Apparatus and methods for positioning a vascular sheath

摘要

An apparatus for positioning an introducer sheath includes a sheath having a distal end including first and second ports, the second port being located distally from the first port. An obturator is slidable within the sheath that includes a distal region that sealingly engages an interior surface of the sheath. The obturator includes first and second openings in the distal region that are alignable with the first and second ports in the sheath. A housing is slidable on the exterior of the sheath that releasably holds a closure element. The sheath may be inserted into an incision communicating with a blood vessel, the first and second ports providing backbleed indication of the depth of the insertion of the sheath into the vessel. The housing is actuated to deploy the closure element to engage and close the incision.

主权项

1. An apparatus for accurately positioning a sheath in order to deliver a vascular closure element into engagement with a puncture site in a blood vessel, the apparatus comprising:
a sheath having a proximal end that terminates in a proximal opening, an external side port at or near the proximal end for providing visual confirmation of bleed back, a distal end that terminates in a distal opening, a lumen extending between the proximal and distal openings formed by a wall of the sheath, and a plurality of ports in fluid communication with the lumen and disposed at a location on the sheath to be used for positioning the sheath in relation to the puncture site of the blood vessel; a housing slidably cooperating with the sheath, the housing releasably holding a vascular closure element and being slidably actuable to move the vascular closure element into position to engage with tissue adjacent the puncture site of the blood vessel; and an elongate member insertable into the lumen of the sheath, the elongate member comprising a distal end of the elongate member that contacts the wall of the sheath to seal the lumen to prevent blood from entering the lumen from the distal opening but does not obscure the plurality of ports so that blood can continue to enter the plurality of ports in order to flow through the lumen and exit the external side port, to provide visual confirmation of bleed back, indicating that the sheath is correctly positioned in relation to the puncture site of the blood vessel to permit correct deployment of the vascular closure element, the distal end of the elongate member contacting the wall of the sheath and sealing the lumen of the sheath and also being distal the distal end of the sheath as the housing slidably cooperates with the sheath to move the vascular closure element, the vascular closure element including tines configured to pierce the blood vessel.