System and method for vessel access closure

Abstract

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

1 . A method for closing a hole in a wall of a vessel, the vessel defining a vascular lumen, comprising the steps of:
 a. inserting a guidewire having proximal and distal ends through the hole and into said lumen;   b. inserting over the guidewire and through the hole (i) an elongate deployment member housing an implantable closure device having proximal and distal ends and being expandable from a collapsed state to an expanded state, the expanded state providing a geometry sufficient to substantially occlude the hole and (ii) then first inserting the distal end of said closure device through said hole and into said lumen until the proximal end of said closure device passes through said hole and into said lumen;   c. positioning the collapsed state of the implantable closure device adjacent the wall of the vessel in a configuration wherein the collapsed implantable closure device spans the hole from within the vascular lumen;   d. deploying a catch member configured to extend away from the proximal end of the closure device to prevent withdrawal of the closure device in its collapsed state through the hole;   e. expanding said closure device; and   f. withdrawing said deployment member and leaving behind said closure device.   
     
     
         2 . The method of  claim 1 , further comprising inserting an introducer sheath through the hole, the introducer sheath defining an introducer lumen sized to accommodate insertion of the deployment member and the closure device in its collapsed state. 
     
     
         3 . The method of  claim 1 , wherein said deployment member has a proximal portion configured for manual manipulation and a distal portion configured to be removably coupled to the implantable closure device. 
     
     
         4 . The method of  claim 1 , further comprising rotating the collapsed closure device relative to the deployment member to place the closure device into a deployment position having a rotated orientation selected to prevent withdrawal of the closure device back out of the hole when the deployment member is withdrawn. 
     
     
         5 . The method of  claim 1 , further comprising urging the expanded implantable closure device toward the hole, wherein the expanded state is configured to contact at least 90 degrees of an inner surface of the vessel adjacent the hole relative to a longitudinal axis of the vascular lumen, and to restrict fluids from exiting the vascular lumen through the hole. 
     
     
         6 . The method of  claim 1 , wherein the closure device is a self-expanding structure configured to expand itself from the collapsed state to the expanded state when not restrained in the collapsed state. 
     
     
         7 . The method of  claim 6 , wherein a deployment tensile element is removably coupled to said closure device and said expanding step comprises moving a portion of the deployment tensile element relative to the self-expanding structure to allow the self-expanding structure to expand itself to the expanded state. 
     
     
         8 . A method for closing a hole in a wall of a vessel, the vessel defining a vascular lumen, comprising:
 a. inserting a guidewire having proximal and distal ends through the hole and into said lumen;   b. inserting over the guidewire and through the hole (i) an elongate deployment member housing an implantable closure device having proximal and distal ends and being expandable from a collapsed state to an expanded state, the expanded state providing a geometry sufficient to substantially occlude the hole and (ii) then first inserting the distal end of said closure device through said hole and into said lumen until the proximal end of said closure device passes through said hole and into said lumen;   c. positioning the collapsed state of the implantable closure device adjacent the wall of the vessel in a configuration wherein the collapsed implantable closure device spans the hole from within the vascular lumen;   d. deploying a catch member configured to extend away from the proximal end of the closure device to prevent withdrawal of the closure device in its collapsed state through the hole;   e. expanding said closure device;   f. withdrawing said deployment member and leaving behind said closure device and at least a distal portion of said guidewire;   g. controllably moving the catch member to a retracted configuration wherein the catch member is movably coupled to and aligned with the deployment member;   h. wherein controllably moving the catch member comprises manually advancing or retracting the catch member relative to the deployment member; and   i. wherein the catch member is cantilevered and coupled to a manually advanceable portion, the advanceable portion being approximately aligned with a longitudinal axis of the deployment member and configured to pull the catch member into alignment with the advanceable portion with increased advancement of the advanceable portion.   
     
     
         9 . The method of  claim 8 , wherein the advanceable portion comprises proximal and distal ends, and wherein the catch member is coupled to the advanceable member at a coupling point in between the proximal and distal ends of the advanceable portion and is directed away from the deployment member at the coupling point through an aperture in the deployment member.