Vascular closure methods and apparatuses

Abstract

A vascular closure device comprised of a sheath-delivered cincture or noose-like device or knot comprised of suture, wire, or other suitable materials, that is placed on the external surface of a puncture wound, and closed. The vascular closure cincture is delivered by a sheath, and after closing is left resident on the external surface of a tissue puncture wound.

1 - 25 . (canceled) 
     
     
         26 . A method of closing an opening in tissue, comprising:
 everting the edges of the opening;   placing a device proximal the everted edges, the device comprising:
 a delivery sheath; 
 a cincture element, removably mounted with the delivery sheath, defining an opening within the cincture element that has a first size when the cincture element is mounted with the delivery sheath, and can assume a second size, smaller than the first, when the cincture element is not mounted with the delivery sheath; 
   removing the cincture element from the delivery sheath such that the cincture element substantially surrounds the everted edges; and   causing the cincture element to assume the second size.   
     
     
         27 . The method of  claim 26 , wherein the cincture element comprises an elongated flexible structure having a one-way fastener mounted therewith, which fastener is operable from a second end of the delivery sheath, and wherein removing the cincture element from the delivery sheath and causing the cincture element to assume the second size comprises operating the one-way fastener. 
     
     
         28 . The method of  claim 27 , wherein the one-way fastener comprises a slipknot. 
     
     
         29 . The method of  claim 26 , wherein a knot is associated with the cincture element. 
     
     
         30 . The method of  claim 29 , further comprising a cylindrical member disposed within the sheath, wherein causing the cincture element to assume the second size comprises withdrawing the cincture through the cylindrical member. 
     
     
         31 . The method of  claim 30 , wherein withdrawing the cincture through the cylindrical member further comprises preventing passage of the knot through the cylindrical member. 
     
     
         32 . A method of closing an opening in tissue, comprising:
 everting the edges of the opening;   placing a device proximal the everted edges, the device comprising:
 a delivery sheath; 
 a cincture element, removably mounted with the delivery sheath, defining an opening within the cincture element that has a first size when the cincture element is mounted with the delivery sheath, and can assume a second size, smaller than the first, when the cincture element is no mounted with the delivery sheath; 
   moving the delivery sheath and the cincture element relative to each other such that delivery sheath is not mounted within the cincture element and the everted edges are substantially within the cincture element; and   causing the cincture element to assume the second size.   
     
     
         33 . The method of  claim 32 , wherein the one-way fastener mounts with a second elongated member that extends from the one-way fastener through a lumen interior to the delivery sheath to the second end of the delivery sheath. 
     
     
         34 . The method of  claim 32 , wherein the cincture element comprises an elongated flexible structure having a one-way fastener mounted therewith, which fastener is operable from a second end of the delivery sheath, and wherein removing the cincture element from the delivery sheath and causing the cincture element to assume the second size comprises operating the one-way fastener. 
     
     
         35 . The method of  claim 34 , wherein the one-way fastener comprises a slipknot. 
     
     
         36 . A method of closing an opening in tissue, comprising:
 everting the edges of the opening;   placing a device proximal the everted edges, the device comprising:
 a delivery sheath; and 
 a cincture element, removably mounted to the delivery sheath, defining an opening that has a first size when the cincture element is mounted with the delivery sheath, and can assume a second size, smaller than the first, when the cincture element is no mounted with the delivery sheath; and 
   moving the delivery sheath and the cincture element relative to each other such that cincture element is not mounted to the delivery sheath and the everted edges are substantially within the cincture element.   
     
     
         37 . The method of  claim 36 , further comprising moving the cincture element from the first size to the second size. 
     
     
         38 . The method of  claim 37 , wherein moving the cincture element comprises moving a plurality of grippers together to hold the opening closed. 
     
     
         39 . The method of  claim 37 , wherein moving the cincture element comprises moving an end of the cincture element through a knot. 
     
     
         40 . The method of  claim 37 , wherein the cincture element includes two ends and wherein moving the cincture element comprises moving both of the two ends through a knot. 
     
     
         41 . The method of  claim 37 , wherein moving the cincture element comprises moving a portion of the cincture element relative to dentates to lock the cincture element. 
     
     
         42 . The method of  claim 37 , wherein the cincture element comprises a plurality of strands of material and moving the cincture element comprises moving the plurality of strands to close the opening. 
     
     
         43 . The method of  claim 37 , wherein moving the delivery sheath and the cincture element relative to each other detaches the cincture element from the delivery sheath, the cincture element contracting to close the opening. 
     
     
         44 . The method of  claim 43 , wherein the cincture element comprises a memory material. 
     
     
         45 . The method of  claim 43 , wherein moving the cincture element forms a star shape upon contracting to close the opening.