IPC분류정보
국가/구분 |
United States(US) Patent
등록
|
국제특허분류(IPC7판) |
|
출원번호 |
UP-0729541
(2003-12-05)
|
등록번호 |
US-7837696
(2011-01-22)
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발명자
/ 주소 |
- Modesitt, D. Bruce
- Zung, Michael
- Barrett, Michael
- Andreas, Bernard H.
- Isbell, Lewis
|
출원인 / 주소 |
|
대리인 / 주소 |
|
인용정보 |
피인용 횟수 :
57 인용 특허 :
322 |
초록
▼
Devices, systems, and methods for suturing of body lumens allow the suturing of vascular puncture sites located at the distal end of a percutaneous tissue tract. An elongated articulated foot near a distal end of a shaft is inserted through the penetration and actuated so that the foot extends along
Devices, systems, and methods for suturing of body lumens allow the suturing of vascular puncture sites located at the distal end of a percutaneous tissue tract. An elongated articulated foot near a distal end of a shaft is inserted through the penetration and actuated so that the foot extends along the lumenal axis. The foot carries suturing attachment cuffs, and needles are advanced from the shaft through the vessel wall outside of the penetration and into engagement with the needle cuffs after the foot has been drawn proximally up against the endothelial surface of the blood vessel. The cross-section of the shaft within the tissue tract can be minimized by laterally deflecting the needles as they leave the shaft, while tapered depressions within the foot can guide the advancing needles into engagement with the cuffs. The cuffs lockingly engage the needles and can be withdrawn proximally along the needle paths and through the tissue tract so as to form a loop of suture across the puncture. The articulating foot may be realigned with the shaft and withdrawn proximally through the tissue tract without dilating the tissue tract.
대표청구항
▼
What is claimed is: 1. A device for closing an opening in a tissue, the device comprising: a shaft having a proximal end portion, a distal end portion, and a foot receptacle disposed at the distal end portion; a foot disposed within the foot receptacle on the distal end portion of the shaft and spa
What is claimed is: 1. A device for closing an opening in a tissue, the device comprising: a shaft having a proximal end portion, a distal end portion, and a foot receptacle disposed at the distal end portion; a foot disposed within the foot receptacle on the distal end portion of the shaft and spaced apart from the proximal end portion, the foot being movable from within the foot receptacle to a deployed position at least in part external to the foot receptacle with the foot extending laterally across the distal end portion of the shaft and from the shaft; a flexible guidebody coupled to and extending distally from the distal end portion of the shaft beyond the foot receptacle; and a needle advanceable from the shaft through the tissue and to the foot when the foot is moved to the deployed position. 2. The device of claim 1, wherein the flexible guidebody defines a guidewire lumen. 3. The device of claim 2, wherein the flexible guidebody has a distal end, wherein the flexible guidebody defines a guidewire entry port at the flexible guidebody distal end, and wherein the flexible guidebody defines a guidewire exit port situated along the flexible guidebody at a location proximal to the guidewire entry port. 4. The device of claim 3, wherein the guidewire exit port is situated at a location distal to the distal end portion of the shaft. 5. The device of claim 1, wherein a portion of the shaft curves such that the flexible guidebody extends from the shaft at an angle relative to an axis of the shaft. 6. The device of claim 1, further comprising a length of suture supported by the foot, the length of suture having a first end and a second end, wherein the flexible guidebody defines a lumen, and wherein the length of suture between the first end and the second end extends distally within the lumen of the flexible guidebody. 7. The device of claim 1, wherein the tissue is a wall of a blood vessel. 8. A method for closing an opening in a tissue, the method comprising: providing a shaft having a distal end portion, a proximal end portion, and a foot receptacle disposed at the distal end portion, at least a portion of the foot receptacle passing through the shaft, a flexible guidebody coupled to and extending distally from the distal end portion of the shaft, the shaft having a movable foot disposed within the foot receptacle at the distal end portion of the shaft and spaced apart from the proximal end portion, the foot being movable from within the foot receptacle to a deployed position at least in part external to the foot receptacle with the foot extending laterally across the distal end portion of the shaft and from the shaft; inserting the flexible guidebody through the opening, the flexible guidebody guiding the shaft to the opening; moving the foot from a parked position to the deployed position; forming a needle path from the shaft through the tissue; and advancing a suture through the tissue along the needle path to position a suture loop across the opening. 9. The method of claim 8, further comprising partially withdrawing the flexible guidebody from the opening to reduce a flow of blood through the opening. 10. The method of claim 8, further comprising using a guidewire to guide the flexible guidebody through the opening. 11. The method of claim 8, further comprising: securing the suture loop to close the opening; and fully withdrawing the flexible guidebody from the opening after the suture loop is at least partially secured. 12. The method of claim 8, wherein the tissue is a wall of a blood vessel. 13. A device for closing an opening in a tissue, the device comprising: a shaft having a proximal end, a distal end, and a foot receptacle disposed at the distal end portion, at least a portion of the foot receptacle passing through the shaft, a portion of the shaft being curved adjacent the distal end; a foot disposed within the foot receptacle near the distal end of the shaft to minimize a cross-section of the shaft and spaced apart from the proximal end, the foot being movable from within the foot receptacle to a deployed position at least in part external to the foot receptacle with the foot extending laterally across the distal end portion of the shaft and from the shaft and a flexible guidebody coupled to and extending distally from the distal end of the shaft at an angle relative to an axis of the shaft; and a needle advanceable from the shaft through the tissue and to the foot when the foot is in a deployed position. 14. The device of claim 13, wherein the flexible guidebody defines a guidewire lumen. 15. The device of claim 14, wherein the flexible guidebody has a distal end, wherein the flexible guidebody defines a guidewire entry port at the flexible guidebody distal end, and wherein the flexible guidebody defines a guidewire exit port situated along the flexible guidebody at a location proximal to the guidewire entry port. 16. The device of claim 15, wherein the guidewire exit port is situated at a location distal to the distal end of the shaft. 17. The device of claim 13, further comprising a length of suture supported by the foot, the length of suture having a first end and a second end. 18. The device of claim 13, wherein the flexible guidebody defines a suture storage lumen. 19. A method for closing an opening in a tissue, the method comprising: providing a shaft having a distal end, a proximal end, and a foot receptacle disposed at the distal end portion, at least a portion of the foot receptacle extending through the shaft, a flexible guidebody coupled to and extending distally from the distal end of the shaft, the shaft having a movable foot disposed within the foot receptacle at the distal end of the shaft to minimize a cross-section of the shaft and spaced apart from the proximal end, the foot being movable from within the foot receptacle to a deployed position at least in part external to the foot receptacle with the foot extending laterally across the distal end portion of the shaft and from shaft; inserting the flexible guidebody through the opening; partially withdrawing the flexible guidebody from the opening to reduce a flow of blood through the opening; forming a needle path from the shaft through the vessel wall; and advancing a suture through the vessel wall along the needle path to position a suture loop across the opening. 20. The method of claim 19, further comprising using a guidewire to guide the flexible guidebody through the opening 21. The method of claim 19, wherein the opening in the tissue is accessed through a tissue tract through subcutaneous tissue. 22. The method of claim 19, further comprising: securing the suture loop to close the opening; and fully withdrawing the flexible guidebody from the vessel after the suture loop is at least partially secured. 23. A method for closing an opening in a tissue, the method comprising: providing a shaft having a distal end, a proximal end, and a foot receptacle disposed at the distal end, at least a portion of the foot receptacle extending through the shaft, a flexible guidebody coupled to and extending distally from the distal end of the shaft, the shaft having a movable foot within the foot receptacle at the distal end of the shaft to minimize a cross-section of the shaft and spaced apart from the proximal end, the foot being movable from within the foot receptacle to a deployed position at least in part external to the foot receptacle within the foot extending laterally across the distal end portion of the shaft and from the shaft; using a guidewire to guide the flexible guidebody through the opening; forming a needle path from the shaft through the tissue adjacent the opening; and advancing a suture through the tissue along the needle path to position a suture loop across the opening. 24. The method of claim 23, further comprising partially withdrawing the flexible guidebody from the opening to reduce a flow of blood through the opening. 25. The method of claim 23, further comprising: securing the suture loop to close the opening; and fully withdrawing the flexible guidebody from the vessel after the suture loop is at least partially secured. 26. A method for closing an opening in a vessel wall of a blood vessel, the opening disposed within a tissue tract of a patient body, the method comprising: providing a shaft having a distal end, a proximal end, and a foot receptacle disposed at the distal end, at least a portion of the foot receptacle extending through the shaft, a foot disposed within the foot receptacle near the distal end of the shaft and spaced apart from the proximal end, the foot being movable from within the foot receptacle to a deployed position at least in part external to the foot receptacle with the foot extending laterally across the distal end portion of the shaft and from the shaft, and a flexible guidebody coupled to and extending from the distal end of the shaft, wherein a portion of the shaft has a curve such that the flexible guidebody extends from the shaft at an angle relative to an axis of the shaft; inserting the flexible guidebody through the opening into the vessel such that the flexible guidebody is positioned coaxially within the vessel and the shaft is positioned coaxially within the tissue tract; forming a needle path from the shaft through the vessel wall; and advancing a suture through the vessel wall along the needle path to position a suture loop across the opening. 27. The method of claim 26, wherein the foot is movable from a parked position to a deployed position, wherein the foot is aligned with the vessel when in the deployed position. 28. The method of claim 26, further comprising partially withdrawing the flexible guidebody from the vessel to reduce a flow of blood through the opening. 29. The method of claim 26, further comprising using a guidewire to guide the flexible guidebody through the opening and into the blood vessel. 30. The method of claim 26, further comprising: securing the suture loop to close the opening; and fully withdrawing the flexible guidebody from the vessel after the suture loop is at least partially secured.
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