Puncture locating system with blood pulsation indicator

Abstract

Disclosed are puncture sealing systems and methods of locating a puncture site within a vessel. The systems can include elongated dilators and access sheaths that are configured to locate the puncture site within a vessel so that the position of the puncture site relative to a distal end of the access sheath is known during a puncture sealing procedure.

What is claimed: 
     
         1 . A method for locating a puncture in a blood vessel of a patient, the method comprising:
 inserting a distal end of a dilator over a proximal end of a guidewire that extends out of the puncture in the blood vessel; and   moving the dilator along the guidewire in a distal direction until blood in the blood vessel flows through an inlet opening of the dilator and into an internal volume at least partially defined by a flexible barrier carried by the dilator, such that, the flexible barrier repeatedly pulses in response to pressure pulsations of blood in the blood vessel, thereby generating a visual and tactile indication of presence of the inlet opening in the blood vessel.   
     
     
         2 . The method of  claim 1 , inserting a guidewire through the puncture into the blood vessel so that the distal end of the guidewire is inside the blood vessel and the guidewire extends out of the puncture. 
     
     
         3 . The method of  claim 1 , wherein the dilator has a plurality of markings, and further comprising:
 retracting the dilator in a proximal direction along the guidewire until the flexible barrier no longer pulses; and   noting a marking of the plurality of markings on the dilator that is adjacent to a surface of a patient's skin when flexible barrier no longer pulses.   
     
     
         4 . The method of  claim 3 , wherein the plurality of markings on the dilator are a first plurality of markings, and the marking is a noted first marking, wherein the method further comprises:
 removing the dilator from the puncture along the guidewire;   moving an access sheath along the guidewire toward the puncture, the access sheath defining a distal end, a proximal end, and a second plurality of markings disposed between the distal end and the proximal end of the access sheath, the second plurality of markings corresponding to the first plurality of markings of the dilator; and   further moving the access sheath along the guidewire until the distal end of the access sheath enters the blood vessel and until a marking of the second plurality of markings on the access sheath that corresponds to the noted first visible marking on the dilator is a first visible marking of the access sheath that is adjacent to the patient's skin.   
     
     
         5 . The method of  claim 1 , after moving the dilator along the guidewire, performing a surgical procedure in the blood vessel. 
     
     
         6 . The method of  claim 5 , comprising the steps of, prior to performing the surgical procedure in the blood vessel includes:
 inserting a procedural sheath into puncture;   inserting a surgical device into the procedural sheath; and   removing the surgical device and procedural sheath from the blood vessel.   
     
     
         7 . The method of  claim 1 , wherein the dilator includes a proximal end spaced from the distal end along a central axis and an outer surface, wherein the outer surface of the dilator defines an outer cross-sectional dimension that is substantially perpendicular to the central axis, wherein the outer cross-sectional dimension is at least 2.50 mm. 
     
     
         8 . The method of  claim 1 , wherein the in pulsations in the blood flow cause the flexible barrier to pulse outwardly, thereby generating the visual and tactile indication of presence of the inlet opening in the blood vessel. 
     
     
         9 . A method for locating a puncture in a blood vessel of a patient, the method comprising:
 inserting a distal end of a dilator over a proximal end of a guidewire that extends out of the puncture of the blood vessel; and   moving the dilator along the guidewire in a distal direction until blood in the blood vessel flows through an inlet opening of the dilator and into an internal volume at least partially defined by a blood pulsation indicator overlying an outlet opening of the dilator, whereby the blood pulsation indicator repeatedly pulses in response to pressure pulsations of blood in the blood vessel, thereby generating a visual and tactile indication of presence of the inlet opening in the blood vessel.   
     
     
         10 . The method of  claim 9 , inserting a guidewire through the puncture into the blood vessel so that the distal end of the guidewire is inside the blood vessel and the guidewire extends out of the puncture. 
     
     
         11 . The method of  claim 9 , wherein the dilator has a plurality of markings, and further comprising:
 retracting the dilator in a proximal direction along the guidewire until the blood pulsation indicator no longer pulses; and   noting a marking of the plurality of markings on the dilator that is adjacent to a surface of a patient's skin when flexible barrier no longer pulses.   
     
     
         12 . The method of  claim 11 , wherein the plurality of markings on the dilator are a first plurality of markings, and the marking is a noted first marking, wherein the method further comprises:
 removing the dilator from the puncture along the guidewire;   moving an access sheath along the guidewire toward the puncture, the access sheath defining a distal end, a proximal end, and a second plurality of markings disposed between the distal end and the proximal end of the access sheath, the second plurality of markings corresponding to the first plurality of markings of the dilator; and   further moving the access sheath along the guidewire until the distal end of the access sheath enters the blood vessel and until a marking of the second plurality of markings on the access sheath that corresponds to the noted first visible marking on the dilator is a first visible marking of the access sheath that is adjacent to the patient's skin.   
     
     
         13 . The method of  claim 9 , after moving the dilator along the guidewire, performing a surgical procedure in the blood vessel. 
     
     
         14 . The method of  claim 13 , comprising the steps of, prior to performing the surgical procedure in the blood vessel includes:
 inserting a procedural sheath into puncture;   inserting a surgical device into the procedural sheath; and   removing the surgical device and procedural sheath from the blood vessel.   
     
     
         15 . The method of  claim 9 , wherein the dilator includes a proximal end spaced from the distal end along a central axis and an outer surface, wherein the outer surface of the dilator defines an outer cross-sectional dimension that is substantially perpendicular to the central axis, wherein the outer cross-sectional dimension is at least 2.50 mm. 
     
     
         16 . The method of  claim 9 , wherein the in pulsations in the blood flow cause the blood pulsation indicator to pulse outwardly, thereby generating the visual and tactile indication of presence of the inlet opening in the blood vessel. 
     
     
         17 . A method for locating a puncture in a blood vessel of a patient, the method comprising:
 inserting a guidewire through the puncture into the blood vessel so that a distal end of the guidewire is inside the blood vessel and the guidewire extends out of the puncture;   inserting a distal end of a dilator over a proximal end of the guidewire; and   moving the dilator along the guidewire in a distal direction until blood in the blood vessel flows through an inlet opening of the dilator and into an internal volume at least partially defined by a blood pulsation indicator carried by the dilator, such that the blood pulsation indicator repeatedly pulses in response to pressure pulsations of blood in the blood vessel, thereby indicating presence of the inlet opening in the blood vessel.   
     
     
         18 . The method of  claim 17 , wherein the dilator has a plurality of markings, and further comprising:
 retracting the dilator in a proximal direction along the guidewire until the blood pulsation indicator no longer pulses; and   noting a marking of the plurality of markings on the dilator that is adjacent to a surface of a patient's skin when flexible barrier no longer pulses.   
     
     
         19 . The method of  claim 18 , wherein the plurality of markings on the dilator are a first plurality of markings, and the marking is a noted first marking, wherein the method further comprises:
 removing the dilator from the puncture along the guidewire;   moving an access sheath along the guidewire toward the puncture, the access sheath defining a distal end, a proximal end, and a second plurality of markings disposed between the distal end and the proximal end of the access sheath, the second plurality of markings corresponding to the first plurality of markings of the dilator; and   further moving the access sheath along the guidewire until the distal end of the access sheath enters the blood vessel and until a marking of the second plurality of markings on the access sheath that corresponds to the noted first visible marking on the dilator is a first visible marking of the access sheath that is adjacent to the patient's skin.   
     
     
         20 . The method of  claim 19 , wherein the in pulsations in the blood flow cause the blood pulsation indicator to pulse outwardly, thereby generating the visual and tactile indication of presence of the inlet opening in the blood vessel.