Abstract: A suture securing system is provided for use in closing a vessel puncture site while eliminating the need for sutures to be manually tied in knots. The system may include an elongate body comprising a shaft and a barrel slidably mounted on the shaft. A knot replacement element may include an outer surface and an inner lumen configured to receive suture lengths. The knot replacement element may be at least partially positioned within the distal end of the barrel adjacent to the distal portion of the shaft and may be configured to selectively fasten the suture lengths together over the vessel repair site. The system may also include a snare configured to draw the suture lengths through the knot replacement element and at least a portion of the elongate body. A trimmer member may be configured to selectively trim the suture lengths extending from the knot replacement element.

Abstract: A closure device configured for closing an opening in a body lumen. The closure device may include a delivery sheath, a cleat, and one or more anchors. The cleat may be disposed within and move longitudinally with respect to the delivery sheath. The one or more anchors may be configured to engage tissue surrounding the body lumen opening and selectively couple to the cleat to obstruct and/or close the body lumen opening.

Abstract: Devices for closing a passage through tissue communicating with a body lumen. The device may include an elongate body, a sheath disposed at the distal end of the device for disposition within a body lumen, a hollow needle disposed within a needle lumen of the body, the needle being selectively advancable through the needle lumen, a suture-anchor ejection mandrel disposed within the hollow needle that is also selectively advancable through the hollow needle, a suture-anchor and suture disposed within the hollow needle, a distal end of the suture attached to the suture anchor for ejection out the hollow needle by the mandrel. A needle guide disposed between the sheath and proximal end of the body may include a needle port through which the needle can exit. A hemostatic plug is disposed over the needle port so as to be penetrated by the needle upon exiting the port.

Abstract: A suture clip having a top surface and an opposing bottom surface with a perimeter sidewall extending therebetween. An aperture extends completely through the clip between the top and bottom surfaces to form a slot. The slot extends into the clip from a mouth at a periphery on a first end of the clip to divide the clip into first and second lateral portions that are separated at the first end but connected at a second end of the clip. The slot is bounded by opposing inner sidewalls of the first and second lateral portions extending between the top and bottom surfaces of the clip. The clip has a sufficient resilient force to allow a suture to be slid into the slot and has a sufficient clamping force to retain the suture in place within the slot once a desired positioned of the suture has been attained.

Abstract: An introducer needle for accessing a body lumen includes an annular-shaped body having a distal end and a proximal end, a leading edge formed on the distal end, and a slot defined in the leading edge and extending proximally from the distal end. In at least one example, the slot can include a first edge and a second edge, the first edge and the second edge each extending proximally from the leading edge and being separated by a central angle greater than 90 degrees and less than 360 degrees. The first end and the second edge are in continuous communication with the leading edge.

Abstract: A medical apparatus that includes a distal member, a needle disposed in the distal member and proximally advanceable from the distal member, and a needle capture portion positioned proximal to the distal member and which includes a through-hole to direct the needle from the needle capture portion towards a graspable member at a trajectory narrower than a trajectory of the needle from the distal member to the needle capture portion.

Abstract: The present disclosure includes vessel closure devices, systems, and methods. A closure device configured to close an opening in a body lumen may include an elongate member having a distal end and a proximal end. An anchor member may be disposed on the elongate member proximate the distal end of the elongate member. A cap member may also be disposed on the elongate member a distance from the distal end of the elongate member. The anchor member and the cap member cooperate to close the opening in the body lumen.

Abstract: An introducer needle for accessing a body lumen includes an annular-shaped body having a distal end and a proximal end, a leading edge formed on the distal end, and a slot defined in the leading edge and extending proximally from the distal end. In at least one example, the slot can include a first edge and a second edge, the first edge and the second edge each extending proximally from the leading edge and being separated by a central angle greater than 90 degrees and less than 360 degrees. The first end and the second edge are in continuous communication with the leading edge.

Abstract: An apparatus for suturing body lumens is provided. The apparatus includes a flexible elongated member that has a proximal end, a distal end, a central passage and multiple needle lumens extending from the proximal end toward the distal end. The flexible elongated member further includes an elongated subsection spanning from the end of the needle lumens in the elongated member to a barrel portion that includes corresponding needle lumens on the proximal end of the elongated member. The elongated subsection provides sufficient space between the needles and the barrel portion to allow transapical insertion of the elongated member into a body lumen. The apparatus further includes needles disposed within and advanceable from the needle lumens. The apparatus also includes a handle disposed at the proximal end of the elongated member. The handle is operable to retract the needles through the needle lumens toward the handle at the proximal end.

Abstract: An apparatus for suturing body lumens is provided. The apparatus includes a flexible elongated member that has a proximal end, a distal end, a central passage and multiple needle lumens extending from the proximal end toward the distal end. The flexible elongated member further includes an elongated subsection spanning from the end of the needle lumens in the elongated member to a barrel portion that includes corresponding needle lumens on the proximal end of the elongated member. The elongated subsection provides sufficient space between the needles and the barrel portion to allow transapical insertion of the elongated member into a body lumen. The apparatus further includes needles disposed within and advanceable from the needle lumens. The apparatus also includes a handle disposed at the proximal end of the elongated member. The handle is operable to retract the needles through the needle lumens toward the handle at the proximal end.

Abstract: A device for penetrating occlusive material in a body lumen is provided that may include an outer tube, an intermediate tube, and an inner tube. At least a portion of the intermediate tube may be moveably disposed within the outer tube. At least a portion of the inner tube may be moveably disposed within the intermediate tube. A first dynamic member may be operably connected to the intermediate tube and the inner tube. The first dynamic member may be configured to penetrate the occlusive material and to anchor the first dynamic member within the occlusive material. A second dynamic member may be operably connected to the outer tube and the intermediate tube. The second dynamic member may be configured to penetrate the occlusive material and to anchor the second dynamic member within the occlusive material and to support movement of the first dynamic member.

Abstract: A suture applying device includes a shaft which carries a pair of needles near its distal end. The needles are joined by a length of suture, and the shaft is used to both introduce the needles into a lumen of a body structure and to draw the needles back through tissue on either side of the puncture site. After the needles have passed through the tissue, they are captured by a needle receiver and drawn outward through the tract, leaving a loop of suture behind to close the puncture site near the body lumen. The suture can then be tied or otherwise secured to close the puncture site.

Abstract: A device configured as a knot pusher and/or a suture trimmer is provided. The device can deliver and secure a suture knot. The apparatus can also trim the suture after the suture knot is secured.

Abstract: An apparatus for occluding a venous or arterial puncture site is disclosed including a plug insertable within, or adjacent to, a puncture site in a wall of a body lumen. An insert is forced into an aperture within the plug to cause expansion thereof. The insert may be drawn into the aperture by applying tension to a line passing therethrough and secured to the insert. Barbs may secure to the plug to engage the wall of the body lumen or adjacent tissue tract. Elongate members passing through the wall of the plug may be forced outwardly into the wall of the body lumen or adjacent tissue as the insert is forced into the aperture.

Abstract: A suture applying device includes a shaft which carries a pair of needles near its distal end. The needles are joined by a length of suture, and the shaft is used to both introduce the needles into a lumen of a body structure and to draw the needles back through tissue on either side of the puncture site. After the needles have passed through the tissue, they are captured by a needle receiver and drawn outward through the tract, leaving a loop of suture behind to close the puncture site near the body lumen. The suture can then be tied or otherwise secured to close the puncture site.

Abstract: A catheter comprising a first lumen for receiving a guidewire and having an exit opening at a distal tip of the catheter. A second lumen, adjacent the first lumen and separated from the first lumen by a common wall, the second lumen configured for receiving contrast fluid, wherein perforations are formed in the common wall; a guidewire in the first lumen the guidewire being configured to be capable of advancement distally to extend out of the exit opening, the guidewire having two conditions: a first condition in which the guidewire is advanced distally to block the perforations whereby fluid may not flow from the second lumen to the first lumen; a second condition in which the guidewire is withdrawn proximally to unblock the perforations whereby fluid may flow from the second lumen into the first lumen and thence out of the exit opening.

Abstract: A needle removal device is provided for removing needles from suturing systems. In an embodiment, the needle removal device may include a base member configured to be selectively positioned substantially adjacent a proximal portion of a suturing system. The proximal portion of the suturing system may include a plurality of needle lumens. The needle removal device may also include a plurality of needle receptacles at least partially defined by the base member. The needle receptacles may be positioned and configured to generally correspond to the needle lumens of the suturing system. The needle receptacles may be further configured to selectively receive and grasp onto one or more needles extending proximally from the needle lumens of the suturing system.

Abstract: Suturing systems and needle removal devices for more efficiently removing needles from suturing systems are provide. In some embodiments, a suturing system guide body includes one or more needle lumens that transfer corresponding needles circumferentially around the guide body. Thus, when the needles exit the needle lumens at the proximal end of the guide body, the needles are in closer proximity to one another for removal. Other embodiments include various needle capture devices tools used for removing needles from a suturing system. Needle capture devices and tools can include needle receptacles positioned and configured to generally correspond to the needle lumens of the suturing system. The needle receptacles may be further configured to selectively receive and grasp onto one or more needles extending proximally from the needle lumens of the suturing system.

Abstract: A surgical device for suturing body lumen is described, as well as methods for suturing tissue employing the surgical device. The device can include a body having a shaft and a foot for insertion into an opening in a body lumen. The body can include tissue ports between the shaft and the foot configured to receive tissue of the body lumen surrounding the opening. The foot can include a suture secured to needle capture devices. Needle can be advanced within the shaft, through tissue within the tissue ports, and into the needle capture devices. The needle capture devices cuffs can then be withdrawn, thereby harvesting the suture, which can then be used to close the opening in the body lumen.

Abstract: Systems and methods for establishing hemostasis relative to a puncture in a lumen wall. A closure device includes a proximal portion and a distal portion. The proximal portion or distal portion rotates during deployment to either close a puncture or plug a puncture to establish hemostasis. A method includes positioning a closure device in a deployment device, positioning the closure device in the tissue tract, and actuating the deployment device to establish relative rotation between the distal portion and the proximal portion of the closure device.