Apparatus and methods for sealing a vascular puncture

A method for sealing a puncture extending through tissue to a body lumen, comprising:

• introducing a tubular sheath into the puncture until a distal end of the sheath extends into the body lumen;
• introducing a positioning member into the puncture until a positioning element on the positioning member is disposed within the body lumen;
• expanding the positioning element within the body lumen;
• at least partially withdrawing the positioning member from the puncture until the expanded positioning element contacts the wall of the body lumen adjacent the puncture;
• introducing a cartridge into the puncture through the sheath, the cartridge carrying a plug therein and a pusher member proximal to the plug;
• at least partially withdrawing the cartridge and the sheath while maintaining the pusher member substantially stationary to expose the plug to bodily fluid within the puncture;
• and
• withdrawing the positioning member and the pusher member from the puncture, leaving the plug within the puncture adjacent the body lumen,
• wherein the cartridge is introduced into the puncture over the positioning member until the pusher member passes over a feature on the positioning member that prevents the pusher member from being retracted proximally, and wherein the feature prevents the pusher member from retracting proximally when the cartridge is at least partially withdrawn to expose the plug to bodily fluid within the puncture.

A method for sealing a puncture extending through tissue to a body lumen using a cartridge carrying a plug therein, the method comprising:

• introducing a distal end of a positioning member into the puncture until a positioning element on the distal end is disposed within the body lumen, while the cartridge and plug are disposed on a proximal end of the positioning member;
• expanding the positioning element within the body lumen;
• withdrawing the positioning member until the expanded positioning element contacts a wall of the body lumen adjacent the puncture;
• introducing the cartridge and plug into the puncture over the positioning member;
• and
• at least partially withdrawing the cartridge while preventing the plug from moving proximally to expose the plug within the puncture,
• wherein the cartridge is introduced into the puncture over the positioning member until a pusher member passes over a feature on the positioning member that prevents the pusher member from being retracted proximally, and wherein the pusher member prevents the plug from moving proximally while the cartridge is at least partially withdrawn to expose the plug within the puncture.

A method for sealing a puncture extending through tissue to a body lumen, comprising:

• providing a positioning member comprising a positioning element on a distal end thereof, a cartridge on the positioning member, the cartridge comprising a proximal end, a distal end disposed adjacent the positioning element, a lumen extending between the proximal and distal ends, and a plug within the cartridge lumen;
• introducing the distal end of the positioning member into the puncture until the positioning element and the cartridge distal end are disposed within the body lumen;
• expanding the positioning element within the body lumen;
• withdrawing the positioning member until the expanded positioning element contacts a wall of the body lumen adjacent the puncture;
• and
• at least partially withdrawing the cartridge to expose the plug within the puncture,
• wherein the cartridge is introduced into the puncture over the positioning member until a pusher member passes over a feature on the positioning member that prevents the pusher member from being retracted proximally, and wherein the pusher member prevents the plug from moving proximally while the cartridge is at least partially withdrawn to expose the plug within the puncture.