Apparatus and methods for sealing a vascular puncture

1. An apparatus for sealing a puncture through a vessel wall comprising:

a positioning assembly including an expandable member disposed at a distal portion of the positioning assembly, the expandable member configured to move between an unexpanded state and an expanded state;

a support member, the positioning assembly configured to move axially within the support member; and

a handle comprising an outer housing portion and an inner housing portion, the inner housing portion connected to the support member, the outer housing portion configured to selectively engage the inner housing portion,

wherein the handle comprises a first actuator and a second actuator, the first and second actuators at least partially exposed to the outside of the outer housing portion to permit manipulation by a user,

wherein the first actuator is an expandable member retraction actuator configured to at least partially retract the expandable member proximally relative to the support member, and

wherein the second actuator is selected from the group consisting of:

a support member actuator configured to move the support member distally relative to the outer housing portion; and

a locking actuator configured to prevent relative movement between the inner housing portion and the outer housing portion until the locking actuator is activated to disengage the inner housing portion.

2. The apparatus of claim 1 , further comprising a sheath through which the support member is axially advanceable.

3. The apparatus of claim 2 , wherein the handle is configured to engage the sheath such that proximal movement of the outer housing portion moves the sheath proximally relative to the support member.

4. The apparatus of claim 2 , wherein the handle further comprises a distal shroud configured to engage the sheath.

5. The apparatus of claim 1 , wherein the outer housing portion is configured to move proximally relative to the inner housing portion when the outer housing portion is disengaged from the inner housing portion.

6. The apparatus of claim 1 , wherein the inner housing portion is configured to move from a proximal position to a distal position relative to the outer housing portion, and wherein the support member is configured to move toward the expandable member when the inner housing portion is in the distal position.

7. The apparatus of claim 1 , wherein the support member is configured to move from a proximal position to a distal position, and wherein the outer housing portion engages the inner housing portion when the support member is in the distal position.

8. The apparatus of claim 1 , further comprising a rack and a pinion, the rack and the pinion are configured to move the support member distally relative to the outer housing portion.

9. The apparatus of claim 8 , further comprising a locking feature configured to engage the rack, wherein the locking feature is configured to prevent proximal movement of the support member.

10. The apparatus of claim 1 , wherein the support member is configured to move from a proximal position to a distal position, and wherein the positioning assembly is configured to move proximally relative to the support member when the support member is in the distal position.

11. The apparatus of claim 1 , wherein, when activated, the second support member actuator is configured to engage the outer housing portion to secure the outer housing portion to the inner housing portion.

12. The apparatus of claim 1 , wherein the third expandable member retraction actuator is configured to engage the inner housing portion until the support member moves distally.

13. The apparatus of claim 1 , wherein the handle further comprises a locking feature configured to selectively prevent the support member from moving relative to the inner housing portion.

14. The apparatus of claim 1 , further comprising a sealant disposed at the distal portion of the positioning assembly and proximal to the expandable member.

15. The apparatus of claim 14 , further comprising a cartridge carrying the sealant therein.

16. The apparatus of claim 14 , wherein the support member is configured to compress the sealant when the support member is moved distally.

17. The apparatus of claim 1 , wherein the second actuator is the locking actuator.

18. The apparatus of claim 17 , further comprising a third actuator being the support member actuator.

19. The apparatus of claim 1 , wherein the expandable member comprises a balloon.