Apparatus and methods for sealing a vascular puncture
View Patent ↗Apparatus for sealing a puncture communicating with a blood vessel includes a porous carrier formed from lyophilized hydrogel or other material. The plug may include at least first and second hydrogel precursors and a pH adjusting agent carried by the porous carrier in an unreactive state prior to exposure to an aqueous physiological environment. Once exposed to bodily fluids, the carrier expands as the lyophilized material hydrates to enhance and facilitate rapid hemostasis of the puncture. When the plug is placed into the puncture, the natural wetting of the plug by bodily fluids (e.g., blood) causes the first and second precursors to react and cross-link into an adhesive or “sticky” hydrogel that aids in retaining the plug in place within the puncture.
1. An apparatus for sealing a blood vessel wall penetration disposed at an end of a tissue tract, said apparatus comprising:
a shaft having a proximal end and a distal end;
a mechanically expandable structure near the distal end of the shaft, said mechanically expandable structure configured for deployment within the blood vessel to occlude the penetration;
a carrier slidably disposed on an exterior surface of the shaft proximal to the mechanically expandable structure, wherein prior to advancement of the apparatus into the tissue tract, the carrier is positioned adjacent the mechanically expandable structure;
a cartridge carried on the shaft, wherein the carrier is positioned in the cartridge prior to advancement of the apparatus into the tissue tract; and
a pusher member proximal to the carrier;
wherein the cartridge is proximally retractable relative to the pusher member and the carrier.
2. The apparatus as in claim 1 , wherein the mechanically expandable structure is an expandable wire mesh.
3. The apparatus as in claim 1 , wherein the carrier is a pro-thrombotic material.
4. The apparatus as in claim 3 , wherein the pro-thrombotic material is selected from the group consisting of collagen, fibrin, carboxymethylcellulose, oxidized cellulose, alginates, gelatin, polyglycolic acids (PGA), polyactides (PLA), and polyvinyl alcohol.
5. The apparatus as in claim 3 , wherein the pro-thrombotic material is collagen.
6. The apparatus as in claim 1 , wherein the mechanically expandable structure is transformable between a radially expanded configuration for positioning the apparatus relative to the puncture and a radially contracted configuration for removal of the mechanically expandable structure through the carrier.
7. The apparatus as in claim 1 , wherein the mechanically expandable structure comprises a covering such that the mechanically expandable structure is substantially nonporous.
8. An apparatus for sealing a puncture extending through tissue comprising:
an elongate member;
an expandable mesh positioned on a distal end of the elongate member;
a carrier slidably positioned on the distal end of the elongate member proximal to the expandable mesh, wherein prior to advancement of the apparatus into the tissue tract, the carrier is positioned adjacent the expandable mesh;
a cartridge carried on the elongate member, wherein the carrier is positioned in the cartridge prior to advancement of the apparatus into the tissue tract; and
a pusher member proximal to the carrier;
wherein the cartridge is proximally retractable relative to the pusher member and the carrier.
9. The apparatus as in claim 8 , wherein the carrier is a pro-thrombotic material.
10. The apparatus as in claim 9 , wherein the pro-thrombotic material is selected from the group consisting of collagen, fibrin, carboxymethylcellulose, oxidized cellulose, alginates, gelatin, polyglycolic acids (PGA), polyactides (PLA), and polyvinyl alcohol.
11. The apparatus as in claim 8 , wherein the expandable mesh is a wire mesh.
12. The apparatus as in claim 8 , wherein the carrier includes a lumen extending between a proximal and a distal end thereof, the lumen defining a longitudinal axis of the carrier.
13. The apparatus as in claim 12 , wherein the lumen is sized to allow the elongate member or other elongate element to slide through the carrier.
14. The apparatus as in claim 8 , wherein the expandable mesh is transformable between a radially expanded configuration for positioning the apparatus relative to the puncture and a radially contracted configuration for removal of the expandable mesh through the carrier.
15. The apparatus as in claim 8 , wherein the expandable mesh comprises a covering such that the expandable mesh is substantially nonporous.
16. An apparatus for sealing a puncture extending through tissue comprising:
an expandable positioning member comprising an elongate member and an expandable mesh positioned on a distal end of the elongate member;
a carrier with pro-thrombotic material slidably positioned on the distal end of the elongate member proximal to the expandable mesh, wherein prior to advancement of the apparatus into the tissue tract, the carrier is positioned adjacent the expandable mesh;
a protective sleeve retractably disposed over the carrier prior to advancement of the apparatus into the tissue tract; and
a pusher member proximal to the carrier;
wherein the protective sleeve is proximally retractable relative to the pusher member and the carrier.
17. The apparatus as in claim 16 , wherein the pro-thrombotic material is selected from the group consisting of collagen, fibrin, carboxymethylcellulose, oxidized cellulose, alginates, gelatin, polyglycolic acids (PGA), polyactides (PLA), and polyvinyl alcohol.
18. The apparatus as in claim 16 , wherein the expandable mesh is a wire mesh.
19. The apparatus as in claim 16 , wherein the carrier includes a lumen extending between a proximal and a distal end thereof, the lumen defining a longitudinal axis of the carrier.
20. The apparatus as in claim 19 , wherein the lumen is sized to allow the elongate member or other elongate element to pass through the carrier.
21. The apparatus as in claim 16 , wherein the expandable mesh is transformable between a radially expanded configuration for positioning the apparatus relative to the puncture and a radially contracted configuration for removal of the expandable mesh through the carrier.
22. The apparatus as in claim 16 , wherein the expandable mesh comprises a covering such that the expandable mesh is substantially nonporous.