Suture securing systems, devices and methods

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.

1 . A suture securing system for use in closing a vessel puncture site while eliminating the need for suture lengths to be manually tied in knots, the system comprising:
 an elongate body comprising a shaft and a barrel, the shaft having a proximal end and a distal portion, the barrel having a proximal end and a distal end comprising an opening, the barrel being mounted on the shaft such that the shaft can slide relative to the barrel, the elongate body being configured for insertion through a tissue tract to position the distal end of the barrel adjacent the vessel puncture site;   a knot replacement element having an outer surface and an inner lumen extending therethrough, the inner lumen being configured to receive the suture lengths, the knot replacement element being at least partially positioned within the distal end of the barrel adjacent to the distal portion of the shaft and being configured to selectively fasten the suture lengths together over the vessel repair site;   a snare having an elongate portion and a snare portion, the snare being configured to draw the suture lengths through the inner lumen of the knot replacement element and at least a portion of the elongate body; and   a trimmer member configured to selectively trim the suture lengths extending proximal of the knot replacement element.   
     
     
         2 . The system of  claim 1 , wherein the shaft includes an access lumen configured to receive the trimmer member and the snare, the trimmer member being slidably mounted within the access lumen, the access lumen extending between a first opening at the proximal end of the shaft and a second opening in the distal portion of the shaft. 
     
     
         3 . The system of  claim 2 , wherein the distal portion of the shaft includes a ramped surface configured to guide the snare between the opening of the knot replacement element and the second opening of the access lumen. 
     
     
         4 . The system of  claim 2 , wherein the opening of the knot replacement element and the second opening of the access lumen are offset. 
     
     
         5 . The system of  claim 2 , wherein the snare is configured to draw the suture lengths proximally through the knot replacement element, into the first opening of the access lumen, and out of the second opening of the access lumen. 
     
     
         6 . The system of  claim 1 , wherein the shaft is configured to selectively eject the knot replacement element from the barrel. 
     
     
         7 . The system of  claim 1 , wherein the knot replacement element is moveable between a first position and a second position wherein the knot replacement element is fastened on the suture lengths. 
     
     
         8 . The system of  claim 7 , wherein the shaft is configured to move the knot replacement element to the second position. 
     
     
         9 . The system of  claim 1 , wherein the barrel includes one or more side ports formed in a wall of the barrel, each of the one or more side ports being in communication with the distal end of the barrel. 
     
     
         10 . The system of  claim 9 , wherein the trimmer member is slidably mounted on the barrel, the trimmer member being moveable between a first position wherein a cutting element of the trimmer member is proximal to the one or more side ports of the barrel and a second position wherein the cutting element of the trimmer member is distal to the one or more side ports of the barrel. 
     
     
         11 . The system of  claim 1 , wherein the knot replacement element comprises a coiled wire having a plurality of coils forming loops of varying diameters, the knot replacement element being moveable between a first position wherein the suture lengths may be looped in and out of the coils and a second position wherein the coils are compressed together to fasten the suture lengths between the coils. 
     
     
         12 . The system of  claim 11 , wherein the shaft is configured to move the knot replacement element from the first position to the second position. 
     
     
         13 . The system of  claim 11 , wherein the coils of the knot replacement element have friction producing elements. 
     
     
         14 . The system of  claim 1 , wherein the knot replacement element comprises a ring having a proximal surface forming a locking edge, a distal surface, the opening of the knot replacement element being tapered and extending between the proximal surface and the distal surface. 
     
     
         15 . The system of  claim 14 , wherein the suture lengths include steps formed therein, the steps being configured to lock on the locking edge of the knot replacement element when a proximal force is applied to the knot replacement element. 
     
     
         16 . The system of  1 , wherein the opening of the knot replacement element is cross-shaped. 
     
     
         17 . The system of  claim 1 , further comprising a collet attached to the distal portion of the shaft, the collet being configured to selectively hold and crimp the knot replacement element onto the suture lengths over the repair site in body tissue. 
     
     
         18 . The system of  claim 17 , wherein the collet comprises a pair of elongate members separated by a predetermined gap, the gap being configured to receive at least a portion of the knot replacement element, each of the pair of elongate members having a semi-circular portion having chambered edges. 
     
     
         19 . The system of  claim 17 , wherein the distal end of the barrel includes a hollow conical portion associated with the collet, the conical portion being configured such that distal movement of the collet within the conical portion compresses the collet to crimp the knot replacement element onto the suture lengths. 
     
     
         20 . The system of  claim 17 , further comprising an actuator configured to actuate the collet. 
     
     
         21 .- 41 . (canceled)