Retracting Unit Transforms Vascular Puncture Into Slit
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Solution Overview
Problem
Current methods for closing large bore vascular punctures, such as those required for complex interventional procedures, face challenges in effectively sealing large vascular access sites without causing vascular stenosis, especially when using plugs, sutures, or clips, which are often limited to smaller sizes and may not be suitable for larger diameters like the femoral vein.
Innovation Solution
A medical apparatus and method that involves a retracting unit to transform the puncture site into a slit-like aperture, allowing for the deployment of closing devices that stretch the perforation orthogonally to the vessel axis and secure it with clips or staples along this stretch, thereby avoiding circular closure that could lead to stenosis.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If plugs, sutures, or clips are used to close large bore vascular punctures, then closure of the aperture is achieved, but vascular stenosis may occur due to circular closure
Solution Approach 1:
The invention transforms the circular aperture into an asymmetric slit-like shape by retracting the tissue edges laterally. This asymmetric configuration allows the closing device to secure the aperture in a non-circular manner, preventing the radial compression that causes vascular stenosis while maintaining effective closure.
Solution Approach 2:
The invention addresses the closure problem by moving from a two-dimensional circular closure to a three-dimensional configuration where the aperture is transformed into a slit extending through the tissue. This dimensional change allows the closing device to engage the tissue in a manner that prevents stenosis while achieving secure closure.
2Reliability
If traditional closing devices are used, then small punctures can be closed, but they are not suitable for large diameters like the femoral vein
Solution Approach 1:
The closing device is divided into multiple segments or components that can be deployed sequentially or simultaneously to engage the tissue around large bore punctures. This segmentation allows the device to adapt to larger diameters while maintaining the mechanical advantage needed for secure closure.
Solution Approach 2:
The closing device incorporates dynamic elements that allow it to expand or adjust its configuration to match the size of the aperture. This dynamic adaptability enables the same device to effectively close both small and large bore punctures, including those in the femoral vein.
3Reliability
If the aperture is closed in a circular manner, then the puncture is sealed, but the risk of vascular stenosis increases
Solution Approach 1:
The invention deliberately creates an asymmetric slit-like closure pattern instead of a symmetric circular closure. This asymmetric configuration seals the aperture effectively while distributing the tissue compression in a manner that preserves vascular patency and prevents stenosis.
Solution Approach 2:
Instead of closing the aperture by compressing it radially inward in a circular manner, the invention inverts the approach by laterally retracting the tissue edges to create a slit, then securing this retracted configuration. This inverted closure mechanism achieves sealing while avoiding the stenosis-causing radial compression.
Data Source
AI summary
The present invention relates to a medical apparatus for closing an aperture, an incision, a puncture, a passage through tissue and/or a communication with a blood vessel or other body lumen (short: aperture) of a tissue of a patient, the medical apparatus comprising a closing device holder, for releasably receiving one or more closing devices; and a retracting unit to come into contact with opposite sides of the aperture and for retracting them and/or for spreading the aperture causing it to change its shape into a slit or a slit-like or a more slit-like aperture or to spread or to augment the dimension or diameter of the aperture in at least one or in exactly one dimension of the aperture.