CA2051360C - Device and method for sealing puncture wounds - Google Patents
Device and method for sealing puncture wounds Download PDFInfo
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- CA2051360C CA2051360C CA002051360A CA2051360A CA2051360C CA 2051360 C CA2051360 C CA 2051360C CA 002051360 A CA002051360 A CA 002051360A CA 2051360 A CA2051360 A CA 2051360A CA 2051360 C CA2051360 C CA 2051360C
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- hemostatic material
- sheath
- puncture
- tissue
- channel
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00637—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for sealing trocar wounds through abdominal wall
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00646—Type of implements
- A61B2017/00654—Type of implements entirely comprised between the two sides of the opening
Abstract
A device is proposed for inserting hemostatic material through a tissue channel and against the outside wall of a blood vessel of a patient, wherein the blood vessel wall has a puncture therein adjacent the tissue channel. The device includes a charge of hemostatic material and a hollow sheath adapted to pass through the tissue channel, the sheath having a cross sectional profile larger than the puncture.
The device places the hemostatic material in the hollow sheath and advances the hemostatic material through the sheath to the outside of the vessel wall around the puncture.
The device places the hemostatic material in the hollow sheath and advances the hemostatic material through the sheath to the outside of the vessel wall around the puncture.
Description
TI LE
DEVICE and METHOD
FOR SEALING PUNCTURE WOUNDS
Field of the Invention The present invention relates to a method for sealing a puncture wound in a blood vessel and a device for practicing said method.
Related Background 2o In certain medical procedures, such as cardiac catheterization, dilatation and counterpulsation, a, catheter or other device is inserted into an artery, most commonly by percutaneous methods, and then fed through the arterial tree to the site where needed, frequently, the region of the heart. The site usually selected for insertion is the groin, because the femoral artery in that region is relatively easy to locate.
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These procedures are normally initiated by insertion of an angiographic needle, followed by passing a guide wire through that needle into the artery. The needle is then removed leaving the guide wire in place. Next, a sheath-dilator set is passed over the guide wire into the artery in order to enlarge the opening sufficiently to permit entry of the catheter or other device. The dilator is then removed, leaving the sheath or guide cannula in place. The catheter or other device can then be inserted through the cannula with full confidence that when it emerges from the distal end it will be within the lumen of the artery.
It should be understood that the subject invention is independent of the nature of the medical device being used to treat the patient. Accordingly, the term "catheter" will be used here in a very generic and broad way to include not only "catheters" in the strict sense, but any device that is inserted into a blood vessel of the body.
Similarly, the subject invention is independent of the blood vessel involved. While it is anticipated that the femoral artery will be the most commonly used blood vessel, other arteries as well as veins might just as easily be involved.
After a procedure, for example, counterpulsation, has been completed, the sheath must be removed and the wound closed. Often, this can be accomplished simply by the application of digital pressure, generally augmented by the use of a pressure dressing.
Customarily, pressure must be applied for at least hour, and frequently for much longer than that. While pressure dressings often suffice, it is not uncommon for additional devices, such as sandbags, to be needed.
In addition, during this period the patient must be immobilized, lest movement interfere with the closing process. Because of the pressure required, the time during which it must be applied and the need for immobilization, the procedure is painful and uncomfortable. Tt also requires prolonged personal attention of a health care professional. Finally, wound closures accomplished in this manner are prone to reopen unexpectedly long after closure appears to have been completed. Patients are therefore often required to remain in the hospital for 24 hours or longer.
Because sealing can be such a problem, cardiologists tend to use the smallest calibre catheters when performing catheterization procedures. Larger calibre catheters, however, are far preferable. An improved sealing procedure whereby larger catheters can be used without increasing the sealing difficulties would greatly facilitate cardiac catheterization.
A series of related devices which were designed to address some of these problems is described in U.S.
patents Nos. 4,744,364, 4,852,568 and 4,890,612. These three patents describe a mushroom or umbrella shaped device which is used to seal the artery from the inside. The head of the device is placed within the arterial lumen and means are provided to pull and hold the underside of the head against the inside wall of the lumen. It is believed, however, that sealing~from the inside can be the source of its own problems, including the promotion of clot formation inside the vessel.
Another method for sealing a puncture wound is described in U.S.P. 4,929,246. The approach taken there is to insert a balloon-tipped catheter into the tissue wound, inflate the balloon against the hole in -.
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the artery and then use a laser to thermally weld the wound closed.
The present invention is believed to overcome most of the drawbacks of the traditional method, without creating any new difficulties. This is accomplished by using a plug, preferably a collagen plug or plug of some other resorbable material, to seal the artery along its outside wall.
to SUMMARY OF THE INVENTION
In its most simplified form, the instant invention involves the placing of hemostatic material against the outside wall of a punctured artery. The hemostatic material covers the entire puncture site and a hemostatic seal is formed so as to stop bleeding from the puncture wound.
In one embodiment, the subject invention teaches the use of a plug, preferably of fibrous collagen material.
The plug is inserted into the tissue wound and is held against the outside of the artery wall so as to overlap the puncture wound. Before plug insertion, the artery is preferably clamped by the use of external digital pressure, at a point slightly upstream of the wound site. After the plug has been inserted, the upstream clamping pressure is maintained for a very short period of time, and then gently removed. Slight pressure may be maintained on the plug to hold it against the artery wall until a good seal has been established.
In order to insert the plug in accordance with the procedure outlined above, a special device has been designed. It is comprised of two basic components, a sheath and a plug pusher or piston. The sheath is inserted through the tissue until its leading end is _ 5 _ near to or abuts the outer wall of the artery,.
Thereafter, the plug is advanced through the sheath by use of the plug pusher until the plug abuts the artery wall and overlaps the arterial puncture on all sides.
Finally, after a good seal has been established, the sheath and pusher are removed.
BRIEF DESCRIPTTC~nt nF mug DgAWING
FIG. 1 is an exploded view of one embodiment of an insertion apparatus in accordance with the instant invention.
FIG. 2 depicts, in cross section, one embodiment of an insertion apparatus in accordance with the instant invention.
FIG. 3 depicts, in cross section, a second embodiment of an insertion device in accordance with the instant invention.
FIG. 4 depicts, in cross section, an exploded view of a third embodiment of an insertion apparatus in accordance with the instant invention.
FIG. 5 is an enlarged, schematic drawing, in cross section, of an insertion site, showing a balloon catheter, having passed over a guide wire through a guide cannula into the femoral artery of a patient.
FIG. 6 shows the insertion site of Fig. 5 after the catheter and cannula have been removed.
FIG. 7 shows the insertion site of Fig. 6 after insertion of a tissue dilator in accordance with the instant invention.
-FIG. 8 shows the insertion site of Fig. 7 after insertion of a sheath over the tissue dilator in accordance with the instant invention.
FIG. 9 shows the insertion site of Fig. 8 after removal of the tissue dilator and guide wire and after partial insertion of a hemostatic plug and plug pusher.
FIG. 10 shows the insertion site of Fig. 9 after the l0 hemostatic plug has been pushed out of the sheath and while -it is being held in intimate contact with the arterial puncture.
FIG. 11 shows an alternative embodiment of the instant invention wherein a collagen balloon is used to seal an arterial puncture.
FIGS. 12a, b, c, d and a show alternative forms of plug which are useful in practicing the instant invention.
FIGS. 13 through 23 show the steps of an alternate procedure for practicing the instant invention.
DETAILED DESCRIPTION
In certain procedures, for example, intra-aortic balloon pumping ("IABP"), percutaneous transluminal co7ronary angioplasty ("PTCA") and angiography, as best seen in Fig. 5, a catheter or other device 7 is inserted, often over a guide wire 15, through a guide cannula 3 into an artery 11, most frequently, the common femoral artery in the groin area of the patient's leg 1. When the procedure (e,~cx., counterpulsation) has been completed, the device (e-a., the catheter), the guide wire and the guide cannula must be removed and the wound closed.
In accordance with one embodiment of the instant invention, wounds of this type are closed by inserting a plug 57 into tissue wound or channel 9, and holding it against the outside of the artery wall over arterial puncture 13 for a short period of time until a good self-sustaining hemostatic seal is established.
Although punctures of the sort made by per~utaneous procedures will generally, after removal of all cannulas and catheters, be in the nature of slits, for l0 ease of understanding, they are depicted in the drawings herein more as holes. The shape of the puncture, however, is not critical.
In order to insert plug 57, to assure that it is properly located and to be able to hold it in place -until a good seal is established, a special insertion apparatus has been designed. One embodiment (Fig. 1) of an insertion apparatus according to the instant invention is comprised of a sheath assembly 23, a plug holder 29 and a plug pusher 33. Sheath assembly 23, in turn, is comprised of an elongated tubular sheath 45 and a collar 35. At its rear end, collar 35 is provided with an external thread 37. In addition, sheath assembly 23 is provided with a sheath channel 27, which runs through the entire assembly, from front end 25, through sheath 45 and through collar 35.
Plug holder 29 is comprised of an elongated rear tubular portion 47 and a coupling 39 which has an internal thread 41. Plug holder 29 also has a channel 31 running throughout its entire length. Coupling thread 41 is designed to mate with collar thread 37 so that when collar 35 is screwed into coupling 39, channels 31 and 27, which preferably are of the same cross sectional size and configuration, are aligned.
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~ :.~ n.~ z3 Like the other two components, the plug pusher 33 is also comprised of two parts, an elongated piston 49, and a stop knob 43. Piston 49 has a cross sectional size and configuration so as to permit sliding passage into channels 31 and 27 with only minimal clearance.
The length of piston 49 is such that when sheath assembly 23 and plug holder 29 are screwed tightly together, shoulder 51 of knob 43 will abut rear end 53 of plug holder 29 as front end 55 of piston 49 is aligned with front end 25 of sheath 45.
It should be noted that pusher 33 is provided with its own channel 19. This is to permit passage therethrough of a guide wire and hence to enable pusher 33 to serve dual functions, as a tissue dilator and as a plug pusher.
In accordance with the method of the instant invention, first the device 7 (e.~., the IAB) and the guide cannula 3 are removed, leaving the guide wire 15 in place (as seen in Fig, 6). If no guide wire has been employed, prior to removal of the catheter and cannula, a guide wire may be inserted. As the cannula is withdrawn, in order to prevent bleeding, the artery is clamped, usually by pressing a finger 2 over the femoral artery upstream of the wound site. Because of this clamping, there is no significant blood pressure inside the artery at the site of the puncture (other than some small retrograde pressure) and the artery tends to collapse.
Although it is believed preferable to employ a guide wire, it is possible to practice the invention without one. It is also possible to practice the instant invention by eliminating the dilator, but this too is not the preferred approach.
g The artery is clamped at least in part to prevent tissue channel 9 from filling with a pool of blood.
When loose fibrous collagen encounters a pool of blood it tends to disintegrate almost immediately.
Obviously, once disintegrated it cannot function properly to seal the arterial puncture. Hence, when collagen in loose fibrous form is employed,..~lamping of the artery is important. It is less important, but still generally advantageous, if the loose fibrous material has been tamped down or otherwise compressed.
As used herein, the term "loose" includes material which has been compressed or tamped down.
Collagen that is more densely packed does not disintegrate upon encountering blood nearly as quickly-as loose fibrous collagen. Therefore, clamping of the artery is not nearly as important when the hemostatic material is in the form of a densely packed material, as it is when a loose fleece-type hemostatic material is employed. Thus, although clamping is believed to be desireable, it is not, in all cases essential.
While the artery remains clamped, the proximal end of guide wire 15 is fed through channel 20 of tissue dilator 17. The physician can then slide the dilator down along the guide wire into tissue channel 9 until it reaches the wall of artery 11 (as depicted in Fig. 7) .
The size and shape of the tissue dilator are such as to ensure that the body thereof will not enter the artery.
In terms of size, preferably a dilator is selected which is significantly larger than the original guide cannula 3. with respect to its shape, unlike more traditional dilators which often have long tapered forward ends, the tissue dilator 17 of the instant invention has a blunt forward end 21. Although end 21 '~ ;:Z .a c9 ' m may be slightly rounded or chamfered in order to facilitate smooth passage through tissue channel 9, it is preferable not to reduce it in size sufficiently to permit entry through the arterial puncture 13 into the lumen of the artery.
As noted above, during this phase of the procedure, there is no significant blood pressure in the region of artery 11 adjacent puncture 13. As a result, when end l0 21 of dilator 17 reaches artery 11, the wall of the artery tends to collapse further (as depicted in Fig.
7). The physician knows that the dilator has reached the artery because a noticeable increase in resistance is felt.
According to the procedure of the instant invention, once increased resistance is encountered, axial pressure is maintained so as to hold end 21 of dilator 17 against artery 11. Next, a sheath 45 is passed over dilator 17 and advanced along the dilator again until increased resistance is encountered. As with the dilator, increased resistance indicates that front end is against artery 11 (as depicted in Fig. 8). In addition, a marker can be placed around the 25 circumference of the dilator to signal when the distal end of the sheath is aligned with the distal end of the dilator.
Because end 25 of sheath 45 is larger than arterial puncture 9, the sheath cannot enter the arterial puncture. Although the precise dimensions of dilator 17 and sheath 45 are not critical, it is believed desirable that the sheath 45 be 30% to 50% or more larger than the previously removed guide cannula 3. In clinical trials done to date, when the guide cannula was 9 Fr., a 13 Fr. tissue dilator and a 14 Fr. sheath were used. It should be understood, however, that ,', rJ
4,j l ._ ~ ~.a cannulae which are oversized by as little as 10% may also be suitable.
once the guide or procedure cannula has been removed, tissue channel 9 tends to collapse. Also, once the procedure cannula and the procedure catheter have been removed, arterial puncture 13 has a tendency to close up. It may therefore be possible or even preferable to use a sheath that is the same size as or even smaller to than the previously removed procedure cannula.
With the front end 25 of sheath 45 held snugly against the wall of artery 11, plug 57 is slid down through lumen 27 of sheath 45 (as shown in Fig. 9) until it reaches end 25 of sheath 45 where it encounters artery 11. If an insertion apparatus like that shown in Fig.
1 is used, plug 57 is initially housed in plug holder 29. When it is time for plug insertion, holder 29 is screwed onto sheath assembly 23 by means of threads 37 and 41, and piston 49 is inserted into channel 31.
Advancement of the piston then forces plug 57 from holder 29 into sheath 45 and through lumen 27 to the artery wall.
Once resistance is felt, the physician slowly withdraws the sheath while continuing to maintain pressure against the piston so that plug 57 remains pressed against artery 11. When shoulder 51 of knob. 43 abuts rear end 53 of holder 29, the physician knows that plug 57 has been pushed entirely out of lumen 27 (as shown in Fig. 10). Axial pressure is maintained for a short period of time, perhaps as little as one minute or as long as five minutes, depending upon the circumstances, to allow plug 57 to seat in tissue channel 9 and against arterial puncture 13. Minimal axial pressure is thereafter continued while clamping pressure is slowly released until a good self-sustaining hemostatic seal has been confirmed. The sheath, holder, and pusher can all then be removed.
While it is believed that the preferable procedure is 5 to permit both piston and sheath to remain in place until a self-sustaining hemostatic seal has been achieved, this is not absolutely necessary...- Some physicians may prefer, once the pressure of the plug against the artery wall has produced hemostasis, to 10 withdraw the sheath so that the tissue wound may begin to close down, while maintaining pressure on the plug by use of the piston alone. Alternatively, the piston might be withdrawn and reliance placed upon the outer rim of the sheath to hold the plug against the artery 15 wall and assure hemostasis in that manner. -In addition, removal of the piston without removal of the sheath permits insertion of a second plug. This might be necessary where the first plug, perhaps of a 20 loose fibrous material, disintegrates upon encountering a pool of blood. A second plug, this one of more densely packed material having greater physical integrity and less of a tendency toward immediate . disintegration, is inserted in the sheath and the 25 piston reinserted behind it.
An apparatus similar to that of Fig. 1 is depicted in Fig. 4. The primary difference between the two is that the plug pusher of the Fig. 4 embodiment does not serve 30 a dual function. Instead, the embodiment of Fig. 4 has a separate tissue dilator 17 with channel 20 running throughout its length.
Another, somewhat different embodiment of an apparatus 35 for inserting a plug in accordance with the instant invention is depicted in Fig. 2. The insertion apparatus 59 of that embodiment is made in the form of a Y, with a common or sheath leg 61, a plug leg 63 and a dilator leg 65.
In one method of using the apparatus of Fig. 2, tissue dilator 17 and insertion apparatus 59 are preassembled by passing the dilator through legs 65 and 61 until enough of dilator 17 extends beyond the forstard end of leg 61 to assure that end 21 will abut artery 11 before front end 26 of leg 61 reaches the surface of the patient's leg. The proximal end of the guide wire is then fed through dilator channel 20 and the dilator is slid down the guide wire into tissue wound 9 until end 21 of dilator 17 reaches the wall of artery 11. While holding the dilator against the artery wall, the physician slides insertion apparatus 59 along dilator -17 until end 26 of leg 61 reaches artery 11.
With end 26 held snugly against artery 11, dilator 17 is withdrawn, but only far enough so as to uncover channel 67 of plug leg 63. Plug pusher 69 is then moved down through channel 67 until plug 57 has entered common leg 61 and pusher 69 is then withdrawn so that it will not interfere with dilator 17 as it passes from leg 65 into leg 61.
Once plug 57 has entered leg 61 and pusher 69 has been retracted, dilator 17 is again advanced into leg 61.
When resistance is encountered, the physician knows that plug 57 has reached the artery. while maintaining axial pressure on dilator 17, apparatus 59 is slowly withdrawn until proximal end 73 of leg 65 reaches indicator mark 71. The distance between indicator 71 and dilator end 21 is the same as the distance between proximal end 73 and forward end 26. Therefore, the physician knows that when mark 71 reaches end 73, all of plug 57 has exited from end 26 of leg 61. As was described in connection with the embodiment of Fig. 1, pressure is then maintained until a good self-sustaining hemostatic seal has been established.
The embodiment of Fig. 3 is very similar to that of 5 Fig. l, except that the dilator and plug legs have been transposed. In the Fig. 3 embodiment, plug leg 74 is coaxial with common leg 61 and dilator leg--~5 is at an angle, whereas in the Fig. 2 embodiment the reverse is true.
Although it is believed that the preferred method for using the embodiment of Fig. 2 is to preassemble dilator 17 in apparatus 59, that is by no means necessary. If the physician prefers, he can just as 15 well insert dilator 17 into tissue channel 9 as was -described above in connection with the embodiment of Fig. 1. He can then pass leg 61 over it. With the embodiment of Figs. 4 and 1, while it is believed preferable to insert dilator 17 first, the physician, 20 if he prefers, can preassemble the dilator in the sheath before passing the dilator over the guide wire.
While plug 57 may be made of any resorbable material, collagen is believed to be most suitable. The physical 25 form of the plug may vary widely, with the one selected by the physician being dependent upon the circumstances of the case. For example, where the puncture wound is relatively small and the patient has not been on high doses of anticoagulant and heparin, a plug, like that 30 depicted in Figure 12a, of loose fibrous material, somewhat like fleece or absorbent cotton or oxygenated cellulose, would serve quite well. Alternatively, for larger wounds in patients who have been on anticoagulants and heparin, it may be necessary that 35 the plug be able to maintain some structural integrity for a longer period of time. Under those circumstances, a plug of more densely packed material, as depicted in Figure 12b, might be preferred.
A third embodiment of a suitable plug is depicted in Figure 12c. In that embodiment, the front end 77 of the plug might be of loose fibrous material, like that depicted in Figure 12a, whereas the remainder 79 could be made of a more densely packed material.
Yet another type of plug is shown in Figure 12d. In this configuration, the front end 81 is a collagen membrane and the remainder 83 is an expandable collagen sponge.
It is believed that when a collagen sponge or a densely packed collagen material are employed, very little if any pressure need be applied after the initial seating of the plug. This is believed to be true because the physical characteristics of the sponge-like or densely packed plug and the expansion thereof, as well as its interaction with body fluids in the tissue channel will be adequate to hold the front end against the artery wall.
It_is also believed that, initially, when the plug is pressed against the artery, hemostasis is achieved by mechanical means, i.e., by application of mechanical pressure all around the arterial puncture. Shortly thereafter, however, the hemostatic material begins to bind to the arterial tissue and biochemical hemostasis takes over. Once biochemical hemostasis becomes sufficiently strong to withstand the normal blood pressure within the artery, and therefore self-sustaining, external mechanical pressure can be removed.
Figure 12e shows yet another form of plug, similar to the plug of Figure 12d, but with a lumen 85. This form of plug is designed for use by physicians who prefer not to remove the guide wire immediately after a procedure. The proximal end of the guide wire 15 can be fed through lumen 85 and through the collagen membrane 81. The plug is slid down along tha guide wire through tissue channel 9 until its front end reaches the wall of the femoral artery. Indeed, the plug of Figure 12e could even be inserted without the use of a sheath. When the wire 15 is withdrawn, the collagen membrane automatically reseals itself.
As noted earlier, the sheath is substantially larger in cross section than is arterial puncture 13. -Consequently, when plug 57, which fills the entire cross section of the sheath channel, reaches the artery, even in its compressed state it overlaps puncture 13 on all sides. Obviously, then, when it exits the sheath and is permitted to expand, a full bandage-like covering over puncture 13 is assured.
In practice it has been found that when using a collagen plug in accordance with the subject invention, a good hemostatic seal can be achieved in five minutes or less. with larger wounds, for example, ones left after removal of 14 Fr. or larger catheters, or after the use of anticoagulants and heparin, sealing may take somewhat longer.
Figure 11 depicts another means for practicing the instant invention. In this embodiment a piston 18 pushes~ahead of its front end a closed balloon 87 formed of a collagen membrane and only partially filled with a collagen substance and a saline solution. The piston 18 has an injection needle 18a on its front end which pierces the balloon during the pushing action.
After the balloon 87 exits from the sheath 23 and is pressed against the wall of the artery 11, an inflation.
fluid is injected via the needle 18a to fill and expand the balloon, as shown in Fig. 11, so that the balloon covers the arterial puncture 13 and fills the region of tissue channel 9 immediately adjacent. the arterial puncture 13. The piston 18 is thereafter r.~tracted to withdraw the injection needle 18a from the balloon 87.
The membrane which forms the balloon 87 then automatically reseals itself to hold the balloon in the inflated condition shown in Fig. 11. The sheath 23 and piston lg may then be withdrawn. When using this embodiment, the inflation fluid itself should be resorbable, preferably a saline solution or saline mixed with collagen in solution. -As noted above, when the procedure cannula is removed, both the arterial puncture 13 and the tissue channel 9 tend to close up somewhat. The method depicted in Figure 13 through 22 is designed to take advantage of this tendency. In the Figures 13-22 method, neither the hemostasis sheath 45 nor the dilator 17 are pushed through channel 9 all the way to arterial puncture 13.
Instead, as shown at 89 in Figures 14, 14A, 15 and 15A
they are inserted no further than to within about 3/4 cm. of the artery.
First, digital pressure (see arrows 105 in Figures 13-21) is applied upstream of the wound so as to close down the artery (see arrows 106). In this way the pressure in the artery at the puncture site 13 is no more than about atmospheric pressure. Although the _ method of this invention could be practiced without applying digital pressure, that would likely result in more profuse bleeding.
- 1 s - ~. .~.: .aa zti Then, as shown in Figure 13, the dilator 17 is inserted over guide wire 15 to about 3/4 cm from puncture 13.
It will generally be inserted so that between about 3 and about 6 cm. of its length is beneath the surface of the skin.
One method for assuring that the sheath is inserted to the proper depth is as follows. Once the artery 107 has been punctured and the guide wire is in place, a to needle clamp 108, as is depicted in Figure 23, is placed on the needle 109 at the skin line 110. With the clamp in place, the needle is removed from the patient. The needle can then be placed along side the sheath and a mark made on the sheath to indicate the distance from needle tip to needle clamp.
Alternatively, a mark can be made 1/2 or 3/4 cm. closer to the distal end of the sheath. As yet another alternative, a kit can be provided of variable length sheaths, each having a hub at one end, and from that kit a sheath of the proper length, i.e., one having a total length, from hub to distal end, of 1/2 or 3/4 cm.
less than the distance from needle tip to needle clamp can be selected.
Next, as is best seen in Figure 14, 'the sheath 45 is slid down over the dilator, again stopping when its distal tip is about 3/4 cm. from the arterial puncture 13. The sheath and dilator can be inserted separately, i.e., in two steps, or together as a unit, in one step.
As can be seen in Figures 14a and 15a, the partially collapsed section of tissue channel 9 which is immediately adjacent puncture 13 is not reexpanded.
znstead, it remains undisturbed.
The next step is to withdraw dilator 17 (as is indicated by arrow A on Figure 15) with guide wire 15 (see Figure 15), leaving only sheath 45 in tissue channel 9. ~As depicted in Figure 16, a preloaded holder or cartridge 91 with plug 93 therein is inserted (see arrow B) into sheath chamber 97. As cartridge 91 5 is fully seated within chamber 97, a plunger 95 is used to push (see arrow C) plug 93 into and through sheath 45 until the plug exits the sheath so as to cover puncture 13 and fill that section of channel 9 which is adjacent puncture 13 (see Figures 17 and 17a).
10 Simultaneously, sheath 45 is slightly withdrawn (indicated by arrows D on Figure 17) to permit plug 93 to be fully discharged from the sheath.
Plunger 95 is then withdrawn, leaving sheath 45 to 15 maintain pressure on plug 93. Sheath 45 can then be used to hold plug 93 in place over puncture 13 until self sustaining hemostasis has been achieved.
Alternatively, as depicted in Figure 18, a second preloaded holder or cartridge 99 can then be inserted 20 (see arrow E) into chamber 97. Once again, a plunger, 103 is used to push (see arrow F) plug 101 through the sheath. Preferably, plug 101 should be long enough so that when fully discharged from the sheath (as depicted in Figure 21), it will fill substantially all of 25 channel 9, reaching almost to the surface of the skin.
when the front end of plug 101 reaches the end of sheath45, it abuts plug 93. Plunger 103 is then used to force about 1 cm. of plug 101 out of the sheath (107 30 on Figure 19). In this way, plug 101 takes over the function of holding plug 93 in place against puncture 13. while plunger 103 continues to hold plug 101 in place (see arrow H), sheath 45 is withdrawn from channel 9 (see arrows G on Figure 20). As can be seen 35 in Figure 22, when sheath 45 is fully withdrawn, plugs 93 and 101 fill substantially all of channel 9.
It is believed to be most desireable that the front plug 93 be of loosely packed material, while rear plug _ 101 be of a more densely packed material. Also, as presently contemplated, in its natural, unrestrained state, plug 101 has a cross section larger than that of cartridge 99. Therefore, in order-to get it into the cartridge, it must be compressed. It then stays in this compressed state while in cartridge 99 as well as while passing through sheath 45 . However, after exiting from sheath 45. it naturally expands and presses against the walls of channel 9. The interaction then between plug 101 and the walls of channel 9 tends to hold the plug in place. As a result, very little if any external pressure is required. -Accordingly, after only a very short period of time, perhaps almost immediately, the plunger can be removed, leaving only the two plugs in the wound (see Figure 21). Pressure on the artery (see arrows 105 in Figures 13-21) can then be released, permitting normal flow through the artery to resume.
Although it is not necessary, in the practice of the method of the instant invention, for plugs 93 and 101 to fill all of channel 9 from artery to skin line, it is believed preferable that they do so. Alternatively, plug 101 can be made longer than necessary to reach the skin line, in which case it could then be cut off flush with the skin. As yet another alternative, a single plug, the size of plugs 93 and 101 combined could be used instead of two separate plugs.
While it is believed most advantageous to remove the procedure cannula and then insert a new sheath, it would be within the scope of the instant invention to use the procedure cannula as the delivery sheath through which the hemostatic material is passed.
It should also be understood that the hemostatic material employed may take many forms. For example, it may be in the form of a liquid or it may have a more viscous paste-like consistency. When using liquid or paste-like materials, the delivery sheath, the hemostatic charge holder and the piston might most advantageously be combined together in a single syringe-like device.
While the method and apparatus of this invention have been described in connection with several specific embodiments, it should be understood that numerous modifications could be made by persons of skill in this art without departing from the scope of this invention.
Accordingly, the above description is intended to be merely illustrative and not limiting. The scope of the invention claimed should be understood as including all those alternatives and modifications which the above specification would readily suggest or which would readily occur or be apparent to one skilled in the art upon reading the above.
DEVICE and METHOD
FOR SEALING PUNCTURE WOUNDS
Field of the Invention The present invention relates to a method for sealing a puncture wound in a blood vessel and a device for practicing said method.
Related Background 2o In certain medical procedures, such as cardiac catheterization, dilatation and counterpulsation, a, catheter or other device is inserted into an artery, most commonly by percutaneous methods, and then fed through the arterial tree to the site where needed, frequently, the region of the heart. The site usually selected for insertion is the groin, because the femoral artery in that region is relatively easy to locate.
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These procedures are normally initiated by insertion of an angiographic needle, followed by passing a guide wire through that needle into the artery. The needle is then removed leaving the guide wire in place. Next, a sheath-dilator set is passed over the guide wire into the artery in order to enlarge the opening sufficiently to permit entry of the catheter or other device. The dilator is then removed, leaving the sheath or guide cannula in place. The catheter or other device can then be inserted through the cannula with full confidence that when it emerges from the distal end it will be within the lumen of the artery.
It should be understood that the subject invention is independent of the nature of the medical device being used to treat the patient. Accordingly, the term "catheter" will be used here in a very generic and broad way to include not only "catheters" in the strict sense, but any device that is inserted into a blood vessel of the body.
Similarly, the subject invention is independent of the blood vessel involved. While it is anticipated that the femoral artery will be the most commonly used blood vessel, other arteries as well as veins might just as easily be involved.
After a procedure, for example, counterpulsation, has been completed, the sheath must be removed and the wound closed. Often, this can be accomplished simply by the application of digital pressure, generally augmented by the use of a pressure dressing.
Customarily, pressure must be applied for at least hour, and frequently for much longer than that. While pressure dressings often suffice, it is not uncommon for additional devices, such as sandbags, to be needed.
In addition, during this period the patient must be immobilized, lest movement interfere with the closing process. Because of the pressure required, the time during which it must be applied and the need for immobilization, the procedure is painful and uncomfortable. Tt also requires prolonged personal attention of a health care professional. Finally, wound closures accomplished in this manner are prone to reopen unexpectedly long after closure appears to have been completed. Patients are therefore often required to remain in the hospital for 24 hours or longer.
Because sealing can be such a problem, cardiologists tend to use the smallest calibre catheters when performing catheterization procedures. Larger calibre catheters, however, are far preferable. An improved sealing procedure whereby larger catheters can be used without increasing the sealing difficulties would greatly facilitate cardiac catheterization.
A series of related devices which were designed to address some of these problems is described in U.S.
patents Nos. 4,744,364, 4,852,568 and 4,890,612. These three patents describe a mushroom or umbrella shaped device which is used to seal the artery from the inside. The head of the device is placed within the arterial lumen and means are provided to pull and hold the underside of the head against the inside wall of the lumen. It is believed, however, that sealing~from the inside can be the source of its own problems, including the promotion of clot formation inside the vessel.
Another method for sealing a puncture wound is described in U.S.P. 4,929,246. The approach taken there is to insert a balloon-tipped catheter into the tissue wound, inflate the balloon against the hole in -.
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the artery and then use a laser to thermally weld the wound closed.
The present invention is believed to overcome most of the drawbacks of the traditional method, without creating any new difficulties. This is accomplished by using a plug, preferably a collagen plug or plug of some other resorbable material, to seal the artery along its outside wall.
to SUMMARY OF THE INVENTION
In its most simplified form, the instant invention involves the placing of hemostatic material against the outside wall of a punctured artery. The hemostatic material covers the entire puncture site and a hemostatic seal is formed so as to stop bleeding from the puncture wound.
In one embodiment, the subject invention teaches the use of a plug, preferably of fibrous collagen material.
The plug is inserted into the tissue wound and is held against the outside of the artery wall so as to overlap the puncture wound. Before plug insertion, the artery is preferably clamped by the use of external digital pressure, at a point slightly upstream of the wound site. After the plug has been inserted, the upstream clamping pressure is maintained for a very short period of time, and then gently removed. Slight pressure may be maintained on the plug to hold it against the artery wall until a good seal has been established.
In order to insert the plug in accordance with the procedure outlined above, a special device has been designed. It is comprised of two basic components, a sheath and a plug pusher or piston. The sheath is inserted through the tissue until its leading end is _ 5 _ near to or abuts the outer wall of the artery,.
Thereafter, the plug is advanced through the sheath by use of the plug pusher until the plug abuts the artery wall and overlaps the arterial puncture on all sides.
Finally, after a good seal has been established, the sheath and pusher are removed.
BRIEF DESCRIPTTC~nt nF mug DgAWING
FIG. 1 is an exploded view of one embodiment of an insertion apparatus in accordance with the instant invention.
FIG. 2 depicts, in cross section, one embodiment of an insertion apparatus in accordance with the instant invention.
FIG. 3 depicts, in cross section, a second embodiment of an insertion device in accordance with the instant invention.
FIG. 4 depicts, in cross section, an exploded view of a third embodiment of an insertion apparatus in accordance with the instant invention.
FIG. 5 is an enlarged, schematic drawing, in cross section, of an insertion site, showing a balloon catheter, having passed over a guide wire through a guide cannula into the femoral artery of a patient.
FIG. 6 shows the insertion site of Fig. 5 after the catheter and cannula have been removed.
FIG. 7 shows the insertion site of Fig. 6 after insertion of a tissue dilator in accordance with the instant invention.
-FIG. 8 shows the insertion site of Fig. 7 after insertion of a sheath over the tissue dilator in accordance with the instant invention.
FIG. 9 shows the insertion site of Fig. 8 after removal of the tissue dilator and guide wire and after partial insertion of a hemostatic plug and plug pusher.
FIG. 10 shows the insertion site of Fig. 9 after the l0 hemostatic plug has been pushed out of the sheath and while -it is being held in intimate contact with the arterial puncture.
FIG. 11 shows an alternative embodiment of the instant invention wherein a collagen balloon is used to seal an arterial puncture.
FIGS. 12a, b, c, d and a show alternative forms of plug which are useful in practicing the instant invention.
FIGS. 13 through 23 show the steps of an alternate procedure for practicing the instant invention.
DETAILED DESCRIPTION
In certain procedures, for example, intra-aortic balloon pumping ("IABP"), percutaneous transluminal co7ronary angioplasty ("PTCA") and angiography, as best seen in Fig. 5, a catheter or other device 7 is inserted, often over a guide wire 15, through a guide cannula 3 into an artery 11, most frequently, the common femoral artery in the groin area of the patient's leg 1. When the procedure (e,~cx., counterpulsation) has been completed, the device (e-a., the catheter), the guide wire and the guide cannula must be removed and the wound closed.
In accordance with one embodiment of the instant invention, wounds of this type are closed by inserting a plug 57 into tissue wound or channel 9, and holding it against the outside of the artery wall over arterial puncture 13 for a short period of time until a good self-sustaining hemostatic seal is established.
Although punctures of the sort made by per~utaneous procedures will generally, after removal of all cannulas and catheters, be in the nature of slits, for l0 ease of understanding, they are depicted in the drawings herein more as holes. The shape of the puncture, however, is not critical.
In order to insert plug 57, to assure that it is properly located and to be able to hold it in place -until a good seal is established, a special insertion apparatus has been designed. One embodiment (Fig. 1) of an insertion apparatus according to the instant invention is comprised of a sheath assembly 23, a plug holder 29 and a plug pusher 33. Sheath assembly 23, in turn, is comprised of an elongated tubular sheath 45 and a collar 35. At its rear end, collar 35 is provided with an external thread 37. In addition, sheath assembly 23 is provided with a sheath channel 27, which runs through the entire assembly, from front end 25, through sheath 45 and through collar 35.
Plug holder 29 is comprised of an elongated rear tubular portion 47 and a coupling 39 which has an internal thread 41. Plug holder 29 also has a channel 31 running throughout its entire length. Coupling thread 41 is designed to mate with collar thread 37 so that when collar 35 is screwed into coupling 39, channels 31 and 27, which preferably are of the same cross sectional size and configuration, are aligned.
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~ :.~ n.~ z3 Like the other two components, the plug pusher 33 is also comprised of two parts, an elongated piston 49, and a stop knob 43. Piston 49 has a cross sectional size and configuration so as to permit sliding passage into channels 31 and 27 with only minimal clearance.
The length of piston 49 is such that when sheath assembly 23 and plug holder 29 are screwed tightly together, shoulder 51 of knob 43 will abut rear end 53 of plug holder 29 as front end 55 of piston 49 is aligned with front end 25 of sheath 45.
It should be noted that pusher 33 is provided with its own channel 19. This is to permit passage therethrough of a guide wire and hence to enable pusher 33 to serve dual functions, as a tissue dilator and as a plug pusher.
In accordance with the method of the instant invention, first the device 7 (e.~., the IAB) and the guide cannula 3 are removed, leaving the guide wire 15 in place (as seen in Fig, 6). If no guide wire has been employed, prior to removal of the catheter and cannula, a guide wire may be inserted. As the cannula is withdrawn, in order to prevent bleeding, the artery is clamped, usually by pressing a finger 2 over the femoral artery upstream of the wound site. Because of this clamping, there is no significant blood pressure inside the artery at the site of the puncture (other than some small retrograde pressure) and the artery tends to collapse.
Although it is believed preferable to employ a guide wire, it is possible to practice the invention without one. It is also possible to practice the instant invention by eliminating the dilator, but this too is not the preferred approach.
g The artery is clamped at least in part to prevent tissue channel 9 from filling with a pool of blood.
When loose fibrous collagen encounters a pool of blood it tends to disintegrate almost immediately.
Obviously, once disintegrated it cannot function properly to seal the arterial puncture. Hence, when collagen in loose fibrous form is employed,..~lamping of the artery is important. It is less important, but still generally advantageous, if the loose fibrous material has been tamped down or otherwise compressed.
As used herein, the term "loose" includes material which has been compressed or tamped down.
Collagen that is more densely packed does not disintegrate upon encountering blood nearly as quickly-as loose fibrous collagen. Therefore, clamping of the artery is not nearly as important when the hemostatic material is in the form of a densely packed material, as it is when a loose fleece-type hemostatic material is employed. Thus, although clamping is believed to be desireable, it is not, in all cases essential.
While the artery remains clamped, the proximal end of guide wire 15 is fed through channel 20 of tissue dilator 17. The physician can then slide the dilator down along the guide wire into tissue channel 9 until it reaches the wall of artery 11 (as depicted in Fig. 7) .
The size and shape of the tissue dilator are such as to ensure that the body thereof will not enter the artery.
In terms of size, preferably a dilator is selected which is significantly larger than the original guide cannula 3. with respect to its shape, unlike more traditional dilators which often have long tapered forward ends, the tissue dilator 17 of the instant invention has a blunt forward end 21. Although end 21 '~ ;:Z .a c9 ' m may be slightly rounded or chamfered in order to facilitate smooth passage through tissue channel 9, it is preferable not to reduce it in size sufficiently to permit entry through the arterial puncture 13 into the lumen of the artery.
As noted above, during this phase of the procedure, there is no significant blood pressure in the region of artery 11 adjacent puncture 13. As a result, when end l0 21 of dilator 17 reaches artery 11, the wall of the artery tends to collapse further (as depicted in Fig.
7). The physician knows that the dilator has reached the artery because a noticeable increase in resistance is felt.
According to the procedure of the instant invention, once increased resistance is encountered, axial pressure is maintained so as to hold end 21 of dilator 17 against artery 11. Next, a sheath 45 is passed over dilator 17 and advanced along the dilator again until increased resistance is encountered. As with the dilator, increased resistance indicates that front end is against artery 11 (as depicted in Fig. 8). In addition, a marker can be placed around the 25 circumference of the dilator to signal when the distal end of the sheath is aligned with the distal end of the dilator.
Because end 25 of sheath 45 is larger than arterial puncture 9, the sheath cannot enter the arterial puncture. Although the precise dimensions of dilator 17 and sheath 45 are not critical, it is believed desirable that the sheath 45 be 30% to 50% or more larger than the previously removed guide cannula 3. In clinical trials done to date, when the guide cannula was 9 Fr., a 13 Fr. tissue dilator and a 14 Fr. sheath were used. It should be understood, however, that ,', rJ
4,j l ._ ~ ~.a cannulae which are oversized by as little as 10% may also be suitable.
once the guide or procedure cannula has been removed, tissue channel 9 tends to collapse. Also, once the procedure cannula and the procedure catheter have been removed, arterial puncture 13 has a tendency to close up. It may therefore be possible or even preferable to use a sheath that is the same size as or even smaller to than the previously removed procedure cannula.
With the front end 25 of sheath 45 held snugly against the wall of artery 11, plug 57 is slid down through lumen 27 of sheath 45 (as shown in Fig. 9) until it reaches end 25 of sheath 45 where it encounters artery 11. If an insertion apparatus like that shown in Fig.
1 is used, plug 57 is initially housed in plug holder 29. When it is time for plug insertion, holder 29 is screwed onto sheath assembly 23 by means of threads 37 and 41, and piston 49 is inserted into channel 31.
Advancement of the piston then forces plug 57 from holder 29 into sheath 45 and through lumen 27 to the artery wall.
Once resistance is felt, the physician slowly withdraws the sheath while continuing to maintain pressure against the piston so that plug 57 remains pressed against artery 11. When shoulder 51 of knob. 43 abuts rear end 53 of holder 29, the physician knows that plug 57 has been pushed entirely out of lumen 27 (as shown in Fig. 10). Axial pressure is maintained for a short period of time, perhaps as little as one minute or as long as five minutes, depending upon the circumstances, to allow plug 57 to seat in tissue channel 9 and against arterial puncture 13. Minimal axial pressure is thereafter continued while clamping pressure is slowly released until a good self-sustaining hemostatic seal has been confirmed. The sheath, holder, and pusher can all then be removed.
While it is believed that the preferable procedure is 5 to permit both piston and sheath to remain in place until a self-sustaining hemostatic seal has been achieved, this is not absolutely necessary...- Some physicians may prefer, once the pressure of the plug against the artery wall has produced hemostasis, to 10 withdraw the sheath so that the tissue wound may begin to close down, while maintaining pressure on the plug by use of the piston alone. Alternatively, the piston might be withdrawn and reliance placed upon the outer rim of the sheath to hold the plug against the artery 15 wall and assure hemostasis in that manner. -In addition, removal of the piston without removal of the sheath permits insertion of a second plug. This might be necessary where the first plug, perhaps of a 20 loose fibrous material, disintegrates upon encountering a pool of blood. A second plug, this one of more densely packed material having greater physical integrity and less of a tendency toward immediate . disintegration, is inserted in the sheath and the 25 piston reinserted behind it.
An apparatus similar to that of Fig. 1 is depicted in Fig. 4. The primary difference between the two is that the plug pusher of the Fig. 4 embodiment does not serve 30 a dual function. Instead, the embodiment of Fig. 4 has a separate tissue dilator 17 with channel 20 running throughout its length.
Another, somewhat different embodiment of an apparatus 35 for inserting a plug in accordance with the instant invention is depicted in Fig. 2. The insertion apparatus 59 of that embodiment is made in the form of a Y, with a common or sheath leg 61, a plug leg 63 and a dilator leg 65.
In one method of using the apparatus of Fig. 2, tissue dilator 17 and insertion apparatus 59 are preassembled by passing the dilator through legs 65 and 61 until enough of dilator 17 extends beyond the forstard end of leg 61 to assure that end 21 will abut artery 11 before front end 26 of leg 61 reaches the surface of the patient's leg. The proximal end of the guide wire is then fed through dilator channel 20 and the dilator is slid down the guide wire into tissue wound 9 until end 21 of dilator 17 reaches the wall of artery 11. While holding the dilator against the artery wall, the physician slides insertion apparatus 59 along dilator -17 until end 26 of leg 61 reaches artery 11.
With end 26 held snugly against artery 11, dilator 17 is withdrawn, but only far enough so as to uncover channel 67 of plug leg 63. Plug pusher 69 is then moved down through channel 67 until plug 57 has entered common leg 61 and pusher 69 is then withdrawn so that it will not interfere with dilator 17 as it passes from leg 65 into leg 61.
Once plug 57 has entered leg 61 and pusher 69 has been retracted, dilator 17 is again advanced into leg 61.
When resistance is encountered, the physician knows that plug 57 has reached the artery. while maintaining axial pressure on dilator 17, apparatus 59 is slowly withdrawn until proximal end 73 of leg 65 reaches indicator mark 71. The distance between indicator 71 and dilator end 21 is the same as the distance between proximal end 73 and forward end 26. Therefore, the physician knows that when mark 71 reaches end 73, all of plug 57 has exited from end 26 of leg 61. As was described in connection with the embodiment of Fig. 1, pressure is then maintained until a good self-sustaining hemostatic seal has been established.
The embodiment of Fig. 3 is very similar to that of 5 Fig. l, except that the dilator and plug legs have been transposed. In the Fig. 3 embodiment, plug leg 74 is coaxial with common leg 61 and dilator leg--~5 is at an angle, whereas in the Fig. 2 embodiment the reverse is true.
Although it is believed that the preferred method for using the embodiment of Fig. 2 is to preassemble dilator 17 in apparatus 59, that is by no means necessary. If the physician prefers, he can just as 15 well insert dilator 17 into tissue channel 9 as was -described above in connection with the embodiment of Fig. 1. He can then pass leg 61 over it. With the embodiment of Figs. 4 and 1, while it is believed preferable to insert dilator 17 first, the physician, 20 if he prefers, can preassemble the dilator in the sheath before passing the dilator over the guide wire.
While plug 57 may be made of any resorbable material, collagen is believed to be most suitable. The physical 25 form of the plug may vary widely, with the one selected by the physician being dependent upon the circumstances of the case. For example, where the puncture wound is relatively small and the patient has not been on high doses of anticoagulant and heparin, a plug, like that 30 depicted in Figure 12a, of loose fibrous material, somewhat like fleece or absorbent cotton or oxygenated cellulose, would serve quite well. Alternatively, for larger wounds in patients who have been on anticoagulants and heparin, it may be necessary that 35 the plug be able to maintain some structural integrity for a longer period of time. Under those circumstances, a plug of more densely packed material, as depicted in Figure 12b, might be preferred.
A third embodiment of a suitable plug is depicted in Figure 12c. In that embodiment, the front end 77 of the plug might be of loose fibrous material, like that depicted in Figure 12a, whereas the remainder 79 could be made of a more densely packed material.
Yet another type of plug is shown in Figure 12d. In this configuration, the front end 81 is a collagen membrane and the remainder 83 is an expandable collagen sponge.
It is believed that when a collagen sponge or a densely packed collagen material are employed, very little if any pressure need be applied after the initial seating of the plug. This is believed to be true because the physical characteristics of the sponge-like or densely packed plug and the expansion thereof, as well as its interaction with body fluids in the tissue channel will be adequate to hold the front end against the artery wall.
It_is also believed that, initially, when the plug is pressed against the artery, hemostasis is achieved by mechanical means, i.e., by application of mechanical pressure all around the arterial puncture. Shortly thereafter, however, the hemostatic material begins to bind to the arterial tissue and biochemical hemostasis takes over. Once biochemical hemostasis becomes sufficiently strong to withstand the normal blood pressure within the artery, and therefore self-sustaining, external mechanical pressure can be removed.
Figure 12e shows yet another form of plug, similar to the plug of Figure 12d, but with a lumen 85. This form of plug is designed for use by physicians who prefer not to remove the guide wire immediately after a procedure. The proximal end of the guide wire 15 can be fed through lumen 85 and through the collagen membrane 81. The plug is slid down along tha guide wire through tissue channel 9 until its front end reaches the wall of the femoral artery. Indeed, the plug of Figure 12e could even be inserted without the use of a sheath. When the wire 15 is withdrawn, the collagen membrane automatically reseals itself.
As noted earlier, the sheath is substantially larger in cross section than is arterial puncture 13. -Consequently, when plug 57, which fills the entire cross section of the sheath channel, reaches the artery, even in its compressed state it overlaps puncture 13 on all sides. Obviously, then, when it exits the sheath and is permitted to expand, a full bandage-like covering over puncture 13 is assured.
In practice it has been found that when using a collagen plug in accordance with the subject invention, a good hemostatic seal can be achieved in five minutes or less. with larger wounds, for example, ones left after removal of 14 Fr. or larger catheters, or after the use of anticoagulants and heparin, sealing may take somewhat longer.
Figure 11 depicts another means for practicing the instant invention. In this embodiment a piston 18 pushes~ahead of its front end a closed balloon 87 formed of a collagen membrane and only partially filled with a collagen substance and a saline solution. The piston 18 has an injection needle 18a on its front end which pierces the balloon during the pushing action.
After the balloon 87 exits from the sheath 23 and is pressed against the wall of the artery 11, an inflation.
fluid is injected via the needle 18a to fill and expand the balloon, as shown in Fig. 11, so that the balloon covers the arterial puncture 13 and fills the region of tissue channel 9 immediately adjacent. the arterial puncture 13. The piston 18 is thereafter r.~tracted to withdraw the injection needle 18a from the balloon 87.
The membrane which forms the balloon 87 then automatically reseals itself to hold the balloon in the inflated condition shown in Fig. 11. The sheath 23 and piston lg may then be withdrawn. When using this embodiment, the inflation fluid itself should be resorbable, preferably a saline solution or saline mixed with collagen in solution. -As noted above, when the procedure cannula is removed, both the arterial puncture 13 and the tissue channel 9 tend to close up somewhat. The method depicted in Figure 13 through 22 is designed to take advantage of this tendency. In the Figures 13-22 method, neither the hemostasis sheath 45 nor the dilator 17 are pushed through channel 9 all the way to arterial puncture 13.
Instead, as shown at 89 in Figures 14, 14A, 15 and 15A
they are inserted no further than to within about 3/4 cm. of the artery.
First, digital pressure (see arrows 105 in Figures 13-21) is applied upstream of the wound so as to close down the artery (see arrows 106). In this way the pressure in the artery at the puncture site 13 is no more than about atmospheric pressure. Although the _ method of this invention could be practiced without applying digital pressure, that would likely result in more profuse bleeding.
- 1 s - ~. .~.: .aa zti Then, as shown in Figure 13, the dilator 17 is inserted over guide wire 15 to about 3/4 cm from puncture 13.
It will generally be inserted so that between about 3 and about 6 cm. of its length is beneath the surface of the skin.
One method for assuring that the sheath is inserted to the proper depth is as follows. Once the artery 107 has been punctured and the guide wire is in place, a to needle clamp 108, as is depicted in Figure 23, is placed on the needle 109 at the skin line 110. With the clamp in place, the needle is removed from the patient. The needle can then be placed along side the sheath and a mark made on the sheath to indicate the distance from needle tip to needle clamp.
Alternatively, a mark can be made 1/2 or 3/4 cm. closer to the distal end of the sheath. As yet another alternative, a kit can be provided of variable length sheaths, each having a hub at one end, and from that kit a sheath of the proper length, i.e., one having a total length, from hub to distal end, of 1/2 or 3/4 cm.
less than the distance from needle tip to needle clamp can be selected.
Next, as is best seen in Figure 14, 'the sheath 45 is slid down over the dilator, again stopping when its distal tip is about 3/4 cm. from the arterial puncture 13. The sheath and dilator can be inserted separately, i.e., in two steps, or together as a unit, in one step.
As can be seen in Figures 14a and 15a, the partially collapsed section of tissue channel 9 which is immediately adjacent puncture 13 is not reexpanded.
znstead, it remains undisturbed.
The next step is to withdraw dilator 17 (as is indicated by arrow A on Figure 15) with guide wire 15 (see Figure 15), leaving only sheath 45 in tissue channel 9. ~As depicted in Figure 16, a preloaded holder or cartridge 91 with plug 93 therein is inserted (see arrow B) into sheath chamber 97. As cartridge 91 5 is fully seated within chamber 97, a plunger 95 is used to push (see arrow C) plug 93 into and through sheath 45 until the plug exits the sheath so as to cover puncture 13 and fill that section of channel 9 which is adjacent puncture 13 (see Figures 17 and 17a).
10 Simultaneously, sheath 45 is slightly withdrawn (indicated by arrows D on Figure 17) to permit plug 93 to be fully discharged from the sheath.
Plunger 95 is then withdrawn, leaving sheath 45 to 15 maintain pressure on plug 93. Sheath 45 can then be used to hold plug 93 in place over puncture 13 until self sustaining hemostasis has been achieved.
Alternatively, as depicted in Figure 18, a second preloaded holder or cartridge 99 can then be inserted 20 (see arrow E) into chamber 97. Once again, a plunger, 103 is used to push (see arrow F) plug 101 through the sheath. Preferably, plug 101 should be long enough so that when fully discharged from the sheath (as depicted in Figure 21), it will fill substantially all of 25 channel 9, reaching almost to the surface of the skin.
when the front end of plug 101 reaches the end of sheath45, it abuts plug 93. Plunger 103 is then used to force about 1 cm. of plug 101 out of the sheath (107 30 on Figure 19). In this way, plug 101 takes over the function of holding plug 93 in place against puncture 13. while plunger 103 continues to hold plug 101 in place (see arrow H), sheath 45 is withdrawn from channel 9 (see arrows G on Figure 20). As can be seen 35 in Figure 22, when sheath 45 is fully withdrawn, plugs 93 and 101 fill substantially all of channel 9.
It is believed to be most desireable that the front plug 93 be of loosely packed material, while rear plug _ 101 be of a more densely packed material. Also, as presently contemplated, in its natural, unrestrained state, plug 101 has a cross section larger than that of cartridge 99. Therefore, in order-to get it into the cartridge, it must be compressed. It then stays in this compressed state while in cartridge 99 as well as while passing through sheath 45 . However, after exiting from sheath 45. it naturally expands and presses against the walls of channel 9. The interaction then between plug 101 and the walls of channel 9 tends to hold the plug in place. As a result, very little if any external pressure is required. -Accordingly, after only a very short period of time, perhaps almost immediately, the plunger can be removed, leaving only the two plugs in the wound (see Figure 21). Pressure on the artery (see arrows 105 in Figures 13-21) can then be released, permitting normal flow through the artery to resume.
Although it is not necessary, in the practice of the method of the instant invention, for plugs 93 and 101 to fill all of channel 9 from artery to skin line, it is believed preferable that they do so. Alternatively, plug 101 can be made longer than necessary to reach the skin line, in which case it could then be cut off flush with the skin. As yet another alternative, a single plug, the size of plugs 93 and 101 combined could be used instead of two separate plugs.
While it is believed most advantageous to remove the procedure cannula and then insert a new sheath, it would be within the scope of the instant invention to use the procedure cannula as the delivery sheath through which the hemostatic material is passed.
It should also be understood that the hemostatic material employed may take many forms. For example, it may be in the form of a liquid or it may have a more viscous paste-like consistency. When using liquid or paste-like materials, the delivery sheath, the hemostatic charge holder and the piston might most advantageously be combined together in a single syringe-like device.
While the method and apparatus of this invention have been described in connection with several specific embodiments, it should be understood that numerous modifications could be made by persons of skill in this art without departing from the scope of this invention.
Accordingly, the above description is intended to be merely illustrative and not limiting. The scope of the invention claimed should be understood as including all those alternatives and modifications which the above specification would readily suggest or which would readily occur or be apparent to one skilled in the art upon reading the above.
Claims (23)
1. A device for inserting hemostatic material inwardly through a tissue channel until it is disposed by an outside wall of a blood vessel of a patient, said, blood vessel wall having a puncture having a predetermined width therein adjacent said tissue channel, said tissue channel and said puncture having been formed by an original procedure sheath, comprising:
a charge of hemostatic material having a width greater than the predetermined width of the puncture, such that said material cannot enter the blood vessel;
a hollow insertion sheath adapted to pass through the tissue channel and having an inner diameter, said inner diameter of said insertion sheath being larger than the predetermined width of the puncture, whereby said charge of hemostatic material is slidable within said inner diameter of said hollow insertion sheath;
means for inserting said hemostatic material into said hollow insertion sheath; and means for advancing said hemostatic material through said hollow insertion sheath inward to the outside of the vessel wall around the puncture, whereby said charge of hemostatic material cannot enter the blood vessel through the puncture.
a charge of hemostatic material having a width greater than the predetermined width of the puncture, such that said material cannot enter the blood vessel;
a hollow insertion sheath adapted to pass through the tissue channel and having an inner diameter, said inner diameter of said insertion sheath being larger than the predetermined width of the puncture, whereby said charge of hemostatic material is slidable within said inner diameter of said hollow insertion sheath;
means for inserting said hemostatic material into said hollow insertion sheath; and means for advancing said hemostatic material through said hollow insertion sheath inward to the outside of the vessel wall around the puncture, whereby said charge of hemostatic material cannot enter the blood vessel through the puncture.
2. The device of claim 1, further comprising a tissue dilator having a cross-section which is larger than the cross-section of the tissue channel, wherein said dilator is adapted to be inserted into the tissue channel, thereby to increase the size of the tissue channel.
3. The device of claim 2, wherein said dilator is larger in cross-section than the puncture.
4. The device of claim 1, wherein said means for inserting said hemostatic material into said insertion sheath is the same as said means for advancing said hemostatic material through said insertion sheath.
5. The device of claim 1, wherein said hemostatic material is made at least primarily of collagen.
6. The device of claim 1, wherein said means for inserting said hemostatic material further comprises a plug holder to retain therein said hemostatic material prior to its insertion into said insertion sheath.
7. The device of claim 1, wherein said means for advancing said hemostatic material through said insertion sheath comprises a tissue dilator having a size substantially corresponding to said width of said charge of hemostatic material.
8. A device for use in sealing a puncture in a wall of a blood vessel of a patient, wherein the blood vessel is separated from the skin of the patient by a layer of tissue, wherein a tissue channel communicates between the puncture and the patient s skin, and wherein a guide wire having proximal and distal ends extends at least from the puncture, through the channel, to the patient's skin, comprising a tissue dilator having a front portion and a rear portion;
a dilator channel running through said dilator from said front portion to said rear portion, said dilator channel being adapted to receive therein and pass therethrough the proximal end of the guide wire;
an elongated hollow sheath having a distal end and a proximal end, said sheath being adapted to pass over said dilator, said sheath having a lumen running therethrough from said proximal end to said distal end;
a plug holder having a channel therein which communicates with said sheath lumen when said dilator is removed;
hemostatic material which is retained within said plug holder channel prior to its insertion into said sheath;
means for inserting said hemostatic material into said sheath; and means for advancing said hemostatic material through said sheath, out of said distal end thereof against the vessel wall around the puncture.
a dilator channel running through said dilator from said front portion to said rear portion, said dilator channel being adapted to receive therein and pass therethrough the proximal end of the guide wire;
an elongated hollow sheath having a distal end and a proximal end, said sheath being adapted to pass over said dilator, said sheath having a lumen running therethrough from said proximal end to said distal end;
a plug holder having a channel therein which communicates with said sheath lumen when said dilator is removed;
hemostatic material which is retained within said plug holder channel prior to its insertion into said sheath;
means for inserting said hemostatic material into said sheath; and means for advancing said hemostatic material through said sheath, out of said distal end thereof against the vessel wall around the puncture.
9. The device of claim 8, wherein said means for inserting said hemostatic material into said sheath is comprised of a plug pusher which is adapted to slide within said plug holder channel thereby to push said hemostatic material from within said plug holder into said lumen of said sheath.
10. The device of claim 8, wherein said means for advancing said hemostatic material through said sheath is comprised of a piston adapted to slide within said lumen of said sheath.
11. The device of claim 8, wherein said hemostatic material is made at least primarily of collagen.
12. A device for inserting hemostatic material through a tissue channel and against the outside wall of a blood vessel of a patient wherein the blood vessel wall has a puncture therein adjacent the tissue channel, comprising a charge of hemostatic material;
advancing means for advancing said hemostatic material through the tissue channel to the outside of the vessel wall around the puncture; and location means for locating the outside of the vessel wall, whereby when said hemostatic material is advanced to the outside of the vessel wall, said hemostatic material is never freely exposed within the blood vessel during said advancement.
advancing means for advancing said hemostatic material through the tissue channel to the outside of the vessel wall around the puncture; and location means for locating the outside of the vessel wall, whereby when said hemostatic material is advanced to the outside of the vessel wall, said hemostatic material is never freely exposed within the blood vessel during said advancement.
13. The device of claim 12, wherein said charge of hemostatic material is in the form of a liquid or paste.
14. The device of claim 13, wherein said hemostatic material includes a material selected from the group consisting of fibrin glue and thrombin.
15. The device of claim 13, further comprising an introduces for inserting said hemostatic material into the tissue channel.
16. The device of claim 15, wherein said introduces comprises a hollow sheath adapted to pass through the tissue channel.
17. The device of claim 16, wherein said location means comprises said hollow sheath having a cross-sectional profile larger than the puncture.
18. The device of claim 12, wherein said charge of hemostatic material comprises collagen.
19. A device for use in sealing a puncture having a predetermined width in a wall of a blood vessel of a patient, wherein the blood vessel is separated from the skin of the patient by a layer of tissue, wherein a tissue channel communicates between the puncture and the patient's skin, and wherein a guide wire having proximal and distal ends extends at least from the puncture, through the channel, to the patient's skin, the tissue channel and the puncture having been formed by an original procedure sheath, comprising a tissue dilator having a front portion and a rear portion;
a dilator channel running through said tissue dilator from said front portion to said rear portion, said dilator channel being adapted to receive therein and pass therethrough the proximal end of the guide wire;
an elongated hollow insertion sheath having a distal end, a proximal end, and an inner diameter, said inner diameter of said hollow insertion sheath being larger than the predetermined width of the puncture;
hemostatic material having a width greater than the predetermined width of the puncture, whereby said hemostatic material is slidable within said inner diameter of said hollow insertion sheath, and said hemostatic material cannot enter the blood vessel through the puncture; and means for inserting said hemostatic material into said hollow insertion sheath;
said tissue dilator having a size substantially corresponding to said width of said hemostatic material for slidably engaging said inner diameter of said hollow insertion sheath and for advancing said hemostatic material through said hollow insertion sheath to the outside of the vessel wall around the puncture without ever actually entering the lumen of the blood vessel.
a dilator channel running through said tissue dilator from said front portion to said rear portion, said dilator channel being adapted to receive therein and pass therethrough the proximal end of the guide wire;
an elongated hollow insertion sheath having a distal end, a proximal end, and an inner diameter, said inner diameter of said hollow insertion sheath being larger than the predetermined width of the puncture;
hemostatic material having a width greater than the predetermined width of the puncture, whereby said hemostatic material is slidable within said inner diameter of said hollow insertion sheath, and said hemostatic material cannot enter the blood vessel through the puncture; and means for inserting said hemostatic material into said hollow insertion sheath;
said tissue dilator having a size substantially corresponding to said width of said hemostatic material for slidably engaging said inner diameter of said hollow insertion sheath and for advancing said hemostatic material through said hollow insertion sheath to the outside of the vessel wall around the puncture without ever actually entering the lumen of the blood vessel.
20. A device for inserting hemostatic material through a tissue channel and toward the outside wall of a blood vessel of a patient, the blood vessel having a puncture therein, comprising hemostatic material;
a hollow insertion sheath adapted to pass through the tissue channel and having .an inner diameter sized for slidably receiving said hemostatic material;
a pusher for advancing said hemostatic material through said hollow insertion sheath to a position outside of the vessel wall; and preventing means for preventing said hemostatic material from entering the blood vessel through the puncture as said hemostatic material is advanced into contact with the vessel wall so it is never freely exposed within the blood vessel.
a hollow insertion sheath adapted to pass through the tissue channel and having .an inner diameter sized for slidably receiving said hemostatic material;
a pusher for advancing said hemostatic material through said hollow insertion sheath to a position outside of the vessel wall; and preventing means for preventing said hemostatic material from entering the blood vessel through the puncture as said hemostatic material is advanced into contact with the vessel wall so it is never freely exposed within the blood vessel.
21. The device of claim 20, wherein said preventing means comprises the puncture having a first width and said hemostatic material having a width greater than said first width.
22. The device of claim 20, wherein said hemostatic material comprises collagen.
23. The device of claim 20, further comprising a tissue dilator, wherein the puncture has a first width and said dilator has a width greater than said first width.
Applications Claiming Priority (6)
Application Number | Priority Date | Filing Date | Title |
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EP90118186A EP0476178A1 (en) | 1990-09-21 | 1990-09-21 | Device for placing styptic material on perforated blood vessels |
EP90118186.7 | 1990-09-21 | ||
US63447890A | 1990-12-27 | 1990-12-27 | |
US07/634,478 | 1990-12-27 | ||
US07/746,339 | 1991-08-16 | ||
US07/746,339 US5391183A (en) | 1990-09-21 | 1991-08-16 | Device and method sealing puncture wounds |
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CA2051360A1 CA2051360A1 (en) | 1992-03-22 |
CA2051360C true CA2051360C (en) | 2000-10-03 |
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Application Number | Title | Priority Date | Filing Date |
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CA002051360A Expired - Lifetime CA2051360C (en) | 1990-09-21 | 1991-09-13 | Device and method for sealing puncture wounds |
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US (7) | US5391183A (en) |
EP (1) | EP0482350B1 (en) |
JP (2) | JP3228965B2 (en) |
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Families Citing this family (652)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5330445A (en) * | 1988-05-26 | 1994-07-19 | Haaga John R | Sheath for wound closure caused by a medical tubular device |
US5620461A (en) * | 1989-05-29 | 1997-04-15 | Muijs Van De Moer; Wouter M. | Sealing device |
US6764500B1 (en) | 1989-05-29 | 2004-07-20 | Kensey Nash Corporation | Sealing device |
NL8901350A (en) * | 1989-05-29 | 1990-12-17 | Wouter Matthijs Muijs Van De M | CLOSURE ASSEMBLY. |
US20080077178A1 (en) * | 1990-09-21 | 2008-03-27 | Datascope Investment Corp. | Device and method for sealing puncture wounds |
US5391183A (en) * | 1990-09-21 | 1995-02-21 | Datascope Investment Corp | Device and method sealing puncture wounds |
US5108421A (en) * | 1990-10-01 | 1992-04-28 | Quinton Instrument Company | Insertion assembly and method of inserting a vessel plug into the body of a patient |
US6325789B1 (en) | 1990-12-27 | 2001-12-04 | Datascope Investment Corporation | Device and method for sealing puncture wounds |
US5290310A (en) * | 1991-10-30 | 1994-03-01 | Howmedica, Inc. | Hemostatic implant introducer |
US6818008B1 (en) * | 1992-01-07 | 2004-11-16 | Cch Associates, Inc. | Percutaneous puncture sealing method |
US6699261B1 (en) * | 1992-01-07 | 2004-03-02 | Cch Associates, Inc. | Blood vessel sealing system |
US5810810A (en) | 1992-04-23 | 1998-09-22 | Scimed Life Systems, Inc. | Apparatus and method for sealing vascular punctures |
US6063085A (en) | 1992-04-23 | 2000-05-16 | Scimed Life Systems, Inc. | Apparatus and method for sealing vascular punctures |
US6350274B1 (en) | 1992-05-11 | 2002-02-26 | Regen Biologics, Inc. | Soft tissue closure systems |
US5326350A (en) * | 1992-05-11 | 1994-07-05 | Li Shu Tung | Soft tissue closure systems |
US5413571A (en) * | 1992-07-16 | 1995-05-09 | Sherwood Medical Company | Device for sealing hemostatic incisions |
US5306254A (en) * | 1992-10-01 | 1994-04-26 | Kensey Nash Corporation | Vessel position locating device and method of use |
US5334216A (en) * | 1992-12-10 | 1994-08-02 | Howmedica Inc. | Hemostatic plug |
US5292309A (en) * | 1993-01-22 | 1994-03-08 | Schneider (Usa) Inc. | Surgical depth measuring instrument and method |
US5383896A (en) * | 1993-05-25 | 1995-01-24 | Gershony; Gary | Vascular sealing device |
US6017359A (en) * | 1993-05-25 | 2000-01-25 | Vascular Solutions, Inc. | Vascular sealing apparatus |
US5868778A (en) * | 1995-10-27 | 1999-02-09 | Vascular Solutions, Inc. | Vascular sealing apparatus and method |
ATE141481T1 (en) * | 1993-06-16 | 1996-09-15 | White Spot Ag | DEVICE FOR INTRODUCING FIBRIN GLUE INTO A STITCH CHANNEL |
EP0708795A4 (en) * | 1993-07-15 | 1996-08-07 | Univ Akron | Heat-resistant polyimide blends and laminates |
US5725551A (en) * | 1993-07-26 | 1998-03-10 | Myers; Gene | Method and apparatus for arteriotomy closure |
US5431639A (en) * | 1993-08-12 | 1995-07-11 | Boston Scientific Corporation | Treating wounds caused by medical procedures |
NL9301526A (en) * | 1993-09-03 | 1995-04-03 | Cordis Europ | Device for hemostasis treatment after catheter surgery. |
US5383899A (en) * | 1993-09-28 | 1995-01-24 | Hammerslag; Julius G. | Method of using a surface opening adhesive sealer |
US5843124A (en) * | 1993-09-28 | 1998-12-01 | Hemodynamics, Inc. | Surface opening adhesive sealer |
US5759194A (en) * | 1993-09-28 | 1998-06-02 | Hemodynamics, Inc. | Vascular patch applicator |
US5653730A (en) * | 1993-09-28 | 1997-08-05 | Hemodynamics, Inc. | Surface opening adhesive sealer |
US5370660A (en) * | 1993-11-01 | 1994-12-06 | Cordis Corporation | Apparatus and method for delivering a vessel plug into the body of a patient |
US5728122A (en) * | 1994-01-18 | 1998-03-17 | Datascope Investment Corp. | Guide wire with releaseable barb anchor |
WO1995026683A1 (en) * | 1994-03-31 | 1995-10-12 | Boston Scientific Corporation | Vascular plug with vessel locator |
US20050065549A1 (en) * | 1997-09-12 | 2005-03-24 | Cates Christopher U. | Percutaneous puncture sealing system |
US20110015670A1 (en) * | 1994-05-20 | 2011-01-20 | Sealing Solutions, Inc. | Percutaneous Puncture Sealing System |
US6033401A (en) * | 1997-03-12 | 2000-03-07 | Advanced Closure Systems, Inc. | Vascular sealing device with microwave antenna |
US6302898B1 (en) | 1994-06-24 | 2001-10-16 | Advanced Closure Systems, Inc. | Devices for sealing punctures in body vessels |
DK0783342T3 (en) * | 1994-09-27 | 1999-07-19 | Delab | Security injector |
US5496332A (en) * | 1994-10-20 | 1996-03-05 | Cordis Corporation | Wound closure apparatus and method for its use |
EP0716833A3 (en) * | 1994-12-14 | 1997-01-29 | Global Therapeutics Inc | Method and apparatus for sealing a body site |
US5814066A (en) * | 1994-12-23 | 1998-09-29 | The University Of Virginia Patent Foundation | Reduction of femoral arterial bleeding post catheterization using percutaneous application of fibrin sealant |
JPH10512470A (en) * | 1995-01-18 | 1998-12-02 | メドケム プロダクツ,インコーポレーテッド | Apparatus and method for applying a hemostatic agent to tissue |
US5634936A (en) * | 1995-02-06 | 1997-06-03 | Scimed Life Systems, Inc. | Device for closing a septal defect |
US5649959A (en) * | 1995-02-10 | 1997-07-22 | Sherwood Medical Company | Assembly for sealing a puncture in a vessel |
US5700273A (en) * | 1995-07-14 | 1997-12-23 | C.R. Bard, Inc. | Wound closure apparatus and method |
US5846253A (en) * | 1995-07-14 | 1998-12-08 | C. R. Bard, Inc. | Wound closure apparatus and method |
US5810846A (en) * | 1995-08-03 | 1998-09-22 | United States Surgical Corporation | Vascular hole closure |
US6162192A (en) * | 1998-05-01 | 2000-12-19 | Sub Q, Inc. | System and method for facilitating hemostasis of blood vessel punctures with absorbable sponge |
US6071300A (en) | 1995-09-15 | 2000-06-06 | Sub-Q Inc. | Apparatus and method for percutaneous sealing of blood vessel punctures |
US6071301A (en) * | 1998-05-01 | 2000-06-06 | Sub Q., Inc. | Device and method for facilitating hemostasis of a biopsy tract |
US5645566A (en) * | 1995-09-15 | 1997-07-08 | Sub Q Inc. | Apparatus and method for percutaneous sealing of blood vessel punctures |
US6183497B1 (en) * | 1998-05-01 | 2001-02-06 | Sub-Q, Inc. | Absorbable sponge with contrasting agent |
US5674231A (en) * | 1995-10-20 | 1997-10-07 | United States Surgical Corporation | Apparatus and method for vascular hole closure |
US6287322B1 (en) * | 1995-12-07 | 2001-09-11 | Loma Linda University Medical Center | Tissue opening locator and everter and method |
US5814065A (en) * | 1996-02-09 | 1998-09-29 | Cordis Corporation | Suture delivery tool |
US5728132A (en) * | 1996-04-08 | 1998-03-17 | Tricardia, L.L.C. | Self-sealing vascular access device |
US6436109B1 (en) | 1996-06-11 | 2002-08-20 | X-Site, L.L.C. | Device and method for suturing blood vessels and the like |
US5855585A (en) * | 1996-06-11 | 1999-01-05 | X-Site, L.L.C. | Device and method for suturing blood vessels and the like |
US5690674A (en) * | 1996-07-02 | 1997-11-25 | Cordis Corporation | Wound closure with plug |
US5728133A (en) * | 1996-07-09 | 1998-03-17 | Cardiologics, L.L.C. | Anchoring device and method for sealing percutaneous punctures in vessels |
DE69738212T2 (en) | 1996-08-06 | 2008-07-17 | St. Jude Medical Puerto Rico B.V. | INTRODUCTION DEVICE FOR INTRODUCING A HEMOSTATIC CLOSURE INTO ONE SECTION |
US6566406B1 (en) * | 1998-12-04 | 2003-05-20 | Incept, Llc | Biocompatible crosslinked polymers |
US8003705B2 (en) * | 1996-09-23 | 2011-08-23 | Incept Llc | Biocompatible hydrogels made with small molecule precursors |
AU4648697A (en) * | 1996-09-23 | 1998-04-14 | Chandrashekar Pathak | Methods and devices for preparing protein concentrates |
US5766183A (en) * | 1996-10-21 | 1998-06-16 | Lasersurge, Inc. | Vascular hole closure |
WO1998019626A2 (en) * | 1996-11-05 | 1998-05-14 | Localmed, Inc. | Method and device for continuous intralumenal delivery of bioactive substances |
US6743248B2 (en) | 1996-12-18 | 2004-06-01 | Neomend, Inc. | Pretreatment method for enhancing tissue adhesion |
US6494848B1 (en) | 1996-12-19 | 2002-12-17 | St. Jude Medical Puerto Rico B.V. | Measuring device for use with a hemostatic puncture closure device |
US5782861A (en) * | 1996-12-23 | 1998-07-21 | Sub Q Inc. | Percutaneous hemostasis device |
US5873854A (en) * | 1996-12-23 | 1999-02-23 | Datascope Investment Corp. | Method for percutaneous insertion of catheters |
CA2278243C (en) | 1997-01-21 | 2006-06-13 | Tyco Group S.A.R.L. | Bioabsorbable hemostatic sealing assembly |
US6045570A (en) * | 1997-02-11 | 2000-04-04 | Biointerventional Corporation | Biological sealant mixture and system for use in percutaneous occlusion of puncture sites and tracts in the human body and method |
US5876411A (en) * | 1997-03-11 | 1999-03-02 | X-Site L.L.C. | Device and method for locating and sealing a blood vessel |
US20040176801A1 (en) * | 1997-03-12 | 2004-09-09 | Neomend, Inc. | Pretreatment method for enhancing tissue adhesion |
US6475182B1 (en) | 1997-03-12 | 2002-11-05 | Olexander Hnojewyj | Fluidic media introduction apparatus |
US6733515B1 (en) | 1997-03-12 | 2004-05-11 | Neomend, Inc. | Universal introducer |
US6371975B2 (en) | 1998-11-06 | 2002-04-16 | Neomend, Inc. | Compositions, systems, and methods for creating in situ, chemically cross-linked, mechanical barriers |
US20030191496A1 (en) * | 1997-03-12 | 2003-10-09 | Neomend, Inc. | Vascular sealing device with microwave antenna |
CA2284679C (en) | 1997-03-27 | 2006-06-13 | Bristol-Myers Squibb Company | Laparoscopic sealant applicator |
US5941897A (en) * | 1997-05-09 | 1999-08-24 | Myers; Gene E. | Energy activated fibrin plug |
US5810849A (en) * | 1997-06-09 | 1998-09-22 | Cardiologics, L.L.C. | Device and method for suturing blood vessels and the like |
US6267761B1 (en) | 1997-09-09 | 2001-07-31 | Sherwood Services Ag | Apparatus and method for sealing and cutting tissue |
US5868762A (en) * | 1997-09-25 | 1999-02-09 | Sub-Q, Inc. | Percutaneous hemostatic suturing device and method |
US8668737B2 (en) | 1997-10-10 | 2014-03-11 | Senorx, Inc. | Tissue marking implant |
US7637948B2 (en) | 1997-10-10 | 2009-12-29 | Senorx, Inc. | Tissue marking implant |
US6139556A (en) * | 1997-10-29 | 2000-10-31 | X-Site, L.L.C. | Device and method for suturing blood vessels and the like |
US9498604B2 (en) | 1997-11-12 | 2016-11-22 | Genesis Technologies Llc | Medical device and method |
US6270464B1 (en) * | 1998-06-22 | 2001-08-07 | Artemis Medical, Inc. | Biopsy localization method and device |
US7435249B2 (en) * | 1997-11-12 | 2008-10-14 | Covidien Ag | Electrosurgical instruments which reduces collateral damage to adjacent tissue |
US6050996A (en) | 1997-11-12 | 2000-04-18 | Sherwood Services Ag | Bipolar electrosurgical instrument with replaceable electrodes |
US6352536B1 (en) * | 2000-02-11 | 2002-03-05 | Sherwood Services Ag | Bipolar electrosurgical instrument for sealing vessels |
US6726686B2 (en) * | 1997-11-12 | 2004-04-27 | Sherwood Services Ag | Bipolar electrosurgical instrument for sealing vessels |
US20100030256A1 (en) | 1997-11-12 | 2010-02-04 | Genesis Technologies Llc | Medical Devices and Methods |
US20030014052A1 (en) * | 1997-11-14 | 2003-01-16 | Buysse Steven P. | Laparoscopic bipolar electrosurgical instrument |
US6228083B1 (en) | 1997-11-14 | 2001-05-08 | Sherwood Services Ag | Laparoscopic bipolar electrosurgical instrument |
US6050986A (en) | 1997-12-01 | 2000-04-18 | Scimed Life Systems, Inc. | Catheter system for the delivery of a low volume liquid bolus |
US6764461B2 (en) * | 1997-12-01 | 2004-07-20 | Scimed Life Systems, Inc. | Catheter system for the delivery of a low volume bolus |
US5906631A (en) * | 1997-12-05 | 1999-05-25 | Surface Genesis, Inc. | Method and device for sealing vascular puncture wounds |
US6478808B2 (en) | 1997-12-17 | 2002-11-12 | Closys Corporation | Clotting cascade initiating apparatus and methods of use and methods of closing wounds |
US6159232A (en) * | 1997-12-16 | 2000-12-12 | Closys Corporation | Clotting cascade initiating apparatus and methods of use and methods of closing wounds |
US6033427A (en) * | 1998-01-07 | 2000-03-07 | Lee; Benjamin I. | Method and device for percutaneous sealing of internal puncture sites |
EP1054635B1 (en) | 1998-02-10 | 2010-01-06 | Artemis Medical, Inc. | Occlusion, anchoring, tensioning or flow direction apparatus |
FR2774895B1 (en) * | 1998-02-16 | 2000-06-30 | Braun Celsa Sa | MEDICAL DEVICE COMPRISING A ROD PROVIDED WITH A MEANS FOR ABSORBING AXIAL CONSTRAINTS |
US6610026B2 (en) * | 1998-05-01 | 2003-08-26 | Sub-Q, Inc. | Method of hydrating a sponge material for delivery to a body |
US6200328B1 (en) | 1998-05-01 | 2001-03-13 | Sub Q, Incorporated | Device and method for facilitating hemostasis of a biopsy tract |
US20010045575A1 (en) * | 1998-05-01 | 2001-11-29 | Mark Ashby | Device and method for facilitating hemostasis of a biopsy tract |
US6315753B1 (en) | 1998-05-01 | 2001-11-13 | Sub-Q, Inc. | System and method for facilitating hemostasis of blood vessel punctures with absorbable sponge |
US7625352B1 (en) | 1998-05-01 | 2009-12-01 | Sub-Q, Inc. | Depth and puncture control for system for hemostasis of blood vessel |
US5980539A (en) * | 1998-05-06 | 1999-11-09 | X-Site L.L.C. | Device and method for suturing blood vessels and the like |
US6077279A (en) * | 1998-05-08 | 2000-06-20 | X-Site L.L.C. | Device and method employing adhesive for sealing blood vessels and the like |
US20050283188A1 (en) * | 1998-05-29 | 2005-12-22 | By-Pass, Inc. | Vascular closure device |
US7396359B1 (en) | 1998-05-29 | 2008-07-08 | Bypass, Inc. | Vascular port device |
US7060084B1 (en) | 1998-05-29 | 2006-06-13 | By-Pass, Inc. | Vascular closure device |
US6726704B1 (en) | 1998-05-29 | 2004-04-27 | By-Pass, Inc. | Advanced closure device |
US6500152B1 (en) | 1998-07-02 | 2002-12-31 | White Spot Ag | Device for introducing fibrin adhesive into a puncture channel |
US6591838B2 (en) * | 1998-07-06 | 2003-07-15 | Scimed Life Systems, Inc. | Implant system and method for bulking tissue |
US6245052B1 (en) * | 1998-07-08 | 2001-06-12 | Innerdyne, Inc. | Methods, systems, and kits for implanting articles |
US6605294B2 (en) * | 1998-08-14 | 2003-08-12 | Incept Llc | Methods of using in situ hydration of hydrogel articles for sealing or augmentation of tissue or vessels |
US6152943A (en) * | 1998-08-14 | 2000-11-28 | Incept Llc | Methods and apparatus for intraluminal deposition of hydrogels |
US7790192B2 (en) | 1998-08-14 | 2010-09-07 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
US6458147B1 (en) | 1998-11-06 | 2002-10-01 | Neomend, Inc. | Compositions, systems, and methods for arresting or controlling bleeding or fluid leakage in body tissue |
US6994686B2 (en) | 1998-08-26 | 2006-02-07 | Neomend, Inc. | Systems for applying cross-linked mechanical barriers |
US6296657B1 (en) | 1998-10-07 | 2001-10-02 | Gregory G. Brucker | Vascular sealing device and method |
US20040249374A1 (en) * | 1998-10-23 | 2004-12-09 | Tetzlaff Philip M. | Vessel sealing instrument |
US7364577B2 (en) | 2002-02-11 | 2008-04-29 | Sherwood Services Ag | Vessel sealing system |
US7267677B2 (en) * | 1998-10-23 | 2007-09-11 | Sherwood Services Ag | Vessel sealing instrument |
US7582087B2 (en) * | 1998-10-23 | 2009-09-01 | Covidien Ag | Vessel sealing instrument |
US7118570B2 (en) * | 2001-04-06 | 2006-10-10 | Sherwood Services Ag | Vessel sealing forceps with disposable electrodes |
WO2000024331A1 (en) * | 1998-10-23 | 2000-05-04 | Sherwood Services Ag | Endoscopic bipolar electrosurgical forceps |
US6183496B1 (en) | 1998-11-02 | 2001-02-06 | Datascope Investment Corp. | Collapsible hemostatic plug |
US6949114B2 (en) | 1998-11-06 | 2005-09-27 | Neomend, Inc. | Systems, methods, and compositions for achieving closure of vascular puncture sites |
US6899889B1 (en) | 1998-11-06 | 2005-05-31 | Neomend, Inc. | Biocompatible material composition adaptable to diverse therapeutic indications |
US6830756B2 (en) * | 1998-11-06 | 2004-12-14 | Neomend, Inc. | Systems, methods, and compositions for achieving closure of vascular puncture sites |
US7279001B2 (en) * | 1998-11-06 | 2007-10-09 | Neomend, Inc. | Systems, methods, and compositions for achieving closure of vascular puncture sites |
CA2317661C (en) * | 1998-11-20 | 2008-04-15 | Medical Industries Corp. | Hemostatic material insertion device |
US6488649B1 (en) * | 1998-11-24 | 2002-12-03 | Edward M. Lichten | Implant device |
EP1051116B8 (en) | 1998-12-01 | 2009-06-10 | Washington University | Embolization device |
AU2045200A (en) * | 1998-12-08 | 2000-06-26 | University Of Virginia Patent Foundation | Device and technique for percutaneous closure of vascular puncture sites |
US20030069601A1 (en) * | 1998-12-15 | 2003-04-10 | Closys Corporation | Clotting cascade initiating apparatus and methods of use |
US6551241B1 (en) * | 1999-12-17 | 2003-04-22 | Leonard S. Schultz | Instruments and methods for performing percutaneous surgery |
US6162203A (en) * | 1999-01-11 | 2000-12-19 | Haaga; John R. | Cargo delivery needle |
US6126675A (en) * | 1999-01-11 | 2000-10-03 | Ethicon, Inc. | Bioabsorbable device and method for sealing vascular punctures |
US9820824B2 (en) | 1999-02-02 | 2017-11-21 | Senorx, Inc. | Deployment of polysaccharide markers for treating a site within a patent |
US7651505B2 (en) | 2002-06-17 | 2010-01-26 | Senorx, Inc. | Plugged tip delivery for marker placement |
US6725083B1 (en) | 1999-02-02 | 2004-04-20 | Senorx, Inc. | Tissue site markers for in VIVO imaging |
US8498693B2 (en) | 1999-02-02 | 2013-07-30 | Senorx, Inc. | Intracorporeal marker and marker delivery device |
US20090030309A1 (en) | 2007-07-26 | 2009-01-29 | Senorx, Inc. | Deployment of polysaccharide markers |
US6862470B2 (en) | 1999-02-02 | 2005-03-01 | Senorx, Inc. | Cavity-filling biopsy site markers |
US8361082B2 (en) | 1999-02-02 | 2013-01-29 | Senorx, Inc. | Marker delivery device with releasable plug |
US7983734B2 (en) | 2003-05-23 | 2011-07-19 | Senorx, Inc. | Fibrous marker and intracorporeal delivery thereof |
EP1156741B1 (en) | 1999-02-10 | 2010-12-22 | Sub-Q, Inc. | Device for facilitating hemostasis of a biopsy tract |
US6261258B1 (en) | 1999-05-03 | 2001-07-17 | Marius Saines | Hemostatic device for angioplasty |
WO2000069350A1 (en) * | 1999-05-19 | 2000-11-23 | Innerdyne, Inc. | System and method for establishing vascular access |
US7273497B2 (en) | 1999-05-28 | 2007-09-25 | Anova Corp. | Methods for treating a defect in the annulus fibrosis |
US20070038231A1 (en) | 1999-05-28 | 2007-02-15 | Ferree Bret A | Methods and apparatus for treating disc herniation and preventing the extrusion of interbody bone graft |
US20060247665A1 (en) | 1999-05-28 | 2006-11-02 | Ferree Bret A | Methods and apparatus for treating disc herniation and preventing the extrusion of interbody bone graft |
WO2000074575A1 (en) | 1999-06-01 | 2000-12-14 | Closys Corporation | Clotting cascade initiating apparatus and methods of use |
US6575991B1 (en) | 1999-06-17 | 2003-06-10 | Inrad, Inc. | Apparatus for the percutaneous marking of a lesion |
US6110184A (en) * | 1999-08-04 | 2000-08-29 | Weadock; Kevin S. | Introducer with vascular sealing mechanism |
US7553329B2 (en) | 1999-08-18 | 2009-06-30 | Intrinsic Therapeutics, Inc. | Stabilized intervertebral disc barrier |
US20040010317A1 (en) * | 1999-08-18 | 2004-01-15 | Gregory Lambrecht | Devices and method for augmenting a vertebral disc |
JP4247519B2 (en) * | 1999-08-18 | 2009-04-02 | イントリンジック セラピューティックス インコーポレイテッド | Apparatus and method for nucleus augmentation and retention |
US7972337B2 (en) | 2005-12-28 | 2011-07-05 | Intrinsic Therapeutics, Inc. | Devices and methods for bone anchoring |
WO2009033100A1 (en) | 2007-09-07 | 2009-03-12 | Intrinsic Therapeutics, Inc. | Bone anchoring systems |
US6936072B2 (en) * | 1999-08-18 | 2005-08-30 | Intrinsic Therapeutics, Inc. | Encapsulated intervertebral disc prosthesis and methods of manufacture |
US6425919B1 (en) | 1999-08-18 | 2002-07-30 | Intrinsic Orthopedics, Inc. | Devices and methods of vertebral disc augmentation |
US7717961B2 (en) | 1999-08-18 | 2010-05-18 | Intrinsic Therapeutics, Inc. | Apparatus delivery in an intervertebral disc |
US7220281B2 (en) | 1999-08-18 | 2007-05-22 | Intrinsic Therapeutics, Inc. | Implant for reinforcing and annulus fibrosis |
US7998213B2 (en) | 1999-08-18 | 2011-08-16 | Intrinsic Therapeutics, Inc. | Intervertebral disc herniation repair |
WO2004100841A1 (en) | 1999-08-18 | 2004-11-25 | Intrinsic Therapeutics, Inc. | Devices and method for augmenting a vertebral disc nucleus |
US8323341B2 (en) | 2007-09-07 | 2012-12-04 | Intrinsic Therapeutics, Inc. | Impaction grafting for vertebral fusion |
US6450942B1 (en) | 1999-08-20 | 2002-09-17 | Cardiorest International Ltd. | Method for reducing heart loads in mammals |
ES2261392T3 (en) | 1999-09-01 | 2006-11-16 | Sherwood Services Ag | ELECTROCHIRURGICAL INSTRUMENT THAT REDUCES THERMAL DISPERSION. |
US8083766B2 (en) * | 1999-09-13 | 2011-12-27 | Rex Medical, Lp | Septal defect closure device |
US7662161B2 (en) | 1999-09-13 | 2010-02-16 | Rex Medical, L.P | Vascular hole closure device |
US7267679B2 (en) * | 1999-09-13 | 2007-09-11 | Rex Medical, L.P | Vascular hole closure device |
US7341595B2 (en) * | 1999-09-13 | 2008-03-11 | Rex Medical, L.P | Vascular hole closure device |
US7942888B2 (en) * | 1999-09-13 | 2011-05-17 | Rex Medical, L.P. | Vascular hole closure device |
AU7373700A (en) | 1999-09-13 | 2001-04-17 | Rex Medical, Lp | Vascular closure |
US6984219B2 (en) | 1999-09-23 | 2006-01-10 | Mark Ashby | Depth and puncture control for blood vessel hemostasis system |
US7695492B1 (en) | 1999-09-23 | 2010-04-13 | Boston Scientific Scimed, Inc. | Enhanced bleed back system |
ATE485774T1 (en) * | 1999-09-23 | 2010-11-15 | Sub Q Inc | DEVICE FOR DETERMINING THE DEPTH OF AN INCISION |
US7887535B2 (en) * | 1999-10-18 | 2011-02-15 | Covidien Ag | Vessel sealing wave jaw |
US8128698B2 (en) | 1999-10-20 | 2012-03-06 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US7951201B2 (en) | 1999-10-20 | 2011-05-31 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US7935147B2 (en) | 1999-10-20 | 2011-05-03 | Anulex Technologies, Inc. | Method and apparatus for enhanced delivery of treatment device to the intervertebral disc annulus |
US8632590B2 (en) | 1999-10-20 | 2014-01-21 | Anulex Technologies, Inc. | Apparatus and methods for the treatment of the intervertebral disc |
US7615076B2 (en) | 1999-10-20 | 2009-11-10 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US6592625B2 (en) | 1999-10-20 | 2003-07-15 | Anulex Technologies, Inc. | Spinal disc annulus reconstruction method and spinal disc annulus stent |
US7052516B2 (en) | 1999-10-20 | 2006-05-30 | Anulex Technologies, Inc. | Spinal disc annulus reconstruction method and deformable spinal disc annulus stent |
US7004970B2 (en) | 1999-10-20 | 2006-02-28 | Anulex Technologies, Inc. | Methods and devices for spinal disc annulus reconstruction and repair |
US20030109875A1 (en) | 1999-10-22 | 2003-06-12 | Tetzlaff Philip M. | Open vessel sealing forceps with disposable electrodes |
US7458956B1 (en) | 1999-11-12 | 2008-12-02 | Boston Scientific Scimed, Inc. | Apparatus for delivery of controlled doses of therapeutic drugs in endoluminal procedures |
US9579091B2 (en) | 2000-01-05 | 2017-02-28 | Integrated Vascular Systems, Inc. | Closure system and methods of use |
US8758400B2 (en) | 2000-01-05 | 2014-06-24 | Integrated Vascular Systems, Inc. | Closure system and methods of use |
US6942674B2 (en) | 2000-01-05 | 2005-09-13 | Integrated Vascular Systems, Inc. | Apparatus and methods for delivering a closure device |
US6461364B1 (en) | 2000-01-05 | 2002-10-08 | Integrated Vascular Systems, Inc. | Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use |
US6391048B1 (en) | 2000-01-05 | 2002-05-21 | Integrated Vascular Systems, Inc. | Integrated vascular device with puncture site closure component and sealant and methods of use |
US7842068B2 (en) * | 2000-12-07 | 2010-11-30 | Integrated Vascular Systems, Inc. | Apparatus and methods for providing tactile feedback while delivering a closure device |
US6547806B1 (en) | 2000-02-04 | 2003-04-15 | Ni Ding | Vascular sealing device and method of use |
CN1226019C (en) | 2000-02-24 | 2005-11-09 | 洛马林达大学医学中心 | Patch and glue delivery system for closing tissue openings during surgery |
US6451031B1 (en) | 2000-03-21 | 2002-09-17 | X-Site, L.L.C. | Blood vessel suturing device with single guide-wire/needle receiving lumen |
US6805695B2 (en) | 2000-04-04 | 2004-10-19 | Spinalabs, Llc | Devices and methods for annular repair of intervertebral discs |
EP1274720A4 (en) * | 2000-04-12 | 2004-08-18 | Human Genome Sciences Inc | Albumin fusion proteins |
US6658288B1 (en) | 2000-05-05 | 2003-12-02 | Endovascular Technologies, Inc. | Apparatus and method for aiding thrombosis through the application of electric potential |
US7771482B1 (en) * | 2000-05-09 | 2010-08-10 | Ben-Zion Karmon | Method for tissue expansion and regeneration using bioresorbable inflatable devices |
US8622739B2 (en) * | 2001-05-09 | 2014-01-07 | Ben-Zion Karmon | Method for enlarging a jaw bone using a hollow dental implant having a side perforation |
US6540735B1 (en) | 2000-05-12 | 2003-04-01 | Sub-Q, Inc. | System and method for facilitating hemostasis of blood vessel punctures with absorbable sponge |
US7094428B2 (en) * | 2000-06-16 | 2006-08-22 | The University Of Medicine And Dentistry Of New Jersey | Hemostatic compositions, devices and methods |
AU2001273401A1 (en) * | 2000-07-14 | 2002-01-30 | Sub-Q Inc. | Sheath-mounted arterial plug delivery device |
US6890342B2 (en) * | 2000-08-02 | 2005-05-10 | Loma Linda University | Method and apparatus for closing vascular puncture using hemostatic material |
US7074232B2 (en) * | 2000-09-01 | 2006-07-11 | Medtronic Angiolink, Inc. | Advanced wound site management systems and methods |
US6767356B2 (en) * | 2000-09-01 | 2004-07-27 | Angiolink Corporation | Advanced wound site management systems and methods |
US8551134B2 (en) * | 2000-09-01 | 2013-10-08 | Medtronic Vascular, Inc. | Wound site management and wound closure device |
AU2000274774A1 (en) * | 2000-09-01 | 2002-03-22 | Angiolink Corporation | Wound site management and wound closure device |
US6533762B2 (en) * | 2000-09-01 | 2003-03-18 | Angiolink Corporation | Advanced wound site management systems and methods |
AU8800801A (en) * | 2000-09-08 | 2002-03-22 | James E Coleman | Surgical staple |
US7201725B1 (en) | 2000-09-25 | 2007-04-10 | Sub-Q, Inc. | Device and method for determining a depth of an incision |
US6626918B1 (en) | 2000-10-06 | 2003-09-30 | Medical Technology Group | Apparatus and methods for positioning a vascular sheath |
CA2659518A1 (en) | 2000-11-20 | 2002-05-30 | Senorx, Inc. | Tissue site markers for in vivo imaging |
US6695867B2 (en) | 2002-02-21 | 2004-02-24 | Integrated Vascular Systems, Inc. | Plunger apparatus and methods for delivering a closure device |
US7806904B2 (en) | 2000-12-07 | 2010-10-05 | Integrated Vascular Systems, Inc. | Closure device |
US8690910B2 (en) | 2000-12-07 | 2014-04-08 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US7211101B2 (en) | 2000-12-07 | 2007-05-01 | Abbott Vascular Devices | Methods for manufacturing a clip and clip |
US7905900B2 (en) | 2003-01-30 | 2011-03-15 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US6623510B2 (en) | 2000-12-07 | 2003-09-23 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US20020099410A1 (en) | 2001-01-11 | 2002-07-25 | Bio-Seal Tech Inc. | Device and method for sealing a puncture in a blood vessel |
US6632237B2 (en) | 2001-01-11 | 2003-10-14 | Bio-Seal Tech, Inc. | Device and method for sealing a puncture in a blood vessel |
US6569185B2 (en) * | 2001-02-15 | 2003-05-27 | Scimed Life Systems Inc | Continuous infusion technique for arterial sealing |
US8187625B2 (en) | 2001-03-12 | 2012-05-29 | Boston Scientific Scimed, Inc. | Cross-linked gelatin composition comprising a wetting agent |
WO2002087636A1 (en) * | 2001-03-12 | 2002-11-07 | Sub-Q, Inc. | Methods for sterilizing cross-linked gelatin compositions |
EP1527747B1 (en) * | 2001-04-06 | 2015-09-30 | Covidien AG | Electrosurgical instrument which reduces collateral damage to adjacent tissue |
US10849681B2 (en) | 2001-04-06 | 2020-12-01 | Covidien Ag | Vessel sealer and divider |
CA2442852C (en) * | 2001-04-06 | 2011-07-26 | Sherwood Services Ag | Molded insulating hinge for bipolar instruments |
US7101373B2 (en) * | 2001-04-06 | 2006-09-05 | Sherwood Services Ag | Vessel sealer and divider |
US7101371B2 (en) | 2001-04-06 | 2006-09-05 | Dycus Sean T | Vessel sealer and divider |
US7083618B2 (en) | 2001-04-06 | 2006-08-01 | Sherwood Services Ag | Vessel sealer and divider |
US7101372B2 (en) * | 2001-04-06 | 2006-09-05 | Sherwood Sevices Ag | Vessel sealer and divider |
US7118587B2 (en) * | 2001-04-06 | 2006-10-10 | Sherwood Services Ag | Vessel sealer and divider |
DE60121229T2 (en) * | 2001-04-06 | 2007-05-24 | Sherwood Services Ag | DEVICE FOR SEALING AND SHARING A VESSEL WITH NON-LASTING END STOP |
US7090673B2 (en) * | 2001-04-06 | 2006-08-15 | Sherwood Services Ag | Vessel sealer and divider |
CA2442960C (en) * | 2001-04-06 | 2011-03-22 | Sherwood Services Ag | Vessel sealing instrument |
US8961541B2 (en) * | 2007-12-03 | 2015-02-24 | Cardio Vascular Technologies Inc. | Vascular closure devices, systems, and methods of use |
US20080114394A1 (en) * | 2001-04-24 | 2008-05-15 | Houser Russell A | Arteriotomy Closure Devices and Techniques |
US7025776B1 (en) | 2001-04-24 | 2006-04-11 | Advanced Catheter Engineering, Inc. | Arteriotomy closure devices and techniques |
US20090143808A1 (en) * | 2001-04-24 | 2009-06-04 | Houser Russell A | Guided Tissue Cutting Device, Method of Use and Kits Therefor |
US8992567B1 (en) | 2001-04-24 | 2015-03-31 | Cardiovascular Technologies Inc. | Compressible, deformable, or deflectable tissue closure devices and method of manufacture |
DK1397167T3 (en) | 2001-05-09 | 2010-06-07 | Biointeractions Ltd | Wound closure system as well as procedure |
US6863680B2 (en) | 2001-11-08 | 2005-03-08 | Sub-Q, Inc. | System and method for delivering hemostasis promoting material to a blood vessel puncture site by fluid pressure |
US7008440B2 (en) * | 2001-11-08 | 2006-03-07 | Sub-Q, Inc. | System and method for delivering hemostasis promoting material to a blood vessel puncture site by fluid pressure |
US7029489B1 (en) | 2001-05-18 | 2006-04-18 | Sub-Q, Inc. | System and method for delivering hemostasis promoting material to a blood vessel puncture site |
IES20010547A2 (en) | 2001-06-07 | 2002-12-11 | Christy Cummins | Surgical Staple |
US7993365B2 (en) * | 2001-06-08 | 2011-08-09 | Morris Innovative, Inc. | Method and apparatus for sealing access |
US20060004408A1 (en) * | 2001-06-08 | 2006-01-05 | Morris Edward J | Method and apparatus for sealing access |
US20070038244A1 (en) * | 2001-06-08 | 2007-02-15 | Morris Edward J | Method and apparatus for sealing access |
CA2452040C (en) * | 2001-06-29 | 2011-03-22 | Cook Biotech Incorporated | Porous sponge matrix medical devices and methods |
US8465516B2 (en) * | 2001-07-26 | 2013-06-18 | Oregon Health Science University | Bodily lumen closure apparatus and method |
JP4180509B2 (en) * | 2001-07-26 | 2008-11-12 | ウイルソンークック メディカル インク. | Vessel occlusion member and distribution device thereof |
EP1418850B1 (en) * | 2001-08-01 | 2010-10-06 | Tyco Healthcare Group LP | Apparatus for providing percutaneous access and medicament to a target surgical site |
ATE502583T1 (en) * | 2001-10-22 | 2011-04-15 | Interventional Therapies Llc | WOUND SEWING DEVICE |
US20030078601A1 (en) * | 2001-10-22 | 2003-04-24 | Oleg Shikhman | Crimping and cutting device |
US7037322B1 (en) | 2001-11-08 | 2006-05-02 | Sub-Q, Inc. | System and method for delivering hemostasis promoting material to a blood vessel puncture with a staging tube |
US7192436B2 (en) * | 2001-11-08 | 2007-03-20 | Sub-Q, Inc. | Pledget-handling system and method for delivering hemostasis promoting material to a blood vessel puncture site by fluid pressure |
US7025748B2 (en) * | 2001-11-08 | 2006-04-11 | Boston Scientific Scimed, Inc. | Sheath based blood vessel puncture locator and depth indicator |
US7037323B2 (en) * | 2001-11-08 | 2006-05-02 | Sub-Q, Inc. | Pledget-handling system and method for delivering hemostasis promoting material to a blood vessel puncture site by fluid pressure |
WO2003071986A2 (en) * | 2002-02-22 | 2003-09-04 | Control Delivery Systems, Inc. | Method for treating otic disorders |
US20040115296A1 (en) * | 2002-04-05 | 2004-06-17 | Duffin Terry M. | Retractable overmolded insert retention apparatus |
EP1513452A4 (en) * | 2002-05-27 | 2009-04-08 | Shlomo Ben-David | Apparatus for sealing a puncture in a blood vessel |
US7850709B2 (en) | 2002-06-04 | 2010-12-14 | Abbott Vascular Inc. | Blood vessel closure clip and delivery device |
US8308758B2 (en) * | 2002-06-12 | 2012-11-13 | Radi Medical Systems Ab | Closure device |
US6939363B2 (en) * | 2002-06-12 | 2005-09-06 | Radi Medical Systems Ab | Closure device |
US8088143B2 (en) * | 2002-06-12 | 2012-01-03 | Radi Medical Systems Ab | Closure device |
DE60309030T2 (en) * | 2002-06-14 | 2007-05-16 | Loma Linda University Medical Center, Loma Linda | DEVICE FOR CLOSING VESSEL WALLS |
WO2004004579A1 (en) * | 2002-07-09 | 2004-01-15 | Eva Corporation | Delivery apparatus for use during a surgical procedure and method of using the same |
ATE462383T1 (en) * | 2002-09-24 | 2010-04-15 | Bogomir Gorensek | STABILIZING DEVICE FOR INTERVERBAL DISCS AND METHOD THEREOF |
US7270664B2 (en) | 2002-10-04 | 2007-09-18 | Sherwood Services Ag | Vessel sealing instrument with electrical cutting mechanism |
US7276068B2 (en) | 2002-10-04 | 2007-10-02 | Sherwood Services Ag | Vessel sealing instrument with electrical cutting mechanism |
US7931649B2 (en) * | 2002-10-04 | 2011-04-26 | Tyco Healthcare Group Lp | Vessel sealing instrument with electrical cutting mechanism |
US20040102730A1 (en) * | 2002-10-22 | 2004-05-27 | Davis Thomas P. | System and method for facilitating hemostasis of blood vessel punctures with absorbable sponge |
US7955353B1 (en) | 2002-11-04 | 2011-06-07 | Sub-Q, Inc. | Dissolvable closure device |
US8317821B1 (en) | 2002-11-04 | 2012-11-27 | Boston Scientific Scimed, Inc. | Release mechanism |
US7455680B1 (en) * | 2002-11-04 | 2008-11-25 | Boston Scientific Scimed, Inc. | Apparatus and method for inhibiting blood loss |
JP4467059B2 (en) | 2002-11-12 | 2010-05-26 | カーモン ベン−ジオン | Expansion device and method for tissue expansion, regeneration and fixation |
US7799026B2 (en) | 2002-11-14 | 2010-09-21 | Covidien Ag | Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion |
US20060036158A1 (en) | 2003-11-17 | 2006-02-16 | Inrad, Inc. | Self-contained, self-piercing, side-expelling marking apparatus |
AU2003295878B2 (en) * | 2002-11-22 | 2008-07-10 | Covidien Lp | Sheath introduction apparatus and method |
US7108710B2 (en) | 2002-11-26 | 2006-09-19 | Abbott Laboratories | Multi-element biased suture clip |
US7033354B2 (en) * | 2002-12-10 | 2006-04-25 | Sherwood Services Ag | Electrosurgical electrode having a non-conductive porous ceramic coating |
US8709038B2 (en) * | 2002-12-20 | 2014-04-29 | Boston Scientific Scimed, Inc. | Puncture hole sealing device |
US20040122349A1 (en) * | 2002-12-20 | 2004-06-24 | Lafontaine Daniel M. | Closure device with textured surface |
US7094209B2 (en) * | 2003-01-14 | 2006-08-22 | Radi Medical Systems Ab | Method for introducer replacement |
US8821534B2 (en) | 2010-12-06 | 2014-09-02 | Integrated Vascular Systems, Inc. | Clip applier having improved hemostasis and methods of use |
US8758398B2 (en) | 2006-09-08 | 2014-06-24 | Integrated Vascular Systems, Inc. | Apparatus and method for delivering a closure element |
US8398656B2 (en) | 2003-01-30 | 2013-03-19 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US8905937B2 (en) | 2009-02-26 | 2014-12-09 | Integrated Vascular Systems, Inc. | Methods and apparatus for locating a surface of a body lumen |
US7857828B2 (en) | 2003-01-30 | 2010-12-28 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US8202293B2 (en) | 2003-01-30 | 2012-06-19 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US7223266B2 (en) | 2003-02-04 | 2007-05-29 | Cardiodex Ltd. | Methods and apparatus for hemostasis following arterial catheterization |
US20060064086A1 (en) * | 2003-03-13 | 2006-03-23 | Darren Odom | Bipolar forceps with multiple electrode array end effector assembly |
US7776036B2 (en) * | 2003-03-13 | 2010-08-17 | Covidien Ag | Bipolar concentric electrode assembly for soft tissue fusion |
JP4653083B2 (en) * | 2003-04-22 | 2011-03-16 | サブ−キュー・インコーポレーテッド | A system that closes the puncture site using a fixed and withdrawing technique |
US7850654B2 (en) * | 2003-04-24 | 2010-12-14 | St. Jude Medical Puerto Rico B.V. | Device and method for positioning a closure device |
CA2523675C (en) * | 2003-05-01 | 2016-04-26 | Sherwood Services Ag | Electrosurgical instrument which reduces thermal damage to adjacent tissue |
US7160299B2 (en) * | 2003-05-01 | 2007-01-09 | Sherwood Services Ag | Method of fusing biomaterials with radiofrequency energy |
US8128624B2 (en) * | 2003-05-01 | 2012-03-06 | Covidien Ag | Electrosurgical instrument that directs energy delivery and protects adjacent tissue |
AU2004241092B2 (en) * | 2003-05-15 | 2009-06-04 | Covidien Ag | Tissue sealer with non-conductive variable stop members and method of sealing tissue |
USD499181S1 (en) | 2003-05-15 | 2004-11-30 | Sherwood Services Ag | Handle for a vessel sealer and divider |
US7877133B2 (en) | 2003-05-23 | 2011-01-25 | Senorx, Inc. | Marker or filler forming fluid |
US7331979B2 (en) * | 2003-06-04 | 2008-02-19 | Access Closure, Inc. | Apparatus and methods for sealing a vascular puncture |
US9289195B2 (en) * | 2003-06-04 | 2016-03-22 | Access Closure, Inc. | Auto-retraction apparatus and methods for sealing a vascular puncture |
US7150749B2 (en) * | 2003-06-13 | 2006-12-19 | Sherwood Services Ag | Vessel sealer and divider having elongated knife stroke and safety cutting mechanism |
US7156846B2 (en) * | 2003-06-13 | 2007-01-02 | Sherwood Services Ag | Vessel sealer and divider for use with small trocars and cannulas |
US7150097B2 (en) | 2003-06-13 | 2006-12-19 | Sherwood Services Ag | Method of manufacturing jaw assembly for vessel sealer and divider |
USD956973S1 (en) | 2003-06-13 | 2022-07-05 | Covidien Ag | Movable handle for endoscopic vessel sealer and divider |
US7857812B2 (en) * | 2003-06-13 | 2010-12-28 | Covidien Ag | Vessel sealer and divider having elongated knife stroke and safety for cutting mechanism |
DK1638485T3 (en) * | 2003-06-20 | 2011-05-02 | Intrinsic Therapeutics Inc | Device for delivery of an implant through an annular defect in an intervertebral disc |
US20040260300A1 (en) * | 2003-06-20 | 2004-12-23 | Bogomir Gorensek | Method of delivering an implant through an annular defect in an intervertebral disc |
US7942897B2 (en) * | 2003-07-10 | 2011-05-17 | Boston Scientific Scimed, Inc. | System for closing an opening in a body cavity |
CA2535452C (en) | 2003-08-14 | 2013-04-02 | Loma Linda University Medical Center | Vascular wound closure device |
US8187627B2 (en) | 2003-09-05 | 2012-05-29 | Loma Linda University Medical Center | Dressing delivery system for internal wounds |
IL157981A (en) | 2003-09-17 | 2014-01-30 | Elcam Medical Agricultural Cooperative Ass Ltd | Auto-injector |
IL157984A (en) * | 2003-09-17 | 2015-02-26 | Dali Medical Devices Ltd | Autoneedle |
US7479150B2 (en) * | 2003-09-19 | 2009-01-20 | Tyco Healthcare Group Lp | Trocar insertion apparatus |
US20050085773A1 (en) * | 2003-10-15 | 2005-04-21 | Forsberg Andrew T. | Method and apparatus for locating vascular punctures |
US8337522B2 (en) | 2003-10-15 | 2012-12-25 | St. Jude Medical Puerto Rico Llc | Vascular sealing device with locking hub |
US20050090860A1 (en) * | 2003-10-23 | 2005-04-28 | Paprocki Loran J. | Segmented plug for tissue tracts |
US9848938B2 (en) | 2003-11-13 | 2017-12-26 | Covidien Ag | Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion |
US8128652B2 (en) * | 2003-11-13 | 2012-03-06 | St. Jude Medical Puerto Rico Llc | Method and apparatus for sealing an internal tissue puncture incorporating a block and tackle |
US7232440B2 (en) * | 2003-11-17 | 2007-06-19 | Sherwood Services Ag | Bipolar forceps having monopolar extension |
US7367976B2 (en) | 2003-11-17 | 2008-05-06 | Sherwood Services Ag | Bipolar forceps having monopolar extension |
US20050273002A1 (en) | 2004-06-04 | 2005-12-08 | Goosen Ryan L | Multi-mode imaging marker |
US7500975B2 (en) * | 2003-11-19 | 2009-03-10 | Covidien Ag | Spring loaded reciprocating tissue cutting mechanism in a forceps-style electrosurgical instrument |
US7131970B2 (en) | 2003-11-19 | 2006-11-07 | Sherwood Services Ag | Open vessel sealing instrument with cutting mechanism |
US7252667B2 (en) * | 2003-11-19 | 2007-08-07 | Sherwood Services Ag | Open vessel sealing instrument with cutting mechanism and distal lockout |
US7811283B2 (en) | 2003-11-19 | 2010-10-12 | Covidien Ag | Open vessel sealing instrument with hourglass cutting mechanism and over-ratchet safety |
US7442193B2 (en) | 2003-11-20 | 2008-10-28 | Covidien Ag | Electrically conductive/insulative over-shoe for tissue fusion |
US7597705B2 (en) * | 2003-12-03 | 2009-10-06 | St. Jude Medical Puerto Rico Llc | Vascular puncture seal anchor nest |
US7621937B2 (en) | 2003-12-03 | 2009-11-24 | St. Jude Medical Puerto Rico LC | Vascular sealing device with high surface area sealing plug |
US7875043B1 (en) | 2003-12-09 | 2011-01-25 | Sub-Q, Inc. | Cinching loop |
US20070060950A1 (en) * | 2003-12-24 | 2007-03-15 | Farhad Khosravi | Apparatus and methods for delivering sealing materials during a percutaneous procedure to facilitate hemostasis |
US20050149117A1 (en) * | 2003-12-24 | 2005-07-07 | Farhad Khosravi | Apparatus and methods for delivering sealing materials during a percutaneous procedure to facilitate hemostasis |
US20050245876A1 (en) * | 2003-12-24 | 2005-11-03 | Accessclosure, Inc. | Apparatus and methods for facilitating access through a puncture including sealing compound therein |
US7074494B2 (en) * | 2004-02-19 | 2006-07-11 | E. I. Du Pont De Nemours And Company | Flame retardant surface coverings |
US7780662B2 (en) | 2004-03-02 | 2010-08-24 | Covidien Ag | Vessel sealing system using capacitive RF dielectric heating |
IL160891A0 (en) | 2004-03-16 | 2004-08-31 | Auto-mix needle | |
US7993366B2 (en) * | 2004-05-27 | 2011-08-09 | Cardiva Medical, Inc. | Self-tensioning vascular occlusion device and method for its use |
US20080154303A1 (en) * | 2006-12-21 | 2008-06-26 | Cardiva Medical, Inc. | Hemostasis-enhancing device and method for its use |
US7572274B2 (en) | 2004-05-27 | 2009-08-11 | Cardiva Medical, Inc. | Self-tensioning vascular occlusion device and method for its use |
US7648493B2 (en) * | 2004-04-20 | 2010-01-19 | St. Jude Medical Puerto Rico Llc | Method and apparatus for locating vascular punctures |
US20050267520A1 (en) * | 2004-05-12 | 2005-12-01 | Modesitt D B | Access and closure device and method |
US20050267521A1 (en) * | 2004-05-13 | 2005-12-01 | St. Jude Medical Puerto Rico B.V. | Collagen sponge for arterial sealing |
IES20040368A2 (en) | 2004-05-25 | 2005-11-30 | James E Coleman | Surgical stapler |
US7678133B2 (en) | 2004-07-10 | 2010-03-16 | Arstasis, Inc. | Biological tissue closure device and method |
US7776041B1 (en) * | 2004-07-12 | 2010-08-17 | Biomet Sports Medicine, Llc | Method and apparatus for implanting a suture anchor |
US9808278B2 (en) * | 2004-07-15 | 2017-11-07 | Boston Scientific Scimed Inc. | Tissue tract lancet |
US8348971B2 (en) * | 2004-08-27 | 2013-01-08 | Accessclosure, Inc. | Apparatus and methods for facilitating hemostasis within a vascular puncture |
US7195631B2 (en) * | 2004-09-09 | 2007-03-27 | Sherwood Services Ag | Forceps with spring loaded end effector assembly |
US20060058844A1 (en) * | 2004-09-13 | 2006-03-16 | St. Jude Medical Puerto Rico B.V. | Vascular sealing device with locking system |
US7540872B2 (en) | 2004-09-21 | 2009-06-02 | Covidien Ag | Articulating bipolar electrosurgical instrument |
US7384421B2 (en) | 2004-10-06 | 2008-06-10 | Sherwood Services Ag | Slide-activated cutting assembly |
US7955332B2 (en) * | 2004-10-08 | 2011-06-07 | Covidien Ag | Mechanism for dividing tissue in a hemostat-style instrument |
US7628792B2 (en) * | 2004-10-08 | 2009-12-08 | Covidien Ag | Bilateral foot jaws |
US20060084973A1 (en) * | 2004-10-14 | 2006-04-20 | Dylan Hushka | Momentary rocker switch for use with vessel sealing instruments |
US7686827B2 (en) * | 2004-10-21 | 2010-03-30 | Covidien Ag | Magnetic closure mechanism for hemostat |
US8262693B2 (en) * | 2004-11-05 | 2012-09-11 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
JP5068662B2 (en) | 2004-11-22 | 2012-11-07 | カーディオデックス リミテッド | Heat treatment technology for varicose veins |
US20080086109A1 (en) * | 2004-11-29 | 2008-04-10 | Paul Shabty | Arterial closure device |
US20060116635A1 (en) * | 2004-11-29 | 2006-06-01 | Med Enclosure L.L.C. | Arterial closure device |
EP1827527B1 (en) * | 2004-12-06 | 2016-08-24 | Cook Incorporated | Inflatable occlusion devices, methods, and systems |
US7909823B2 (en) * | 2005-01-14 | 2011-03-22 | Covidien Ag | Open vessel sealing instrument |
US7686804B2 (en) | 2005-01-14 | 2010-03-30 | Covidien Ag | Vessel sealer and divider with rotating sealer and cutter |
AU2006213822B2 (en) * | 2005-02-09 | 2011-05-26 | Covidien Lp | Synthetic sealants |
US20060184199A1 (en) * | 2005-02-14 | 2006-08-17 | O'leary Shawn | Apparatus and methods for reducing bleeding from a cannulation site |
US7243983B2 (en) * | 2005-02-23 | 2007-07-17 | Asc Incorporated | Retractable pillar for convertible vehicle |
US7686788B2 (en) | 2005-03-03 | 2010-03-30 | Boston Scientific Scimed, Inc. | Catheter having a distal drug delivery unit and method of using same |
US20060212062A1 (en) * | 2005-03-16 | 2006-09-21 | David Farascioni | Radially expandable access system including trocar seal |
US7491202B2 (en) * | 2005-03-31 | 2009-02-17 | Covidien Ag | Electrosurgical forceps with slow closure sealing plates and method of sealing tissue |
US20090204114A1 (en) * | 2005-03-31 | 2009-08-13 | Covidien Ag | Electrosurgical Forceps with Slow Closure Sealing Plates and Method of Sealing Tissue |
US7618436B2 (en) * | 2005-04-12 | 2009-11-17 | St. Jude Medical Puerto Rico Llc | Tissue puncture closure device with scroll gear transmission tamping system |
US10357328B2 (en) | 2005-04-20 | 2019-07-23 | Bard Peripheral Vascular, Inc. and Bard Shannon Limited | Marking device with retractable cannula |
US7806856B2 (en) * | 2005-04-22 | 2010-10-05 | Accessclosure, Inc. | Apparatus and method for temporary hemostasis |
US8002742B2 (en) * | 2005-04-22 | 2011-08-23 | Accessclosure, Inc. | Apparatus and methods for sealing a puncture in tissue |
EP1871241B1 (en) * | 2005-04-22 | 2012-12-19 | Rex Medical, L.P. | Closure device for left atrial appendage |
DE102005035795A1 (en) * | 2005-05-03 | 2006-11-09 | Rheinisch-Westfälisch Technische Hochschule Aachen | Device for detecting physiological parameters inside the body |
US7622628B2 (en) | 2005-05-04 | 2009-11-24 | Innovasa Corporation | Hemostatic wire guided bandage and method of use |
US8088144B2 (en) * | 2005-05-04 | 2012-01-03 | Ensure Medical, Inc. | Locator and closure device and method of use |
CN101217916B (en) | 2005-05-12 | 2013-04-10 | 阿尔斯塔西斯公司 | Access and closure device and method |
US20070042326A1 (en) * | 2005-06-01 | 2007-02-22 | Osseous Technologies Of America | Collagen antral membrane expander |
US8926633B2 (en) | 2005-06-24 | 2015-01-06 | Abbott Laboratories | Apparatus and method for delivering a closure element |
US8313497B2 (en) | 2005-07-01 | 2012-11-20 | Abbott Laboratories | Clip applier and methods of use |
US7837685B2 (en) * | 2005-07-13 | 2010-11-23 | Covidien Ag | Switch mechanisms for safe activation of energy on an electrosurgical instrument |
KR100695758B1 (en) | 2005-07-15 | 2007-03-15 | 주식회사 엠아이텍 | apparatus for punctured vessel closure using hemostatic plug |
US20070032824A1 (en) * | 2005-08-04 | 2007-02-08 | St. Jude Medical Puerto Rico B.V. | Tissue puncture closure device with track plug |
US7628791B2 (en) | 2005-08-19 | 2009-12-08 | Covidien Ag | Single action tissue sealer |
US9456811B2 (en) | 2005-08-24 | 2016-10-04 | Abbott Vascular Inc. | Vascular closure methods and apparatuses |
US20070060895A1 (en) | 2005-08-24 | 2007-03-15 | Sibbitt Wilmer L Jr | Vascular closure methods and apparatuses |
US8920442B2 (en) | 2005-08-24 | 2014-12-30 | Abbott Vascular Inc. | Vascular opening edge eversion methods and apparatuses |
US7879035B2 (en) * | 2005-09-30 | 2011-02-01 | Covidien Ag | Insulating boot for electrosurgical forceps |
US7922953B2 (en) | 2005-09-30 | 2011-04-12 | Covidien Ag | Method for manufacturing an end effector assembly |
US7722607B2 (en) * | 2005-09-30 | 2010-05-25 | Covidien Ag | In-line vessel sealer and divider |
US7789878B2 (en) * | 2005-09-30 | 2010-09-07 | Covidien Ag | In-line vessel sealer and divider |
CA2561034C (en) | 2005-09-30 | 2014-12-09 | Sherwood Services Ag | Flexible endoscopic catheter with an end effector for coagulating and transfecting tissue |
US7846161B2 (en) | 2005-09-30 | 2010-12-07 | Covidien Ag | Insulating boot for electrosurgical forceps |
DE602006020488D1 (en) * | 2005-10-05 | 2011-04-14 | Univ Loma Linda Med | Vascular wound closure device |
US8052658B2 (en) | 2005-10-07 | 2011-11-08 | Bard Peripheral Vascular, Inc. | Drug-eluting tissue marker |
WO2007064819A2 (en) * | 2005-12-02 | 2007-06-07 | Cook Incorporated | Devices, systems, and methods for occluding a defect |
US8317822B2 (en) * | 2005-12-22 | 2012-11-27 | Ethicon, Inc. | Systems and methods for closing a vessel wound |
US9427216B2 (en) * | 2005-12-23 | 2016-08-30 | CARDINAL HEALTH SWITZERLAND 515 GmbH | Systems and methods for closing a vessel wound |
US8267942B2 (en) * | 2005-12-23 | 2012-09-18 | Ethicon, Inc. | Systems and methods for closing a vessel wound |
US8382794B2 (en) * | 2006-01-04 | 2013-02-26 | St. Jude Medical Puerto Rico Llc | Balloon insertion apparatus and method of sealing a tissue puncture |
US8241282B2 (en) | 2006-01-24 | 2012-08-14 | Tyco Healthcare Group Lp | Vessel sealing cutting assemblies |
US8734443B2 (en) | 2006-01-24 | 2014-05-27 | Covidien Lp | Vessel sealer and divider for large tissue structures |
US8298232B2 (en) | 2006-01-24 | 2012-10-30 | Tyco Healthcare Group Lp | Endoscopic vessel sealer and divider for large tissue structures |
US8882766B2 (en) | 2006-01-24 | 2014-11-11 | Covidien Ag | Method and system for controlling delivery of energy to divide tissue |
US7766910B2 (en) * | 2006-01-24 | 2010-08-03 | Tyco Healthcare Group Lp | Vessel sealer and divider for large tissue structures |
US8808310B2 (en) | 2006-04-20 | 2014-08-19 | Integrated Vascular Systems, Inc. | Resettable clip applier and reset tools |
US7641653B2 (en) * | 2006-05-04 | 2010-01-05 | Covidien Ag | Open vessel sealing forceps disposable handswitch |
US20070260238A1 (en) * | 2006-05-05 | 2007-11-08 | Sherwood Services Ag | Combined energy level button |
US7846158B2 (en) | 2006-05-05 | 2010-12-07 | Covidien Ag | Apparatus and method for electrode thermosurgery |
US7758598B2 (en) * | 2006-05-19 | 2010-07-20 | Ethicon Endo-Surgery, Inc. | Combination knotting element and suture anchor applicator |
US7850710B2 (en) * | 2006-05-23 | 2010-12-14 | St. Jude Medical Puerto Rico Llc | Puncture closure apparatuses, sealing plugs, and related methods |
WO2010062971A1 (en) | 2008-11-26 | 2010-06-03 | Anova Corporation | Methods and apparatus for anulus repair |
US8834496B2 (en) | 2006-06-13 | 2014-09-16 | Bret A. Ferree | Soft tissue repair methods and apparatus |
US8764835B2 (en) | 2006-06-13 | 2014-07-01 | Bret A. Ferree | Intervertebral disc treatment methods and apparatus |
US9232938B2 (en) | 2006-06-13 | 2016-01-12 | Anova Corp. | Method and apparatus for closing fissures in the annulus fibrosus |
EP2043531B1 (en) | 2006-06-15 | 2013-01-02 | Cook Medical Technologies LLC | Systems and devices for the delivery of endoluminal prostheses |
US8556930B2 (en) | 2006-06-28 | 2013-10-15 | Abbott Laboratories | Vessel closure device |
USD611144S1 (en) | 2006-06-28 | 2010-03-02 | Abbott Laboratories | Apparatus for delivering a closure element |
US7776037B2 (en) * | 2006-07-07 | 2010-08-17 | Covidien Ag | System and method for controlling electrode gap during tissue sealing |
US20080015575A1 (en) * | 2006-07-14 | 2008-01-17 | Sherwood Services Ag | Vessel sealing instrument with pre-heated electrodes |
US7744615B2 (en) * | 2006-07-18 | 2010-06-29 | Covidien Ag | Apparatus and method for transecting tissue on a bipolar vessel sealing instrument |
US8597297B2 (en) * | 2006-08-29 | 2013-12-03 | Covidien Ag | Vessel sealing instrument with multiple electrode configurations |
US7789893B2 (en) * | 2006-09-12 | 2010-09-07 | Boston Scientific Scimed, Inc. | Method and apparatus for promoting hemostasis of a blood vessel puncture |
US8617204B2 (en) * | 2006-09-13 | 2013-12-31 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
US7749248B2 (en) * | 2006-09-18 | 2010-07-06 | St. Jude Medical Puerto Rico Llc | Flexible tamping device |
US8070746B2 (en) | 2006-10-03 | 2011-12-06 | Tyco Healthcare Group Lp | Radiofrequency fusion of cardiac tissue |
US7951149B2 (en) * | 2006-10-17 | 2011-05-31 | Tyco Healthcare Group Lp | Ablative material for use with tissue treatment device |
US8064987B2 (en) | 2006-10-23 | 2011-11-22 | C. R. Bard, Inc. | Breast marker |
US20080109033A1 (en) * | 2006-10-31 | 2008-05-08 | Texas Heart Institute | Method and device for prevention of pneumothorax during vascular access |
EP3542748B1 (en) | 2006-12-12 | 2023-08-16 | C. R. Bard, Inc. | Multiple imaging mode tissue marker |
ES2432572T3 (en) | 2006-12-18 | 2013-12-04 | C.R. Bard, Inc. | Biopsy marker with imaging properties generated in situ |
US8721679B2 (en) * | 2007-02-05 | 2014-05-13 | Boston Scientific Scimed, Inc. | Apparatus and method for closing an opening in a blood vessel using a permanent implant |
USD649249S1 (en) | 2007-02-15 | 2011-11-22 | Tyco Healthcare Group Lp | End effectors of an elongated dissecting and dividing instrument |
US20090227981A1 (en) * | 2007-03-05 | 2009-09-10 | Bennett Steven L | Low-Swelling Biocompatible Hydrogels |
US20090227689A1 (en) * | 2007-03-05 | 2009-09-10 | Bennett Steven L | Low-Swelling Biocompatible Hydrogels |
US8080034B2 (en) * | 2007-03-29 | 2011-12-20 | St. Jude Medical, Inc. | Vascular hemostasis device and deployment apparatus |
US8267935B2 (en) | 2007-04-04 | 2012-09-18 | Tyco Healthcare Group Lp | Electrosurgical instrument reducing current densities at an insulator conductor junction |
EP2134267A4 (en) * | 2007-04-06 | 2015-02-25 | Interventional Therapies | Suturing, crimping and cutting device |
US8226681B2 (en) | 2007-06-25 | 2012-07-24 | Abbott Laboratories | Methods, devices, and apparatus for managing access through tissue |
US8906059B2 (en) * | 2007-07-13 | 2014-12-09 | Rex Medical, L.P. | Vascular hole closure device |
US20090024106A1 (en) * | 2007-07-17 | 2009-01-22 | Morris Edward J | Method and apparatus for maintaining access |
US8067028B2 (en) * | 2007-08-13 | 2011-11-29 | Confluent Surgical Inc. | Drug delivery device |
US8366706B2 (en) | 2007-08-15 | 2013-02-05 | Cardiodex, Ltd. | Systems and methods for puncture closure |
US8333787B2 (en) | 2007-12-31 | 2012-12-18 | St. Jude Medical Puerto Rico Llc | Vascular closure device having a flowable sealing material |
US8568445B2 (en) * | 2007-08-21 | 2013-10-29 | St. Jude Medical Puerto Rico Llc | Extra-vascular sealing device and method |
US7877853B2 (en) | 2007-09-20 | 2011-02-01 | Tyco Healthcare Group Lp | Method of manufacturing end effector assembly for sealing tissue |
US7877852B2 (en) | 2007-09-20 | 2011-02-01 | Tyco Healthcare Group Lp | Method of manufacturing an end effector assembly for sealing tissue |
US8267936B2 (en) | 2007-09-28 | 2012-09-18 | Tyco Healthcare Group Lp | Insulating mechanically-interfaced adhesive for electrosurgical forceps |
US8251996B2 (en) * | 2007-09-28 | 2012-08-28 | Tyco Healthcare Group Lp | Insulating sheath for electrosurgical forceps |
US8241283B2 (en) | 2007-09-28 | 2012-08-14 | Tyco Healthcare Group Lp | Dual durometer insulating boot for electrosurgical forceps |
US20090088723A1 (en) * | 2007-09-28 | 2009-04-02 | Accessclosure, Inc. | Apparatus and methods for treating pseudoaneurysms |
US8235993B2 (en) * | 2007-09-28 | 2012-08-07 | Tyco Healthcare Group Lp | Insulating boot for electrosurgical forceps with exohinged structure |
US8236025B2 (en) * | 2007-09-28 | 2012-08-07 | Tyco Healthcare Group Lp | Silicone insulated electrosurgical forceps |
US20090088745A1 (en) * | 2007-09-28 | 2009-04-02 | Tyco Healthcare Group Lp | Tapered Insulating Boot for Electrosurgical Forceps |
US8235992B2 (en) * | 2007-09-28 | 2012-08-07 | Tyco Healthcare Group Lp | Insulating boot with mechanical reinforcement for electrosurgical forceps |
US7993367B2 (en) * | 2007-09-28 | 2011-08-09 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
WO2009045793A1 (en) * | 2007-09-28 | 2009-04-09 | Access Closure, Inc. | Apparatus and methods for sealing a vascular puncture |
US20090088750A1 (en) * | 2007-09-28 | 2009-04-02 | Tyco Healthcare Group Lp | Insulating Boot with Silicone Overmold for Electrosurgical Forceps |
US20090088748A1 (en) * | 2007-09-28 | 2009-04-02 | Tyco Healthcare Group Lp | Insulating Mesh-like Boot for Electrosurgical Forceps |
US8221416B2 (en) * | 2007-09-28 | 2012-07-17 | Tyco Healthcare Group Lp | Insulating boot for electrosurgical forceps with thermoplastic clevis |
US9023043B2 (en) * | 2007-09-28 | 2015-05-05 | Covidien Lp | Insulating mechanically-interfaced boot and jaws for electrosurgical forceps |
US8795326B2 (en) | 2007-10-05 | 2014-08-05 | Covidien Lp | Expanding seal anchor for single incision surgery |
US20090105744A1 (en) * | 2007-10-17 | 2009-04-23 | Modesitt D Bruce | Methods for forming tracts in tissue |
JP2011502582A (en) * | 2007-11-02 | 2011-01-27 | インセプト,エルエルシー | Device and method for blocking vascular puncture |
US20090157101A1 (en) | 2007-12-17 | 2009-06-18 | Abbott Laboratories | Tissue closure system and methods of use |
US8893947B2 (en) | 2007-12-17 | 2014-11-25 | Abbott Laboratories | Clip applier and methods of use |
US7841502B2 (en) | 2007-12-18 | 2010-11-30 | Abbott Laboratories | Modular clip applier |
US8840640B2 (en) | 2007-12-31 | 2014-09-23 | St. Jude Medical Puerto Rico Llc | Vascular closure device having an improved plug |
US9282953B2 (en) * | 2007-12-31 | 2016-03-15 | St. Jude Medical Puerto Rico Llc | Systems and methods for locating and closing a tissue puncture |
US8311610B2 (en) | 2008-01-31 | 2012-11-13 | C. R. Bard, Inc. | Biopsy tissue marker |
US8764748B2 (en) * | 2008-02-06 | 2014-07-01 | Covidien Lp | End effector assembly for electrosurgical device and method for making the same |
US20110029013A1 (en) | 2008-02-15 | 2011-02-03 | Mcguckin James F | Vascular Hole Closure Device |
US8491629B2 (en) | 2008-02-15 | 2013-07-23 | Rex Medical | Vascular hole closure delivery device |
US8920462B2 (en) | 2008-02-15 | 2014-12-30 | Rex Medical, L.P. | Vascular hole closure device |
US8070772B2 (en) | 2008-02-15 | 2011-12-06 | Rex Medical, L.P. | Vascular hole closure device |
US9226738B2 (en) | 2008-02-15 | 2016-01-05 | Rex Medical, L.P. | Vascular hole closure delivery device |
US8920463B2 (en) | 2008-02-15 | 2014-12-30 | Rex Medical, L.P. | Vascular hole closure device |
US8623276B2 (en) * | 2008-02-15 | 2014-01-07 | Covidien Lp | Method and system for sterilizing an electrosurgical instrument |
US20090228002A1 (en) * | 2008-03-04 | 2009-09-10 | Rioux Robert F | Electromagnetic energy assisted tissue penetration device and method |
US9364206B2 (en) | 2008-04-04 | 2016-06-14 | Access Closure, Inc. | Apparatus and methods for sealing a vascular puncture |
CA2720206C (en) * | 2008-04-04 | 2016-10-04 | Curaseal, Inc. | Implantable fistula closure device |
US8029533B2 (en) | 2008-04-04 | 2011-10-04 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
AU2009244462B2 (en) | 2008-05-06 | 2013-04-11 | Cook Medical Technologies Llc | Apparatus and methods for delivering therapeutic agents |
US8709039B2 (en) * | 2008-05-12 | 2014-04-29 | Humparkull, Llc | Hemostatic devices and methods for use thereof |
US9539381B2 (en) | 2008-05-12 | 2017-01-10 | Humparkull, Llc | Hemostatic devices and methods for use thereof |
US10426483B2 (en) | 2008-05-12 | 2019-10-01 | Mitchell R. Humphreys | Hemostatic devices and methods for use thereof |
US9282965B2 (en) | 2008-05-16 | 2016-03-15 | Abbott Laboratories | Apparatus and methods for engaging tissue |
US8118832B1 (en) | 2008-06-16 | 2012-02-21 | Morris Innovative, Inc. | Method and apparatus for sealing access |
US20090318892A1 (en) * | 2008-06-20 | 2009-12-24 | Maria Aboytes | Removable Core Implant Delivery Catheter |
US8469956B2 (en) * | 2008-07-21 | 2013-06-25 | Covidien Lp | Variable resistor jaw |
JP2011528606A (en) * | 2008-07-21 | 2011-11-24 | アルスタシス,インコーポレイテッド | Apparatus and method for forming a tract in tissue |
JP2011528605A (en) * | 2008-07-21 | 2011-11-24 | アルスタシス,インコーポレイテッド | Device, method, and kit for forming a tube in tissue |
US8257387B2 (en) * | 2008-08-15 | 2012-09-04 | Tyco Healthcare Group Lp | Method of transferring pressure in an articulating surgical instrument |
US8162973B2 (en) * | 2008-08-15 | 2012-04-24 | Tyco Healthcare Group Lp | Method of transferring pressure in an articulating surgical instrument |
US9603652B2 (en) * | 2008-08-21 | 2017-03-28 | Covidien Lp | Electrosurgical instrument including a sensor |
WO2010027693A2 (en) | 2008-08-26 | 2010-03-11 | Killion Douglas P | Method and system for sealing percutaneous punctures |
US8317787B2 (en) * | 2008-08-28 | 2012-11-27 | Covidien Lp | Tissue fusion jaw angle improvement |
US20100057081A1 (en) * | 2008-08-28 | 2010-03-04 | Tyco Healthcare Group Lp | Tissue Fusion Jaw Angle Improvement |
US8795274B2 (en) * | 2008-08-28 | 2014-08-05 | Covidien Lp | Tissue fusion jaw angle improvement |
US8784417B2 (en) * | 2008-08-28 | 2014-07-22 | Covidien Lp | Tissue fusion jaw angle improvement |
EP2330985A4 (en) | 2008-09-04 | 2015-11-18 | Curaseal Inc | Inflatable devices for enteric fistula treatment |
US20100063500A1 (en) * | 2008-09-05 | 2010-03-11 | Tyco Healthcare Group Lp | Apparatus, System and Method for Performing an Electrosurgical Procedure |
US8303582B2 (en) | 2008-09-15 | 2012-11-06 | Tyco Healthcare Group Lp | Electrosurgical instrument having a coated electrode utilizing an atomic layer deposition technique |
US20100069953A1 (en) * | 2008-09-16 | 2010-03-18 | Tyco Healthcare Group Lp | Method of Transferring Force Using Flexible Fluid-Filled Tubing in an Articulating Surgical Instrument |
US9327061B2 (en) | 2008-09-23 | 2016-05-03 | Senorx, Inc. | Porous bioabsorbable implant |
US20100076430A1 (en) * | 2008-09-24 | 2010-03-25 | Tyco Healthcare Group Lp | Electrosurgical Instrument Having a Thumb Lever and Related System and Method of Use |
US8968314B2 (en) * | 2008-09-25 | 2015-03-03 | Covidien Lp | Apparatus, system and method for performing an electrosurgical procedure |
US9375254B2 (en) * | 2008-09-25 | 2016-06-28 | Covidien Lp | Seal and separate algorithm |
US8535312B2 (en) * | 2008-09-25 | 2013-09-17 | Covidien Lp | Apparatus, system and method for performing an electrosurgical procedure |
US8142473B2 (en) * | 2008-10-03 | 2012-03-27 | Tyco Healthcare Group Lp | Method of transferring rotational motion in an articulating surgical instrument |
US8469957B2 (en) * | 2008-10-07 | 2013-06-25 | Covidien Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US8016827B2 (en) * | 2008-10-09 | 2011-09-13 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US8636761B2 (en) | 2008-10-09 | 2014-01-28 | Covidien Lp | Apparatus, system, and method for performing an endoscopic electrosurgical procedure |
US8163022B2 (en) | 2008-10-14 | 2012-04-24 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US8486107B2 (en) * | 2008-10-20 | 2013-07-16 | Covidien Lp | Method of sealing tissue using radiofrequency energy |
US20100106137A1 (en) * | 2008-10-29 | 2010-04-29 | Warsaw Orthopedic, Inc. | Drug Delivery System |
US8398676B2 (en) | 2008-10-30 | 2013-03-19 | Abbott Vascular Inc. | Closure device |
US8702677B2 (en) * | 2008-10-31 | 2014-04-22 | Warsaw Orthopedic, Inc. | Device and method for directional delivery of a drug depot |
CA2962054C (en) | 2008-11-12 | 2019-08-06 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
US8197479B2 (en) * | 2008-12-10 | 2012-06-12 | Tyco Healthcare Group Lp | Vessel sealer and divider |
US8323312B2 (en) | 2008-12-22 | 2012-12-04 | Abbott Laboratories | Closure device |
US8858594B2 (en) | 2008-12-22 | 2014-10-14 | Abbott Laboratories | Curved closure device |
WO2010074949A1 (en) * | 2008-12-23 | 2010-07-01 | Wilson-Cook Medical Inc. | Apparatus and methods for containing and delivering therapeutic agents |
US8670818B2 (en) | 2008-12-30 | 2014-03-11 | C. R. Bard, Inc. | Marker delivery device for tissue marker placement |
US9414820B2 (en) | 2009-01-09 | 2016-08-16 | Abbott Vascular Inc. | Closure devices, systems, and methods |
US20100179589A1 (en) | 2009-01-09 | 2010-07-15 | Abbott Vascular Inc. | Rapidly eroding anchor |
US9089311B2 (en) | 2009-01-09 | 2015-07-28 | Abbott Vascular Inc. | Vessel closure devices and methods |
US9486191B2 (en) | 2009-01-09 | 2016-11-08 | Abbott Vascular, Inc. | Closure devices |
US9173644B2 (en) | 2009-01-09 | 2015-11-03 | Abbott Vascular Inc. | Closure devices, systems, and methods |
US8114122B2 (en) | 2009-01-13 | 2012-02-14 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US20100185234A1 (en) | 2009-01-16 | 2010-07-22 | Abbott Vascular Inc. | Closure devices, systems, and methods |
US9913634B2 (en) | 2009-02-20 | 2018-03-13 | Boston Scientific Scimed, Inc. | Locking element for vascular closure device |
US8375553B2 (en) * | 2009-02-20 | 2013-02-19 | Boston Scientific Scimed, Inc. | Locking element for vascular closure device |
US8052914B2 (en) * | 2009-02-20 | 2011-11-08 | Boston Scientific Scimed, Inc. | Modified plug for arteriotomy closure |
US20100217309A1 (en) * | 2009-02-20 | 2010-08-26 | Boston Scientific Scimed, Inc. | Plug for arteriotomy closure and method of use |
US8529598B2 (en) * | 2009-02-20 | 2013-09-10 | Boston Scientific Scimed, Inc. | Tissue puncture closure device |
US8292918B2 (en) * | 2009-02-20 | 2012-10-23 | Boston Scientific Scimed, Inc. | Composite plug for arteriotomy closure and method of use |
US8317824B2 (en) | 2009-02-20 | 2012-11-27 | Boston Scientific Scimed, Inc. | Tissue puncture closure device |
JP5807970B2 (en) * | 2009-04-09 | 2015-11-10 | カーディオバスキュラー テクノロジーズ、インク. | Tissue suturing device, transfer device and system, kit and method therefor |
JP5684239B2 (en) * | 2009-05-04 | 2015-03-11 | インセプト・リミテッド・ライアビリティ・カンパニーIncept Llc | Biomaterial for track and puncture closure |
US8187273B2 (en) | 2009-05-07 | 2012-05-29 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
WO2010132835A1 (en) * | 2009-05-15 | 2010-11-18 | Arstasis, Inc. | Devices, methods and kits for forming tracts in tissue |
US9101744B2 (en) | 2009-05-29 | 2015-08-11 | Cook Medical Technologies Llc | Systems and methods for delivering therapeutic agents |
US8118777B2 (en) | 2009-05-29 | 2012-02-21 | Cook Medical Technologies Llc | Systems and methods for delivering therapeutic agents |
US20100324597A1 (en) * | 2009-06-19 | 2010-12-23 | Oleg Shikhman | Crimping and cutting device |
US8246618B2 (en) | 2009-07-08 | 2012-08-21 | Tyco Healthcare Group Lp | Electrosurgical jaws with offset knife |
US8192456B2 (en) * | 2009-07-13 | 2012-06-05 | Vascular Solutions, Inc. | Metal vascular aperture closure device |
WO2011025529A1 (en) * | 2009-08-24 | 2011-03-03 | St. Jude Medical Puerto Rico Llc | Single piece, dual component sealing pad and methods |
US20110054492A1 (en) | 2009-08-26 | 2011-03-03 | Abbott Laboratories | Medical device for repairing a fistula |
US8133254B2 (en) | 2009-09-18 | 2012-03-13 | Tyco Healthcare Group Lp | In vivo attachable and detachable end effector assembly and laparoscopic surgical instrument and methods therefor |
AU2010298315A1 (en) * | 2009-09-22 | 2012-04-19 | Arstasis, Inc. | Devices, methods, and kits for forming tracts in tissue |
US8112871B2 (en) | 2009-09-28 | 2012-02-14 | Tyco Healthcare Group Lp | Method for manufacturing electrosurgical seal plates |
US20110087274A1 (en) * | 2009-10-08 | 2011-04-14 | Tyco Healtcare Group LP, New Haven, Ct | Wound Closure Device |
US20110087273A1 (en) * | 2009-10-08 | 2011-04-14 | Tyco Healthcare Group Lp | Wound Closure Device |
US9498271B2 (en) * | 2009-10-29 | 2016-11-22 | Cook Medical Technologies Llc | Coaxial needle cannula with distal spiral mixer and side ports for fluid injection |
WO2011057131A1 (en) | 2009-11-09 | 2011-05-12 | Spotlight Technology Partners Llc | Polysaccharide based hydrogels |
AU2010314994B2 (en) | 2009-11-09 | 2016-10-06 | Spotlight Technology Partners Llc | Fragmented hydrogels |
US9179900B2 (en) * | 2009-12-08 | 2015-11-10 | Phillips Medical Llc | Hemostatic device and its methods of use |
US9993236B2 (en) | 2009-12-08 | 2018-06-12 | Phillips Medical, LLC | Hemostatic device and its methods of use |
EP2521493B1 (en) * | 2010-01-06 | 2016-12-14 | St. Jude Medical, Inc. | System for sealing percutaneous punctures |
US8460319B2 (en) | 2010-01-11 | 2013-06-11 | Anulex Technologies, Inc. | Intervertebral disc annulus repair system and method |
US8444673B2 (en) * | 2010-02-11 | 2013-05-21 | Boston Scientific Scimed, Inc. | Automatic vascular closure deployment devices and methods |
US8303624B2 (en) | 2010-03-15 | 2012-11-06 | Abbott Cardiovascular Systems, Inc. | Bioabsorbable plug |
AU2011243001B2 (en) | 2010-04-19 | 2016-03-31 | Phillips Medical Llc | A hemostatic device and its methods of use |
US8715719B2 (en) | 2010-06-16 | 2014-05-06 | Abbott Vascular, Inc. | Stable chitosan hemostatic implant and methods of manufacture |
US10231721B2 (en) | 2010-06-24 | 2019-03-19 | St. Croix Surgical Systems, Llc | Failsafe percutaneous wound barrier |
US8834418B2 (en) * | 2010-07-22 | 2014-09-16 | Covidien Lp | Molds for in situ forming materials |
US9561094B2 (en) | 2010-07-23 | 2017-02-07 | Nfinium Vascular Technologies, Llc | Devices and methods for treating venous diseases |
US8758399B2 (en) | 2010-08-02 | 2014-06-24 | Abbott Cardiovascular Systems, Inc. | Expandable bioabsorbable plug apparatus and method |
US8603116B2 (en) | 2010-08-04 | 2013-12-10 | Abbott Cardiovascular Systems, Inc. | Closure device with long tines |
US8597340B2 (en) | 2010-09-17 | 2013-12-03 | Boston Scientific Scimed, Inc. | Torque mechanism actuated bioabsorbable vascular closure device |
US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
US8758402B2 (en) | 2010-12-17 | 2014-06-24 | Boston Scientific Scimed, Inc. | Tissue puncture closure device |
US9113940B2 (en) | 2011-01-14 | 2015-08-25 | Covidien Lp | Trigger lockout and kickback mechanism for surgical instruments |
ES2870965T3 (en) | 2011-01-19 | 2021-10-28 | Access Closure Inc | Procedures to seal a vascular puncture |
US9820728B2 (en) | 2011-01-19 | 2017-11-21 | Access Closure, Inc. | Apparatus and methods for sealing a vascular puncture |
US8617184B2 (en) | 2011-02-15 | 2013-12-31 | Abbott Cardiovascular Systems, Inc. | Vessel closure system |
US9149276B2 (en) | 2011-03-21 | 2015-10-06 | Abbott Cardiovascular Systems, Inc. | Clip and deployment apparatus for tissue closure |
US9386968B2 (en) | 2011-05-11 | 2016-07-12 | Access Closure, Inc. | Apparatus and methods for sealing a vascular puncture |
CN103874466B (en) | 2011-06-16 | 2016-10-05 | 库拉希尔公司 | Device and correlation technique for fistula treatment |
US9131941B2 (en) | 2011-06-17 | 2015-09-15 | Curaseal Inc. | Fistula treatment devices and methods |
WO2013023075A1 (en) | 2011-08-09 | 2013-02-14 | Cook General Biotechnology Llc | Vial useable in tissue extraction procedures |
US9050067B2 (en) | 2011-09-26 | 2015-06-09 | Cook Medical Technologies, LLC | Percutaneous nephrostomy plug delivery device |
US9332976B2 (en) | 2011-11-30 | 2016-05-10 | Abbott Cardiovascular Systems, Inc. | Tissue closure device |
USD680220S1 (en) | 2012-01-12 | 2013-04-16 | Coviden IP | Slider handle for laparoscopic device |
US9757105B2 (en) | 2012-03-23 | 2017-09-12 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
US8721680B2 (en) | 2012-03-23 | 2014-05-13 | Accessclosure, Inc. | Apparatus and methods for sealing a vascular puncture |
US9642604B2 (en) * | 2012-04-12 | 2017-05-09 | Phillips Medical Llc | Hemostatic system and its methods of use |
US20130317481A1 (en) | 2012-05-25 | 2013-11-28 | Arstasis, Inc. | Vascular access configuration |
US20130317438A1 (en) | 2012-05-25 | 2013-11-28 | Arstasis, Inc. | Vascular access configuration |
US9468428B2 (en) | 2012-06-13 | 2016-10-18 | Phillips Medical Llc | Hemostatic device and its methods of use |
US9364209B2 (en) | 2012-12-21 | 2016-06-14 | Abbott Cardiovascular Systems, Inc. | Articulating suturing device |
US9737294B2 (en) | 2013-01-28 | 2017-08-22 | Cartiva, Inc. | Method and system for orthopedic repair |
AU2014209124A1 (en) | 2013-01-28 | 2015-09-17 | Cartiva, Inc. | Systems and methods for orthopedic repair |
US20140228868A1 (en) * | 2013-02-14 | 2014-08-14 | Access Closure, Inc. | Vascular closure apparatus and related method |
US20160220235A1 (en) * | 2013-02-14 | 2016-08-04 | Access Closure, Inc. | Vascular closure apparatus and related method |
JP6147906B2 (en) * | 2013-03-15 | 2017-06-14 | アボット カーディオバスキュラー システムズ インコーポレイテッド | Tissue adhesive coating for drug balloons |
US9867931B2 (en) | 2013-10-02 | 2018-01-16 | Cook Medical Technologies Llc | Therapeutic agents for delivery using a catheter and pressure source |
US11931227B2 (en) | 2013-03-15 | 2024-03-19 | Cook Medical Technologies Llc | Bimodal treatment methods and compositions for gastrointestinal lesions with active bleeding |
JP3206339U (en) * | 2013-04-01 | 2016-09-15 | テルモ株式会社 | Guiding catheter assembly |
US9724081B2 (en) | 2013-06-04 | 2017-08-08 | Phillips Medical Llc | Hemostatic system and its methods of use |
US9839416B2 (en) | 2013-07-12 | 2017-12-12 | Phillips Medical, LLC | Hemostatic device and its methods of use |
US10085730B2 (en) | 2013-07-12 | 2018-10-02 | Phillips Medical, LLC | Hemostatic device and its methods of use |
US10646267B2 (en) | 2013-08-07 | 2020-05-12 | Covidien LLP | Surgical forceps |
WO2015034870A2 (en) * | 2013-09-03 | 2015-03-12 | Arocha Max | Double-chamber mixing syringe and method of use |
USD715442S1 (en) | 2013-09-24 | 2014-10-14 | C. R. Bard, Inc. | Tissue marker for intracorporeal site identification |
USD715942S1 (en) | 2013-09-24 | 2014-10-21 | C. R. Bard, Inc. | Tissue marker for intracorporeal site identification |
USD716451S1 (en) | 2013-09-24 | 2014-10-28 | C. R. Bard, Inc. | Tissue marker for intracorporeal site identification |
USD716450S1 (en) | 2013-09-24 | 2014-10-28 | C. R. Bard, Inc. | Tissue marker for intracorporeal site identification |
US9364208B2 (en) | 2014-03-18 | 2016-06-14 | King Abdullah International Medical Research Center | Medical material delivery device |
US20150351775A1 (en) | 2014-06-04 | 2015-12-10 | Nfinium Vascular Technologies, Llc | Low radial force vascular device and method of occlusion |
US9764122B2 (en) | 2014-07-25 | 2017-09-19 | Warsaw Orthopedic, Inc. | Drug delivery device and methods having an occluding member |
US9775978B2 (en) | 2014-07-25 | 2017-10-03 | Warsaw Orthopedic, Inc. | Drug delivery device and methods having a retaining member |
US10231777B2 (en) | 2014-08-26 | 2019-03-19 | Covidien Lp | Methods of manufacturing jaw members of an end-effector assembly for a surgical instrument |
US9795366B2 (en) | 2014-09-18 | 2017-10-24 | Edwards Lifesciences Corporation | Bio-absorbable wound closure device and method |
US20160287796A1 (en) * | 2015-04-02 | 2016-10-06 | Xend Medical Systems, Llc | Cartridge system to which a syringe body can be attached |
US9730773B2 (en) | 2015-04-22 | 2017-08-15 | Maxillent Ltd. | Bone graft injection methods |
US9987078B2 (en) | 2015-07-22 | 2018-06-05 | Covidien Lp | Surgical forceps |
US10631918B2 (en) | 2015-08-14 | 2020-04-28 | Covidien Lp | Energizable surgical attachment for a mechanical clamp |
WO2017031712A1 (en) | 2015-08-26 | 2017-03-02 | Covidien Lp | Electrosurgical end effector assemblies and electrosurgical forceps configured to reduce thermal spread |
EP3355803A4 (en) | 2015-09-28 | 2019-06-12 | M-V Arterica AB | Vascular closure device |
US10213250B2 (en) | 2015-11-05 | 2019-02-26 | Covidien Lp | Deployment and safety mechanisms for surgical instruments |
US10076650B2 (en) | 2015-11-23 | 2018-09-18 | Warsaw Orthopedic, Inc. | Enhanced stylet for drug depot injector |
IL243401A (en) | 2015-12-29 | 2017-12-31 | Zion Karmon Ben | Devices and methods for elevating the schneiderian membrane |
USD802755S1 (en) | 2016-06-23 | 2017-11-14 | Warsaw Orthopedic, Inc. | Drug pellet cartridge |
US10856933B2 (en) | 2016-08-02 | 2020-12-08 | Covidien Lp | Surgical instrument housing incorporating a channel and methods of manufacturing the same |
IL248472A0 (en) | 2016-10-13 | 2017-01-31 | Zion Karmon Ben | Devices for tissue regeneration |
US10434261B2 (en) | 2016-11-08 | 2019-10-08 | Warsaw Orthopedic, Inc. | Drug pellet delivery system and method |
US10918407B2 (en) | 2016-11-08 | 2021-02-16 | Covidien Lp | Surgical instrument for grasping, treating, and/or dividing tissue |
US11166759B2 (en) | 2017-05-16 | 2021-11-09 | Covidien Lp | Surgical forceps |
US10542996B2 (en) | 2017-06-27 | 2020-01-28 | Covidien Lp | Vessel closure device |
US11179145B2 (en) | 2017-11-16 | 2021-11-23 | M-V Arterica AB | Collapsible tube for hemostasis |
US11638578B2 (en) * | 2017-11-28 | 2023-05-02 | Pneumonix Medical, Inc. | Apparatus and method to seal a tissue tract |
US11504271B2 (en) | 2018-03-30 | 2022-11-22 | Surgical Design Corporation | Surgical hand-piece with a bottom fluid tube convertible from irrigation to aspiration |
CN109330635B (en) * | 2018-07-27 | 2024-02-06 | 尚华 | Multifunctional intravascular tissue puncture needle and application method thereof |
USD935611S1 (en) | 2018-12-10 | 2021-11-09 | Pneumonix Medical, Inc. | Tissue tract sealant device |
US11504105B2 (en) | 2019-01-25 | 2022-11-22 | Rex Medical L.P. | Vascular hole closure device |
US11090050B2 (en) | 2019-09-03 | 2021-08-17 | Covidien Lp | Trigger mechanisms for surgical instruments and surgical instruments including the same |
JP2023503038A (en) | 2019-11-19 | 2023-01-26 | アーテリカ, インコーポレイテッド | Vascular closure device and method |
JP2021122293A (en) * | 2020-01-31 | 2021-08-30 | 朝日インテック株式会社 | Drug solution injection device |
US20220240965A1 (en) * | 2021-02-04 | 2022-08-04 | Naomi Marshall | Acne extraction tool device |
Family Cites Families (40)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US34866A (en) * | 1862-04-01 | Improvement in files | ||
US3016895A (en) * | 1958-08-01 | 1962-01-16 | Pan American Lab Inc | Injector for subcutaneous implantation of solids |
US3490448A (en) * | 1967-07-31 | 1970-01-20 | Harvey C Upham | Adhesive pressure pad |
US3572335A (en) * | 1969-01-10 | 1971-03-23 | Ralph R Robinson | Cervical implant method and device |
US3703897A (en) * | 1969-10-09 | 1972-11-28 | Kendall & Co | Hydrophobic non-adherent wound dressing |
US3874388A (en) * | 1973-02-12 | 1975-04-01 | Ochsner Med Found Alton | Shunt defect closure system |
DE2515786C3 (en) * | 1975-04-11 | 1979-01-04 | Laerdal, Asmund S., Stavanger (Norwegen) | Printing compound |
US4588395A (en) * | 1978-03-10 | 1986-05-13 | Lemelson Jerome H | Catheter and method |
US4900303A (en) * | 1978-03-10 | 1990-02-13 | Lemelson Jerome H | Dispensing catheter and method |
US4578061A (en) * | 1980-10-28 | 1986-03-25 | Lemelson Jerome H | Injection catheter and method |
US4377159A (en) * | 1981-06-29 | 1983-03-22 | Minnesota Mining And Manufacturing Company | Pressure bandages and methods for making the same |
US4638803A (en) * | 1982-09-30 | 1987-01-27 | Rand Robert W | Medical apparatus for inducing scar tissue formation in a body |
US4619261A (en) * | 1984-08-09 | 1986-10-28 | Frederico Guerriero | Hydrostatic pressure device for bleeding control through an inflatable, stitchable and retrievable balloon-net system |
JPS61122222A (en) * | 1984-11-19 | 1986-06-10 | Koken:Kk | Hemostatic agent composed of collagen or gelatin and protamine |
US4878906A (en) * | 1986-03-25 | 1989-11-07 | Servetus Partnership | Endoprosthesis for repairing a damaged vessel |
US4890612A (en) * | 1987-02-17 | 1990-01-02 | Kensey Nash Corporation | Device for sealing percutaneous puncture in a vessel |
US4744364A (en) * | 1987-02-17 | 1988-05-17 | Intravascular Surgical Instruments, Inc. | Device for sealing percutaneous puncture in a vessel |
USRE34866E (en) * | 1987-02-17 | 1995-02-21 | Kensey Nash Corporation | Device for sealing percutaneous puncture in a vessel |
US4852568A (en) * | 1987-02-17 | 1989-08-01 | Kensey Nash Corporation | Method and apparatus for sealing an opening in tissue of a living being |
US4994028A (en) * | 1987-03-18 | 1991-02-19 | Endocon, Inc. | Injector for inplanting multiple pellet medicaments |
DE3855054T2 (en) * | 1987-05-26 | 1996-07-18 | Sumitomo Pharma | Device for the administration of solid preparations |
DE3802158A1 (en) * | 1987-08-11 | 1989-02-23 | Hoechst Ag | DEVICE FOR APPLICATION OF IMPLANTS |
US4790819A (en) * | 1987-08-24 | 1988-12-13 | American Cyanamid Company | Fibrin clot delivery device and method |
US4838280A (en) * | 1988-05-26 | 1989-06-13 | Haaga John R | Hemostatic sheath for a biopsy needle and method of use |
US4895564A (en) * | 1988-06-08 | 1990-01-23 | Farrell Edward M | Percutaneous femoral bypass system |
US5053046A (en) * | 1988-08-22 | 1991-10-01 | Woodrow W. Janese | Dural sealing needle and method of use |
US4929246A (en) * | 1988-10-27 | 1990-05-29 | C. R. Bard, Inc. | Method for closing and sealing an artery after removing a catheter |
FR2641692A1 (en) * | 1989-01-17 | 1990-07-20 | Nippon Zeon Co | Plug for closing an opening for a medical application, and device for the closure plug making use thereof |
DE8907370U1 (en) * | 1989-06-16 | 1989-08-03 | Dimitrov, Pentcho, Dr., 5270 Gummersbach, De | |
US5061274A (en) * | 1989-12-04 | 1991-10-29 | Kensey Nash Corporation | Plug device for sealing openings and method of use |
US5021059A (en) * | 1990-05-07 | 1991-06-04 | Kensey Nash Corporation | Plug device with pulley for sealing punctures in tissue and methods of use |
ES2030639T1 (en) * | 1990-09-21 | 1992-11-16 | Bioplex Medical B.V. | DEVICE FOR PLACING STYPTIC MATERIAL, IN CONCRETE IN A FIBROUS OR SPONJIFORM FORM ON PERFORATED BLOOD VESSELS, IN CONCRETE ARTERIES. |
US5391183A (en) * | 1990-09-21 | 1995-02-21 | Datascope Investment Corp | Device and method sealing puncture wounds |
US5108421A (en) * | 1990-10-01 | 1992-04-28 | Quinton Instrument Company | Insertion assembly and method of inserting a vessel plug into the body of a patient |
US5129882A (en) * | 1990-12-27 | 1992-07-14 | Novoste Corporation | Wound clotting device and method of using same |
US5221259A (en) * | 1990-12-27 | 1993-06-22 | Novoste Corporation | Wound treating device and method of using same |
US5310407A (en) * | 1991-06-17 | 1994-05-10 | Datascope Investment Corp. | Laparoscopic hemostat delivery system and method for using said system |
NL9101051A (en) * | 1991-06-18 | 1993-01-18 | Ashridge Ag | CLOSING DEVICE FOR A VESSEL OR THE LIKE. |
US5290310A (en) * | 1991-10-30 | 1994-03-01 | Howmedica, Inc. | Hemostatic implant introducer |
US5292332A (en) * | 1992-07-27 | 1994-03-08 | Lee Benjamin I | Methods and device for percutanceous sealing of arterial puncture sites |
-
1991
- 1991-08-16 US US07/746,339 patent/US5391183A/en not_active Expired - Lifetime
- 1991-09-12 AU AU83847/91A patent/AU656534B2/en not_active Expired
- 1991-09-13 CA CA002051360A patent/CA2051360C/en not_active Expired - Lifetime
- 1991-09-18 DE DE69123817T patent/DE69123817T2/en not_active Expired - Lifetime
- 1991-09-18 EP EP91115844A patent/EP0482350B1/en not_active Expired - Lifetime
- 1991-09-18 AT AT91115844T patent/ATE146664T1/en not_active IP Right Cessation
- 1991-09-18 DK DK91115844.2T patent/DK0482350T3/en active
- 1991-09-18 ES ES91115844T patent/ES2098292T3/en not_active Expired - Lifetime
- 1991-09-20 AR AR91320717A patent/AR247087A1/en active
- 1991-09-20 BR BR919104042A patent/BR9104042A/en not_active IP Right Cessation
- 1991-09-21 JP JP24211191A patent/JP3228965B2/en not_active Expired - Lifetime
- 1991-09-23 MX MX9101223A patent/MX9101223A/en unknown
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1993
- 1993-05-10 US US08/058,358 patent/US5437631A/en not_active Expired - Lifetime
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1994
- 1994-10-05 US US08/318,380 patent/US5830130A/en not_active Expired - Lifetime
- 1994-10-05 US US08/318,381 patent/US5591204A/en not_active Expired - Lifetime
-
1996
- 1996-09-12 US US08/712,772 patent/US5725498A/en not_active Expired - Lifetime
- 1996-09-12 US US08/712,774 patent/US5741223A/en not_active Expired - Lifetime
- 1996-12-17 US US08/768,236 patent/US5948425A/en not_active Expired - Lifetime
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2001
- 2001-06-21 JP JP2001187827A patent/JP3475185B2/en not_active Expired - Fee Related
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JP3475185B2 (en) | 2003-12-08 |
CA2051360A1 (en) | 1992-03-22 |
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JP2002058673A (en) | 2002-02-26 |
US5437631A (en) | 1995-08-01 |
EP0482350A2 (en) | 1992-04-29 |
AU8384791A (en) | 1992-03-26 |
BR9104042A (en) | 1992-05-26 |
EP0482350A3 (en) | 1992-07-22 |
DK0482350T3 (en) | 1997-03-17 |
US5830130A (en) | 1998-11-03 |
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