Systems and methods for puncture closure

Abstract

Systems, apparatuses and methods are provided for use in closing punctures in vessel walls. An apparatus may have various combinations of an anchoring device, a positioning device and a heating element for closing a puncture within a vessel wall. An anchoring device may be a balloon, an expansible cage, a wire operated T-anchor, and/or a floating anchor. A positioning device may be a balloon, a sponge, and/or an expansible cage. A heating element may be flexible or rigid and preferably provides heat to target tissue through conduction and convection. A heating element may be flat-ended or dome-shaped. The heating element and anchoring device may be positioned a fixed distance apart to sandwich tissue between the heating element and the anchoring device. The heating element may operate in multiple stages. An initial stage may non-permanently adhere the heating element to the tissue and the subsequent stage may close the puncture.

1 . An apparatus for closing a puncture in a vessel wall comprising:
 an anchor shaft,   an anchor coupled to a distal end of the anchor shaft wherein the anchor is deployed within a vessel lumen and moved into contact with an inner surface of a vessel wall,   a heating element for passing over the anchor shaft to a position a predetermined distance from the anchor, wherein the heating element is not within the vessel lumen, and   wherein tissue is compressed between the anchor and the heating element during activation of the heating element.   
     
     
         2 . The apparatus of  claim 1 , wherein the anchor is selected from the group consisting of a balloon, a T-anchor, an expansible cage, a floating anchor, and combinations thereof. 
     
     
         3 . The apparatus of  claim 1 , further comprising a positioning device passing over the anchor shaft. 
     
     
         4 . The apparatus of  claim 3 , wherein the positioning device is selected from the group consisting of a balloon, a sponge, an expansible cage, and combinations thereof. 
     
     
         5 . The apparatus of  claim 1 , wherein the heating element is selected from the group consisting of flat-ended, dome-shaped, flattened dome-shaped, and combinations thereof. 
     
     
         6 . The apparatus of  claim 1 , wherein the heating element comprises a patterned conducting element. 
     
     
         7 .- 30 . (canceled) 
     
     
         31 . A method of closing a puncture in a vessel wall comprising:
 providing an apparatus comprising:
 an anchor shaft, 
 an anchor coupled to a distal end of the anchor shaft, and 
 a heating element, 
   inserting the distal end of the anchor shaft into a vessel lumen through a puncture,   deploying the anchor within the vessel lumen,   inserting the heating element into the vicinity of the puncture,   initially heating the heating element for minimally adhering tissue to the heating element,   withdrawing the anchor device through the heating element,   completely activating the heating element, and   withdrawing the heating element.   
     
     
         32 . The method of  claim 31 , further comprising sandwiching tissue between the anchor and the heating element. 
     
     
         33 . The method of  claim 31 , wherein the anchor is selected from the group consisting of a balloon, a T-anchor, an expansible cage, a floating anchor, and combinations thereof. 
     
     
         34 . The method of  claim 31 , wherein the heating element is selected from the group consisting of a flat-ended heating element, a dome-shaped heating element, a flattened dome-shaped heating element, and combinations thereof. 
     
     
         35 .- 52 . (canceled) 
     
     
         53 . A method of closing a puncture in a vessel wall comprising:
 providing an apparatus comprising:
 an anchor shaft, 
 an anchor coupled to a distal end of the anchor shaft, 
 a pass-through device at least partially surrounding the anchor shaft, and 
 a heating element, 
   inserting the distal end of the anchor shaft into a vessel lumen through a puncture,   deploying the anchor within the vessel lumen,   inserting the heating element into the vicinity of the puncture by passing the heating element through the pass-through device,   withdrawing the pass-through device after positioning the heating element,   activating the heating element,   withdrawing the anchor, and   withdrawing the heating element.   
     
     
         54 . The method of  claim 53 , wherein the pass-through device is withdrawn by applying pressure away from a distal end of the anchor shaft. 
     
     
         55 . The method of  claim 53 , wherein activating the heating element comprises initially heating the heating element for minimally adhering tissue to the heating element, and secondarily heating the heating element. 
     
     
         56 . The method of  claim 55 , wherein the anchor is withdrawn through the heating element between the initial heating and the secondary heating. 
     
     
         57 . The method of  claim 53 , further comprising sandwiching tissue between the anchor and the heating element. 
     
     
         58 . The method of  claim 53 , wherein the anchor is selected from the group consisting of a balloon, a T-anchor, an expansible cage, a floating anchor, and combinations thereof. 
     
     
         59 . The method of  claim 53 , wherein the heating element is selected from the group consisting of a flat-ended heating element, a dome-shaped heating element, a flattened dome-shaped heating element, and combinations thereof. 
     
     
         60 . The method of  claim 53 , further comprising inserting a guide wire into the vessel lumen with the anchor. 
     
     
         61 . The method of  claim 60 , further comprising measuring position of the heating element with the guide wire.