Vascular access to closure sheath and methods

#The present disclosure relates generally to medical devices and more particularly to sheath devices for providing access through a tissue wall.

#Various surgical procedures are routinely carried out intravascularly or intraluminally. For example, in the treatment of vascular disease, such as arteriosclerosis, it is a common practice to invade the artery and insert an instrument (e.g., a balloon or other type of catheter) to carry out a procedure within the artery. Such procedures usually involve the percutaneous puncture of the artery so that an insertion sheath can be placed in the artery and thereafter instruments (e.g., catheters) can pass through the sheath and to an operative position within the artery. Intravascular and intraluminal procedures unavoidably present the problem of stopping the bleeding at the percutaneous puncture after the procedure has been completed and after the instruments (and any insertion sheaths used therewith) have been removed. Bleeding from puncture sites, particularly in the case of femoral arterial punctures, is typically stopped by utilizing vascular closure devices, such as those described in U.S. Pat. Nos. 6,090,130 and 6,045,569, which are hereby incorporated in their entireties by this reference.

#Prior closure devices, such as the ones described in the above-mentioned patents, place an anchor inside the vessel to provide a backstop against which a sealing member that is positioned outside the vessel can be compressed. In some instances, a particular shaped insertion sheath is used to help position the anchor within the vessel. This insertion sheath may be different from the insertion sheath used for procedures related to treating the patient prior to sealing closed the vessel puncture with the vascular closure device.

#The accompanying drawings illustrate various embodiments of the present disclosure and are a part of the specification. The illustrated embodiments are merely examples and do not limit the scope of the invention.

#FIG. 1 is a perspective view of an example insertion sheath according to the present disclosure.

#FIG. 2 is a perspective view of a portion of the insertion sheath of FIG. 1 with a procedural instrument extending from a distal end of the insertion sheath.

#Throughout the drawings, identical reference numbers designate similar, but not necessarily identical, elements.

#As mentioned above, vascular procedures are conducted throughout the world and require access to a vessel through a puncture. Often, the artery is a femoral artery. Typically, a procedural insertion sheath is used to provide access into the vessel through the puncture for instruments and devices used to treat the patient. Such instruments and devices may include, for example, catheters or guidewires that pass through a lumen defined by the procedural insertion sheath. The lumen size is usually maximized to provide easier passage of the procedural instruments through the procedural insertion sheath for a given puncture size.

#Some types of vascular closure devices include an anchor member that is positioned within the vessel. The anchor is usually intended to remain in the vessel (intraluminal) at least while the puncture in the vessel is sealed closed. Some insertion sheaths used with such vascular closure devices include a monofold structure at a distal end of the insertion sheath. The monofold structure provides an obstruction to return passage of an anchor member into the insertion sheath after the anchor has been deployed distally from the insertion sheath. The distal end of the insertion sheath, due in part to the monofold structure, may provide a surface against which the anchor engages to rotate the anchor into a position generally parallel with the internal wall of the vessel. The anchor may then anchor against the vessel wall when the insertion sheath is retracted from the puncture.