Source: http://www.google.com/patents/US8002793?dq=645576
Timestamp: 2016-02-10 22:46:49
Document Index: 765826419

Matched Legal Cases: ['Application No. 08011884', 'Application No. 180497', 'Application No. 179173', 'Application No. 180497', 'Application No. 179173', 'Application No. 2005244834', 'Application No. 2007', 'Application No. 05787529', 'Application No. 2007', 'Application No. 2008', 'Application No. 200580023327', 'Application No. 2005272102', 'Application No. 2005800293656', 'Application No. 2006800252468', 'Application No. 2006247355', 'Application No. 179173', 'Application No. 180497', 'Application No. 2006800252468', 'Application No. 2005800293656']

Patent US8002793 - Access and closure device and method - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inPatentsDevices and methods for accessing and closing vascular sites are disclosed. Self-sealing closure devices and methods are disclosed. A device that can make a steep and controlled access path into a vascular lumen is disclosed. Methods for using the device are also disclosed....http://www.google.com/patents/US8002793?utm_source=gb-gplus-sharePatent US8002793 - Access and closure device and methodAdvanced Patent SearchPublication numberUS8002793 B2Publication typeGrantApplication numberUS 11/545,272Publication dateAug 23, 2011Filing dateOct 6, 2006Priority dateMay 12, 2004Fee statusPaidAlso published asCA2566743A1, CN101431948A, CN101431948B, CN104257410A, EP1748735A2, EP1748735A4, EP1972282A2, EP1972282A3, EP1972282A8, EP2499976A2, EP2499976A3, EP2913008A1, US7998169, US8002791, US8002792, US8012168, US20050267520, US20070027454, US20070027455, US20070032802, US20070032803, US20070032804, US20120089166, WO2005112791A2, WO2005112791A3Publication number11545272, 545272, US 8002793 B2, US 8002793B2, US-B2-8002793, US8002793 B2, US8002793B2InventorsD. Bruce ModesittOriginal AssigneeArstasis, Inc.Export CitationBiBTeX, EndNote, RefManPatent Citations (275), Non-Patent Citations (79), Classifications (38), Legal Events (3) External Links: USPTO, USPTO Assignment, EspacenetAccess and closure device and method
US 8002793 B2Abstract
Devices and methods for accessing and closing vascular sites are disclosed. Self-sealing closure devices and methods are disclosed. A device that can make a steep and controlled access path into a vascular lumen is disclosed. Methods for using the device are also disclosed.
1. A method for forming a self-sealing tract in a vessel wall comprising:
a. advancing a first introducer into the vessel wall through a first arteriotomy that has first angle with respect to the vessel wall;
b. applying a force to the first introducer to position a portion of the vessel wall adjacent the first introducer in a desired configuration relative to the first introducer;
c. advancing a second introducer through a proximal extension of the first introducer into the vessel wall to form a tract defined between overlapping tissue portions of the vessel wall, while maintaining the vessel wall portion in the desired configuration with the first introducer wherein a distal portion of the tract defines a second angle with respect to the vessel wall and wherein the first angle is larger than the second angle; and
d. expanding the tract with a sheath so that a procedure may be performed therethrough, wherein after the procedure has been performed and the device and sheath have been withdrawn from the tract, blood pressure acting on the vessel causes the overlapping tissue portions to collapse and self-seal.
2. The method of claim 1, wherein the vessel comprises an artery.
3. The method of claim 1, wherein the tract includes at least one sloped region.
4. The method of claim 1, wherein the vessel wall defines a lumen, and identifying the location of the portion of the vessel wall with the first introducer comprises advancing the first introducer into the lumen to locate a surface of the vessel wall.
5. The method of claim 4, wherein the method comprises contacting an interior surface of the vessel wall with the first introducer and advancing the second introducer into the vessel wall while the first introducer is in contact with the interior surface of the vessel wall. Description
This application is a continuation of U.S. Ser. No. 10/844,247, filed May 12, 2004, which is hereby incorporated by reference in its entirety.
A number of diagnostic and interventional vascular procedures are now performed translumenally, where a catheter is introduced to the vascular system at a convenient access location—such as the femoral, brachial, or subclavian arteries—and guided through the vascular system to a target location to perform therapy or diagnosis. When vascular access is no longer required, the catheter and other vascular access devices must be removed from the vascular entrance and bleeding at the puncture site must be stopped.
Due to the deficiencies of the above methods and devices, a need exists for a more reliable vascular closure method and device. There also exists a need for a vascular closure device and method that does not implant a foreign substance and is self-sealing. There also exists a need for a vascular closure device and method requiring no or few extra steps to close the vascular site.
A device for accessing a biological lumen is disclosed. The biological lumen has a lumen wall having a longitudinal lumen wall axis. The device has an elongated member that has a longitudinal member axis. The member is configured to access the lumen at a first angle. The first angle is defined by the longitudinal lumen wall axis and the longitudinal member axis. The first angle is less than about 19 degrees.
The first angle can be less than about 15 degrees. The first angle can be less than about 10 degrees. The device can also have an anchor. The anchor can be configured to hold the elongated member at a fixed angle with respect to the longitudinal lumen wall axis.
The device can also have a retainer. The retainer can be configured to hold the elongated member at a fixed angle with respect to the longitudinal lumen axis.
Another device for accessing a biological lumen is disclosed. The biological lumen has a lumen wall and a longitudinal lumen wall axis. The device has a first elongated member and a second elongated member. The first elongated member has a first elongated member axis. The second elongated member has a second elongated member axis. The second elongated member is configured so that the second elongated member axis is parallel to the longitudinal lumen wall axis.
The second elongated member can have a retainer. The retainer can have an inflatable member. The retainer can have a resilient member. The second elongated member can extend substantially adjacent to the lumen wall.
Also disclosed is a device for closing an opening on a biological lumen wall. The device has a longitudinal axis, a first force-applying member, a second force-applying member, and a resilient member. The resilient member provides to the first and the second force-applying members a force that is radially outward with respect to the longitudinal axis.
A method of accessing a blood vessel through a blood vessel wall is also disclosed. The blood vessel wall has a longitudinal wall axis. The method includes entering the vessel at an angle of less than about 19 degrees with respect to the longitudinal wall axis. The method also includes inserting a lumenal tool into the vessel.
Also disclosed is a method for accessing a biological lumen. The biological lumen has a lumen wall and a longitudinal lumen wall axis. The method includes inserting in the biological lumen a second elongated member. The second elongated member has a second elongated member axis. The method also includes aligning the second elongated member so that the second elongated member axis is substantially parallel to the longitudinal lumen wall axis. Further, the method includes inserting in the biological lumen a first elongated member comprising a first elongated member axis.
Additionally disclosed is a method of closing a vascular opening. The vascular opening has an inside surface and a longitudinal axis. The method includes inserting a device in the opening and applying a force to the inside surface. The force is directed in at least one radially outward direction from the longitudinal axis.
The method can include maintaining the force. The applying a force can include the device applying at least a part of the force. The applying of a force can include the device applying all of the force.
Also disclosed is a method for accessing and closing a blood vessel having a vessel wall. The vessel wall can have an inside surface and an outside surface. The method includes forming an arteriotomy and deploying a closure augmentation device in the arteriotomy. The closure augmentation device produces pressure on the inside surface and the outside surface.
FIG. 1 is a front perspective view of an embodiment of the arteriotomy device.
FIG. 2 is a side view of the arteriotomy device of FIG. 1.
FIG. 3 is a close-up view of the arteriotomy device of FIG. 1.
FIGS. 4 and 5 are close-up views of various embodiments of the anchor.
FIG. 6 is a side perspective view of an embodiment of the arteriotomy device with the introduction device deployed.
FIG. 7 is a close-up view of an embodiment of the arteriotomy device with the introduction device deployed.
FIGS. 8 and 9 are side views of various embodiments of the arteriotomy device with the introduction devices deployed.
FIG. 10 is a bottom perspective view of an embodiment of the arteriotomy device.
FIG. 11 is a side view of an embodiment of the arteriotomy device with the lumenal retainer deployed.
FIG. 12 is a bottom perspective view of an embodiment of the arteriotomy device with the lumenal retainer deployed.
FIG. 13 is a side perspective view of an embodiment of the arteriotomy device.
FIG. 14 is a side perspective view of an embodiment of the arteriotomy device with the entry wall retainer deployed.
FIGS. 15 and 16 illustrate various embodiments of the tensioner.
FIGS. 17 and 18 illustrate various embodiments of the pressure clip.
FIGS. 19 and 20 illustrate various embodiments of the toggle.
FIG. 21 illustrates a method for deploying the arteriotomy device in a cross-section of a lumen.
FIGS. 22 and 23 illustrate methods for deploying the retainers in a cross-section of a lumen.
FIGS. 24 and 25 illustrate a method for deploying the introduction device in a cross-section of a lumen.
FIG. 26 illustrates a method for deploying a guidewire in a cross-section of a lumen.
FIGS. 27-30 illustrate a method for deploying the introduction device in a cross-section of a lumen.
FIG. 31 illustrates a method for deploying a guidewire in a cross-section of a lumen.
FIG. 32 illustrates a portion of an arteriotomized lumen.
FIG. 33 illustrates section A-A of FIG. 28.
FIGS. 34-36 illustrate a method for deploying a tensioner in a see-through portion of lumen wall.
FIGS. 37-40 illustrate methods for deploying various embodiments of the pressure clip in a cross-section of a lumen.
FIG. 41 illustrates a method of using a suture on a portion of an arteriotomized lumen.
FIG. 42 illustrates section B-B of FIG. 41 with the out-of-section suture.
FIG. 43 illustrates a method of using pledgets on a portion of an arteriotomized lumen.
FIG. 44 illustrates section C-C of FIG. 43.
FIG. 45 illustrates an embodiment of the toggle deployment device in a first configuration.
FIG. 46 is a close-up view of FIG. 45.
FIG. 47 illustrates an embodiment of the toggle deployment device in a second configuration.
FIG. 48 is a close-up view of FIG. 47.
FIG. 49 illustrates a method of using the toggle deployment device in a cross-section of a lumen.
FIG. 50 illustrates FIG. 49 with a portion of the toggle deployment device shown in section D-D.
FIG. 51 illustrates a method of using the toggle deployment device in a cross-section of a lumen.
FIG. 52 illustrates FIG. 51 with a portion of the toggle deployment device shown in section E-E.
FIGS. 53-55 illustrate a method of using the toggle deployment device in a cross-section of a lumen.
FIG. 56 is a close-up view of FIG. 55.
FIG. 57 illustrates an embodiment of a deployed toggle in a cross-section of a lumen.
FIG. 58 is a close-up view of FIG. 59.
FIGS. 59-61 illustrate a method for deploying a toggle in a cross-section of a lumen.
FIG. 62 is a close-up view of FIG. 61.
FIG. 63 illustrates a method for deploying a toggle in a cross-section of a lumen.
FIGS. 64-66 shown, in cross-section, a method for deploying the guidewire through an arteriotomy.
FIGS. 67 and 68 illustrate a method for attaching guidewire to the anchor.
FIGS. 1 through 3 illustrate a device for accessing a biological lumen, such as an arteriotomy device 2. The arteriotomy device 2 can have a delivery guide 4. The delivery guide 4 can be slidably attached to an anchor 6. The anchor 6 can be rigid, flexible or combinations thereof. The anchor 6 can be resilient, deformable or combinations thereof. The anchor 6 can be retractable and extendable from the delivery guide 4. The delivery guide 4 can have an introducer lumen 8. The introducer lumen 8 can have an introducer lumen exit port 10. The introducer lumen exit port 10 can be on the surface of the delivery guide 4.
The anchor 6 can have an anchor angle section 12. The anchor 6 can have an anchor extension section 14, for example a guide eye sheath or an attachable guidewire. The anchor extension section 14 can extend from the anchor angle section 12. The anchor extension section 14 can be separate from and attached to, or integral with, the anchor angle section 12.
The anchor angle section 12 can have an anchor angle first sub-section 16, an anchor bend 20 and an anchor angle second sub-section 18. The anchor angle first and/or second sub-sections 16 and/or 18 can be part of the anchor bend 20. The anchor bend 20 can have a sharp or gradual curve. The radius of curvature for the anchor bend 20 can be from about 0.1 mm (0.004 in.) to about 2.0 mm (0.079 in.).
The anchor angle first sub-section 16 can have an anchor angle first sub-section diameter 22 from about 0.38 mm (0.015 in.) to about 1.0 mm (0.039 in.), for example about 0.71 mm (0.028 in.). The anchor angle second sub-section 18 can have an anchor angle second sub-section diameter 24 from about 0.38 mm (0.015 in.) to about 1.0 mm (0.039 in.), for example about 0.71 mm (0.028 in.).
The anchor angle first sub-section 16 can have a delivery longitudinal axis 26. The anchor angle second sub-section 18 can have an anchor longitudinal axis 28. The intersection of the delivery longitudinal axis 26 and the anchor longitudinal axis 28 can be an anchoring angle 30. The anchoring angle 30 can be from about 20� to about 90�, more narrowly from about 30� to about 60�, for example about 45�.
Any or all elements of the arteriotomy device 2 or other devices or apparatuses described herein can be made from, for example, a single or multiple stainless steel alloys, nickel titanium alloys (e.g., Nitinol), cobalt-chrome alloys (e.g., ELGILOY� from Elgin Specialty Metals, Elgin, Ill.; CONICHROME� from Carpenter Metals Corp., Wyomissing, Pa.), molybdenum alloys (e.g., molybdenum TZM alloy, for example as disclosed in International Pub. No. WO 03/082363 A2, published 9 Oct. 2003, which is herein incorporated by reference in its entirety), tungsten-rhenium alloys, for example, as disclosed in International Pub. No. WO 03/082363, polymers such as polyester (e.g., DACRON� from E.I. Du Pont de Nemours and Company, Wilmington, Del.), polypropylene, polytefrafluoroethylene (PTFE), expanded PTFE (ePTFE), polyether ether ketone (PEEK), nylon, polyether-block co-polyamide polymers (e.g., PEBAX� from ATOFINA, Paris, France), aliphatic polyether polyurethanes (e.g., TECOFLEX� from Thermedics Polymer Products, Wilmington, Mass.), polyvinyl chloride (PVC), polyurethane, thermoplastic, fluorinated ethylene propylene (FEP), absorbable or resorbable polymers such as polyglycolic acid (PGA), polylactic acid (PLA), polydioxanone, and pseudo-polyamino tyrosine-based acids, extruded collagen, silicone, zinc, echogenic, radioactive, radiopaque materials or combinations thereof. Examples of radiopaque materials are barium sulfate, zinc oxide, titanium, stainless steel, nickel-titanium alloys, tantalum and gold.
Any or all elements of the arteriotomy device 2, including supplemental closure devices, such as tensioners, clips, toggles, sutures, or other devices or apparatuses described herein can be or have a matrix for cell ingrowth or used with a fabric, for example a covering (not shown) that acts as a matrix for cell ingrowth. The matrix and/or fabric can be, for example, polyester (e.g., DACRON� from E.I. du Pont de Nemours and Company, Wilmington, Del.), polypropylene, PTFE, ePTFE, nylon, extruded collagen, silicone or combinations thereof.
The elements of the arteriotomy device 2 and/or the fabric can be filled and/or coated with an agent delivery matrix known to one having ordinary skill in the art and/or a therapeutic and/or diagnostic agent. The agents within these matrices can include radioactive materials; radiopaque materials; cytogenic agents; cytotoxic agents; cytostatic agents; thrombogenic agents, for example polyurethane, cellulose acetate polymer mixed with bismuth trioxide, and ethylene vinyl alcohol; lubricious, hydrophilic materials; phosphor cholene; anti-inflammatory agents, for example non-steroidal anti-inflammatories (NSAIDs) such as cyclooxygenase-1 (COX-1) inhibitors (e.g., acetylsalicylic acid, for example ASPIRIN� from Bayer AG, Leverkusen, Germany; ibuprofen, for example ADVIL� from Wyeth, Collegeville, Pa.; indomethacin; mefenamic acid), COX-2 inhibitors (e.g., VIOXX� from Merck & Co., Inc., Whitehouse Station, N.J.; CELEBREX� from Pharmacia Corp., Peapack, N.J.; COX-1 inhibitors); immunosuppressive agents, for example Sirolimus (RAPAMUNE�, from Wyeth, Collegeville, Pa.), or matrix metalloproteinase (MMP) inhibitors (e.g., tetracycline and tetracycline derivatives) that act early within the pathways of an inflammatory response. Examples of other agents are provided in Walton et al, Inhibition of Prostoglandin E2 Synthesis in Abdominal Aortic Aneurysms, Circulation, Jul. 6, 1999, 48-54; Tambiah et al, Provocation of Experimental Aortic Inflammation Mediators and Chlamydia Pneumoniae, Brit. J. Surgery 88 (7), 935-940; Franklin et al, Uptake of Tetracycline by Aortic Aneurysm Wall and Its Effect on Inflammation and Proteolysis, Brit. J. Surgery 86 (6), 771-775; Xu et al, Sp1 Increases Expression of Cyclooxygenase-2 in Hypoxic Vascular Endothelium, J. Biological Chemistry 275 (32) 24583-24589; and Pyo et al, Targeted Gene Disruption of Matrix Metalloproteinase-9 (Gelatinase B) Suppresses Development of Experimental Abdominal Aortic Aneurysms, J. Clinical Investigation 105 (11), 1641-1649 which are all incorporated by reference in their entireties.
FIG. 4 illustrates that the anchor angle section 12 and the anchor extension section 14 can have a flexible elongated element. The flexible elongated element can be resilient and/or deformable. The flexible elongated element can have an integral, or multiple separate and fixedly attached, wound wire 32. The anchor angle section 12 can be in a sheath 34. FIG. 5 illustrates that the anchor angle section 12 can have a wire coating 36, for example a lubricious coating and/or a coating made from urethane.
FIGS. 6 and 7 illustrate that the arteriotomy device 2 can have an introduction device 38. The introduction device 38 can be slidably attached to the introducer lumen 8. The introduction device 38 can have a hollow needle (as shown in FIG. 6). The introduction device 38 can have a solid needle (as shown in FIG. 7). The introduction device 38 can have a guidewire.
The introduction device 38 can have an introduction longitudinal axis 40. The intersection of the introduction longitudinal axis 40 and the anchor longitudinal axis 28 can be an introduction angle 42. The introduction angle 42 can be less than or equal to about 19�, more narrowly less than or equal to about 15�, yet more narrowly from about 5� to about 10�, for example about 01�.
The introduction device 38 can have an introduction device diameter 44. The introduction device diameter 44 can be from about 0.25 mm (0.010 in.) to about 1.0 mm (0.039 in.), for example about 0.56 mm (0.022 in.).
FIGS. 8 and 9 illustrate that the arteriotomy device 2 can be configured so that the introduction device 38 can be deployed from the anchor 6. The anchor 6 can have an introduction device port 46. The introduction device 38 can be a hollow needle (as shown in FIG. 8). When fully deployed, the introduction device 38 can contact the introducer lumen exit port 10. The introduction device 38 can be a channel between the introducer lumen 8 and the anchor 6. The anchor 6 can have a port (not shown) configured to communicate with the biological lumen and the introduction device 38. The introduction device 38 can be a solid needle (as shown in FIG. 9).
FIG. 10 illustrates that a lumenal retainer 48 can have a first retracted configuration. The lumenal retainer 48 can be seated in a lumenal retainer port 50. The lumenal retainer port 50 can be in the anchor 6. The lumenal retainer 48 can be a wire, scaffold or stent—for example made from a deformable or resilient material, such as a shape memory alloy—an inflatable balloon, or combinations thereof. Intralumenal inflatable balloons, such as those inflated with saline solution or carbon dioxide, are known to those having ordinary skill in the art. The lumenal retainer 48 can extend into the delivery guide 4.
FIGS. 11 and 12 illustrate that the lumenal retainer 48 can have a second deployed configuration. FIG. 11 shows that the lumenal retainer 48 can be a wire or balloon. FIG. 12 shows that the lumenal retainer 48 can be a wire. In the deployed configuration, the lumenal retainer 48 can deploy away from the lumenal retainer port. The lumenal retainer 48 can have a lumenal retainer deployed diameter 52. The lumenal retainer deployed diameter 52 can be from about 2.54 mm (0.100 in.) to about 10.2 mm (0.400 in.), for example about 6.35 mm (0.250 in.).
FIG. 13 illustrates that the arteriotomy device 2 can have an entry wall retainer port 54. The entry wall retainer port 54 can be at or near the anchor bend 20. The entry wall retainer port 54 can be at or near the anchor angle first sub-section 16. The entry wall retainer port 54 can be in fluid communication with a sensor or port (not shown) on or near the delivery guide 4 of the arteriotomy device 2.
FIG. 14 illustrates that an entry wall retainer 56 can be deployed through the entry wall retainer port 54. The entry wall retainer 56 can have a first retracted configuration (as shown in FIG. 13). The entry wall retainer 56 can have a second deployed configuration (as shown in FIG. 14).
FIGS. 15 through 20 illustrate various supplemental closure devices. The supplemental closure devices can be completely or partially bioabsorbable, bioresorbable, bioadsorbable or combinations thereof. The supplemental closure devices can be made from homograft, heterografts or combinations thereof. The supplemental closure devices can be made from autografts, allografts or combinations thereof.
FIG. 15 illustrates a tensioner 58. The tensioner 58 can be resilient, deformable, or combinations thereof. The tensioner 58 can have a tensioner longitudinal axis 60. The tensioner 58 can have a resilient element, such as a spring, for example a tensioner head 62. The tensioner head 62 can have a tensioner first shoulder 64. The tensioner head 62 can have a tensioner second shoulder 66. The tensioner first and second shoulders 64 and 66 can rotatably attached to a separate or integral tensioner first leg 68 and a separate or integral tensioner second leg 70, respectively. The tensioner first and second legs 68 and 70 can attach to tensioner first and second feet 72 and 74, respectively.
The tensioner legs 68 and 70 can have tensioner leg diameters 76. The tensioner leg diameters 76 can be from about 0.1 mm (0.005 in.) to about 0.76 mm (0.030 in.), for example about 0.38 mm (0.015 in.). The tensioner first and second legs 68 and 70 can have a tensioner inter-leg outer diameter 78. The tensioner inter-leg outer diameter 78 can be from about 1.3 mm (0.050 in.) to about 5.08 mm (0.200 in.), for example about 4.06 mm (0.160 in.). The tensioner shoulders 64 and/or 66 and/or the tensioner feet 72 and/or 74 can extend to a greater radius from the tensioner longitudinal axis 60 than their respective tensioner inter-leg radius.
FIG. 16 illustrates a tensioner first strut 80 that can attach to the tensioner first leg 68 and the tensioner second leg 70. The tensioner first leg 68 can be resilient, deformable or combinations thereof. A tensioner second strut 82 can attach to the tensioner first leg 68 and the tensioner second leg 70. The tensioner second leg 70 can be resilient and/or deformable. The tensioner 58 can have no tensioner head 62. The tensioner 58 can have more than two tensioner struts 80 and 82.
FIG. 17 illustrates a pressure clip 84. The pressure clip 84 can be resilient. The pressure clip 84 can be deformable. The pressure clip 84 can have a pressure clip longitudinal axis 86. The pressure clip 84 can have a pressure clip head 88. The pressure clip head 88 can be rotatably attached to a separate or integral pressure clip first leg 90. The pressure clip head 88 can be rotatably attached to a separate or integral pressure clip second leg 92. The pressure clip can have a pressure clip first end 94 and a pressure clip second end 96. The pressure clip first leg 90 can terminate in the pressure clip first end 94. The pressure clip second leg 92 can terminate in the pressure clip second end 96. The pressure clip first leg 90 and/or the pressure clip second leg 92 can be biased toward the pressure clip longitudinal axis 86.
FIG. 18 illustrates the pressure clip 84 that can have a pressure clip sheath 98 slidably attached to the pressure clip second leg 92. The pressure clip first and/or second ends 94 and/or 96 can be pressure dissipaters, such as flat and/or curved portions, for example circular loops. The pressure clip first and/or second ends 94 and/or 96 can be resilient and/or deformable. The pressure clip first leg 90 can be rotatably attached to the pressure clip second leg 92. The pressure clip first leg 90 can be attached to the pressure clip second leg 92 via a rotatable, and/or deformable, and/or flexural joint in the pressure clip head 88.
FIG. 19 illustrates a toggle 100. The toggle 100 can have a toggle first end 102. The toggle 100 can have a toggle second end 104. The toggle first and/or second ends 102 and/or 104 can be bars, dowels, rods, beams, or combinations thereof. The toggle 100 can have a filament 106. The filament 106 can be fixedly attached at a filament first end 107 to the toggle first end 102. The filament 106 can be fixedly attached at a filament second end 109 to the toggle second end 104. The filament 106 can be resilient or deformable. The filament 106 can be substantially flexible.
FIG. 20 illustrates the toggle 100 that can have the filament 106 that can be slidably attached to the toggle second end 104 at a hole 108. The filament 106 can frictionally fit the hole 108. The filament 106 can have no pawls 110 (not shown in FIG. 20). The filament 106 can interference fit the hole 108. The filament 106 can have one or more pawls 110. The hole 108 can have one or more notches 112. The notches 112 can be internal to the hole 108. The notches 112 and the pawls 110 can be configured to allow the toggle second end 104 to slide toward the toggle first end 102. The notches 112 and the pawls 110 can be configured to provide an interference fit when the toggle second end 104 is attempted to be moved away from the toggle first end 102.
The elements of the arteriotomy device 2, including the supplemental closure devices, can be directly attached by, for example, melting, screwing, gluing, welding or use of an interference fit or pressure fit such as crimping, snapping, or combining methods thereof. The elements can be integrated, for example, molding, die cutting, laser cutting, electrical discharge machining (EDM) or stamping from a single piece or material. Any other methods can be used as known to those having ordinary skill in the art.
Integrated parts can be made from preformed resilient materials, for example resilient alloys (e.g., Nitinol, ELGILOY� that are preformed and biased into the post-deployment shape and then compressed into the deployment shape as known to those having ordinary skill in the art.
Any elements of the arteriotomy device 2, including the supplemental closure devices, or the arteriotomy device 2, including the supplemental closure devices, as a whole after assembly, can be coated by dip-coating, brush-coating or spray-coating methods known to one having ordinary skill in the art. For example, these methods can be used to coat the wound wire 32 with the wire coating 36 can be spray coated, dip-coated or brushed onto the wire 32.
The supplemental closure devices can be covered with a fabric, for example polyester (e.g., DACRON� from E.I. du Pont de Nemours and Company, Wilmington, Del.), polypropylene, PTFE, ePTFE, nylon, extruded collagen, silicone or combinations thereof. Methods of covering an implantable device with fabric are known to those having ordinary skill in the art.
FIG. 21 illustrates a method of inserting the anchor 6 into a biological lumen 114, for example a blood vessel, such as a femoral artery. The biological lumen 114 can have a lumen wall 116 and a lumen wall surface 118. The anchor 6 can be inserted into the biological lumen 114 using a Seldinger technique, modified Seldinger technique, or other method known to one having ordinary skill in the art. The anchor 6 can create a first arteriotomy 120. The anchor 6 can be inserted into the lumen 114 so that the anchor angle second sub-section 18 can be substantially parallel with the lumen wall surface 118. The anchor 6 can be inserted into the lumen 114 so that the anchor angle second sub-section 18 can be substantially in contact with the lumen wall surface 118.
FIG. 22 illustrates a method of deploying, as shown by arrow, the lumenal retainer 48 from the first retracted configuration to the second deployed configuration. The lumenal retainer 48 can be deployed by extending a wire, scaffold or stent, or by inflating a balloon. When the lumenal retainer 48 is deployed, the anchor angle second sub-section 18 can be made substantially parallel with the lumen wall surface 118. When the lumenal retainer 48 is deployed, the anchor angle second sub-section 18 can be made to be substantially in contact with the lumen wall surface 118.
FIG. 23 illustrates a method of deploying, as shown by arrow 122, the entry wall retainer 56 from the first retracted configuration to the second deployed configuration. When the lumenal retainer is in the second deployed configuration, the lumenal retainer 48 can be substantially parallel with the lumen wall surface 118. When the lumenal retainer is in the second deployed configuration, the lumenal retainer 48 can be substantially in contact with the lumen wall surface 118.
A proximal force, as shown by arrow 124, can be applied to the anchor 6, for example by being applied to the delivery guide 4. When the proximal force is applied, the anchor angle second sub-section 18 can be made substantially parallel with the lumen wall surface 118. When the proximal force is applied, the anchor angle second sub-section 18 can be made to be substantially in contact with the lumen wall surface 118.
FIGS. 24 and 25 illustrate a method for deploying the introduction device 38. The introduction device 38 can egress from the introducer lumen 8 and the introducer lumen exit port 10. As shown in FIG. 24, the introduction device 38 can be pushed, as shown by arrow, into and through the lumen wall 116. The introduction device 38 can form a second arteriotomy 128. As shown in FIG. 25, the introduction device 38 can be pushed, as shown by arrow, adjacent to or through the anchor 6. The anchor 6 can be configured to have ports suitable to allow the introduction device 38 to pass through the anchor 6. A tip of the introduction device 38 can enter the lumen 114.
The introduction device 38 can pass through an introduction run 132 and an introduction rise 134. The introduction run 132 can be the component of the length of the introduction device 38 in the lumen wall 116 that is parallel to the lumen wall 116. The introduction run 132 can be the component of the length parallel to the lumen wall 116 between the opening of the second arteriotomy 128 on the outside of the lumen wall 116 and the opening of the second arteriotomy 128 on the inside lumen wall surface 118. The introduction run 132 can be from about 0.10 cm (0.010 in.) to about 3.810 cm (1.500 in.), for example about 0.64 cm (0.25 in.).
The introduction rise 134 can be the component of the length of the introduction device 38 in the lumen wall 116 that is perpendicular to the lumen wall 116. The introduction rise 134 can be the component of the length perpendicular to the lumen wall 116 between the opening of the second arteriotomy 128 on the outside of the lumen wall 116 and the opening of the second arteriotomy 128 on the inside lumen wall-surface 118. The introduction rise 134 can be from about 0.51 mm (0.020 in.) to about 5.08 mm (0.200 in.), for example about 1.0 mm (0.040 in.). An introduction slope can be the ratio of the introduction rise 134 to the introduction run 132. The introduction slope can be from about � to about 1/40 or less, for example about ⅙, also for example about ⅓. The introduction slope can be, for examples, equal to or less than about � or ⅓, more narrowly equal to or less than about ⅓ or �, yet more narrowly equal to or less than about ⅕ or ⅙, even still more narrowly than about equal to or less than about 1/10.
The introduction rise 134 and the introduction run 132 can be components of an introduction vector. The introduction run 132 can be the component of the introduction vector parallel to the lumen wall 116. The introduction rise 134 can be the component of the introduction vector perpendicular to the lumen wall 116. The introduction vector can be a vector from an outer opening 136 to an inner opening 138. The outer opening 136 can be a temporary or permanent opening on the outside of the lumen wall 116 formed by the introduction device 38. The inner opening 138 can be a temporary or permanent opening on the inside of the vessel wall.
FIG. 26 illustrates that the introduction device 38, for example a hollow needle, can act as a pathway for a lumenal tool, for example tools such as a guidewire 168, to be deployed, as shown by arrow, into the lumen 114. The introduction device 38, for example a solid needle, can be removed from the second arteriotomy 128 and the lumenal tool can be deployed through, for example, the introducer lumen exit port 10, and the second arteriotomy 128. The introduction device 38 can be the lumenal tool, for example a guidewire. The introduction device 38 can be further deployed and used as a lumenal tool after passing through the lumen wall 116.
FIGS. 27 through 30 illustrates a method of deploying the introduction device 38 that can have a pre-formed bend. As shown in FIG. 27, the arteriotomy device 2 can be configured to deploy the introduction device 38 at the introduction angle 42 from about 0� to about 5�, for example about 0�.
As shown in FIG. 28, the introduction device 38 can be pushed, as shown by arrow, through the lumen wall 116. The introduction device 38 can cleave a plane in the lumen wall 116. The plane can be substantially parallel with the lumen wall surface 118. The introduction device 38 can be adjacent to the adventitia in a blood vessel. The introduction device 38 can be advanced along the subintimal or submedial cleavage plane in a blood vessel. Once the lumen wall has been cleaved, a subintimal angioplasty can be performed as known to one having ordinary skill in the art. Once the lumen wall has been cleaved, a remote endarterectomy can be performed as known to one having ordinary skill in the art. Bent and straight introduction devices 38 can be swapped during use to selectively cleave the lumen wall 116. Tools, such as guidewires, can be inserted through hollow introduction devices 38 to selectively cleave the lumen wall 116.
As shown in FIG. 29, when the bend in the introduction device 38 moves into the lumen wall 116, the introduction device 38 can rotate, as shown by arrow, toward the biological lumen 114. As shown in FIG. 30, the bend in the introduction device 38 can continue to rotate the introduction device 38 toward the biological lumen 114. As described infra, the introduction device 38 can enter the lumen 114. FIG. 31 illustrates that the introduction device 38 that can have the bend can act as a pathway for a lumenal tool, as described infra.
An introducer sheath can be inserted over the guidewire 168 and/or the introduction device 38. The introducer sheath can be less than about 22 French (7.3 mm, 0.29 in. diameter) or less than the diameter of the lumen to which the introducer sheath is introduced. The introducer sheath can be, for examples, about 6 French (2.3 mm, 0.092 in. diameter), and about 8 French (2.67 mm, 0.105 in. diameter). The introducer sheath can be known to one having ordinary skill in the art, for example the introducer sheath described in U.S. Pat. No. 5,183,464 to Dubrul, et al.
The introducer sheath can be inserted into the second arteriotomy 128. The introducer sheath can expand the second arteriotomy 128 to a workable size. The introducer sheath can be inserted into the second arteriotomy 128 before and/or after and/or concurrently with the supplemental closure device is deployed and/or other closure method is used.
FIGS. 32 and 33 illustrate an exemplary biological lumen 114 after the arteriotomy device 2 has been deployed to, and removed from, the biological lumen 114. The biological lumen 114 can have the first and second arteriotomies 120 and 128. The biological lumen 114 can have a second arteriotomy 128. The biological lumen 114 can have a first web 140 on one side of the arteriotomy (shown for the second arteriotomy 128), and a second web 142 on the opposite side of the arteriotomy 120 or 128. The natural pressure, shown by arrows, from the first and second webs 140 and 142 can self-seal the arteriotomy 120 or 128.
One or more supplemental closure devices can be deployed to the first and/or second arteriotomies 120 and/or 128. The supplemental closure devices can provide a force or restraint to aid hemostasis. The supple mental closure devices can be permanently or temporarily deployed. The supplemental closure devices can biodissolve after hemostasis is achieved and/or after the relevant arteriotomy 120 or 128 is substantially or completely healed. The force from the supplemental closure device can be maintained from about 15 minutes to about 24 hours or more, for example about 120 minutes.
FIG. 34 illustrates a tensioner 58 in a compressed configuration. Compressive forces, shown by arrows, can compress the tensioner first and second legs 68 and 70. In a compressed configuration, the tensioner inter-leg outer diameter 78 can be from about 0.51 mm (0.020 in.) to about 2.54 mm (0.100 in.), for example about 1.5 mm (0.060 in.).
FIGS. 35 and 36 illustrate a method of deploying the tensioner 58. As shown in FIG. 35, the tensioner 58 can be in a compressed configuration. The tensioner 58 can be exposed to the compressive forces, as shown by arrows 144. The compressive forces can be applied by a retractable sheath, clamps, other methods known to one having ordinary skill in the art, or combinations thereof. A deployment force, shown by arrow 146, can deploy the tensioner 58 into the arteriotomy 120 or 128.
The arteriotomy 120 or 128 can have an arteriotomy diameter 148. The arteriotomy diameter 148 can be from about 0.5 mm (0.020 in.) to about 400 mm (15 in.), yet a narrower range from about 1.0 mm (0.040 in.) to about 10.2 mm (0.400 in.), for example about 2.54 mm (0.100 in.). When in the compressed configuration, the tensioner inter-leg outer diameter 78 can be smaller than the arteriotomy diameter 148. The tensioner first and second shoulders 64 and 66 can be wide enough to interference fit with the arteriotomy 120 or 128. The tensioner first and second shoulders 64 and 66 can dissipate force on the lumen wall surface 118.
As shown in FIG. 36, the compressive forces can be removed from the tensioner 58. The tensioner first and second leg 68 and 70 can expand, as shown by arrows. The tensioner 58 can force the arteriotomy 120 or 128 into a substantially or completely flat and/or closed and/or stretched configuration. The walls of the arteriotomy 120 or 128 can come into close contact.
The arteriotomy 120 or 128 can have an arteriotomy width 150 and an arteriotomy height 152. The arteriotomy width 150 can be about half the circumference of the arteriotomy 120 or 128. The arteriotomy width 150 can be from about 1.0 mm (0.040 in.) to about 10.2 mm (0.400 in.), for example about 4.06 mm (0.160 in.).
The arteriotomy height 152 can be about the tensioner leg diameter 76. The arteriotomy height 152 can be less than about 0.51 mm (0.020 in.), more narrowly, less than about 0.38 mm (0.015 in.). The arteriotomy height 152 can be from about 0.25 mm (0.010 in.) to about 1.3 mm (0.050 in.), for example about 0.38 mm (0.0.15 in.). The arteriotomy height 152 can be small enough to enable cell growth, blood clotting, acoustic sealing, heat sealing, gluing, enhanced self-sealing and combinations thereof across the arteriotomy 120 or 128.
The tensioner first and second shoulders 64 and 66 can be wide enough to interference fit with the arteriotomy 120 or 128. The tensioner first and second feet 72 and 74 can be wide enough to interference fit with the arteriotomy 120 or 128. The tensioner first and second feet 72 and 74 can dissipate force on the lumen wall surface 118.
The arteriotomy 120 or 128 can be plugged, and/or packed, and/or tamponed before, and/or concurrent with, and/or after using any of any of the supplemental closure devices infra and/or supra, the self-sealing closure method, or combinations thereof. The plug, pack, tampon, or combinations thereof (not shown) can be made from gelfoam, collagen, other implantable and biocompatible tampon materials known to those having ordinary skill in the art, or combinations thereof.
FIGS. 37 through 40 illustrate deploying the pressure clip 84 to the arteriotomy 120 or 128. FIG. 37 illustrates extending, and/or thinning, and/or straightening, and/or tensioning the pressure clip second end 96. The pressure clip sheath 98 can be translated, as shown by arrow, along the pressure clip second leg 92 and onto the pressure clip second end 96. The pressure clip 84 can be deployed to the arteriotomy after the pressure clip second end 96 is extended, and/or thinned, and/or straightened, and/or tensioned.
As shown in FIG. 38, the pressure clip second leg 92 can be rotated with respect to the pressure clip head 88, so that the pressure clip second leg 92 and the pressure clip head 88 are substantially aligned. The pressure clip second leg 92 can be deployed, as shown by the arrow, through the first arteriotomy 120. The pressure clip second leg 92 can be deployed through the lumen wall 116 (e.g., if there is no existing first arteriotomy 120, if the first arteriotomy 120 is not suitably located with respect to the second arteriotomy 128).
FIG. 39 illustrates contracting, and/or widening, and/or releasing and/or relaxing the pressure clip second end 96. The pressure clip sheath 98 can be translated, as shown by arrow, along the pressure clip second leg 92 and off of the pressure clip second end 96. The pressure clip second end 96 can be contracted, and/or widened, and/or released and/or relaxed after the pressure clip 84 is deployed to the arteriotomy.
As shown in FIG. 40, after the pressure clip second leg 92 is deployed through the first arteriotomy 120, the pressure clip second leg 92 can be released or deformed so as to rotate with respect to the pressure clip head 88. The pressure clip head 88 can seat in the first arteriotomy 120. The pressure clip first and second legs 90 and 92 can apply force, as shown by arrows, to the first and second webs 140 and 142, respectively.
FIGS. 41 and 42 illustrate a method of deploying a stitch 154 surrounding and/or through the arteriotomy 120 or 128. The stitch 154 can be tightened to apply additional pressure to the arteriotomy 120 or 128. The stitch 154 can have a knot 156, or other tying configuration or device, for example a pledget or clamp.
FIGS. 43 and 44 illustrate a method of deploying the filament 106 adjacent to and/or through the arteriotomy 120 or 128. The filament 106 can be attached to a first pledget 158 a by a first knot 156 a or other tying configuration or device. The filament 106 can be attached to a second pledget 158 b by a second knot 156 b or other tying configuration or device. The first and second pledgets 158 a and 158 b can be other pressure diffusers known to one having ordinary skill in the art, such as the toggles 100 described infra and supra.
FIGS. 45 and 46 illustrate a toggle deployment device 159 that can be in a first retracted configuration. The toggle deployment device 159 can have a pressure check port 160. The pressure check port 160 can be in fluid communication with a sensor or port on or near the handle (not shown) of the toggle deployment device 159, such as an external lumen where blood flow can be observed, for example from flow from the end of an external tube or port and/or through a transparent or translucent window. The pressure check port 160 can facilitate deployment of the toggle deployment device 159 to a location where the pressure check port 160 is introduced to pressure, for example when the pressure check port 160 enters the biological lumen 114. The sensor or port on or near the handle of the toggle deployment device 159 will signal that the pressure check port 160 has been placed into the biological lumen 114 (e.g., by displaying a small amount of blood flow). The pressure check port 160 can be deployed into the biological lumen 114 and then withdrawn from the biological lumen 114 to the point where the lumen wall 116 just stops the pressure in the pressure check port 160. The entry wall retainer port 54 can additionally perform the function as described herein for the pressure check port 160. The toggle deployment device 159 can have a delivery needle port 161.
FIGS. 47 and 48 illustrate the toggle deployment device 159 that can be in a second delivery configuration. A delivery needle 162 can be slidably attached to the toggle deployment device 159. The delivery needle 162 can egress from the delivery needle port 161 when the toggle deployment device 159 is in the second delivery configuration.
FIGS. 49 and 50 illustrate that the toggle deployment device 159 can be deployed into the arteriotomy 120 or 128 at a location where the pressure check port 160 can be located in the biological lumen 114. The delivery needle port 161 can be in, or adjacent to, the lumen wall 116.
FIGS. 51 and 52 illustrate that the toggle deployment device 159 can be placed in the second delivery configuration. If the delivery needle port is in, or adjacent to, the lumen wall 116 when the toggle deployment device 159 is placed in the second delivery configuration, the delivery needle 162 can enter the lumen wall 116. For example, the delivery needle 162 can enter the second web 142. The delivery needle 162 can exit the second web 142 and enter, as shown by arrows, the biological lumen 114.
FIG. 53 illustrates that a pusher 164 can be slidably attached to the delivery needle 162. The delivery needle 162 can have a needle tip port 166. The toggle 100 can be in the delivery needle 162. The toggle 100 can be configured in the delivery needle 162 such that the toggle first end 102 can be located on the needle tip port 166 side of the pusher 164.
FIG. 54 illustrates that the pusher 164 can be moved, as shown by arrow, toward the needle tip port 166. The delivery needle 162 can be moved back relative to the pusher 164, the pusher 164 can be moved forward relative to the delivery needle 162, or combinations thereof. The pusher 164 can push the toggle first end 102 out of the delivery needle 162. The pusher 164 can push the toggle first end 102 into the biological lumen 114.
FIGS. 55 and 56 illustrate that the toggle deployment device 159 can be in a first retracted configuration after deploying the toggle first end 102 into the biological lumen 114. When the delivery needle 162 retracts into the toggle deployment device 159, the toggle second end 104 can be in the toggle deployment device 159. The filament 106 can extend though the delivery needle port 161.
FIGS. 57 and 58 illustrate that the toggle 100 can be deployed across the lumen wall. When the toggle deployment device 159 is removed from the arteriotomy, the toggle second end 104 can deploy on the outside of the lumen wall 116 from the delivery needle port 161. The toggle first end 102 can form an interference fit with the lumen wall surface 118. The toggle second end 104 can form an interference fit with the outside of the lumen wall 116 or the surrounding tissue, such as subcutaneous tissue. The toggle second end 104 can be slidably translated along the filament 106 toward the lumen wall 116, for example for the toggle 100 illustrated in FIG. 20. The length of the filament 106 on the opposite side of toggle second end 104 from the toggle first end 102 can be cut, snapped, torn or otherwise removed.
FIGS. 59 through 63 illustrate a method for deploying the toggle 100. The delivery needle 162 can egress, as shown by arrow, from a toggle deployment delivery port 163. The toggle deployment delivery port 163 can be in the delivery guide 4. The delivery needle 162 can be advanced toward the lumen 114.
FIG. 60 illustrates that the delivery needle 162 can be deployed through the lumen wall. When the delivery needle 162 is deployed through the lumen wall 116, the delivery needle can intersect, or pass adjacent to, the second arteriotomy.
FIGS. 61 and 62 illustrate that the pusher 164 can be advanced, as shown by arrow, through the delivery needle 162. The toggle first end 102 can egress from the needle tip port 166. The toggle first end 102 can deploy into the lumen 114.
FIG. 63 illustrates that the delivery needle 162 can be retracted into the delivery guide 4 and/or the filament 106 can be pulled taught, both shown by arrow. The toggle first end 102 can form an interference fit with the lumen wall surface 118. The toggle second end 104 (not shown in FIG. 63) can be slidably translated on the filament 106 down to, and form an interference fit with, the outside of the lumen wall 116. The length of the filament 106 on the opposite side of toggle second end 104 from the toggle first end 102 can be cut, snapped, torn or otherwise removed.
FIG. 64 illustrates an introducer needle 165 that can have an end inserted, as shown by arrow, through the lumen wall 116 and into the lumen 114, for example by using the Seldinger technique. The introducer needle 165 can be hollow and/or have a longitudinal channel. FIG. 65 illustrates that the guidewire 168 can be deployed, shown by arrows, through the hollow and/or longitudinal channel of the introducer needle 165.
FIG. 66 illustrates that the introducer needle 165 can be removed, as shown by arrow, from the lumen wall 116. The guidewire 168 can remain substantially in place. After the introducer needle 165 is removed, a portion of the guidewire 168 can be outside the lumen 114 and another portion of the guidewire 168 can be inside the lumen 114.
FIG. 67 illustrates a method of fixedly or slidably attaching the guidewire 168 to the anchor 6. A guidewire proximal end 170 can be placed in proximity to an anchor distal end 172. The guidewire proximal end 170 can then be attached, as shown by arrows, to the anchor distal end 172. The guidewire proximal end 170 can be attached to the anchor distal end 172 while some or all of the guidewire 168 is in the lumen 114. The guidewire proximal end 170 can be configured to snap-fit, interference fit, slidably attach or combinations thereof, to the anchor 6. When the guidewire 168 is attached to the anchor 6, the guidewire 168 can act as the anchor extension section 14 and/or the lumenal tool. FIG. 68 illustrates the guidewire 168 attached to the anchor 6.
Where applicable, the methods described supra for deploying any supplemental closure device can be used for deploying any of the other supplementary deployment device. It is apparent to one skilled in the art that various changes and modifications can be made to this disclosure, and equivalents employed, without departing from the spirit and scope of the invention. Elements shown with any embodiment are exemplary for the specific embodiment and can be used on other embodiments within this disclosure.
Patent CitationsCited PatentFiling datePublication dateApplicantTitleUS2857925Jun 30, 1955Oct 28, 1958Stopford Higginbotham RichardGround gripping ferrule for use on walking sticks, crutches and the likeUS3727614May 13, 1971Apr 17, 1973Merck & Co IncMultiple dosage inoculatorUS3730185Oct 29, 1971May 1, 1973Cook IncEndarterectomy apparatusUS4006747Apr 23, 1975Feb 8, 1977Ethicon, Inc.Surgical methodUS4744364 *Feb 17, 1987May 17, 1988Intravascular Surgical Instruments, Inc.Device for sealing percutaneous puncture in a vesselUS4774949Jun 14, 1983Oct 4, 1988Fogarty Thomas JDeflector guiding catheterUS4850960Jul 8, 1987Jul 25, 1989Joseph GrayzelDiagonally tapered, bevelled tip introducing catheter and sheath and method for insertionUS4890611Apr 5, 1988Jan 2, 1990Thomas J. FogartyEndarterectomy apparatus and methodUS4921484Jul 25, 1988May 1, 1990Cordis CorporationMesh balloon catheter deviceUS4955897Aug 22, 1988Sep 11, 1990Ship Arthur GTissue forcepsUS4962755Jul 21, 1989Oct 16, 1990Heart Tech Of Minnesota, Inc.Method for performing endarterectomyUS5183464May 17, 1991Feb 2, 1993Interventional Thermodynamics, Inc.Radially expandable dilatorUS5271415Jan 28, 1992Dec 21, 1993Baxter International Inc.Guidewire extension systemUS5304184Oct 19, 1992Apr 19, 1994Indiana University FoundationApparatus and method for positive closure of an internal tissue membrane openingUS5336221Nov 6, 1992Aug 9, 1994Premier Laser Systems, Inc.Method and apparatus for applying thermal energy to tissue using a clampUS5358507Dec 15, 1992Oct 25, 1994Pat O. DailyThromboendarterectomy suction dissectorUS5364359Mar 1, 1991Nov 15, 1994Advanced Protective Injection Systems Medical B.V.Syringe with retractable needleUS5364389Nov 25, 1992Nov 15, 1994Premier Laser Systems, Inc.Method and apparatus for sealing and/or grasping luminal tissueUS5368601Apr 30, 1992Nov 29, 1994Lasersurge, Inc.Trocar wound closure deviceUS5380290Apr 16, 1992Jan 10, 1995Pfizer Hospital Products Group, Inc.Body access deviceUS5383897Dec 10, 1993Jan 24, 1995Shadyside HospitalMethod and apparatus for closing blood vessel puncturesUS5391182Aug 3, 1993Feb 21, 1995Origin Medsystems, Inc.Apparatus and method for closing puncture woundsUS5391183Aug 16, 1991Feb 21, 1995Datascope Investment CorpDevice and method sealing puncture woundsUS5403329Mar 21, 1994Apr 4, 1995United States Surgical CorporationInstrument for closing trocar puncture woundsUS5415657Oct 13, 1992May 16, 1995Taymor-Luria; HowardPercutaneous vascular sealing methodUS5417699Dec 10, 1992May 23, 1995Perclose IncorporatedDevice and method for the percutaneous suturing of a vascular puncture siteUS5437665Oct 12, 1993Aug 1, 1995Munro; Malcolm G.Electrosurgical loop electrode instrument for laparoscopic surgeryUS5439469Nov 5, 1993Aug 8, 1995Advanced Surgical, Inc.Wound closure deviceUS5451230Oct 11, 1994Sep 19, 1995Steinert; Roger F.Cataract disassemblyUS5462561Aug 5, 1993Oct 31, 1995Voda; Jan K.Suture deviceUS5467786May 16, 1994Nov 21, 1995William C. AllenMethod for repairing tears and incisions in soft tissueUS5470338Oct 8, 1993Nov 28, 1995United States Surgical CorporationInstrument for closing trocar puncture woundsUS5474568Nov 24, 1993Dec 12, 1995United States Surgical CorporationInstrument for closing trocar puncture woundsUS5476470Apr 15, 1994Dec 19, 1995Fitzgibbons, Jr.; Robert J.Trocar site suturing deviceUS5489288Apr 4, 1994Feb 6, 1996Advanced Surgical, Inc.Device and method for applying large-diameter ligating loopUS5496332Oct 20, 1994Mar 5, 1996Cordis CorporationWound closure apparatus and method for its useUS5496334Mar 31, 1994Mar 5, 1996J. Stro/ bel & Sohne GmbH & Co.Suturing apparatusUS5503634Sep 27, 1993Apr 2, 1996Christy; William J.Surgical stab wound closure device and methodUS5507744Apr 30, 1993Apr 16, 1996Scimed Life Systems, Inc.Apparatus and method for sealing vascular puncturesUS5527321Jul 14, 1993Jun 18, 1996United States Surgical CorporationInstrument for closing trocar puncture woundsUS5527322Nov 8, 1993Jun 18, 1996Perclose, Inc.Device and method for suturing of internal puncture sitesUS5536255Oct 3, 1994Jul 16, 1996Moss; GeraldDilator/introducer apparatus for percutaneous gastrostomyUS5571169Jun 7, 1993Nov 5, 1996Endovascular Instruments, Inc.Anti-stenotic method and product for occluded and partially occluded arteriesUS5613974Jun 1, 1994Mar 25, 1997Perclose, Inc.Apparatus and method for vascular closureUS5620461Jan 5, 1995Apr 15, 1997Muijs Van De Moer; Wouter M.Sealing deviceUS5622188Mar 13, 1995Apr 22, 1997Endovascular Instruments, Inc.Method of restoring reduced or absent blood flow capacity in an arteryUS5645566Sep 15, 1995Jul 8, 1997Sub Q Inc.Apparatus and method for percutaneous sealing of blood vessel puncturesUS5653717Aug 28, 1995Aug 5, 1997Urohealth Systems, Inc.Wound closure deviceUS5695504Feb 24, 1995Dec 9, 1997Heartport, Inc.Devices and methods for performing a vascular anastomosisUS5700273Jul 14, 1995Dec 23, 1997C.R. Bard, Inc.Wound closure apparatus and methodUS5709224Jun 7, 1995Jan 20, 1998Radiotherapeutics CorporationMethod and device for permanent vessel occlusionUS5746755Nov 15, 1995May 5, 1998Perclose, Inc.Method and device for providing hemostasis at vascular penetration sitesUS5762066May 22, 1995Jun 9, 1998Ths International, Inc.Multifaceted ultrasound transducer probe system and methods for its useUS5766183Oct 21, 1996Jun 16, 1998Lasersurge, Inc.Vascular hole closureUS5772673Mar 7, 1996Jun 30, 1998United States Surgical CorporationApparatus for applying surgical clipsUS5779719Jun 14, 1994Jul 14, 1998Perclose, Inc.Device and method for the percutaneous suturing of a vascular puncture siteUS5792152Apr 26, 1996Aug 11, 1998Perclose, Inc.Device and method for suturing of internal puncture sitesUS5797929Nov 2, 1995Aug 25, 1998Perclose, Inc.Apparatus and methods for advancing surgical knotsUS5810810Jun 6, 1995Sep 22, 1998Scimed Life Systems, Inc.Apparatus and method for sealing vascular puncturesUS5817108May 19, 1997Oct 6, 1998Medtronic, Inc.Device and method for suturing woundUS5830232Apr 14, 1997Nov 3, 1998Hasson; Harrith M.Device for closing an opening in tissue and method of closing a tissue opening using the deviceUS5836955Jul 14, 1997Nov 17, 1998C.R. Bard, Inc.Wound closure apparatus and methodUS5846253Sep 19, 1996Dec 8, 1998C. R. Bard, Inc.Wound closure apparatus and methodUS5860990Aug 23, 1996Jan 19, 1999Nr Medical, Inc.Method and apparatus for suturingUS5860991Aug 22, 1997Jan 19, 1999Perclose, Inc.Method for the percutaneous suturing of a vascular puncture siteUS5868762Sep 25, 1997Feb 9, 1999Sub-Q, Inc.Percutaneous hemostatic suturing device and methodUS5882302Jun 24, 1996Mar 16, 1999Ths International, Inc.Methods and devices for providing acoustic hemostasisUS5902311Jun 15, 1995May 11, 1999Perclose, Inc.Low profile intraluminal suturing device and methodUS5921994Oct 7, 1997Jul 13, 1999Perclose, Inc.Low profile intraluminal suturing device and methodUS5941897May 9, 1997Aug 24, 1999Myers; Gene E.Energy activated fibrin plugUS5954732Sep 10, 1997Sep 21, 1999Hart; Charles C.Suturing apparatus and methodUS5972005Feb 17, 1998Oct 26, 1999Advanced Cardiovascular Systems, Ind.Wound closure assembly and method of useUS5972013Sep 19, 1997Oct 26, 1999Comedicus IncorporatedDirect pericardial access device with deflecting mechanism and methodUS5980539May 6, 1998Nov 9, 1999X-Site L.L.C.Device and method for suturing blood vessels and the likeUS5984917Oct 1, 1997Nov 16, 1999Ep Technologies, Inc.Device and method for remote insertion of a closed loopUS5984948May 21, 1998Nov 16, 1999Hasson; Harrith M.Device for closing an opening in tissue and method of closing a tissue opening using the deviceUS5984950Jul 20, 1998Nov 16, 1999Sub-Q, Inc.Percutaneous hemostasis deviceUS6033401Nov 3, 1997Mar 7, 2000Advanced Closure Systems, Inc.Vascular sealing device with microwave antennaUS6036699Mar 26, 1997Mar 14, 2000Perclose, Inc.Device and method for suturing tissueUS6036721 *May 17, 1999Mar 14, 2000Cap IncorporatedPuncture closureUS6042601Mar 18, 1998Mar 28, 2000United States Surgical CorporationApparatus for vascular hole closureUS6063085Oct 22, 1993May 16, 2000Scimed Life Systems, Inc.Apparatus and method for sealing vascular puncturesUS6071292Jun 28, 1997Jun 6, 2000Transvascular, Inc.Transluminal methods and devices for closing, forming attachments to, and/or forming anastomotic junctions in, luminal anatomical structuresUS6071300Jul 7, 1997Jun 6, 2000Sub-Q Inc.Apparatus and method for percutaneous sealing of blood vessel puncturesUS6077276Feb 17, 1999Jun 20, 2000X-Site L.L.C.Device and method for suturing blood vessels and the likeUS6080175Jul 29, 1998Jun 27, 2000Corvascular, Inc.Surgical cutting instrument and method of useUS6093173Sep 9, 1998Jul 25, 2000Embol-X, Inc.Introducer/dilator with balloon protection and methods of useUS6117144Jan 14, 1999Sep 12, 2000Sutura, Inc.Suturing device and method for sealing an opening in a blood vessel or other biological structureUS6117145Oct 16, 1997Sep 12, 2000Perclose, Inc.Method and device for providing hemostasis at vascular penetration sitesUS6136010Mar 4, 1999Oct 24, 2000Perclose, Inc.Articulating suturing device and methodUS6139560Mar 16, 1999Oct 31, 2000Kremer; Frederic B.Cutting device and method for making controlled surgical incisionsUS6143004Aug 18, 1998Nov 7, 2000Atrion Medical Products, Inc.Suturing deviceUS6146397Apr 6, 1999Nov 14, 2000Harkrider, Jr.; William W.Endarterectomy loopUS6152918Apr 9, 1998Nov 28, 2000Eclipse Surgical Technologies, Inc.Laser device with auto-piercing tip for myocardial revascularization proceduresUS6159232Dec 15, 1998Dec 12, 2000Closys CorporationClotting cascade initiating apparatus and methods of use and methods of closing woundsUS6171317Sep 14, 1999Jan 9, 2001Perclose, Inc.Knot tying device and methodUS6179832Aug 21, 1998Jan 30, 2001Vnus Medical Technologies, Inc.Expandable catheter having two sets of electrodesUS6190396Sep 14, 1999Feb 20, 2001Perclose, Inc.Device and method for deploying and organizing sutures for anastomotic and other attachmentsUS6197042Jan 5, 2000Mar 6, 2001Medical Technology Group, Inc.Vascular sheath with puncture site closure apparatus and methods of useUS6203554Nov 23, 1999Mar 20, 2001William RobertsApparatus, kit and methods for puncture site closureUS6206893Apr 8, 1998Mar 27, 2001Perclose, Inc.Device and method for suturing of internal puncture sitesUS6206895Oct 6, 1999Mar 27, 2001Scion Cardio-Vascular, Inc.Suture with toggle and delivery systemUS6245079Dec 23, 1999Jun 12, 2001Sutura, Inc.Suturing device and method for sealing an opening in a blood vessel or other biological structureUS6258084Mar 10, 1999Jul 10, 2001Vnus Medical Technologies, Inc.Method for applying energy to biological tissue including the use of tumescent tissue compressionUS6302898Feb 10, 1998Oct 16, 2001Advanced Closure Systems, Inc.Devices for sealing punctures in body vesselsUS6358244Apr 20, 1999Mar 19, 2002Endo Surgical Devices, Inc.Endarterectomy surgical instrument and procedureUS6358556Jan 23, 1998Mar 19, 2002Boston Scientific CorporationDrug release stent coatingUS6371975Nov 6, 1998Apr 16, 2002Neomend, Inc.Compositions, systems, and methods for creating in situ, chemically cross-linked, mechanical barriersUS6383208Nov 3, 2000May 7, 2002Onux Medical, Inc.Apparatus and method for approximating and closing the walls of a hole or puncture in a physiological shell structureUS6395015Jul 29, 1998May 28, 2002Medtronic Inc.Temporary vascular seal for anastomosisUS6398782May 15, 1995Jun 4, 2002Edwards Lifesciences CorporationBipolar vascular sealing apparatus and methodsUS6454777Feb 27, 2001Sep 24, 2002David T. GreenApparatus and method for suturing a blood vesselUS6457182Jun 8, 2001Oct 1, 2002The United States Of America As Represented By The Secretary Of The ArmyProtective gloveUS6458147Apr 1, 1999Oct 1, 2002Neomend, Inc.Compositions, systems, and methods for arresting or controlling bleeding or fluid leakage in body tissueUS6468228Jun 18, 1996Oct 22, 2002Vance Products IncorporatedSurgical tissue morcellatorUS6475182Aug 26, 1998Nov 5, 2002Olexander HnojewyjFluidic media introduction apparatusUS6506210Sep 11, 2000Jan 14, 2003Angiolink CorporationWound site management and wound closure deviceUS6517553Jan 24, 2001Feb 11, 2003Abbott LaboratoriesDevice and method for suturing of internal puncture sitesUS6524321Jan 3, 2001Feb 25, 2003Nozomu KanesakaClosure device for puncture in vesselUS6524326Jun 5, 1998Feb 25, 2003Loma Linda University Medical CenterTissue opening locator and everter and methodUS6533795Apr 11, 2000Mar 18, 2003Opus Medical, IncDual function suturing apparatus and methodUS6562059Apr 23, 2002May 13, 2003Neomend, Inc.Vascular sealing device with microwave antennaUS6565583Jul 7, 2000May 20, 2003Acumen Vascular, Inc.Endarterectomy apparatus and methodUS6569012Jan 8, 2002May 27, 2003Topcoder, Inc.Systems and methods for coding competitionsUS6623510Feb 21, 2002Sep 23, 2003Integrated Vascular Systems, Inc.Closure device and methods for making and using themUS6626855Nov 22, 2000Sep 30, 2003Therus CorpoationControlled high efficiency lesion formation using high intensity ultrasoundUS6641592Nov 15, 2000Nov 4, 2003Lsi Solutions, Inc.System for wound closureUS6656136Oct 25, 2000Dec 2, 2003Therus CorporationUse of focused ultrasound for vascular sealingUS6663655May 25, 2001Dec 16, 2003Core Medical, Inc.Apparatus and methods for sealing vascular puncturesUS6676685Jun 18, 2001Jan 13, 2004Tyco Healthcare Group LpArterial hole closure apparatusUS6682489Jan 11, 2002Jan 27, 2004Radi Medical Systems AbTechnique to confirm correct positioning of arterial wall sealing deviceUS6689152Jan 10, 2003Feb 10, 2004Edwards Lifesciences Corp.Introducer/dilator with balloon protection and methods of useUS6719694Dec 22, 2000Apr 13, 2004Therus CorporationUltrasound transducers for imaging and therapyUS6719750Jun 22, 2001Apr 13, 2004The Johns Hopkins UniversityDevices for intraocular drug deliveryUS6733515Mar 10, 1998May 11, 2004Neomend, Inc.Universal introducerUS6743195Mar 14, 2001Jun 1, 2004CardiodexBalloon method and apparatus for vascular closure following arterial catheterizationUS6749621Feb 21, 2002Jun 15, 2004Integrated Vascular Systems, Inc.Sheath apparatus and methods for delivering a closure deviceUS6749622Oct 11, 2002Jun 15, 2004Rex Medical, L.P.Vascular closureUS6767356Jun 21, 2002Jul 27, 2004Angiolink CorporationAdvanced wound site management systems and methodsUS6773699Oct 9, 2001Aug 10, 2004Tissue Adhesive Technologies, Inc.Light energized tissue adhesive conformal patchUS6780197Dec 7, 2000Aug 24, 2004Integrated Vascular Systems, Inc.Apparatus and methods for delivering a vascular closure device to a body lumenUS6790220Jun 10, 2002Sep 14, 2004Morris Innovative Research, Inc.Method and apparatus for sealing accessUS6802822Mar 31, 2000Oct 12, 20043M Innovative Properties CompanyDispenser for an adhesive tissue sealant having a flexible linkUS6818008Sep 12, 1997Nov 16, 2004Cch Associates, Inc.Percutaneous puncture sealing methodUS6840952Dec 7, 2001Jan 11, 2005Mark B. SakerTissue tract sealing deviceUS6843792Jun 12, 2003Jan 18, 2005Scimed Life Systems, Inc.Device for controlled endoscopic penetration of injection needleUS6846319Dec 14, 2000Jan 25, 2005Core Medical, Inc.Devices for sealing openings through tissue and apparatus and methods for delivering themUS6846320Sep 24, 2001Jan 25, 2005Sub-Q, Inc.Device and method for facilitating hemostasis of a biopsy tractUS6846321Oct 30, 2002Jan 25, 2005Cardiodex, Ltd.Mechanical method and apparatus for enhancing hemostatis following arterial catheterizationUS6860895Jun 18, 1999Mar 1, 2005Radi Medical Systems AbTool, a sealing device, a system and a method for closing a woundUS6863680Nov 8, 2001Mar 8, 2005Sub-Q, Inc.System and method for delivering hemostasis promoting material to a blood vessel puncture site by fluid pressureUS6890342Aug 1, 2001May 10, 2005Loma Linda UniversityMethod and apparatus for closing vascular puncture using hemostatic materialUS6890343May 10, 2002May 10, 2005Ensure Medical, Inc.Plug with detachable guidewire element and methods for useUS6890344Nov 1, 2002May 10, 2005Scion Cardiovascular, Inc.Hemostasis pad and methodUS6893431Oct 15, 2001May 17, 2005Scimed Life Systems, Inc.Medical device for delivering patchesUS6896692May 10, 2002May 24, 2005Ensure Medical, Inc.Plug with collet and apparatus and method for delivering such plugsUS6929655Jun 14, 2002Aug 16, 2005Radi Medical Systems AbTamping mechanismUS6936053Apr 23, 2003Aug 30, 2005Jeffrey N. WeissOcular implant needleUS6939348Oct 2, 2003Sep 6, 2005Cierra, Inc.Energy based devices and methods for treatment of patent foramen ovaleUS6939357May 1, 2002Sep 6, 2005Francis NavarroInstrument for closing, by subcutaneous suturing, an orifice made in the abdominal wall of a patientUS6939363Jun 12, 2002Sep 6, 2005Radi Medical Systems AbClosure deviceUS6939364Oct 9, 2001Sep 6, 2005Tissue Adhesive Technologies, Inc.Composite tissue adhesiveUS6942674Feb 21, 2002Sep 13, 2005Integrated Vascular Systems, Inc.Apparatus and methods for delivering a closure deviceUS6949080Aug 15, 2002Sep 27, 2005Percardia, Inc.Left ventricular conduits to coronary arteries and methods for coronary bypassUS6949107Jun 27, 2003Sep 27, 2005Rex Medical, LpInjection method for locating vessel lumenUS6949114Feb 9, 2001Sep 27, 2005Neomend, Inc.Systems, methods, and compositions for achieving closure of vascular puncture sitesUS6964668May 20, 2002Nov 15, 2005Abbott LaboratoriesArticulating suturing device and methodUS6969397May 10, 2002Nov 29, 2005Ensure Medical, Inc.Guide wire element for positioning vascular closure devices and methods for useUS6981983Mar 31, 2000Jan 3, 2006Rosenblatt Peter LSystem and methods for soft tissue reconstructionUS6994686Feb 28, 2001Feb 7, 2006Neomend, Inc.Systems for applying cross-linked mechanical barriersUS7001400Aug 29, 2000Feb 21, 2006Abbott LaboratoriesArticulating suturing device and methodUS7008440Sep 26, 2002Mar 7, 2006Sub-Q, Inc.System and method for delivering hemostasis promoting material to a blood vessel puncture site by fluid pressureUS7008442Jan 20, 2003Mar 7, 2006Medtronic Vascular, Inc.Vascular sealant delivery device and sheath introducer and methodUS7025746Dec 24, 2002Apr 11, 2006Yale UniversityVascular access deviceUS7025776Aug 21, 2002Apr 11, 2006Advanced Catheter Engineering, Inc.Arteriotomy closure devices and techniquesUS7029489Jun 13, 2003Apr 18, 2006Sub-Q, Inc.System and method for delivering hemostasis promoting material to a blood vessel puncture siteUS7037322Jun 13, 2003May 2, 2006Sub-Q, Inc.System and method for delivering hemostasis promoting material to a blood vessel puncture with a staging tubeUS7037323Dec 9, 2003May 2, 2006Sub-Q, Inc.Pledget-handling system and method for delivering hemostasis promoting material to a blood vessel puncture site by fluid pressureUS7041119Sep 23, 2002May 9, 2006Green David TApparatus for suturing a blood vesselUS7074232Dec 21, 2001Jul 11, 2006Medtronic Angiolink, Inc.Advanced wound site management systems and methodsUS7077848Mar 11, 2000Jul 18, 2006John Hopkins UniversitySutureless occular surgical methods and instruments for use in such methodsUS7083628Sep 3, 2002Aug 1, 2006Edwards Lifesciences CorporationSingle catheter mitral valve repair device and method for useUS7141055Apr 24, 2003Nov 28, 2006Surgical Connections, Inc.Resection and anastomosis devices and methodsUS7186251Feb 25, 2004Mar 6, 2007Cierra, Inc.Energy based devices and methods for treatment of patent foramen ovaleUS7226467May 19, 2003Jun 5, 2007Evalve, Inc.Fixation device delivery catheter, systems and methods of useUS7235087Aug 29, 2003Jun 26, 2007Abbott ParkArticulating suturing device and methodUS7247162Jun 4, 2002Jul 24, 2007Edwards Lifesciences CorporationDirect access atherectomy devicesUS7250028Nov 28, 2001Jul 31, 2007Intuitive Surgical IncEndoscopic beating-heart stabilizer and vessel occlusion fastenerUS7335220Nov 5, 2004Feb 26, 2008Access Closure, Inc.Apparatus and methods for sealing a vascular punctureUS7361180Sep 29, 2004Apr 22, 2008Usgi Medical, Inc.Apparatus for manipulating and securing tissueUS7381210Mar 14, 2003Jun 3, 2008Edwards Lifesciences CorporationMitral valve repair system and method for useUS7390329Jan 14, 2005Jun 24, 2008Usgi Medical, Inc.Methods for grasping and cinching tissue anchorsUS7470237Jan 10, 2005Dec 30, 2008Ethicon Endo-Surgery, Inc.Biopsy instrument with improved needle penetrationUS7609673Jan 21, 2003Oct 27, 2009Telefonaktiebolaget Lm Ericsson (Publ)Packet-based conversational service for a multimedia session in a mobile communications systemUS7621925Sep 30, 2004Nov 24, 2009Usgi Medical, Inc.Needle assembly for tissue manipulationUS7635329Sep 27, 2005Dec 22, 2009Evalve, Inc.Methods and devices for tissue grasping and assessmentUS7704264Nov 17, 2004Apr 27, 2010Usgi Medical, Inc.Apparatus and methods for forming and securing gastrointestinal tissue foldsUS20010031922Dec 22, 2000Oct 18, 2001Therus CorporationUltrasound transducers for imaging and therapyUS20010047165Jul 24, 2001Nov 29, 2001Transvascular, Inc.Catheters and related devices for forming passageways between blood vessels or other anatomical structuresUS20020016614Jan 24, 2001Feb 7, 2002Perclose, IncDevice and method for suturing of internal puncture sitesUS20020062146Nov 26, 2001May 23, 2002Joshua MakowerMethods and apparatus for transmyocardial direct coronary revascularizationUS20020156495Mar 25, 2002Oct 24, 2002Rodney BrennemanApparatus and method for percutaneous sealing of blood vessel puncturesUS20030093093May 20, 2002May 15, 2003Modesitt D. BruceArticulating suturing device and methodUS20030100921May 8, 2002May 29, 2003Neomend, Inc.Systems, methods, and compositions for achieving closure of vascular puncture sitesUS20030158578Feb 21, 2002Aug 21, 2003Integrated Vascular Systems, Inc.Sheath apparatus and methods for delivering a closure deviceUS20030233120Jun 12, 2002Dec 18, 2003Radi Medical Systems AbClosure deviceUS20040044350May 19, 2003Mar 4, 2004Evalve, Inc.Steerable access sheath and methods of useUS20040086951Aug 23, 2002May 6, 2004Archakov Alexandr IvanovichMethod for detecting in/vitro food antigen intoleranceUS20040092964Feb 4, 2003May 13, 2004Modesitt D. BruceArticulating suturing device and methodUS20040093024Aug 6, 2003May 13, 2004James LousararianAdvanced wound site management systems and methodsUS20040097978Aug 29, 2003May 20, 2004Modesitt D. BruceArticulating suturing device and methodUS20040122449Dec 5, 2003Jun 24, 2004Modesitt D. BruceArticulating suturing device and methodUS20040138522Sep 30, 2003Jul 15, 2004Haarstad Philip J.Methods and apparatus providing suction-assisted tissue engagement through a minimally invasive incisionUS20040143290Jan 20, 2003Jul 22, 2004Jerry BrightbillVascular sealant delivery device and sheath introducer and methodUS20040153123Aug 8, 2003Aug 5, 2004Integrated Vascular Systems, Inc.Clip applier and methods of useUS20040158287Jan 9, 2004Aug 12, 2004Cragg Andrew H.Sheath-mounted arterial plug delivery deviceUS20040172058Mar 8, 2004Sep 2, 2004Neomend, Inc.Universal introducerUS20040176758Mar 3, 2004Sep 9, 2004Cardiva Medical, Inc.Apparatus and methods for closing vascular penetrationsUS20040215232Apr 24, 2003Oct 28, 2004Belhe Kedar RavindraDevice and method for positioning a closure deviceUS20040220594Apr 29, 2004Nov 4, 2004Cardio Life Research S.A.Two-part clamping deviceUS20040220604Apr 30, 2003Nov 4, 2004Fogarty Thomas J.Tissue separation apparatus and methodUS20040267307Mar 22, 2004Dec 30, 2004Access Closure, Inc.Occlusion member and tensioner apparatus and methods of their use for sealing a vascular punctureUS20040267308Mar 22, 2004Dec 30, 2004Accessclosure, Inc.Auto-retraction apparatus and methods for sealing a vascular punctureUS20050033361Jun 16, 2004Feb 10, 2005Galdonik Jason A.Temporary hemostatic plug apparatus and method of useUS20050049634Aug 7, 2003Mar 3, 2005Scimed Life Systems, Inc.Medical closure deviceUS20050075653Nov 18, 2004Apr 7, 2005Usgi Medical Inc.Apparatus and methods for forming and securing gastrointestinal tissue foldsUS20050085773Oct 15, 2003Apr 21, 2005Forsberg Andrew T.Method and apparatus for locating vascular puncturesUS20050085851Oct 15, 2003Apr 21, 2005William FiehlerTissue puncture closure device with automatic tampingUS20050085852Oct 15, 2003Apr 21, 2005Theresa DitterVascular sealing device with locking hubUS20050085854Oct 17, 2003Apr 21, 2005Ensure Medical, Inc.Locator and closure device and method of useUS20050085855Oct 17, 2003Apr 21, 2005Forsberg Andrew T.Automatic suture locking deviceUS20050085856May 21, 2004Apr 21, 2005Ensure Medical, Inc.Locator and delivery device and method of useUS20050090860Oct 23, 2003Apr 28, 2005Paprocki Loran J.Segmented plug for tissue tractsUS20050096697Nov 4, 2003May 5, 2005Forsberg Andrew T.Vascular insertion sheath with stiffened tipUS20050107826Aug 16, 2004May 19, 2005Zhu Yong H.Vascular wound closure device and methodUS20050125030Dec 3, 2003Jun 9, 2005Forsberg Andrew T.Vascular puncture seal anchor nestUS20050143761Aug 2, 2004Jun 30, 2005Modesitt D. B.Articulating suturing device and methodUS20050149065Dec 19, 2003Jul 7, 2005Modesitt D. B.Device and method for suturing of internal puncture sitesUS20050228443Apr 9, 2004Oct 13, 2005Cardiva Medical, Inc.Device and method for sealing blood vesselsUS20050234507Mar 31, 2005Oct 20, 2005Jeff GeskeMedical tool for access to internal tissueUS20050251189Sep 29, 2004Nov 10, 2005Usgi Medical Inc.Multi-position tissue manipulation assemblyUS20050267520May 12, 2004Dec 1, 2005Modesitt D BAccess and closure device and methodUS20050267522Oct 25, 2004Dec 1, 2005Cardiva Medical, Inc.Self-tensioning vascular occlusion device and method for its useUS20050277980May 27, 2004Dec 15, 2005Cardiva Medical, Inc.Self-tensioning vascular occlusion device and method for its useUS20060009802Jul 10, 2004Jan 12, 2006Modesitt D BBiological tissue closure device and methodUS20060064159Aug 31, 2005Mar 23, 2006Porter Christopher HDevice and method for vascular accessUS20060079914Nov 14, 2005Apr 13, 2006Modesitt D BArticulating suturing device and methodUS20060111741Nov 23, 2004May 25, 2006Instrasurgical, LlcWound closure deviceUS20060135990Dec 17, 2004Jun 22, 2006Johnson Eric GDelivery systemUS20060135991Dec 16, 2005Jun 22, 2006Terumo Kabushiki KaishaTissue closure and tissue closing deviceUS20060136035Jul 5, 2005Jun 22, 2006Vascular Architects, Inc. A Delaware CorporationCoiled endoluminal prosthesis system and delivery catheterUS20060142785Feb 27, 2006Jun 29, 2006Modesitt D BArticulating suturing device and methodUS20060167476Mar 27, 2006Jul 27, 2006Perclose, IncSystems, devices and methods for suturing patient tissueUS20060206125Mar 14, 2006Sep 14, 2006Fogarty Thomas JTissue separation apparatus and methodUS20060235449Apr 19, 2005Oct 19, 2006Vascular Architects, Inc., A Delaware CorporationVascular intimal lining removal assemblyUS20060259017Apr 27, 2005Nov 16, 2006Cardiac Pacemakers, Inc.Adhesive elements and methods for accessing the pericardial spaceUS20060264975May 17, 2005Nov 23, 2006Pipenhagen Catherine ASuture loop closure deviceUS20060271078May 12, 2006Nov 30, 2006Modesitt D BAccess and closure device and methodUS20070027454Oct 6, 2006Feb 1, 2007Modesitt D BAccess and closure device and methodUS20070027455Oct 6, 2006Feb 1, 2007Modesitt D BAccess and closure device and methodUS20070032802Oct 6, 2006Feb 8, 2007Modesitt D BAccess and closure device and methodUS20070032803 *Oct 6, 2006Feb 8, 2007Modesitt D BAccess and closure device and methodUS20070032804Oct 6, 2006Feb 8, 2007Modesitt D BAccess and closure device and methodUS20070106246Oct 6, 2006May 10, 2007Modesitt D BAccess and closure device and methodUS20070167959Mar 20, 2007Jul 19, 2007Abbott LaboratoriesArticulating suturing device and methodUS20070255313Apr 19, 2007Nov 1, 2007Arstasis, Inc.Access and closure device and methodUS20090105744Oct 17, 2007Apr 23, 2009Modesitt D BruceMethods for forming tracts in tissueUS20090318889May 15, 2009Dec 24, 2009Arstasis, Inc.Access and closure device and methodUS20100016786Jul 21, 2009Jan 21, 2010Arstasis, Inc.Devices, methods, and kits for forming tracts in tissueUS20100016810Jul 21, 2009Jan 21, 2010Arstasis. Inc.,Devices and methods for forming tracts in tissueUS20100125296Jan 25, 2010May 20, 2010Modesitt D BruceBiological tissue closure device and methodEP0637431A1Jul 11, 1994Feb 8, 1995VODA, JanSuture deviceWO2005112791A2May 12, 2005Dec 1, 2005D Bruce ModesittAccess and closure device and methodWO2006017023A2Jun 30, 2005Feb 16, 2006Bruce D ModesittBiological tissue closure device and methodWO2006124896A2May 12, 2006Nov 23, 2006D Bruce ModesittAccess and closure device and method* Cited by examinerNon-Patent CitationsReference1European Search Report from European Patent Office for EP application No. EP05787529.6, Applicant Arstasis, Inc., EPO Forms 1507, 1503, and P0459, dated Nov. 5, 2010. (5 pages).2European Search Report mailed on Jun. 26, 2009, for EP Patent Application No. 08011884.7, filed on May 12, 2005, five pages.3File history for related U.S. Appl. No. 10/844,247, filed May 12, 2004, Inventor D. Bruce Modesitt, (211 pages total).4File history for related U.S. Appl. No. 10/888,682, filed Jul. 10, 2004, Inventor D. Bruce Modesitt, (141 pages total).5File history for related U.S. Appl. No. 11/432,982, filed May 12, 2006, Inventor D. Bruce Modesitt, including (128 pages).6File history for related U.S. Appl. No. 11/544,149, filed Oct. 6, 2006, Inventor D. Bruce Modesitt, including (170 pages total).7File history for related U.S. Appl. No. 11/544,177, filed Oct. 6, 2006, Inventor D. Bruce Modesitt, (167 pages total).8File history for related U.S. Appl. No. 11/544,196, filed Oct. 6, 2006, Inventor D. Bruce Modesitt, (126 pages total).9File history for related U.S. Appl. No. 11/544,317, filed Oct. 6, 2006, Inventor D. Bruce Modesitt, (163 pages).10File history for related U.S. Appl. No. 11/544,365, filed Oct. 6, 2006, Inventor D. Bruce Modesitt, (152 pages total).11File history for related U.S. Appl. No. 11/788,509, filed Apr. 19, 2007, Inventor D. Bruce Modesitt, (288 pages).12File history for related U.S. Appl. No. 11/873,957, filed Oct. 17, 2007, Inventor D. Bruce Modesitt, et al., (90 pages).13File history for related U.S. Appl. No. 12/467,251, filed May 15, 2009, Inventor D. Bruce Modesitt, including (46 pages).14File history for related U.S. Appl. No. 12/507,038, filed Jul. 21, 2009, Inventor Michael Drews, et al., including (90 pages): Application for U.S. Appl. No. 12/507,038, filed Jul. 21, 2009.15File history for related U.S. Appl. No. 12/507,043, filed Jul. 21, 2009, Inventor Michael Drews, et al., including (97 pages): Application for U.S. Appl. No. 12/507,043, filed Jul. 21, 2009.16File history for related U.S. Appl. No. 12/693,395, filed Jan. 25, 2010, Inventor D. Bruce Modesitt, including (61 pages).17File history for related U.S. Appl. No. 12/780,768, filed May 14, 2010, Inventor Michael Drews, et al., including (97 pages): Application for U.S. Appl. No. 12/780,768, filed May 14, 2010.18File History for related U.S. Appl. No. 12/888,209, filed Sep. 22, 2010, Inventor D. Bruce Modesitt, et al., including ( pages): Application for U.S. Appl. No. 12/888,309, filed Sep. 22, 2010.19File history for related U.S. Appl. No. 13/004,848, filed Jan. 11, 2011, Inventor D. Bruce Modesitt, et al., including (91 pages): Application for U.S. Appl. No. 13/004,848, filed Jan. 11, 2011.20Final Office Action mailed on Aug. 14, 2009, for U.S. Appl. No. 11/544,317, filed Oct. 6, 2006, eight pages.21Final Office Action mailed on Aug. 21, 2009, for U.S. Appl. No. 11/788,509, filed Apr. 19, 2007, ten pages.22Final Office Action mailed on Dec. 8, 2009, for U.S. Appl. No. 11/544,149, filed Oct. 6, 2006, 9 pages.23Final Office Action mailed on Jul. 6, 2009, for U.S. Appl. No. 10/844,247, filed May 12, 2004, nine pages.24Final Office Action mailed on Jun. 11, 2009, for U.S. Appl. No. 11/432,982, filed May 12, 2006, seven pages.25Final Office Action mailed on May 6, 2009, for U.S. Appl. No. 10/888,682, filed Jul. 10, 2004, eight pages.26Final Office Action mailed on Nov. 18, 2009, for U.S. Appl. No. 11/544,365, filed Oct. 6, 2006, 6 pages.27Final Office Action mailed on Nov. 25, 2009, for U.S. Appl. No. 11/544,177, filed Oct. 6, 2006, 8 pages.28Final Office Action mailed on Nov. 27, 2009, for U.S Appl. No. 11/544,196, filed Oct. 6, 2006, 6 pages.29Franklin, I.J. et al. (1999). "Uptake of Tetracycline by Aortic Aneurysm Wall and Its Effect on Inflammation and Proteolysis,"Brit. J. Surgery 86(6):771-775.30Further Office Action dated May 24, 2010, for Israeli Patent Application No. 180497, with a filing date of May 12, 2005, with English translation provided by Israeli associate. (5 pages).31Further Office Action dated Sep. 6, 2010, for Israeli Patent Application No. 179173, with a filing date of Jun. 30, 2005, with English translation provided by Israeli associate. (9 pages).32Initial Office Action dated Jan. 24, 2010, for Israeli Patent Application No. 180497, with a filing date of May 12, 2005, with English translation provided by Israeli associate. (5 pages).33Initial Office Action dated Jan. 25, 2010, for Israeli Patent Application No. 179173, with a filing date of Jun. 30, 2005, with English translation provided by Israeli associate. (5 pages).34International Preliminary Report on Patentability issued on Mar. 3, 2009, for PCT Application No. PCT/US2005/023107, filed on Jun. 30, 2005, five pages.35International Preliminary Report on Patentability issued on Nov. 14, 2007, for PCT Application No. PCT/US2006/018915, filed on May 12, 2006, five pages.36International Preliminary Report on Patentability mailed on Mar. 5, 2009, for PCT Application No. PCT/US2005/016623, filed on May 12, 2005, five pages.37International Search Report mailed Aug. 8, 2008, for PCT Application No. PCT/US05/16623 filed May 12, 2005, three pages.38International Search Report mailed Jun. 5, 2008, for PCT Application No. PCT/US05/23107 filed Jun. 30, 2005, two pages.39International Search Report mailed on Sep. 3, 2009, for PCT Application No. PCT/US2009/051317, filed on Jul. 21, 2009, three pages.40International Search Report, mailed Aug. 20, 2007, for PCT Application No. PCT/US06/18915 filed on May 12, 2006, 2 pages.41Invitation to Pay Additional Fees mailed on Sep. 10, 2009, for PCT Application No. PCT/US09/51320, filed on Jul. 21, 2009, two pages.42Non-final office action dated May 28, 2011, for related U.S. Appl. No. 12/467,251, Inventor D. Bruce Modesitt, filed May 15, 2009, (11 pages).43Non-Final Office Action mailed Jan. 9, 2009, for U.S. Appl. No. 11/544,317, filed Oct. 6, 2006, 11 pages.44Non-Final Office Action mailed Jul. 31, 2008, for U.S. Appl. No. 10/888,682, filed Jul. 10, 2004, 12 pages.45Non-Final Office Action mailed Nov. 12, 2008, for U.S. Appl. No. 10/844,247, filed May 12, 2004, nine pages.46Non-Final Office Action mailed Oct. 29, 2008, for U.S. Appl. No. 11/788,509, filed Apr. 19, 2007, eight pages.47Non-Final Office Action mailed Oct. 8, 2008, for U.S. Appl. No. 11/432,982, filed May 12, 2006, seven pages.48Non-Final Office Action mailed on Apr. 15, 2010, for U.S. Appl. No. 11/432,982, filed May 12, 2006, eight pages.49Non-Final Office Action mailed on Feb. 18, 2009, for U.S. Appl. No. 11/544,149, filed Oct. 6, 2006, eight pages.50Non-Final Office Action mailed on Feb. 23, 2009, for U.S. Appl. No. 11/544,196, filed Oct. 6, 2006, seven pages.51Non-Final Office Action mailed on Feb. 23, 2009, for U.S. Appl. No. 11/544,365, filed Oct. 6, 2006, six pages.52Non-Final Office Action mailed on Feb. 24, 2009, for U.S. Appl. No. 11/544,177, filed Oct. 6, 2006, seven pages.53Notice of Allowance mailed on Nov. 3, 2009, for U.S. Appl. No. 10/888,682, filed Jul. 10, 2004, 9 pages.54Office Action dated Apr. 13, 2010, for Australian Patent Application No. 2005244834, with a filing date of May 12, 2005. (3 pages).55Office Action dated Dec. 8, 2010, for Japanese Patent Application No. 2007-0520363, with a filing date of Jun. 30, 2005, and with English translation provided by Japanese associate, (5 pages).56Office Action dated Feb. 14, 2011, for European Patent Application No. 05787529.6, with a filing date of Jun. 30, 2005, (15 pages).57Office Action dated Jan. 24, 2011, for Japanese Patent Application No. 2007-513356, with a filing date of May 12, 2005, and with English translation provided by Japanese associate, (7 pages).58Office Action dated Jan. 24, 2011, for Japanese Patent Application No. 2008-123950, with a filing date of May 12, 2005, and with English translation provided by Japanese associate, (4 pages).59Office Action dated Jun. 3, 2010, for Chinese Patent Application No. 200580023327.X, with a filing date of May 12, 2005, with English translation provided by Chinese associate. (7 pages).60Office Action dated Jun. 4, 2010, for Australian Patent Application No. 2005272102, with a filing date of Jun. 30, 2005. (3 pages).61Office Action dated Jun. 4, 2010, for Chinese Patent Application No. 2005800293656, with a filing date of Jun. 30, 2005, with English translation provided by Chinese associate. (10 pages).62Office Action dated May 22, 2009, for Chinese Patent Application No. 2006800252468, with a filing date of May 12, 2006, with English translation provided by Chinese associate. (7 pages).63Office action for related AU Patent Application No. 2006247355, dated Mar. 16, 2011, (16 pages).64PCT International Preliminary Report on Patentability for PCT/US2009/051320, Applicant Arstasis, Inc., Forms PCT/IB/373 and PCT/ISA/237 dated Jan. 25, 2011. (7 pages).65PCT International Search Report and Written Opinion for PCT/ US2009/051320, Applicant Arstasis, Inc., Forms PCT/ISA/210, 220, and 237 dated Nov. 6, 2009. (11 pages).66PCT International Search Report and Written Opinion for PCT/ US2010/035001, Applicant Arstasis, Inc., Forms PCT/ISA/210, 220, and 237 dated Jul. 19, 2010. (11 pages).67PCT International Search Report and Written Opinion for PCT/ US2010/049859, Applicant Arstasis, Inc., Forms PCT/ISA/210, 220, and 237 dated Nov. 5, 2010. (14 pages).68Pyo, R. et al. (Jun. 2000). "Targeted Gene Disruption of Matrix Metalloproteinase-9 (Gelatinase B) Suppresses Development of Experimental Abdominal Aortic Aneurysms," J. Clinical Investigation 105(11):1641-1649.69Response to Office Action submitted Jul. 13, 2010, for Israeli Patent Application No. 179173, with a filing date of Jun. 30, 2005. (1 page).70Response to Office Action submitted May 23, 2010, for Israeli Patent Application No. 180497, with a filing date of May 12, 2005, with English translation provided by Israeli associate. (7 pages).71Response to Office Action submitted Nov. 6, 2010, for Chinese Patent Application No. 2006800252468, with English instructions to respond provided to Chinese associate. (29 pages).72Response to Office Action submitted Oct. 18, 2010, for Chinese Patent Application No. 2005800293656, with English instructions to respond provided to Chinese associate, (27 pages).73Tambiah, J. et al. (2001). "Provocation of Experimental Aortic Inflammation and Dilatation by Inflammatory Mediators and Chlamydia pneumoniae," Brit. J. Surgery 88(7):935-940.74Walton, L.J. et al. (Jul. 6, 1999). "Inhibition of Prostaglandin E2 Synthesis in Abdominal Aortic Aneurysms," Circulation 100:48-54.75Written Opinion mailed on Aug. 20, 2007, for PCT Application No. PCT/US06/18915, filed on May 12, 2006, four pages.76Written Opinion mailed on Aug. 8, 2008, for PCT Application No. PCT/US05/16623, filed on May 12, 2005, three pages.77Written Opinion mailed on Jun. 5, 2008, for PCT Application No. PCT/US05/23107, filed on Jun. 30, 2005, four pages.78Written Opinion mailed on Sep. 3, 2009, for PCT Application No. PCT/US2009/051317, filed on Jul. 21, 2009, seven pages.79Xu, Q. et al. (Aug. 11, 2000). "Sp1 Increases Expression of Cyclooxygenase-2 in Hypoxic Vascular Endothelium," J. Biological Chemistry 275(32):24583-24589.Classifications U.S. Classification606/213, 606/215International ClassificationA61B17/06, A61B17/128, A61B17/068, A61B17/064, A61B17/08, A61B17/12, A61B17/04, A61B17/00Cooperative ClassificationA61B17/1285, A61B2017/0419, A61M25/06, A61B2017/06052, A61M25/01, A61B2017/00637, A61B17/12009, A61B2017/0403, A61M2025/0002, A61B17/0469, A61B2017/0417, A61B17/3403, A61B2017/0496, A61B17/0644, A61B17/0057, A61M25/04, A61B17/0401, A61B2017/00659, A61B17/068, A61B2017/00672, A61B2017/0406, A61B2017/00676, A61B2017/3405European ClassificationA61M25/04, A61B17/00P, A61B17/34D, A61M25/06, A61M25/01Legal EventsDateCodeEventDescriptionJan 11, 2007ASAssignmentOwner name: ARSTASIS, INC., CALIFORNIAFree format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:MODESITT, D. BRUCE;REEL/FRAME:018745/0791Effective date: 20061106Feb 19, 2015FPAYFee paymentYear of fee payment: 4Mar 23, 2015ASAssignmentOwner name: GREENHEART INVESTMENTS, LLC, CALIFORNIAFree format text: SECURITY INTEREST;ASSIGNOR:ARSTASIS, INC.;REEL/FRAME:035228/0841Effective date: 20150312RotateOriginal ImageGoogle Home - Sitemap - USPTO Bulk Downloads - Privacy Policy - Terms of Service - About Google Patents - Send FeedbackData provided by IFI CLAIMS Patent Services