Apparatus and methods for sealing a vascular puncture
A sealant is provided for sealing a puncture through tissue that includes an elongate first section including a proximal end, a distal end, and a cross-section sized for delivery into a puncture through tissue, and a second section fused to and extending from the distal end of the first section. The first section may be formed from a freeze-dried hydrogel that expands when exposed to physiological fluid within a puncture. The second section may be formed from a solid mass of non-freeze-dried, non-crosslinked hydrogel precursors, the precursors remaining in an unreactive state until exposed to an aqueous physiological, whereupon the precursors undergo in-situ crosslinking with one another to provide an adhesive layer bonded to the first section. Apparatus and methods for delivering the sealant into a puncture through tissue are also provided.
1. A method for making a sealant for sealing a puncture through tissue, comprising:
forming an elongate rolled proximal section including a proximal end, a distal end, an exterior side surface therebetween, and a cross-section sized for delivery into a puncture through tissue, the rolled proximal section formed from a freeze-dried hydrogel that expands when exposed to physiological fluid within a puncture; and
fusing a solid mass of non-crosslinked hydrogel precursors onto a cross-sectional face of the distal end of the rolled proximal section, to form a distal section fused onto the cross-sectional face of the distal end of the rolled proximal section, the precursors remaining in an unreactive state until exposed to an aqueous physiological fluid, whereupon the precursors undergo in-situ crosslinking with one another to adhere to the puncture.
2. A method for making a sealant for sealing a puncture through tissue, comprising:
forming a sheet of a freeze-dried hydrogel that expands when exposed to physiological fluid within a puncture;
rolling the sheet into a tubular roll including a proximal end, a distal end, and a lumen extending between the proximal and distal ends;
loading the tubular roll into a tubular member such that the distal end of the tubular roll is offset inwardly from a first end of the tubular member;
melting a plurality of non-crosslinked hydrogel precursors, the precursors remaining in an unreactive state until exposed to an aqueous physiological fluid, whereupon the precursors undergo in-situ crosslinking;
applying the melted precursors to a cross-sectional face of the distal end of the tubular roll within the tubular member; and
allowing the melted precursors to solidify to create a solid mass fused to the cross-sectional face of the distal end of the tubular roll resulting in a sealant having a proximal section comprising the tubular roll and a distal section comprising the solid mass of precursors.
3. The method of claim 1 , further comprising melting PEG-amine and PEG-ester powders into a liquid mixture of non-crosslinked PEG precursors, and wherein fusing a solid mass of non-crosslinked hydrogel precursors onto the cross-sectional face of the distal end comprises using a vacuum generator to apply the liquid mixture of non-crosslinked PEG precursors onto the distal end.
4. The method of claim 3 , wherein the liquid mixture is applied onto the cross-sectional face of the distal end within a substantially dry environment.
5. The method of claim 4 , wherein the liquid mixture cools and solidifies into a solid mass fused to the cross-sectional face of the distal end.
6. The method of claim 1 , wherein forming the elongate rolled proximal section comprises:
forming a sheet of the freeze-dried hydrogel; and
rolling the sheet into a tubular roll including a lumen extending between the proximal and distal ends.
7. The method of claim 6 , wherein rolling the sheet comprises loading the sheet into a tubular member to create the tubular roll, and wherein a vacuum generator draws a liquid mixture of non-crosslinked PEG precursors into the tubular member to apply the liquid mixture to the cross-sectional face of the distal end.
8. The method of claim 1 , wherein fusing a solid mass of non-crosslinked hydrogel precursors onto the cross-sectional face of the distal end comprises:
providing the precursors in a solid state;
melting the precursors to a liquid state;
applying the melted precursors to the cross-sectional face of the distal end of the proximal section; and
allowing the melted precursors to solidify to create the solid mass.
9. The method of claim 8 , wherein the melted precursors are applied to the cross-sectional face of the distal end using a vacuum.
10. The method of claim 8 , wherein the precursors are melted and applied onto the cross-sectional face of the distal end within a substantially dry environment.
11. The method of claim 1 , further comprising including one or more reinforcement elements in the distal section.
12. The method of claim 2 , wherein a vacuum generator is used to draw the melted precursors into the tubular member to apply the melted precursors to the cross-sectional face of the distal end.
13. The method of claim 2 , further comprising placing one or more reinforcement members within the first end of the tubular member before applying the melted precursors such that the one or more reinforcement members are embedded in the solid mass.
14. The method of claim 13 , wherein the one or more reinforcement members comprise a mesh.
15. The method of claim 13 , wherein the one or more reinforcement members comprise one or more filaments wound helically into the first end of the tubular member.
16. The method of claim 2 , further comprising:
providing a plurality of precursors in a solid state; and
mixing the solid precursors together before melting the precursors.
17. The method of claim 16 , further comprising mixing one or more pH adjusting agents with the solid precursors before melting the precursors.
18. The method of claim 2 , further comprising mixing one or more diluents with the melted precursors before applying the melted precursors to the distal end to enhance one or more mechanical properties of the resulting solid mass.
19. The method of claim 2 , further comprising coating, embedding, or impregnating one or more pH adjusting agents in an outer surface of the solid mass.
20. The method of claim 2 , wherein the precursors are melted and applied onto the cross-sectional face of the distal end within a substantially dry environment.
21. The method of claim 2 , further comprising a step of loading the tubular member containing the sealant therein into a delivery apparatus for delivery into the puncture.
22. The method of claim 2 , wherein the tubular member is sized such that its length can accommodate the sealant.