SEC FORM 4

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

QUACKENBUSH JAMES

(Last)

(First)

(Middle)

6464 SYCAMORE COURT

(Street)

MINNEAPOLIS

55369

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
VASCULAR SOLUTIONS INC [ VASC ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
	VP of Manufacturing

3. Date of Earliest Transaction (Month/Day/Year)
11/11/2009

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock								27,974⁽¹⁾	D
Common Stock	11/11/2009		M⁽²⁾		1,000	A	$0.84	27,974⁽³⁾	D
Common Stock	11/11/2009		J		1,000	D	$7.91	27,974	D

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)		5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Stock Option (Right to Buy)	$2.51							⁽⁴⁾	10/19/2011	Common Stock	5,000		5,000	D
Stock Option (Right to Buy)	$0.84	11/11/2009		M⁽²⁾			1,000	⁽⁴⁾	02/18/2013	Common Stock	24,500⁽⁵⁾	$0	23,500	D
Stock Option (Right to Buy)	$0.084							⁽⁴⁾	02/18/2013	Common Stock	2,500⁽⁵⁾		2,500	D
Stock Option (Right to Buy)	$0.84							⁽⁴⁾	02/18/2013	Common Stock	10,000⁽⁵⁾		10,000	D
Stock Option (Right to Buy)	$0.84							⁽⁴⁾	02/18/2013	Common Stock	10,000		10,000	D
Stock Option (Right to Buy)	$0.84							⁽⁴⁾	02/18/2013	Common Stock	15,000		15,000	D
Stock Option (Right to Buy)	$6.74							⁽⁴⁾	01/27/2014	Common Stock	15,000		15,000	D
Stock Option (Right to Buy)	$9.46							⁽⁴⁾	01/28/2015	Common Stock	15,000		15,000	D

Explanation of Responses:

1. Increase from last filing represents 204 shares acquired under the Vascular Solutions Employee Stock Purchase Plan for the period ending October 31, 2009 at $5.27/share.

2. Exercise and sale of shares at direction of former spouse.

3. Acquisition of shares not reported in total as the reporting person does not retain pecuniary interest in the shares. See footnote 4.

4. 100% fully vested.

5. Reporting person does not own the economic benefit of and disclaims ownership of 6,435, 791, and 900 options from the 24,500, 2,500 and 10,000 options respectively. The options are held in constructive trust on behalf of his former spouse pursuant to a divorce decree issued in 2000.

	/s/ James Quackenbush	11/13/2009
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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