A method and device for positioning an expandable support in a blood vessel is disclosed herein. The device may include a handle, a catheter assembly, a core wire, and an expandable support. The expandable support may be used to position the device relative to the arteriotomy, as well as to provide temporary hemostasis. The expandable support may be attached to the catheter assembly at a first end, and to the core wire at a second end to optimize the width of the expandable support based on the function being performed by the expandable support at a given time. The catheter assembly may be able to move relative to the handle and the core wire, thereby moving the first end of the expandable support relative to the handle and the core wire.

An apparatus for delivering a clip includes an introducer sheath including an outer surface extending between its proximal and distal ends. A clip is carried on the outer surface, e.g., on a carrier assembly that is slidable along the outer surface from the proximal end towards the distal end. A skin overlies the outer surface of the sheath and the carrier assembly that is separable from the outer surface as the carrier assembly is advanced from the proximal end towards the distal end of the sheath. During use, the distal end of the sheath is inserted into an opening through tissue, e.g., into a puncture communicating with a blood vessel. The carrier assembly is advanced towards the distal end of the sheath, causing the skin to separate from the outer surface of the elongate member, and the clip is deployed from the carrier to seal the opening.

Systems and methods are provided for suturing tissue. An elongated deployment shaft carries a needle deployment assembly with needles carrying suture material. A needle catcher is disposed over the shaft and configured to engage and retain at least a portion of each of the needles carrying the suture material when the needles are passed through the tissue to be sutured to a proximal position.

Systems and methods are provided for suturing tissue. An elongated deployment shaft carries a needle deployment assembly with needles carrying suture material and a stabilizer that is reconfigurable between an unexpanded insertion profile and an expanded profile. A catcher tube over the shaft having a catcher at a distal end may retain at least a portion of the needles carrying the suture material when the needles are passed through the tissue to be sutured into engagement with the catcher. A sheath over the catcher tube may sandwich tissue to be sutured against the stabilizer when expanded under control of first actuator. A second actuator may control the needles.

A device for closing a tissue opening includes a proximal housing portion having a first portion, a second portion, a third portion, and a fourth portion. The first portion and the fourth portion extending transversely to a longitudinal axis of the proximal housing portion on opposite sides of the proximal housing portion. A distal portion extends from the proximal housing portion. At least the second portion and the third portion are configured to move toward the first portion.

Disclosed are puncture sealing systems and methods of locating a puncture site within a vessel. The systems can include puncture locating dilators and access sheaths that are configured to locate the puncture site within a vessel so that the position of the puncture site relative to a distal end of the access sheath is known during a puncture sealing procedure.

A system for sealing a percutaneous puncture communicating with a blood vessel in a living being and method of use thereof. The system, referred to in the present embodiment, as a balloon closure device, includes an inner member, referred to as an anchor catheter, slidable within an outer member, referred to as an occlusion catheter, and separate expandable members, referred to as balloons, coupled to the distal ends of both the anchor and occlusion catheters. Also, incorporated into the distal end of the anchor catheter are blood vessel locator holes for determining the position of the blood vessel via the percutaneous puncture. The vessel locator includes means for enabling blood from the vessel to flow therethrough so that the position of the vessel can be rapidly determined. Once the balloon closure device has been extended into the puncture and the vessel has been located, the ballon closure device may be deployed. The anchor catheter and its balloon are located within the blood vessel, while the occlusion catheter and its balloon are located within the puncture tract leading to the vessel. Once the balloon closure device is positioned, hemostasis occurs rapidly, and the necessary components are locked in place.

A proximal end of the occlusion catheter includes a port for delivering fluid into the balloon, and a cylindrical lumen that communicates with the port. A proximal end of the anchor catheter includes a port for delivering fluid into the balloon, and a cylindrical lumen that communicates with the port. The anchor catheter may also include a cylindrical lumen to accommodate a guidewire. The balloon closure device is introduced like a standard sheath exchange. First, the existing sheath is removed over a guidewire. Next, the occlusion catheter coupled with an inner distally tapered anchor catheter/introducer is passed over the guidewire through the puncture, disposing the anchor catheter/introducer with its collapsed balloon in the vessel lumen, while the occlusion catheter with its collapsed balloon is disposed in the puncture tract. Once vessel lumen location is confirmed, fluid is introduced into the anchor catheter port, inflating the anchor balloon. The anchor balloon is withdrawn to seal the puncture. The occlusion catheter is advanced to the distal end of the puncture tract just outside the vessel wall, and abutting the inflated anchor balloon. Fluid is introduced into the occlusion catheter port, inflating the occlusion balloon, to both occlude the puncture and secure the occlusion catheter in the puncture tract. The anchor balloon is then deflated, allowing the anchor catheter/introducer to be withdrawn into the puncture tract and r

A surgical instrument and method for indicating a tissue penetration site includes an inner needle and a head. The inner needle has a driver configured to translate the inner needle form a first position to a second position. The head is securely attached to the inner needle at an end opposite the driver and is configured to expand from a contracted state to an expanded state and thereby indicate the tissue penetration site.

A device is configured for closing an aperture in a wall of a blood vessel. An embodiment of the device includes a body and at least one suture element held within the body. A suture capture rod is positioned within the body and is operatively associated with the suture element and arranged to pass the suture element through a vessel wall such that opposed portions of the suture element extend from the vessel wall. A removable guidewire segment is removably attached to a distal end of the body.

A hemostatic device for sealing a puncture of a vessel includes a first tube defining a first lumen, and a malecot coupled to the first tube. The malecot is selectively actuatable from a neutral configuration to a stopper configuration. The hemostatic device also includes a second tube circumscribing at least a portion of the first tube. The second tube at least partially defines a second lumen and a third lumen. The second tube includes a first opening in flow communication with the third lumen and positioned proximally relative to the malecot. The second tube is selectively orientable to at least partially expose a hemocoagulant agent retained in the second lumen.