# US 10,499,893 B2 · Apparatus and methods for sealing a vascular puncture > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,499,893 B2 - Document ID: US10499893B2 - Status: Granted - Kind: B2 - Application number: 15/662,506 - Filed: 2017-07-28 - Published: 2018-01-11 - Granted: 2019-12-10 - Earliest claimed: 2012-03-23 - Assignees: AccessClosure, Inc. - Applicants: Accessclosure, Inc. - Inventors: Ronald R. Hundertmark; Andy H. Uchida; David L. Fiscella; Moshe Zilversmit; Brandon R. Fell; Vincent Ku; Curt Guyer; Richard E. Repp; Mark Sponsel - Web page: https://patentgrep.com/patent/US10499893B2 ## CPC - A61B 17/0057: {Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect (sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009)} - A61B 2017/00367: {Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like} - A61B 2017/00557: {inflatable (A61B2017/22051 takes precedence)} - A61B 2017/00623: {Introducing or retrieving devices therefor} - A61B 2017/0065: {the implement being an adhesive} - A61B 2017/00654: {entirely comprised between the two sides of the opening} - A61B 2017/00672: {Locating means therefor, e.g. bleed back lumen} - A61B 2017/22067: {Blocking; Occlusion (A61B2017/22054 takes precedence)} - A61B 2017/22069: {Immobilising; Stabilising} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract An apparatus for sealing a puncture through a vessel wall including a positioning assembly, a sheath releasably engaged with the positioning assembly, and a support member axially advanceable through the sheath. The positioning assembly includes a positioning element positioned at a distal portion of the positioning assembly and a sealant disposed at a distal portion of the positioning assembly. The sheath guides the sealant and positioning assembly to the puncture in the vessel wall. ## Claims ### Claim 1 A method for sealing an arteriotomy in a vessel, the method comprising: positioning an apparatus relative to an arteriotomy, the apparatus comprising: a positioning assembly comprising an elongate member and a positioning element at a distal portion of the elongate member; a sealant disposed at a distal portion of the positioning assembly; a support tube proximal to the sealant; and a positioning assembly retraction lock provided in a first position that prevents the positioning assembly from moving proximally relative to the support tube; exposing the sealant; tamping the sealant by distally advancing the support tube, wherein distal advancement of the support tube moves the positioning assembly retraction lock to a second position that allows at least a portion of the positioning assembly to move proximally relative to the support tube; retracting the positioning element from the sealant by withdrawing at least a portion of the positioning assembly proximally while the support tube maintains the position of the sealant; and retracting the positioning assembly and the support tube from the arteriotomy, leaving the sealant to seal the arteriotomy. ### Claim 2 (depends on 1) The method of claim 1, wherein the step of positioning the apparatus relative to the arteriotomy comprises: inserting a distal end of the apparatus into the arteriotomy until the positioning element is within the vessel having the arteriotomy; and withdrawing the positioning element within the vessel until the positioning element abuts the arteriotomy. ### Claim 3 (depends on 2) The method of claim 2, further comprising: expanding the positioning element prior to withdrawing the positioning element within the vessel; and reducing a cross-section of the positioning element prior to retracting the positioning element from the sealant. ### Claim 4 (depends on 3) The method of claim 3, further comprising: locking the positioning element in an expanded state prior to withdrawing the positioning element within the vessel; and unlocking the positioning element to allow the cross-section of the positioning element to be reduced prior to reducing the cross-section of the positioning element. ### Claim 5 (depends on 2) The method of claim 2, wherein the sealant is exposed by retracting a sheath relative to the sealant. ### Claim 6 (depends on 1) The method of claim 1, wherein the steps are performed in the order recited. ### Claim 7 (depends on 1) The method of claim 1, wherein retracting the positioning element from the sealant occurs after tamping the sealant. ### Claim 8 (depends on 1) The method of claim 1, wherein the apparatus comprises a handle and the handle is configured such that tamping the sealant can be performed using a single hand. ### Claim 9 (depends on 1) The method of claim 1, wherein tamping the sealant is performed by actuating a support tube actuator. ### Claim 10 (depends on 9) The method of claim 9, wherein actuating the support tube actuator moves the positioning assembly retraction lock to the second position. ### Claim 11 (depends on 1) The method of claim 1, wherein retracting the positioning element is performed by actuating a positioning assembly retraction actuator. ### Claim 12 (depends on 11) The method of claim 11, wherein actuating the positioning assembly retraction actuator is prevented when the positioning assembly retraction lock is in the first position. ### Claim 13 A method for sealing an arteriotomy in a vessel, the method comprising: inserting a distal end of an apparatus into an arteriotomy, the apparatus comprising: a positioning assembly comprising an elongate member and a positioning element at a distal portion of the elongate member; a sealant disposed at a distal portion of the positioning assembly; a support tube proximal to the sealant; and a positioning assembly retraction lock provided in a first position that prevents the positioning assembly from moving proximally relative to the support tube; wherein the positioning element is positioned within the vessel having the arteriotomy; expanding the positioning element; locking the positioning element in an expanded state; withdrawing the positioning element within the vessel until the positioning element abuts the arteriotomy; exposing the sealant; tamping the sealant by distally advancing the support tube, wherein distal advancement of the support tube moves the positioning assembly retraction lock to a second position that allows at least a portion of the positioning assembly to move proximally relative to the support tube; unlocking the positioning element to allow a cross-section of the positioning element to be reduced; reducing the cross-section of the positioning element; retracting the positioning element from the sealant by withdrawing at least a portion of the positioning assembly proximally while the support tube maintains the position of the sealant; and retracting the positioning assembly and the support tube from the arteriotomy, leaving the sealant to seal the arteriotomy. ### Claim 14 (depends on 13) The method of claim 13, wherein the sealant is exposed by retracting a sheath relative to the sealant. ### Claim 15 (depends on 13) The method of claim 13, wherein the steps are performed in the order recited. ### Claim 16 (depends on 13) The method of claim 13, wherein retracting the positioning element from the sealant occurs after tamping the sealant. ### Claim 17 (depends on 13) The method of claim 13, wherein the apparatus comprises a handle and the handle is configured such that tamping the sealant can be performed using a single hand. ### Claim 18 (depends on 13) The method of claim 13, wherein tamping the sealant is performed by actuating a support tube actuator. ### Claim 19 (depends on 18) The method of claim 18, wherein actuating the support tube actuator moves the positioning assembly retraction lock to the second position. ### Claim 20 (depends on 13) The method of claim 13, wherein retracting the positioning element is performed by actuating a positioning assembly retraction actuator. ### Claim 21 (depends on 20) The method of claim 20, wherein actuating the positioning assembly retraction actuator is prevented when the positioning assembly retraction lock is in the first position.