Instrument and methods for surgically closing percutaneous punctures
A closure device for sealing a percutaneous puncture in a wall of a body passageway, the closure device including at least one of a toggle configured to engage an interior surface of the body passageway or a plug configured to engage an exterior surface of the body passageway and a guide wire configured to extend from an outside of the body to inside the body passageway, wherein at least one of the toggle and the plug is associated with the guide wire.
1. A method for sealing a puncture in a wall of artery, the method comprising:
inserting a toggle of a closure device carried by a delivery assembly along a guidewire into the puncture of the artery in a distal direction such that the toggle is slidable along the guidewire until the toggle is positioned inside the artery on the guidewire, wherein toggle is fixed to a distal end of the delivery assembly;
releasing the toggle from the distal end of the delivery assembly while the toggle is in the artery;
locking a plug and the toggle in place along a suture to seal the puncture; and
removing the guidewire from the toggle and the artery.
2. The method of claim 1 , wherein the toggle includes a cavity, and inserting the toggle of the closure device into the artery includes positioning the guidewire through the cavity of the toggle so that the toggle slides along the guidewire.
3. The method of claim 1 , wherein releasing the toggle from the distal end of the delivery assembly includes actuating with an actuator the delivery assembly to transition the delivery assembly from a first state, where the toggle is fixed to the distal end of the delivery assembly, into a second state where the toggle is released from the distal end of the delivery assembly.
4. The method of claim 3 , wherein releasing the toggle from the distal end of the delivery assembly while the toggle is in the artery includes releasing the toggle from between a distal end of a delivery component and a release component of the delivery assembly.
5. The method of claim 4 , wherein actuating the actuator causes translation of the release component relative to the delivery component to release the toggle.
6. The method of claim 1 , wherein the plug has an aperture configured to receive the guidewire, such that the toggle and the plug are slidable along the guide wire when toggle is inserted into the artery.
7. The method of claim 1 , further comprising, prior to locking the plug and the toggle in place along the suture to seal the puncture, pulling the toggle in a proximal direction that is opposite the distal direction until the toggle contacts an inner surface of the wall of the artery.
8. The method of claim 1 , further comprising sliding a tamper along the suture to compress the plug into the puncture adjacent the toggle.
9. The method of claim 1 , wherein locking the plug and the toggle in place along the suture includes sliding a locking member into contact with the plug to compress the plug against the toggle.
10. The method of claim 1 , further comprising, prior to inserting the closure device into the artery:
inserting an access sheath into the artery along the guidewire; and
inserting the delivery assembly into the access sheath until the delivery assembly is fully seated in the access sheath.
11. A method for sealing a puncture in a wall of artery, the method comprising:
inserting a toggle of a closure device carried by a delivery assembly into the puncture of the artery in a distal direction until the toggle is positioned inside the artery, wherein the toggle is fixed to the delivery assembly;
actuating the delivery assembly via an actuator in order to move the delivery assembly in a proximal direction and release the toggle from between a distal end of a delivery component and a release component of the delivery assembly while the toggle is in the artery; and
locking a plug and the toggle in place along a suture to seal the puncture.
12. The method of claim 11 , wherein the toggle includes a cavity, and inserting the toggle of the closure device into the artery includes positioning guidewire through the cavity of the toggle so that the toggle slides along the guidewire.
13. The method of claim 12 , wherein the plug has an aperture configured to receive the guidewire, such that the toggle and the plug are slidable along the guidewire when the toggle is inserted into the artery.
14. The method of claim 12 , wherein locking the plug and the toggle in place along the suture includes sliding a locking member into contact with the plug to compress the plug against the toggle.
15. The method of claim 11 , wherein actuating the actuator causes translation of the release component relative to the delivery component to release the toggle.
16. The method of claim 11 , further comprising, prior to locking the plug and the toggle in place along the suture to seal the puncture, pulling the toggle in a proximal direction that is opposite the distal direction until the toggle contacts an inner surface of the wall of the artery.
17. The method of claim 11 , further comprising sliding a tamper along the suture to compress the plug into the puncture adjacent the toggle.
18. The method of claim 11 , further comprising, prior to inserting the closure device into the artery:
inserting an access sheath into the artery along the guidewire; and
inserting the delivery assembly into the access sheath until the delivery assembly is fully seated in the access sheath.