Apparatus and methods for delivering hemostatic materials for blood vessel closure
Apparatus for sealing a vascular wall penetration disposed at the end of the tissue tract comprises a shaft, an occlusion element, a hemostatic implant, and a protective sleeve. The apparatus is deployed through the tissue tract with the occlusion element temporarily occluding the vascular wall penetration and inhibiting backbleeding therethrough. The hemostatic implant, which will typically be a biodegradable polymer such as collagen carrying an anti-proliferative agent or coagulation promoter, will then be deployed from the sealing apparatus and left in place to enhance closure of the vascular wall penetration with minimum scarring. The implant may be radiopaque to allow observation before release.
1. An apparatus for sealing a blood vessel penetration disposed at the end of a tissue tract, the apparatus comprising:
a shaft having a proximal end and a distal end;
a radially expandable occlusion element at a distal end of the shaft;
a hemostatic implant disposed over and in contact with an exterior surface at the distal end of the shaft; and
a retractable outer sleeve constraining the hemostatic implant on the shaft to maintain the hemostatic implant in a position between the retractable outer sleeve and the exterior surface at the distal end of the shaft;
wherein the hemostatic implant is configured to remain stationary on the shaft while the outer sleeve is being retracted, and
wherein the constrained hemostatic implant has a first mass on a first lateral side of the shaft and a second mass on a second lateral side of the shaft opposite the first side, the first mass being greater than the second mass so that the hemostatic implant hydrates and expands asymmetrically to open laterally to release from the first lateral side of the shaft after the outer sleeve is fully retracted from over the implant.
2. An apparatus as in claim 1 , further comprising a back stop on the shaft wherein the backstop is configured to prevent the hemostatic implant from being displaced proximally while the outer sleeve is retracted.
3. An apparatus as in claim 1 , wherein the apparatus further includes an inner release sheath inside of the outer sleeve and covering the implant, wherein the release sheath inhibits sticking between the outer sleeve and the hemostatic implant as the outer sleeve is retracted.
4. An apparatus as in claim 3 , wherein the inner release sheath is split so that it opens over the hemostatic implant after the outer sleeve is retracted.
5. An apparatus as in claim 3 , wherein the outer sleeve is configured to couple to and retract the inner release sheath to expose and release the hemostatic implant as the outer sleeve is retraced.
6. An apparatus as in claim 3 , wherein the inner release sheath is configured to be retracted separately from the outer sleeve.
7. An apparatus as in claim 1 , wherein the hemostatic implant comprises a cylindrical body which circumscribes the shaft and having at least one axial split along its length.
8. An apparatus as in claim 1 , wherein the hemostatic implant has a crescent-shaped cross-section.
9. An apparatus as in claim 1 , wherein the hemostatic implant comprises a wrapped sheet which is axially split and which partially or fully circumscribes the shaft.