to one example; 
         FIG. 1B  illustrates an exploded view of the closure system of  FIG. 1A ; 
         FIG. 1C  illustrates a cross sectional view of the guide member and associated first plunger of  FIG. 1B  taken along section  1 C- 1 C of  FIG. 1B ; 
         FIG. 1D  illustrates a cross sectional view of the closure system shown in  FIG. 1A  taken along section  1 D- 1 D of  FIG. 1A ; 
         FIG. 2A  illustrates a closure system in an a pre-deployed state according to one example; 
         FIG. 2B  illustrates the closure system of  FIG. 2A  in an intermediate state according to one example; 
         FIG. 2C  illustrates the closure system of  FIGS. 2A-2B  in a deployed state; 
         FIG. 3A  illustrates steps for closing a puncture in a vessel wall in which a closure system is in an a pre-deployed state and in proximity to an arteriotomy according to one example; 
         FIG. 3B  illustrates steps for closing a puncture in a vessel wall in which the closure system of  FIG. 3A  is located relative to a vessel wall; 
         FIG. 3C  illustrates steps for closing a puncture in a vessel wall in which detachable needles are deployed through the vessel wall; 
         FIG. 3D  illustrates a more detailed view of engagement between a detachable needle and the vessel wall of  FIG. 3A ; 
         FIG. 3E  illustrates steps for closing a puncture in a vessel wall in which the sutures and needles are secured in place to close the puncture in the vessel wall; and 
         FIG. 4  illustrates a detachable needle according to one example. 
     
    
    
     It should be noted that the figures are not drawn to scale and that elements of similar structures or functions are generally represented by like reference numerals for illustrative purposes throughout the figures. It also should be noted that the figures are only intended to facilitate the description of example configurations of the present disclosure. 
     DETAILED DESCRIPTION 
     The present disclosure relates to devices, systems, and methods for closing an opening in a body lumen. In one example embodiment, a closure system of the present disclosure may allow an operator to quickly and efficiently close a body lumen opening while simultaneously providing the operator with a greater measure of control and flexibility in positioning and anchoring the closure system than previously available. For example, the closure system may allow an operator to achieve a more intimate securement of a closure element in the tissue surrounding a body lumen opening. In a yet further embodiment, the closure system may be compatible with a wider range of body lumen wall thicknesses, thereby taking into account the possibility of calcifications or scar tissue in the lumen wall. 
       FIG. 1A  illustrates a side view of a closure system  10  according to one example. The closure system  10  may include a handle  100 , an outer housing  110 , a first plunger  120  coupled to a guide member  130 , an optional plug  140 , a second plunger  150  coupled to a plurality of needle carriers  160 A,  160 B, a plurality of detachable needles  170 A,  170 B removably coupled to the needle carriers  160 A,  160 B respectively, an anchor member  180  and control members  190 A,  190 B coupled to the anchor member  180 . 
     The anchor member  180  and control members  190 A,  190 B may cooperate to allow the closure system  10  to be located relative to a puncture in a vessel wall, such as an arteriotomy. Any type of locator having any configuration may be used as desired to position the closure system  10  in proximity to a vessel wall. 
     In the illustrated example, the control members  190 A,  190 B can be manipulated to move the anchor member  180  between a pre-deployed state (not shown in  FIG. 1A ) to the expanded or deployed state shown in  FIG. 1A . In particular, the control members  190 A,  190 B may be coupled to the anchor member  180  and extend proximally from the anchor member  180  through the plug  140 , the guide member  130 , the first plunger  120 , and the second plunger  150 . In the illustrated example, manipulation of the control members  190 A,  190 B may be performed manually, though it will be appreciated that any suitable device and/or method may be used to manipulate the control members  190 A,  190 B. 
     As shown in  FIG. 1B , the control members  190 A,  190 B and the anchor member  180  may form a continuous member. In such an example, retracting the control members  190 A,  190 B may anchor the anchor member  180  against the distal surface of a vessel wall or any other surface against which the anchor member  180  is positioned. In one embodiment, retracting both control members  190 A,  190 B simultaneously may produce tension or some other force in the anchor member  180  which may increase the resistance of the anchor member  180  to contracting. 
     For example, the tension of both control members  190 A,  190 B may be simultaneously transferred to the anchor member  180  thereby creating sufficient tension in the anchor member  180  to resist movement away from its expanded configuration. In addition, providing an opposing force against a proximal surface of the anchor member  180 , such as with a vessel wall, may also assist in creating sufficient tension in the anchor member  180  to resist contraction of the anchor member  180 . In a further implementation, the wires of the anchor member  180  may overlap or cross over each other in order to increase resistance. 
     In at least one example, retracting only one of the control members  190 A,  190 B, may lessen the tension in the anchor member  180 , thereby allowing the anchor member  180  to move from its deployed, expanded configuration to a contracted configuration. As a result, by retracting only one of the control members  190 A or  190 B, without applying tension to the other control member  190 B or  190 A or by applying a distal force to the other control member  190 B or  190 A, the anchor member  180  may contract and be retracted into the outer housing  110 . 
     Referring again to  FIG. 1A , the guide member  130  may be configured to house at least a portion of the control members  190 A,  190 B and to allow axial translation of the control members  190 A,  190 B relative to the guide member  130 . Such a configuration may allow the control members  190 A,  190 B to be manipulated at a proximal location to control the anchor member  180  at a distal location. 
     The guide member  130 , and thus the control members  190 A,  190 B that extend there through, may be at least partially housed within the outer housing  110  and/or within the handle  100 . As previously discussed, the guide member  130  may be coupled to the first plunger  120 . Such a configuration may cause actuation of the first plunger  120  to result in axial movement of the guide member  130 . In at least one example, axial movement of the first plunger  120  results in similar axial movement of the guide member  130 . Such a configuration may allow the first plunger  120  to extend and retract the guide member  130  from the outer housing  110  as desired. While actuation of the first plunger  120  may been described with reference to axial movement of the first plunger  120  relative to the handle  100 , it will be appreciated that actuation of the first plunger  120  may include any type of action that results in desired movement of the guide member  130 . 
     The optional plug  140  may be secured to the guide member  130  in such a manner that axial movement of the first plunger  120  also results in a corresponding movement of the plug  140 . Such a configuration may thereby allow axial movement of the first plunger  120  to also extend and retract the plug  140  from the outer housing  110  as desired by extending and retracting the guide member  130 . Although the guide member  130  and the plug  140  are shown as moving together, it will be appreciated that the plug  140  may also be independently controlled and moved, such as by the use of additional plungers and/or shafts. 
     In addition to serving as a mandrel to thereby move the plug, the guide member  130  may also be configured to house the needle carriers  160 A,  160 B and the detachable needles  170 A,  170 B. More specifically, the guide member  130  may be configured to allow the needle carriers  160 A,  160 B and the detachable needles  170 A,  170 B to move between a pre-deployed state and the deployed state shown in  FIG. 1A . In a pre-deployed state (not shown in  FIG. 1A ), the needle carriers  160 A,  160 B and/or the detachable needles  170 A,  170 B are retracted within the guide member  130 . In the deployed state shown in  FIG. 1A , the detachable needles  170 A,  170 B and/or the needle carriers  160 A,  160 B extend radially and/or distally from the guide member  130 . 
     The needle carriers  160 A,  160 B are coupled to the second plunger  150  in such a way that actuation of the second plunger  150  causes the needle carriers  160 A,  160 B to move between the pre-deployed and deployed states described above. In at least one example, axial movement of the second plunger  150  relative to the first plunger  120  moves the needle carriers  160 A,  160 B between the pre-deployed and deployed states. While actuation of the second plunger  150  may be provided by axial movement of the second plunger  150  relative to the first plunger  120 , it will be appreciated that actuation of the second plunger  150  may include any type of action that results in desired movement of the needle carriers  160 A,  160 B. 
     As will be described in more detail, the actions described above allow the closure system  10  to deploy the detachable needles  170 A,  170 B into a vessel wall as part of a method for closing a puncture in the vessel wall. Exemplary structure of each of the components introduced above will first be introduced briefly followed by a discussion of the assembly and interaction of adjacent components. Thereafter, function of an exemplary closure system will be discussed, followed by a discussion of an exemplary method of closing a puncture in a vessel wall. 
       FIG. 1B  illustrates an exploded view of the closure system  10 . As illustrated in  FIG. 1B , the handle  100  includes a distal end  100 A and a proximal end  100 B. A guide member receiving lumen  102  extends proximally from the distal end  100 A. A first plunger receiving lumen  104  extends distally from the proximal end  100 B and is in communication with the guide member receiving lumen  102 . In the illustrated example, a shoulder  106  is formed at a transition between the guide member receiving lumen  102  and the first plunger receiving lumen  104 . 
     The outer housing  110  may be coupled to the distal end  100 A of the handle  100 . In particular, the outer housing  110  may include a distal end  110 A and a proximal end  110 B. A guide member receiving lumen  112  may be formed therein that extends through the distal end  100 A and the proximal end  110 B. The guide member receiving lumen  112  may be configured to allow the guide member  130  to translate axially within the outer housing  110  as will be described in more detail hereinafter. In at least one example, the guide member receiving lumen  112  may have approximately the same size as the guide member receiving lumen  102  defined in the handle  102 . 
     As shown in  FIG. 1B , the proximal end  110 B of the outer housing  110 A may be coupled to the distal end  100 A of the handle  100  in such a manner that the guide member receiving lumens  102 ,  112  are aligned to thereby form a single lumen that is in communication with the distal end  110 A of the outer housing  110  and the first plunger receiving lumen  104  in the handle  100 . Such a configuration may allow the first plunger  120  to translate axially relative to the handle  100  while moving the guide member  130  axially relative to outer housing  110  and the handle  100 . 
     More specifically, the first plunger  120  may include a distal end  120 A and a proximal end  120 B. The distal end  120 A may be sized to translate within the first plunger receiving lumen  104 . In the example shown, proximal translation of the first plunger  120  relative to the handle  100  may be limited by engagement between the distal end  120 A of the first plunger  120  and the shoulder  106  in the handle  100 . 
     As previously introduced, the first plunger  120  may be coupled to the guide member  130 . In particular, the distal end  120 A of the first plunger  120  may be coupled to a proximal end  130 B of the guide member  130 . Accordingly, as the first plunger  120  moves proximally relative to the handle  100 , the proximal end  130 B of the guide member  130  also translates relative to the handle  100  as well as the outer housing  110 . In at least one example, axial movement of the proximal end  130 B of the guide member  130  results in a proportional or similar movement of a distal end  130 A. This may allow an operator to move the first plunger  120  axially to move the distal end  130 A of the guide member  130  between positions in which the distal end  130 A is retracted within the distal end  110 A of the outer housing  110  and positions in which the distal end  130 A extends beyond the distal end  110 A of the outer housing  110 . The distal end  130 A of the guide member  130  can be extended distally beyond distal end  110 A of the outer housing  110  to deploy the plug  140  and/or position the needle carriers  160 A,  160 B for deployment. Deployment of the plug  140  will first be discussed, followed by a discussion of the deployment of the needle carriers  160 A,  160 B. 
     As previously introduced, the plug  140  may be coupled to the guide member  130 . In particular, the plug  140  may be coupled to the distal end  130 A of the guide member  130 . As a result, the plug  140  may be retracted within and extended from the distal end  110 A of the outer housing  110  by axial movement of the first plunger  120 . 
     In at least one example, the plug  140  may be formed of an expandable material. Suitable materials can include, without limitation, collagen and/or one or more polymers such as PEG. When the plug  140  is moved out of the outer housing  110 , the plug  140  may move toward an expanded state. Similarly, when the plug  140  is retracted back into the outer housing  110 , the plug  140  may be compressed to fit within the outer housing  110 . Accordingly, the distal end  130 A of the guide member  130  can be extended beyond the distal end  110 A of the outer housing  110  to deploy the plug  140  and/or retracted within the outer housing  110  to retrieve the plug  140 . 
     The distal end  130 A of the guide member  130  can also be extended beyond the distal end  110 A to allow for deployment of the needle carrier  160 A,  160 B. In particular, relative movement between the second plunger  150  and the first plunger  120  may move the needle carriers  160 A,  160 B between retracted and extended positions relative to the guide member  130 . The configuration of the guide member  130  will first be discussed in more detail, followed by a discussion of the interaction of the guide member  130  and the needle carriers  160 A,  160 B. 
       FIG. 1C  illustrates a cross sectional view of the first plunger  120  and the guide member  130 . As shown in  FIG. 1C , the first plunger  120  has a second plunger receiving recess  124  defined therein that extends distally from a proximal end  120 B. The first plunger  120  also has needle carrier lumens  126 A,  126 B defined therein that extend proximally from the distal end  120 A and into communication with the second plunger receiving recess  124 . A shoulder  128  is formed at a junction of the needle carrier lumens  126 A,  126 B and the second plunger receiving recess  124 . 
     The guide member  130  may also have needle carrier lumens  132 A,  132 B defined therein that extend distally from the proximal end  130 B. In the illustrated example, the needle carrier lumens  132 A,  132 B include axially aligned portions  134 A,  134 B and curved, angled portions  136 A,  136 B that are in communication with openings  138 A,  138 B in the guide member  130 . The axially aligned portions  134 A,  134 B are aligned with the needle carrier lumens  126 A,  126 B defined in the first plunger  120  to thereby form continuous lumens that extend from near the distal end  130 A of the guide member  130  to the plunger receiving recess  124  in the first plunger member  120 . The configuration of the guide member  130  can allow the guide member  130  to house the needle carriers  160 A,  160 B ( FIG. 1B ) therein prior to deployment and to guide the needle carriers  160 A,  160 B radially outward and distally away from the guide member  130 . An exemplary configuration of the needle carriers  160 A,  160 B will first be discussed, followed by the interaction between the needle carriers  160 A,  160 B and the guide member  130  with reference to  FIG. 1B . 
     As shown in  FIG. 1B , proximal ends  162 A,  162 B of the needle carriers  160 A,  160 B may be coupled to a distal end  150 A of the second plunger  150  in such a way that axial movement of the second plunger  150  results in similar movement of the needle carriers  160 A,  160 B, including distal ends  164 A,  164 B. As a result, when the second plunger  150  is positioned at least partially within the second plunger receiving lumen  124 , the needle carriers  160 A,  160 B extend through the first plunger  120  by way of the needle carrier lumens  126 A,  126 B and into the guide member  130  by way of needle carrier lumens  132 A,  132 B. 
     The distal ends  164 A,  164 B of the needle carriers  160 A,  160 B may be positioned such that axial movement of the second plunger  150  relative to the first plunger  120  moves the needle carriers  160 A,  160 B between retracted and extended positions relative to the guide member  130 . When the needle carriers  160 A,  160 B are retracted, the distal ends  164 A,  164 B of the needle carriers  160 A,  160 B may be positioned proximally and/or radially inward relative to the openings  138 A,  138 B. When the needle carriers  160 A,  160 B are extended, the distal ends  164 A,  164 B extend both radially outward and distally away from the openings  138 A,  138 B in the guide member  130 . Accordingly, the guide member  130  is configured to house the needle carriers  160 A,  160 B and to guide the needle carriers  160 A,  160 B between the retracted and extended positions described above. 
     In at least one example, guide member  130  can be used to initially position the anchor member  180 . Further, the guide member  130  may be configured to house the control members  190 A,  190 B in addition to the needle carriers  160 A,  160 B.  FIG. 1D  illustrates a cross sectional view of the closure system  10  taken along section  1 D- 1 D of  FIG. 1A . As shown in  FIG. 1D , the control member lumens  139 A,  139 B may be defined in the guide member  139 A,  139 B to pass through the guide member  130 . The control member lumens  139 A,  139 B may be positioned at any location and orientation desired.  FIG. 1D  also illustrates that the needle carriers  160 A,  160 B may have suture lumens  166 A,  166 B defined therein. The suture lumens  166 A,  166 B may house sutures (not shown), which may be coupled to the detachable needles  170 A,  170 B ( FIG. 1B ). As will be discussed in more detail below, the closure system  10  may be configured to deploy the detachable needles  170 A,  170 B ( FIG. 1B ) into a vessel wall as part of a method for closing a puncture in a vessel wall. The function of the closure system  10  will first be described in isolation, followed by a discussion of the method for closing a puncture in a vessel wall using the closure system. 
       FIGS. 2A-2C  are cross-sectional views of the closure system  10  at various positions taken along section  2 - 2  of  FIG. 1A . In particular,  FIG. 2C  is a cross-section view of the closure system  10  in the deployed state shown in  FIG. 1A  while  FIGS. 2A and 2B  show the closure system in a pre-deployed state and a location state according to one example. For ease of reference, various components will be described in which one component is being moved toward a second component. It will be appreciated that a second member can also be moved toward the first member or some combination of movement of the two can also be used to accomplish the same function. 
     As shown in  FIG. 2A , while in a pre-deployed state the first plunger  120  is drawn proximally from the handle  100  to thereby position the distal end  130 A of the guide member  130  as well as the plug  140  within the outer housing  110 . While the plug  140  is thus positioned within the outer housing  110 , the plug  140  may be compressed ( FIG. 1B ). Further, the second plunger  150  may be positioned proximally from the first plunger  120  to thereby position the distal ends  160 A,  160 B of the needle carriers  160 A,  160 B within the guide member  130 . As also shown in  FIG. 2A , the control members  190 A,  190 B may be manipulated and positioned to move the anchor member  180  to a pre-deployed position within the outer housing  110 . 
     The closure system  10  may be moved from the pre-deployed state shown in  FIG. 2A  to the locator state shown in  FIG. 2B  by manipulating the control members  190 A,  190 B and moving the first plunger  120  toward the handle  100 . In at least one example the second plunger  150  may move with the first plunger  120  as the first plunger  120  moves toward the handle  100 . Such a configuration may allow the second plunger  150  to deploy the needle carriers  160 A,  160 B separately from movement of the first plunger  120 . 
     As shown in  FIG. 2B , as the first plunger  120  moves toward the handle  100 , the anchor member  180 , the plug  140  and/or the distal end  130 A of the guide member  130  move distally from the distal end of the outer housing  110 . The anchor member  180  may then be manipulated by the control members  190 A,  190 B to move the deployed state shown in  FIG. 2B . 
     More specifically, the anchor member  180  may be configured to move from an initial, contracted configuration within the outer housing  110  to a deployed, expanded configuration once deployed from the outer housing  110 . To facilitate movement from an initial, contracted configuration to a deployed, expanded configuration, the anchor member  180  may include one or more superelastic or shape memory materials such as shape memory alloys. 
     For example, the anchor member  180  may be heat set in a deployed, expanded configuration. The anchor member  180  may then be elastically deformed into an initial, contracted configuration contracted and disposed within the outer housing  110 . In its initial, contracted configuration shown in  FIG. 2A , the anchor member  180  may store sufficient energy to return to its deployed, expanded configuration once released from the outer housing  110  shown in  FIG. 2B . 
     Retracting the handle  100  in a proximal direction may position and/or anchor the anchor member  180  against a distal surface of a vessel wall. In a further embodiment, further retracting the plunger  120  in a proximal direction may retract the anchor member  180  from the vessel and/or into the outer housing  110 . 
     Once the anchor member  180  is at a desired position, the first plunger  120  can be moved toward the handle  100  while holding the control members  190 A,  190 B stationary to thereby the advance the plug  140  toward the anchor member  180 . The plug  140 , which may have expanded from the compressed state described above upon exiting the outer housing  110 , can thus be positioned relative to the anchor member  180 . Such a configuration can allow the closure system  10  to engage vessels walls of varying thicknesses as the plug  140  can be advanced until it engages a vessel wall since the anchor member  180  is positioned on an opposing side of the vessel wall. Such a configuration can also place the distal end  130 A of the guide member  130  in position to deploy the needle carriers  160 A,  160 B. 
     As shown in  FIG. 2C , the needle carriers  160 A,  160 B can be deployed by moving the second plunger  150  toward the first plunger  120 . As the second plunger  150  moves toward the first plunger  120 , the needle carriers  160 A,  160 B, and the distal ends  164 A,  164 B in particular, move the detachable needles  170 A,  170 B distally and radially away from the distal end  130 A of the guide member  130 . Such a configuration can allow the detachable needles  170 A,  170 B to be moved into engagement with a vessel wall, as part of an exemplary method for closing a puncture in a vessel wall, which will now be discussed in more detail with reference to  FIG. 3A-3D . 
       FIG. 3A  illustrates first steps of a method for closing a puncture  300  in a vessel wall  310 . For ease of reference, only the distal portion of the closure system  10  is shown and described. It will be appreciated that the distal components can be manipulated by proximal components in a similar manner as described above with reference to  FIGS. 1A-2C . 
     Referring now to  FIG. 3A , the method can begin by positioning a distal end  110 A of the outer housing  110  in proximity with the puncture  300  while the closure system  10  is in a pre-deployed state. With the distal end  110 A of the outer housing  110  in proximity with the puncture  300 , the anchor member  180  can be passed through the puncture  300  and moved to the deployed, expanded position shown as shown in  FIG. 3B . 
     As shown in  FIG. 3C , the anchor member  180  can then be drawn proximally into engagement with a posterior side  310 A of the vessel wall  310  adjacent the puncture  300  and the distal end  130 A of the guide member  130  can be urged distally toward the anterior side  310 B of the vessel wall  310 , thereby positioning the vessel wall  310  adjacent the puncture  300  between the plug  140  and the anchor member  180 . With the vessel wall  310  positioned between the anchor member  180  and the plug  140 , the vessel wall  310  can be described as being located by the closure system  10  since the position of vessel wall  310  is established as being between the plug  140  and the anchor member  180 . In at least one example, the expanded plug  140  can cover the puncture  300  while pressure between the plug  140  and the anchor member can provide sufficient contact between the plug  140  and the vessel wall  310  to limit the flow of fluid from the puncture  300 . 
     As also shown in  FIG. 3C , when the guide member  130  is in position with respect to the vessel wall  310 , the distal end  130 A of the guide member  130  can be positioned distally of the distal end  110 A of the outer housing  110  to thereby expose the openings  138 A,  138 B ( FIG. 1C ) from within the outer housing  110 . With the openings  138 A,  138 B ( FIG. 1C ) thus exposed, the needle carriers  160 A,  160 B and detachable needles  170 A,  170 B can be moved distally beyond and radially outward from the distal end  130 A of the guide member  130  to move the detachable needles  170 A,  170 B at least partially through the vessel wall  310  on opposing sides of the puncture  300 . 
       FIG. 3D  shows the detachable needle  170 A in more detail. While a single detachable needle  170 A is shown in  FIG. 3D , it will be appreciated that the discussion of the detachable needle  170 A can be equally applicable to the detachable needle  170 B ( FIG. 3C ) as well as any number of other detachable needles. As shown in  FIG. 3D , the detachable needle  170 A may include features that allow it to readily pierce the vessel wall  310  while resisting retraction therefrom. In particular, the detachable needle  170 A includes a generally conical body  172  having a tip  174  and a base  176 . The detachable needle  170 A may also include a shaft  178  coupled to the base  178 . 
     In at least one example, the shaft  178  is configured to have a suture  320  coupled thereto. The shaft  178  can be further configured to be positioned within the suture lumen  166 A to provide a slip fit between the needle carrier  160 A and the shaft  178 . The shaft  178  may also have a narrower aspect than the base  176 . Such a configuration allows the needle carrier  160 A to exert a distally acting force on the detachable needle  170 A by way of the base  176 . Such a distally acting force can cause the tip  174  to pierce the vessel wall  310  while the width of the base  176  anchors the detachable needle  170 A to the vessel wall  310  and resists proximal retraction. 
     Referring again to  FIG. 3C , once the detachable needles  170 A,  170 B are anchored in the vessel wall  310 , the needle carriers  160 A,  160 B can be drawn proximally into the guide member  130 . The engagement between the detachable needles  170 A,  170 B and the vessel wall  310  can be sufficient to detach the detachable needles  170 A,  170 B from the needle carriers  160 A,  160 B as the needle carriers  160 A,  160 B are withdrawn. 
     After the needle carriers  160 A,  160 B are drawn into the guide member  130 , one of the control members  190 A,  190 B can be moved in one direction more than the other of the control members  190 A,  190 B to move the anchor member  180  into a contracted or collapsed state. The guide member  130 , the plug  140 , and the control member  180  can then be drawn into the outer housing  110 . Thereafter, the closure system  10  can be withdrawn, leaving the detachable needles  170 A,  170 B engaged in the vessel wall  310  with the sutures  320  extending proximally from the detachable needles  170 A,  170 B as shown in  FIG. 3D . 
     As also shown in  FIG. 3E , a constrictor  330  can be passed over the sutures  320 . The constrictor  330  can have a smaller diameter than the distance between the detachable needles  170 A,  170 B. As a result, moving the constrictor  330  over the sutures  320  while maintaining tension on the sutures  320  can act to draw the detachable needles  170 A,  170 B toward each other, thereby pulling the puncture  300  closed, as shown in  FIG. 3E . 
     Once the puncture  300  is sufficiently closed, the constrictor  330  can be secured to maintain tension in the sutures  320  between the detachable needles  170 A,  170 B and the constrictor  330 . For example, in one embodiment the constrictor  330  can be an annular member that can be crimped to maintain the tension in the sutures  320 . While an annular member can be used, it will be appropriate that any constrictor can be used to establish tension in the sutures  170 A,  170 B. It will also be appreciated that any suitable means may also be used to maintain the tension in the sutures  170 A,  170 B. Thereafter, the sutures  170 A,  170 B can be trimmed as desired using any appropriate method and/or device. 
     Accordingly, as shown in  FIGS. 1A-3E , the closure system  10  can be configured to deploy detachable needles  170 A,  170 B in a vessel wall  310 . A constrictor  330  can then be used to establish tension in suture extending away from the detachable needles  170 A,  170 B to thereby close the puncture  300  in the vessel wall  310 . In the illustrated example, two needle carriers  160 A,  160 B and detachable needles  170 A,  170 B have been described. It will be appreciated that in other examples, any number of needle carriers and detachable needles can be used, include four or more needle carriers and detachable needles. 
     In the example shown above, the detachable needles included a conical shape in which the sutures are anchored in a vessel wall by engagement with a proximal portion of the detachable needle.  FIG. 4  illustrates one configuration for a detachable needle  400 . The detachable needle  400  can have a body  410  having a tapered point  420 . A suture  430  can be positioned in a manner that causes the detachable needle  400  to rotate when tension is applied to the suture  430  to thereby cause a lateral portion of the detachable needle  400  to engage a vessel wall to thereby anchor the detachable needle  400  thereto. For example, the suture  430  can be offset either radially from a center axis  440  of the detachable needle  400  and/or distally from a proximal end  450  of the body  410 . 
     Embodiments of the anchor, detachable needles and the like may include a material made from any of a variety of known suitable biocompatible materials, such as a biocompatible shape memory material (SMM). For example, the SMM may be shaped in a manner that allows for a delivery orientation while within the tube set, but may automatically retain the memory shape of the detachable needles once deployed into the tissue to close the opening. SMMs have a shape memory effect in which they may be made to remember a particular shape. Once a shape has been remembered, the SMM may be bent out of shape or deformed and then returned to its original shape by unloading from strain or heating. Typically, SMMs may be shape memory alloys (SMA) comprised of metal alloys, or shape memory plastics (SMP) comprised of polymers. The materials may also be referred to as being superelastic. 
     Usually, an SMA may have an initial shape that may then be configured into a memory shape by heating the SMA and conforming the SMA into the desired memory shape. After the SMA is cooled, the desired memory shape may be retained. This allows for the SMA to be bent, straightened, twisted, compacted, and placed into various contortions by the application of requisite forces; however, after the forces are released, the SMA may be capable of returning to the memory shape. The main types of SMAs are as follows: copper-zinc-aluminum; copper-aluminum-nickel; nickel-titanium (NiTi) alloys known as nitinol; nickel-titanium platinum; nickel-titanium palladium; and cobalt-chromium-nickel alloys or cobalt-chromium-nickel-molybdenum alloys known as elgiloy alloys. The temperatures at which the SMA changes its crystallographic structure are characteristic of the alloy, and may be tuned by varying the elemental ratios or by the conditions of manufacture. This may be used to tune the detachable needles so that it reverts to the memory shape to close the arteriotomy when deployed at body temperature and when being released from the tube set. 
     For example, the primary material of an anchor, detachable needles, and/or ring may be of a NiTi alloy that forms superelastic nitinol. In the present case, nitinol materials may be trained to remember a certain shape, retained within the tube set, and then deployed from the tube set so that the tines penetrate the tissue as it returns to its trained shape and closes the opening. Also, additional materials may be added to the nitinol depending on the desired characteristic. The alloy may be utilized having linear elastic properties or non-linear elastic properties. 
     An SMP is a shape-shifting plastic that may be fashioned into a detachable needles in accordance with the present disclosure. Also, it may be beneficial to include at least one layer of an SMA and at least one layer of an SMP to form a multilayered body; however, any appropriate combination of materials may be used to form a multilayered device. When an SMP encounters a temperature above the lowest melting point of the individual polymers, the blend makes a transition to a rubbery state. The elastic modulus may change more than two orders of magnitude across the transition temperature (Ttr). As such, an SMP may be formed into a desired shape of an endoprosthesis by heating it above the Ttr, fixing the SMP into the new shape, and cooling the material below Ttr. The SMP may then be arranged into a temporary shape by force and then resume the memory shape once the force has been released. Examples of SMPs include, but are not limited to, biodegradable polymers, such as oligo(ε-caprolactone)diol, oligo(ρ-dioxanone)diol, and non-biodegradable polymers such as, polynorborene, polyisoprene, styrene butadiene, polyurethane-based materials, vinyl acetate-polyester-based compounds, and others yet to be determined. As such, any SMP may be used in accordance with the present disclosure. 
     An anchor, detachable needles, ring and the like may have at least one layer made of an SMM or suitable superelastic material and other suitable layers may be compressed or restrained in its delivery configuration within the garage tube or inner lumen, and then deployed into the tissue so that it transforms to the trained shape. For example, a detachable needles transitions to close the opening in the body lumen while an anchor may expand to anchor the closure system. 
     Also, the anchor, detachable needles, ring, or other aspects or components of the closure system may be comprised of a variety of known suitable deformable materials, including stainless steel, silver, platinum, tantalum, palladium, nickel, titanium, nitinol, nitinol having tertiary materials (U.S. 2005/0038500, which is incorporated herein by reference, in its entirety), niobium-tantalum alloy optionally doped with a tertiary material (U.S. 2004/0158309, 2007/0276488, and 2008/0312740, which are each incorporated herein by reference, in their entireties) cobalt-chromium alloys, or other known biocompatible materials. Such biocompatible materials may include a suitable biocompatible polymer in addition to or in place of a suitable metal. The polymeric detachable needles may include biodegradable or bioabsorbable materials, which may be either plastically deformable or capable of being set in the deployed configuration. 
     In one embodiment, the detachable needles, anchor, and/or ring may be made from a superelastic alloy such as nickel-titanium or nitinol, and includes a ternary element selected from the group of chemical elements consisting of iridium, platinum, gold, rhenium, tungsten, palladium, rhodium, tantalum, silver, ruthenium, or hafnium. The added ternary element improves the radiopacity of the nitinol detachable needles. The nitinol detachable needles has improved radiopacity yet retains its superelastic and shape memory behavior and further maintains a thin body thickness for high flexibility. 
     In one embodiment, the anchor, detachable needles, and/or ring may be made at least in part of a high strength, low modulus metal alloy comprising Niobium, Tantalum, and at least one element selected from the group consisting of Zirconium, Tungsten, and Molybdenum. 
     In further embodiments, the detachable needles, anchor, and/or ring may be made from or be coated with a biocompatible polymer. Examples of such biocompatible polymeric materials may include hydrophilic polymer, hydrophobic polymer biodegradable polymers, bioabsorbable polymers, and monomers thereof. Examples of such polymers may include nylons, poly(alpha-hydroxy esters), polylactic acids, polylactides, poly-L-lactide, poly-DL-lactide, poly-L-lactide-co-DL-lactide, polyglycolic acids, polyglycolide, polylactic-co-glycolic acids, polyglycolide-co-lactide, polyglycolide-co-DL-lactide, polyglycolide-co-L-lactide, polyanhydrides, polyanhydride-co-imides, polyesters, polyorthoesters, polycaprolactones, polyesters, polyanydrides, polyphosphazenes, polyester amides, polyester urethanes, polycarbonates, polytrimethylene carbonates, polyglycolide-co-trimethylene carbonates, poly(PBA-carbonates), polyfumarates, polypropylene fumarate, poly(p-dioxanone), polyhydroxyalkanoates, polyamino acids, poly-L-tyrosines, poly(beta-hydroxybutyrate), polyhydroxybutyrate-hydroxyvaleric acids, polyethylenes, polypropylenes, polyaliphatics, polyvinylalcohols, polyvinylacetates, hydrophobic/hydrophilic copolymers, alkylvinylalcohol copolymers, ethylenevinylalcohol copolymers (EVAL), propylenevinylalcohol copolymers, polyvinylpyrrolidone (PVP), combinations thereof, polymers having monomers thereof, or the like. 
     The present disclosure may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the disclosure is, therefore, indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.