초록 ▼

A method and apparatus for closing a vascular wound includes a guidewire and/or other surgical implement extending from the wound. A hemostatic material is advanced over the surgical implement and into contact with an area of the blood vessel surrounding the wound. The surgical implement is removed.

A method and apparatus for closing a vascular wound includes a guidewire and/or other surgical implement extending from the wound. A hemostatic material is advanced over the surgical implement and into contact with an area of the blood vessel surrounding the wound. The surgical implement is removed. Blood soaks the hemostatic material, and blood clotting is facilitated by the hemostatic agent within the material. A sealing layer of adhesive can be applied to the hemostatic material, confining the blood flow to the material. Thus, the vascular puncture wound is sealed by natural blood clot formation.

대표청구항 ▼

What is claimed is: 1. An assembly for closing a vascular wound comprising: a hemostatic material adapted to facilitate blood clotting sufficient to close the vascular wound; a delivery tube defining a chamber configured to accommodate the hemostatic material therewithin, the delivery tube having a

What is claimed is: 1. An assembly for closing a vascular wound comprising: a hemostatic material adapted to facilitate blood clotting sufficient to close the vascular wound; a delivery tube defining a chamber configured to accommodate the hemostatic material therewithin, the delivery tube having a proximal end and a distal end, the hemostatic material being carried within the chamber; an apparatus configured to position the distal end of the delivery tube at or near a vascular wound; and a pusher member having a distal portion configured to fit at least partially through the proximal end of the delivery tube without deforming the delivery tube, the pusher member and delivery tube releasably connected to one another with the distal portion of the pusher member fit at least partially into the proximal end of the delivery tube and proximal of the hemostatic material within the chamber, a portion of the pusher member having a diameter larger than an inner diameter of at least a portion of the delivery tube; wherein the pusher member and delivery tube are configured so that as the pusher member is moved distally relative to the delivery tube while the hemostatic material remains within the chamber, the pusher member engages the delivery tube proximal of at least a portion of the hemostatic material and through that engagement deforms the delivery tube so as to create at least one opening for the hemostatic material to exit the chamber. 2. The assembly of claim 1, wherein the apparatus comprises a catheter having a tapered distal portion and at least one catheter hole proximal said distal portion. 3. The assembly of claim 2, wherein the catheter extends through the delivery tube. 4. The assembly of claim 3, wherein the hemostatic material is disposed between the catheter and the delivery tube. 5. The assembly of claim 4, wherein the chamber is a substantially enclosed space when the catheter is in place extending through the delivery tube. 6. The assembly of claim 5, wherein the catheter is releasably coupled to the coupled pusher member and delivery tube so that the catheter, pusher member and delivery tube selectively move as a unit. 7. The assembly of claim 2 further comprising: a stop member disposed about a surface of the catheter; and a coupling member movably disposed about the catheter and configured to engage the stop member and engage a proximal coupling member on the pusher member to releasably couple the catheter and pusher member so that the catheter and pusher member are fixed relative to one another. 8. The assembly of claim 7, wherein the pusher member is releasably coupled to the delivery tube, which is releasably coupled to the catheter, so that the catheter, pusher member, and delivery tube are all releasably coupled to one another, and are movable together as a single unit when coupled together. 9. The assembly of claim 1 further comprising means for releasably and simultaneously coupling the delivery tube, the apparatus, and the pusher member in fixed relation to one another. 10. The assembly of claim 1, wherein the delivery tube is generally conical, and the inner wall of the delivery tube has a generally constant taper. 11. The assembly of claim 1, wherein the delivery tube comprises at least one weakened portion. 12. The assembly of claim 11, wherein the at least one weakened portion comprises a wall section of reduced thickness. 13. The assembly of claim 11, wherein the at least one weakened portion comprises a scored wall section. 14. The assembly of claim 1, wherein the delivery tube comprises two separate halves coupled together. 15. The assembly of claim 14, wherein the halves are joined by an elastic member that helps hold the halves together before the pusher member deforms the delivery tube. 16. The assembly of claim 1, wherein the delivery tube comprises an elastic material. 17. The assembly of claim 16, wherein the delivery tube is configured to elastically deform when engaged by the pusher member so as to create the at least one opening. 18. The assembly of claim 1, wherein the hemostatic material comprises a fibrous chitosan material. 19. The assembly of claim 1, wherein the delivery tube is configured so that when the pusher member engages the delivery tube proximal of at least a portion of the hemostatic material, at least one opening is created generally distal of the hemostatic material. 20. The assembly of claim 1, wherein no portion of the pusher member is disposed distal of all of the hemostatic material. 21. A method for closing a vascular wound, comprising: providing an assembly comprising a delivery tube and a pusher member, the delivery tube defining a chamber having a hemostatic material disposed therewithin, the pusher member having a distal portion configured to fit at least partially through a proximal end of the delivery tube, an engagement portion of the pusher member having a diameter larger than an inner diameter of at least a portion of the delivery tube, the chamber being substantially closed so that the hemostatic material remains enclosed within the chamber and the pusher member engagement portion disposed generally proximal of the hemostatic material; positioning the distal end of the delivery tube at or near a vascular wound; and moving the pusher member distally relative to the delivery tube so that the engagement portion of the pusher member engages the delivery tube at a location proximal to at least a portion of the hemostatic material and deforms at least a portion of the delivery tube so as to create at least one opening; wherein after the at least one opening is formed by the pusher member deforming the delivery tube, the hemostatic material begins to be dispatched from the chamber, and the hemostatic material is dispatched from the chamber through the at least one opening. 22. The method of claim 21, wherein the delivery tube breaks when the pusher member is moved distally so that the engagement portion engages the delivery tube, and wherein the hemostatic material is dispatched through the break in the delivery tube. 23. The method of claim 21, wherein when the pusher member is moved distally relative to the delivery tube, the pusher member engages the hemostatic material and urges the hemostatic material through the at least one opening. 24. The method of claim 23, wherein the engagement portion of the pusher member comprises a distal end of the pusher member. 25. The method of claim 23, wherein the engagement portion of the pusher member is positioned proximal of a distal end of the pusher member. 26. The method of claim 21 additionally comprising providing a catheter extending through the delivery tube chamber, wherein the distal end of the chamber is substantially sealed about the catheter. 27. The method of claim 21, wherein the pusher member engagement portion engages the delivery tube at a point proximal of the hemostatic material within the chamber. 28. The method of claim 21, wherein the assembly is provided with the delivery tube and the pusher member being releasably coupled so as to move as a unit, and wherein the coupled delivery tube and pusher member are moved as a unit toward a vascular wound during the step of positioning the distal end of the delivery tube is at or near a vascular wound, and additionally comprising uncoupling the pusher member from the delivery tube after positioning the distal end of the delivery tube at or near a vascular wound. 29. The method of claim 21 additionally comprising providing a catheter extending through the delivery tube chamber, wherein the distal end of the chamber is substantially sealed about the catheter, and wherein the assembly is provided with the catheter, delivery tube and pusher member being releasably coupled so as to move as a unit, and additionally comprising uncoupling the pusher member from the delivery tube after positioning the distal end of the delivery tube at or near a vascular wound. 30. An assembly for closing a vascular wound comprising: a hemostatic material; a delivery tube having a proximal end and a distal end, an inner wall of the delivery tube defining a chamber that accommodates the hemostatic material therewithin, a first portion of the chamber having a first diameter, a second portion of the chamber being proximal of the first portion and having a second diameter greater than the first diameter, and a third portion of the chamber being proximal of the second portion and having a third diameter greater than the second diameter; a catheter extending through the delivery tube, the chamber being defined between the catheter and the inner wall, the distal end of the delivery tube engaging the catheter so that the chamber is closed at its distal end; an apparatus configured to position the distal end of the delivery tube at or near a vascular wound; a pusher member having an engagement portion configured to fit within the third portion of the chamber, the engagement portion of the pusher member having a diameter greater than the first and second chamber portion diameters, but less than or equal to the third chamber portion diameter; and the hemostatic material being within the chamber between the first portion and the third portion, the chamber enclosing the hemostatic material therewithin, the engagement portion of the pusher member being disposed generally proximal of the hemostatic material; wherein the pusher member and chamber are configured so that when the pusher member is moved distally relative to the delivery tube, the hemostatic material remains enclosed within the chamber and generally distal of the pusher member engagement portion until the pusher member engagement portion engages the inner wall in the second chamber portion and deforms the delivery tube so that at least one opening is created in the chamber, and the pusher member dispatches the hemostatic material through the at least one opening created when the pusher member deforms the delivery tube. 31. An assembly as in claim 30, wherein the inner wall is tapered generally continuously from the first chamber portion to the third chamber portion. 32. An assembly as in claim 31, wherein the delivery tube comprises a retractor having at least two retractor halves movably connected to each other, wherein the halves are joined by an elastic member that helps hold the halves together before the hemostatic material is deployed. 33. An assembly as in claim 32 additionally comprising a first coupler adapted to releasably couple the catheter to the pusher member and a second coupler adapted to releasably couple the pusher member to the delivery tube so that when the first and second couplers are engaged, the catheter, pusher member and delivery tube are in a fixed relationship relative to one another. 34. An assembly as in claim 30, wherein the delivery tube comprises a retractor having at least two retractor halves movably connected to each other, wherein the halves are joined by an elastic member that helps hold the halves together before the hemostatic material is deployed. 35. An assembly as in claim 30, wherein the pusher member engagement portion engages the inner wall in the second chamber portion at a position proximal to substantially all of the hemostatic material within the chamber.