Articulating suturing and device and method

Abstract

Devices, systems, and methods for suturing of body lumens allow the suturing of vascular puncture sites located at the distal end of a percutaneous tissue tract. An elongated articulated foot near a distal end of a shaft is inserted through the penetration and actuated so that the foot extends along the lumenal axis. The foot carries suturing attachment cuffs, and needles are advanced from the shaft through the vessel wall outside of the penetration and into engagement with the needle cuffs after the foot has been drawn proximally up against the endothelial surface of the blood vessel. The cross-section of the shaft within the tissue tract can be minimized by laterally deflecting the needles as they leave the shaft, while tapered depressions within the foot can guide the advancing needles into engagement with the cuffs. The cuffs lockingly engage the needles and can be withdrawn proximally along the needle paths and through the tissue tract so as to form a loop of suture across the puncture. The articulating foot may be realigned with the shaft and withdrawn proximally through the tissue tract without dilating the tissue tract.

1 - 13 . (canceled) 
     
     
         14 . A suture configuration comprising:
 a length of monofilament suture having a first end; and   a bight spaced from the first end, the bight being set to remain in a looped configuration.   
     
     
         15 . The suture configuration of  claim 14 , wherein the bight is a looped configuration that defines a clinch knot. 
     
     
         16 . The suture configuration of  claim 14 , wherein the length of monofilament suture includes a second end; wherein the bight includes a first loop, a second loop, and a third loop; and wherein the second end is wrapped to form the first loop, the second end is further wrapped to form the second loop transverse to the first loop, the second end is further wrapped in an opposite direction relative to the first loop to form the third loop, and the second end is further routed through the second loop. 
     
     
         17 . The suture configuration of  claim 16 , wherein the first loop comprises a plurality of loops wrapped in the same direction.