Suture based vascular closure apparatus and method incorporating a pre-tied knot

A vascular closure device, comprising:

• an anchor configured to extend through an opening in a blood vessel, the anchor being configured to move between a contracted configuration where the anchor is sized to fit through the opening in the blood vessel and an expanded configuration where the anchor is too large to fit through the opening in the blood vessel;
• a snare configured to be inserted through a wall of the blood vessel at a location that is laterally adjacent to the opening in the blood vessel, the snare comprising a loop portion;
• a suture and a needle combination configured to be inserted through the wall of the blood vessel at another location that is laterally adjacent to the opening, the loop portion of the snare also being configured to receive the suture and needle combination after the snare and the suture and needle combination are inserted through the wall of the blood vessel and to grasp the suture in the blood vessel and retract the suture through the wall of the blood vessel;
• wherein the vascular closure device is configured to close the opening in the blood vessel.

A method of closing a vascular opening utilizing a vascular closure device comprising:

• inserting a sheath into a vessel through a vessel opening;
• inserting a snare into the vessel on a first side of and laterally adjacent the vessel opening, the snare comprising a loop portion;
• inserting a needle with a suture into the vessel on a second side of and laterally adjacent the vessel opening;
• positioning the needle with the suture inside the loop portion of the snare after inserting the snare and the needle with suture into the vessel;
• grasping the suture with the loop portion of the snare;
• pulling the suture across the vessel opening and through the vessel on the first side of the vessel opening;
• directing the distal end of the suture through a pre-tied knot formed at a proximal end of the suture to create a knot to approximate tissue surrounding the vessel opening.

A vascular closure device, comprising:

• a needle positioned at a distal end of the vascular closure device, the needle being configured to move between a retracted position and an extended position;
• a suture having a free end configured to move with the needle from the retracted position to the extended position, wherein a portion of the suture extends lengthwise from a tip of the needle toward a proximal end of the vascular closure device, the portion of the suture being positioned outside of the needle;
• and
• a pre-tied knot positioned at a proximal end of the vascular closure device;
• a snare comprising a loop portion;
• wherein the vascular closure device is configured to pass the loop portion of the snare through a wall of the blood vessel at a first location on the wall laterally adjacent to a tissue puncture, pass the suture and the needle through the wall of the blood vessel at a second location on the wall laterally adjacent to the tissue puncture, and then pass the suture and needle into the loop portion, the loop portion of the snare being configured to grasp the suture at a location spaced from the free end and retract the suture through the wall of the blood vessel and on through the pre-tied knot to approximate tissue surrounding an opening in the blood vessel.

A method of closing an opening in a blood vessel with a vascular closure device, comprising:

• inserting a needle and a suture together through a wall of the blood vessel at a location that is adjacent to the opening;
• inserting a snare through the wall of the blood vessel at another location that is adjacent to the opening, the snare comprising a loop portion;
• positioning the needle and the suture within the loop portion of the snare after the needle and suture and the snare are inserted through the wall of the blood vessel;
• grasping the suture with the loop portion of the snare after removing the needle from within the loop portion;
• withdrawing the suture through the wall of the blood vessel;
• and
• tightening the suture to close the opening in the blood vessel.

A vascular closure device, comprising:

• a first needle and a second needle both of which are configured to move between a retracted position and an extended position relative to a sheath;
• a suture and a suture pusher configured to move with the first needle from the retracted position to the extended position;
• a snare configured to move with the second needle from the retracted position to the extended position, the snare including a wire loop having a memory that causes the wire loop to open in a repeatable orientation;
• and
• a pre-tied knot disposed on a proximal end of the suture such that a distal end of the suture can be directed through the pre-tied knot to approximate tissue surrounding a vascular opening;
• the, suture pusher, suture and first needle being positionable inside the wire loop of the snare after the first and second needles move to the extended position;
• wherein the wire loop grasps the suture after the first needle and the suture pusher are removed from inside the wire loop.

A method of closing a vascular opening utilizing a vascular closure device comprising:

• inserting a sheath into a vessel through a vessel opening;
• inserting a snare into the vessel at a first location laterally adjacent to the vessel opening, the snare including a wire loop;
• inserting a suture with a needle into the vessel at a second location laterally adjacent to the vessel opening;
• inserting the suture with the needle into the wire loop;
• extending the wire loop across the vessel opening to grasp the suture;
• pulling the suture across the vessel opening and through the vessel on the first side of the vessel opening;
• directing the distal end of the suture through a pre-tied knot formed at a proximal end of the suture to create a knot to approximate tissue surrounding the vessel opening.