Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Devices for closing a passage through tissue communicating with a body lumen. The device may include an elongate body, a sheath disposed at the distal end of the device for disposition within a body lumen, a hollow needle disposed within a needle lumen of the body, the needle being selectively advanceable through the needle lumen, a suture-anchor ejection mandrel disposed within the hollow needle that is also selectively advanceable through the hollow needle, a suture-anchor and suture disposed within the hollow needle, a distal end of the suture attached to the suture anchor for ejection out the hollow needle by the mandrel. A needle guide disposed between the sheath and proximal end of the body may include a needle port through which the needle can exit. A hemostatic plug is disposed over the needle port so as to be penetrated by the needle upon exiting the port.

A tissue puncture locator device that includes an expandable member, a deformable membrane, and an actuator. The expandable member is movable between an unexpanded position and an expanded position. The deformable membrane extends around at least a portion of the expandable member. The membrane has a stress relief portion. The actuator is operable to move the expandable member between the unexpanded and expanded positions.

A sealant for sealing a puncture through tissue includes a first section, e.g., formed from freeze-dried hydrogel, and a second section extending from the distal end. The second section may be formed from PEG-precursors including PEG-ester and PEG-amine, e.g., in an equivalent ratio of active group sites of PEG-ester/PEG-amine greater than one-to-one, e.g., such that excess esters may provide faster activation upon contact with physiological fluids and enhance adhesion of the sealant within a puncture. At least some of the precursors remain in an unreactive state until exposed to an aqueous physiological environment, e.g., within a puncture, whereupon the precursors undergo in-situ cross-linking to provide adhesion to tissue adjacent the puncture. For example, the PEG-amine precursors may include the free amine form and the salt form. The free amine form at least partially cross-links with the PEG-ester and the salt form remains in the unreactive state in the sealant before introduction into the puncture.

A medical device includes a sheath having a proximal end and a distal end, the sheath having an opening at both the proximal end and the distal end, and a removable dilator having a distal end and a proximal end, the dilator having at least one blood detector disposed on a tapered portion of the distal end of the dilator, the dilator positionable within the sheath such that the tapered portion of the distal end of the dilator extends through the opening in the distal end of the sheath, the proximal end of the dilator extends through the opening in the proximal end of the sheath, and at least a portion of the at least one blood detector is adjacent to the distal end of the sheath.

Embodiments are described for closing vascular access ports, such as arteriotomies, which involve placement and deployment of an expandable device configured to prevent blood flow across a subject arteriotomy while also keeping disturbance of intravascular flow to a minimum. Suitable prostheses may comprise one or more frames constructed from lengths of flexible materials, such as shape memory alloys or polymers. Such frames may be coupled to sheetlike or tube-like structures configured to spread loads, minimize thrombosis which may be related to intravascular flow, and maintain hemostasis.

A vessel locator apparatus (30) having a locator housing, and an elongated cavity defined in the locator housing, is described. The vessel locator apparatus include a superelastic wire (46) positioned at least partially in the elongated cavity, the superelastic having a proximal end and a distal end. The superelastic wire may have an elongated portion extending in a substantially longitudinal direction and a distal locator portion having an original shape configuration. The original shape configuration of distal locator portion may include a first curved segment, a second curved segment, an intermediate segment extending between the first curved segment and the second curved segment, and an end segment extending between the second curved segment and the distal end of the superelastic wire. A method of locating a vessel, such as a blood vessel, using a vessel locator apparatus is also described.

A system to facilitate sealing a puncture of a vessel includes an implant having first and second expandable sections, and a delivery device that includes an inner tube and a circumscribing outer tube. The outer tube defines a first lumen configured to retain the implant, and a second lumen configured to channel fluid from the vessel through a distal opening proximal to the implant. A pusher circumscribed at least partially by the outer tube is configured to compress the implant to selectively expand the first and second expandable sections. The outer tube is selectively retractable relative to the inner tube such that the first expandable section remains substantially within the first lumen and the second expandable section is positioned outside of the first lumen. The outer tube is further selectively retractable relative to the inner tube such that the first expandable section is positioned outside of the first lumen.

An apparatus for sealing a puncture through a vessel wall including a positioning assembly, a sheath releasably engaged with the positioning assembly, and a support member axially advanceable through the sheath. The positioning assembly includes a positioning element positioned at a distal portion of the positioning assembly and a sealant disposed at a distal portion of the positioning assembly. The sheath guides the sealant and positioning assembly to the puncture in the vessel wall.

Collapsible tube embodiments may be used to promote hemostasis at surgical sites or any other suitable location. In some cases, vascular closure device embodiments may include collapsible tube embodiments in order to promote hemostasis at a surgical site during a vascular closure procedure.