Abstract: A solution is provided to push a knot and/or cut a suture using a housing having a tip, a first side and a second side, the first side and the second side having a recessed center. The housing further has at least one slit positioned at the tip, and a blade moveable between retracted and extended positions, and positioned within the housing such that the blade passes through the slit as it is moved from the retracted position to the extended position within the slit. A notch may be positioned at the tip to push the knot to a desired position.

Abstract: An apparatus to puncture a blood vessel has an elongate body portion having a first end, a second end, and a lumen. A pusher member is received by the lumen and a gentle flow tip is coupled to the second end. A blade is in communication with the pusher member, wherein the blade is positioned around the outer curvature of the gentle flow tip.