WO2012163880A1

WO2012163880A1 - Medical implant for arrangement within a hollow body, in particular an aneurysm, and method for producing a medical implant

Info

Publication number: WO2012163880A1
Application number: PCT/EP2012/059944
Authority: WO
Inventors: Giorgio Cattaneo
Original assignee: Acandis Gmbh & Co. Kg
Priority date: 2011-05-31
Filing date: 2012-05-29
Publication date: 2012-12-06
Also published as: DE102011102955A1; DE102011102955B4

Abstract

The invention relates to a medical implant for arrangement within a hollow body, said implant comprising a lattice consisting of first wires, each of which runs in a first direction R1 in the interior of the lattice and second wires, each of which runs in a second direction R2 in the interior of the lattice and which intersects the first wires to form meshes in the lattice. The lattice takes the form of a sail and has a lattice border comprising smooth external edges, each of which is formed by the first and/or second wires and which delimit the lattice braid on at least four sides. Each of the first and second wires is diverted via diverter points at the transition from the lattice interior into the external edges, and individual wires of the first and second wires are fed to the external edges from the lattice interior such that the number of wires forming each external edge successively changes along the external edge. The wires which are diverted at the lattice edge are only diverted into smooth external edges. The invention also relates to a method for producing a medical implant.

Description

Medical implant for placement within a hollow body, in particular an aneurysm, and method for producing a medical implant

description

The invention relates to a medical implant for placement within a hollow body, in particular an aneurysm, according to the preamble of patent claim 1. Such a medical implant is known, for example, from WO

99/05977 AI known. Furthermore, the invention relates to a method for producing a medical implant.

The aforementioned WO 99/05977 Al discloses a device for closing an aneurysm, in particular a Occiusionsdevice comprising a substantially plate or parabolic grating structure. The grid structure has first wires that extend in a spoke-like manner from a central point. Further, second wires are provided, which extend annularly around the center of the dish-shaped grid structure and intersect to form meshes with the first wires.

The known Occiusionsdevice is connected to a feeder and in particular compressible in a catheter. Via the catheter, the known occlusion device is guided to the treatment site, in particular an aneurysm. Within the aneurysm, the occlusion device is released from the catheter, with the plate-shaped structure spanning. The Occiusionsdevice is placed in the aneurysm so that the aneurysm neck, so the opening of the aneurysm to the adjacent blood vessel is closed. This ensures that the blood flow within the aneurysm is reduced or completely stopped. The blood in the aneurysm clots or coagulates, so that a further expansion of the aneurysm with the risk of aneurysmal rupture is reduced.

Other devices for treating aneurysms that aim to occlude the aneurysm neck to prevent or at least reduce bleeding of blood into the aneurysm are disclosed in the references

WO 02/069783 A2, WO 2008/151204 A1, US Pat. No. 6,669,721 B1, US 2008/0221600 A1 and WO 97/26939 A1. However, the abovementioned occlusion devices have disadvantages in the treatment of already ruptured aneurysms or in aneurysms whose vascular walls are weakened. Ruptured aneurysms are aneurysms whose vessel wall is already broken, which can lead to uncontrolled bleeding. Often the rupture can be closed again by the formation of a blood clot, so that neurological damage is limited, especially in the case of bleeding in the cerebral area. However, the risk of a renewed aneurysmal rupture is very high. It is also known that a new rupture is associated with a high mortality. Ruptured aneurysms should therefore be treated medically.

A known treatment method is to support the formation of the largest possible blood clot in the rupture. It has been shown that the blood clots or thrombi forming in the aneurysm usually do not fill the entire aneurysm. Especially in the area of the aneurysm neck, a blood flow is still present, which prevents the further expansion of the clot. A further expansion of the blood clot is also undesirable because it may be associated with the risk of occlusion of the adjacent blood vessel.

The use of coils is a known treatment option for promoting thrombus formation within the aneurysm. Stents are often used to hold the coils within the aneurysm, especially in aneurysms that, due to their shape, do not provide sufficient support for the coils. The use of stents in the adjacent blood vessel, however, can promote thrombus formation in the bloodstream, so that usually a drug, antithrombotic treatment is required. However, the administration of antithrombogenic substances is extremely dangerous, especially in the presence of ruptured aneurysms, since the clot can be released due to the drug treatment.

Basically, it is useful in the use of implants that are used in the aneurysm neck or the adjacent blood vessel, for example, stents or flow diverters (flow diverter), from a medical point of view, a durable treatment with antithrombotic drugs to avoid vessel occlusion. At the same time, however, the risk of aneurysm rupture is increased. Classically, aneurysms are treated by inserting coils into the aneurysm. Coils are small, flexible wires that deform essentially freely within the aneurysm. The coils form tangles that contribute to influencing the blood flow in the aneurysm. The coils are preferably released in the area of the ruptured site of the aneurysm. The coils fill out a part of the aneurysm. In particular, the coils can be positioned so as to avoid protruding coils into the adjacent blood vessel. At the same time, however, the arrangement of the coils in the area of the rupture is dangerous, since the coils can move freely within the aneurysm, whereby the density of coils, ie the number of coils, is reduced in the area of the rupture. Thus, near the rupture unfavorable bloodstreams can develop, which can prevent the formation of a thrombus and thus promote a renewed rupture of the aneurysm. Due to the irregular rippling of the coils in the aneurysm, the influence of the coils on the flow is also difficult to predict. The curvature of the coils is largely dependent on the external environment, in particular the shape of the aneurysm, so that it is difficult to estimate how the blood flow within the aneurysm develops after use of a coil.

It is further proposed in the prior art to treat aneurysms by devices which have substantially a spherical geometry. Such devices are known for example from US 6,589,265 Bl, WO 2010/030991 AI, WO 99/08743 AI and WO 2007/006139 AI. The disadvantage of such spherical Occlusionsdevices is that they are difficult to adapt to the anatomy of the respective aneurysm. Thus, even in the case of spherical occlusion devices, similar to coils, there is the risk that part of the occlusion device protrudes into the bloodstream of the adjacent blood vessel and leads to clot formation there. Therefore, even with the use of such Occlusionsdevices a drug antithrombogenic treatment appropriate, which in turn increases the risk of rupture.

From DE 10 2006 050 385 AI an implantable device is further known, which has nested grid structures, wherein the device rivet-like closes a vessel wall opening in use.

The invention has for its object to provide a medical implant for placement within a hollow body, in particular an aneurysm, indicate that allows a reproducible flow influencing within the hollow body and reduces the risk of rupture. Furthermore, it is the object of the invention to specify a method for producing a medical implant.

This object is achieved with regard to the device by the subject-matter of patent claim 1 and with regard to the method by the subject-matter of patent claim 16.

The invention is based on the idea to provide a medical implant for placement within a hollow body, in particular an aneurysm, with a mesh of first wires extending in the braid inside each in a first direction, and second wires, each in the braid inside in a second Direction and cross the first wires to form meshes of the grid mesh. The grid mesh has a gusset edge that includes smooth outer edges. The smooth outer edges are each formed by the first or second wires and define the grid mesh on at least four sides. The first wires and the second wires are each deflected at the transition from the braid inside to the outer edge such that the first wires along the outer edge in the second direction and the second wires along the outer edge in the first direction. The outer edges are each supplied with individual wires from the interior of the braid in such a way that the number of wires forming the respective outer edge changes successively along the outer edge. The wires, which are deflected at the edge of the fabric, are only deflected into smooth outer edges.

Preferably, the grid mesh is formed like a sail. In concrete terms, this means that the grid of the implant according to the invention, like a sail, has smooth outer edges and is substantially flat or flat. In this case, the gullet mesh further has a flexibility that allows adaptation of the mesh to the inner contour of the hollow body. The grid mesh may be designed in the form of a sail so that the grid mesh can assume a three-dimensional arched structure. The bubble-shaped lattice structure can thus curve over at least two axes arranged at an angle to each other, so that a total curvature sets. This corresponds figuratively to a sail inflated in the wind. The grid may also have a torsion or be flexible so that the grid mesh twisted or twisted. In essence, the mesh braid is flexible on different forms of hollow body adaptable or adapted so that the grid mesh over the entire surface of the wall of the hollow body applies.

The grid mesh has a gusset edge, in particular a circumferential gusset edge on. In particular, the mesh is limited on all sides by the edge of the mesh. The outer contour of the mesh is thus determined by the edge of the mesh. At least in sections, the edge of the fabric is formed by the smooth outer edges. The edge of the fabric can also be formed exclusively by smooth outer edges. In this way, an atraumatic tether edge is provided.

The wires, which are deflected at the edge of the fabric, are only deflected into smooth outer edges. In other words, only deflection points are arranged on the edge of the braid, which are each associated with a smooth outer edge. So no wires are deflected along the edge of the grid, without these wires are converted into a smooth outer edge. Those wires or wire sections that extend to the edge of the braid and are deflected at a deflection point, which is arranged on the edge of the braid, so are deflected only in smooth outer edges.

In principle, the invention can be used in all hollow bodies of the human organism. Preference is given to an insert in hollow bodies of the cardiovascular system. The invention may be specially adapted for placement in an aneurysm and / or a blood vessel. Advantageously, the implant can be used in sections of tubular or tubular blood vessels which have an opening in the vessel wall of the blood vessel. The opening may for example form an access opening to an aneurysm or a branch to a secondary vessel. The implant according to the invention can be arranged within the main vessel such that the opening, in particular the access opening to a secondary vessel, is closed or covered.

Furthermore, it can be provided in a preferred manner that the first wires and the second wires are deflected only in each case, in particular exclusively, in the transition from the interior of the braid into the outer edges. In particular, the first wires and the second wires can in each case in the braid inside between two spaced apart, in particular arranged in parallel, outer edges rectilinear, in particular directions change, run. In the process of the invention, two intersecting wires run in different directions when between the wires is formed an angle which is at least 25 °, in particular at least 30 °, in particular at least 45 °.

Advantageously, each of the outer edges of individual first wires or second wires from the braid interior are supplied such that the number of the respective outer edge forming wires along the outer edge changes successively. In other words, advantageously each individual outer edge can be formed only or exclusively from wires which run in the same direction inside the braid, in particular parallel to one another. The individual outer edges are thus formed either only by first wires or only by second wires, which are deflected in each case during the transition from the interior of the braid into the outer edge. The individual wires may be spaced apart in the interior of the braid, i. in the inner part of the braid, one mesh at a time. The individual wires are preferably not bundled in the interior of the braid to form a strand or a strand. Rather, the bundling into strands takes place only in the outer edge.

The implant according to the invention has the advantage that damage to the vessel wall is avoided by the smooth outer edges. In particular, when dismissing the implant within an aneurysm, injury to the vessel wall is avoided by the smooth outer edges, since the smooth outer edges can easily slide along the vessel wall. Due to the structure of the lattice mesh, which is preferably formed regularly, in particular an independent of the external circumstances flow influencing is achieved. Thus, in principle, it can be anticipated how the implant within the aneurysm affects blood flow, regardless of the shape of the aneurysm.

Furthermore, the implant has a comparatively high stability through the grid mesh or generally the grid structure, so that the implant can be used directly in the region of the rupture and additionally supports the aneurysmal wall. In contrast to the known occlusion devices, which occlude the aneurysm in the area of the opening to adjacent blood vessels, the implant according to the invention is well suited for placement directly in the area of rupture of the aneurysm, without risking a renewed aneurysmal rupture. In particular, the smooth outer edges act atraumatic.

According to a preferred embodiment of the implant according to the invention, the mesh has at least two corners, in each of which two outer edges are merged. The two outer edges merged in a corner have different directions. In particular, it is provided that in each case a corner of the mesh braid, a first outer edge, which runs in the first direction, ie parallel to the first wires of the mesh, meets a second outer edge, in the second direction, that is parallel to the second wires of the grid, runs. Preferably, the two outer edges are connected together in the corner.

In a preferred embodiment of the invention form two diametrically opposite arranged corners of the mesh braid reinforcing corners. The number of wires of the two outer edges, which are merged in the reinforced corner, can each increase in the direction of the reinforcement corner and be maximum in the reinforcement area. It is envisaged that along the outer edges of the mesh braid deflection points are arranged, at each of which a wire is deflected from the braid interior and the outer edge is supplied. Each outer edge preferably has a plurality of deflection points, which are arranged spaced from each other. At adjacent deflection points of the outer edge is thus supplied in each case a wire from the braid interior, so that along the outer edge successively, in particular from deflection to deflection, the number of wires forming the outer edge increases or decreases. In the preferred embodiment, the number of wires increases successively toward the reinforcement corner. This applies in a particularly advantageous manner for both outer edges, which are brought together in the reinforcement corner. In the area of the reinforcement corner, the number of wires that together form an outer edge is therefore maximum. Preferably, two reinforcing corners are provided, which are arranged diametrically opposite one another. This contributes to the stability of the mesh braid.

In general, the mesh or medical implant may be compressible, for example, to introduce the implant into a delivery system that brings the implant to the treatment site. The compression is preferably carried out by moving the reinforcement corners in opposite directions such that the reinforcement corners move away from each other. In this way, the grid mesh is stretched and thus compressed in total.

According to a further preferred embodiment of the implant according to the invention, it is provided that a holding element is arranged on at least one corner of the lattice braid, which is arranged to fix the lattice mesh in the aneurysm. fits. The holding element not only enables improved fixation of the implant in the aneurysm, but also accurate positioning. For example, the holding element may be partially arranged within the catheter when the mesh is already completely dismissed. The position of the grid can be adjusted exactly in this way.

The holding element may be connected to the first wires and / or the second wires. This has the advantage that the holding element can be produced separately. In particular, the holding element may comprise a different material, whereby the fixing function of the holding element is independent of the flexibility of the grid mesh adjustable.

Alternatively, the holding element may be made in one piece from the first wires and / or the second wires, in particular from a first wire and / or a second wire. As a result, the production of the implant is accelerated, as can be dispensed with an additional process step, namely the connection of the holding element with the grid mesh.

In a preferred embodiment, the first wires and / or the second wires continue beyond the corner of the mesh braid and are interconnected to form the retaining element. In particular, the first wires and / or the second wires can be twisted and / or coupled with a sleeve to form the retaining element. As the retaining elements continue beyond a corner of the mesh braid, a joining region is provided which allows easy connection of the retaining element to the wires of the mesh braid. Specifically, it may be provided that at least two wires, in particular a first wire and a second wire, which run in different directions, in particular form different outer edges, are brought together in one corner of the grid and, moreover, continue together. The continued wires can form the retaining element. Furthermore, the continued wires can also be used for connection to a separately produced holding element.

In a preferred variant of the invention, the holding element has a length which is at least the simple, in particular at least double, in particular at least triple, in particular at least quadruple, in particular at least five times, in particular at least seven times, in particular at least ten times, in particular at least fifteenfold, in particular dere at least twenty times, corresponds to the width of the mesh of the grid mesh. The meshes of the lattice mesh preferably have substantially the same size, in particular width, on. This is particularly preferred for all meshes of the mesh. In other words, in an advantageous embodiment, the mesh has a uniform braiding pattern or mesh pattern, with all meshes of the mesh mesh having substantially the same shape and / or the same dimensions. The width of a mesh corresponds to the distance between two parallel in the braid inside first or second wires that limit the mesh on two opposite sides. The wires running parallel inside the braid thus preferably have a constant, in particular over the whole grid mesh, like distance to one another. It is particularly preferred if the distance between the first wires, which extend in the first direction in the braid interior, and the distance between the second wires, which extend in the braid inside in the second direction, is the same. This essentially results in stitches with a diamond-like shape. The braiding pattern or mesh pattern of the lattice braid preferably extends as far as the outer edges of the lattice braid.

Specifically, the outer edges of the grid mesh together form a closed frame that limits the grid to all sides. Within the closed frame preferably only identically shaped and equal meshes are arranged.

In a preferred embodiment of the implant according to the invention, the grid mesh comprises a total of four corners. In each case two diametrically opposite arranged corners, in particular all corners, each having a holding element. In general, therefore, two or more holding elements may be provided, which are arranged at the corners of the grid mesh. The fixation and positioning of the implant in an aneurysm is further improved by the at least two retaining elements. This applies in particular to a grid mesh having four corners or two times two diametrically opposite corners, each comprising a holding element. Thus, in each case a holding element extends substantially in four different directions, so that the grid mesh can be fixed well in the aneurysm both in a longitudinal direction and in a transverse direction.

The grid may be curved in a state of rest about a longitudinal axis parallel to a connecting line between the two diametrically opposite Gend arranged reinforcing corners is arranged. In other words, the mesh may be precalculated due to the production. Due to the pre-curvature around the longitudinal axis, the stress that acts on the aneurysm wall by clamping the mesh or implant in an aneurysm is reduced.

The grid may be curved in a resting state about a transverse axis, which is arranged at right angles to the longitudinal axis. The curvature of the lattice mesh about the transverse axis is particularly advantageous because the reinforcement corners in the implanted state apply a relatively high force to the aneurysmal wall. Due to the production-related pre-curvature around the transverse axis, the pressure which the reinforcing corners apply to the aneurysm wall is reduced. The risk of injury to the aneurysmal wall or rupture of the aneurysm is thus further reduced.

In general, the grid may be substantially flat or flat at rest. However, the mesh is so flexible that it is in the

Use around the longitudinal axis and / or the transverse axis is curved. Overall, the mesh can take a three-dimensional, in particular sail-like, curvature by flexible properties. This allows the mesh to adapt to the contour of the aneurysm. It is also possible that the grid mesh is preformed or pre-curved or bulged in such a way that the grid mesh in the implanted state does not fully contact the aneurysmal wall. Rather, the grid mesh may be arranged in sections spaced from the aneurysm wall.

In a further preferred embodiment of the medical implant according to the invention, the holding element in each case has at least one core wire, which is connected to a first wire and / or a second wire at a corner of the grid mesh or integral with the first wire and / or the second wire. The core wire can be sheathed, at least in sections, by a coil. The sheathing of the core wire with a coil increases the flexibility of the retaining element. In this way, the adaptation of the retaining element to the contour of the aneurysm wall or generally vessel wall is improved.

With regard to the outer edges of the grid may be provided that at least one outer edge, in particular all outer edges, is formed by at least one reinforcing wire having a larger cross-sectional diameter than the has remaining wires of the grid mesh. The reinforcing wire may advantageously form a frame or a closed frame which limits the mesh to all sides. The grid may be stretched substantially on the framework or the frame. In particular, it can be provided that the reinforcing wire specifies the basic shape of the lattice braid. Preferably, the reinforcing wire has a cross-sectional diameter which is greater than the cross-sectional diameter of the remaining wires by at least 50%, in particular at least 100%. In general, the reinforcing wire increases the stability of the mesh, wherein the aforementioned cross-sectional diameter ratios for the overall relatively small dimensions of the implant according to the invention have proved to be particularly advantageous for increasing the stability.

According to a secondary aspect, the invention is based on the idea of providing a method for producing a medical implant, in particular an implant according to claim 1, with a pacifier-type mesh, comprising the following steps:

- Providing a wicker thorn;

Braiding at least one first wire and at least one second wire from a common first retaining pin of the braiding mandrel such that at least two smooth outer edges are formed;

- Redirecting the first wire and the second wire to one each

second and third retaining pin of the braiding mandrel, wherein the second retaining pin and the third retaining pin are arranged at the same height of the braiding mandrel;

Braiding the first wire and the second wire in the direction of a fourth retaining pin, which is arranged in the axial direction of the braiding mandrel spaced from the first retaining pin, such that two further, smooth outer edges are formed.

Preferably, the second retaining pin and the third retaining pin are arranged directly adjacent to each other. Specifically, the second retaining pin and the third retaining pin can almost touch, so that almost the entire circumferential extent of the braiding mandrel can be used to determine the width of the mesh braid. The invention will be explained in more detail below by means of embodiments with reference to the accompanying schematic drawings. Show in it

Fig. 1 is a plan view of an inventive medical

Implant according to a preferred embodiment;

Fig. 2 is a plan view of an inventive medical

Implant according to another preferred embodiment with four holding elements, which are formed from braided wires, which are connected to each other with a sleeve;

Fig. 3 is a plan view of an inventive medical

Implant according to a further preferred embodiment with four retaining elements having straps;

Fig. 4 is a plan view of an inventive medical

Implant according to another preferred embodiment with two holding elements, which are arranged at diametrically opposite corners of the grid mesh;

Fig. 5 is a side view of the medical implant according to

Fig. 3 in the implanted state within an aneurysm;

6 shows a side view of the medical implant according to FIG

Fig. 3 when released from a delivery system into an aneurysm;

FIG. 7 shows the medical implant according to FIG. 3 released from a catheter into an aneurysm, with more than half of the implant being released; FIG. FIG. 8 is a plan view of the medical implant of FIG. 1 in a bulging condition; FIG.

9 shows a side view of a medical implant according to the invention according to a further preferred embodiment when released from a catheter into an aneurysm, the mesh being bulged such that there is a gap between the aneurysm wall and the mesh;

FIG. 10 shows the medical implant according to FIG. 9 in the fully implanted state within an aneurysm; FIG.

Fig. 11 is a side view of the medical invention

Implant according to another preferred embodiment with a single holding element which is spirally arranged within an aneurysm;

12 is a side view of a medical implant according to the invention according to a further preferred embodiment with four holding elements, wherein one of the holding elements is guided by holding loops of the other holding elements;

13 is a side view of a medical implant according to the invention according to a further preferred embodiment with four retaining elements, wherein two diametrically opposed holding elements have a length such that the holding elements protrude into an adjacent blood vessel;

Fig. 14 is a plan view of an inventive medical

Implant according to a further preferred embodiment, wherein three holding elements are provided with straps and a further holding element having a sleeve; Fig. 15 is a plan view of an inventive medical

Implant according to another preferred embodiment, wherein a holding element is provided, which is coupled by a sleeve with wires of the grid mesh; and

Fig. 16 is a plan view of an inventive medical

Implant according to another preferred embodiment, wherein a holding element is provided with a coil which is integrally connected to the wires of the grid mesh.

The embodiments described below show a medical implant for placement within an aneurysm. Such implants may include, for example, occlusion devices or generally aneurysm sails. The implant comprises a mesh 10, which is formed from first wires 11 and second wires 12. The first wires run in the interior of the braid in each case in a first direction Rl. The second wires 12 each extend in the interior of the braid in a second direction R2. Preferably, a plurality of first wires 11 are provided, which extend in the first direction Rl, that are arranged parallel to each other. Likewise, a plurality of second wires 12 may be provided which extend in the second direction R2 or are arranged parallel to one another. The first wires 11 and the second wires 12 intersect in the braid interior of the grid mesh 10, whereby stitches 15 are formed. The stitches 15 are each bounded by two first wires 11 and two second wires 12. The mesh 10 has a plurality of meshes 15, which have substantially the same size, in particular the same mesh width. The mesh width is determined by the distance between two parallel wires 11, 12. Preferably, the stitches 15 are diamond-shaped so that the distance between two first wires 11 and two second wires 12 bounding the stitch 15 is the same.

The mesh 10 is formed as a sail. Specifically, the mesh 10 has a flexibility that allows adaptation of the mesh 10 to an aneurysmal wall. In the rest state, the mesh 10 may be flat or flat, in particular flat. In other words, the mesh 10 may have a planar structure to conform to the shape of the aneurysm 60 when implanted. The curvature of the lattice braid 10 can thus only take place within the aneurysm 60. It is also possible that the grid mesh 10 is bulged, that is, in the state of rest has a three-dimensional curvature or at least a two-dimensional curvature. The pearled mesh has smooth outer edges 21, 22, 23, 24 formed by the first wires 11 and / or the second wires 12, respectively. The mesh 10 in particular has four sides 31, 32, 33, 34, which are each formed as a smooth outer edge 21, 22, 23, 24. The mesh 10 is thus limited on four sides 31, 32, 33, 34 by smooth outer edges 21, 22, 23, 24.

The structural design of the outer edges 21, 22, 23, 24 is explained below:

The outer edges 21, 22, 23, 24 are smooth. This means that essentially no protruding edges, shoulders or projections are provided along the outer edges 21, 22, 23, 24. In particular, no projecting edges along the outer edge 21, 22, 23, 24 can be seen, which is greater than the wire diameter of the wires 11, 12.

The formation of the outer edges 21, 22, 23, 24 will be described by way of example with reference to the first outer edge 21 in FIG. 1. The construction of the individual outer edges 21, 22, 23, 24 is basically identical in all exemplary embodiments.

The first outer edge 21 of the lattice braid 10 according to FIG. 1 is formed by a total of four second wires 12, wherein three second wires 12 run in the braid inside in the second direction R2. The first direction R1 and the second direction R2 are shown in the figures by corresponding arrows. The first outer edge 21 extends in the first direction Rl.

Three of the second wires 12 extend in the interior of the braid in the second direction R2. Another second wire 12 extends along the second end edge 22 in the second direction R2. All four second wires 12 are deflected in the transition from the interior of the braid or from the second outer edge 22 into the first outer edge 21. Along the first outer edge 21 three deflection points 16 are provided, at which the second wires 12 are deflected from the second direction R2 in the first direction Rl. The deflection points 16 are arranged downstream of the first outer edge 21. The deflection of the second wires 12 into the first outer edge 21 is preferably carried out at the same angle, so that all deflected second wires te 12 along the first outer edge 21 in the same direction. In this way it is achieved that at each deflection point 16, the number of second wires 12 in the first outer edge 21 changes successively. Depending on the perspective, the number of second wires 12 in the first outer edge 21 increases or decreases.

At the deflection points 16, in each case a single first or second wire 11, 12 is deflected into the respective outer edge 21, 22, 23, 24. It is also possible for more than one first or second wire 11, 12 to be transferred into the outer edge 21, 22, 23, 24 at the individual deflection points. For example, at a deflection point 16 of the first outer edge 21, at least two second wires 12 can be deflected and transferred into the first outer edge 21. The same applies, for example, to the second outer edge 22, which may likewise have a deflection point 16, at which at least two first wires 11 are transferred into the second outer edge 22. Similarly, the third and fourth outer edge 23, 24 may each comprise one or more deflection points 16, on each of which two or more first or second wires 11, 12 are transferred into the outer edge. In general, therefore, at least two first or second wires 11, 12 can be deflected at a common deflection point 16 or at the same deflection point 16 and transferred into the respective outer edge 21, 22, 23, 24.

In essence, the construction of the individual outer edges 21, 22, 23, 24 corresponds to the structure of the braid end of the tubular or basket-shaped grid structure described in the post-published international patent application PCT / EP2010 / 007302. The aforementioned patent application, in particular pages 16 to 24 of the description, is hereby incorporated by reference into the disclosure of the present application.

The above-described structure of the first outer edge 21 applies to all outer edges 21, 22, 23, 24 mentioned in the context of this application. In this case, more than four first or second wires 11, 12 can be provided, which cover the respective outer edge 21, 22, 23 , 24 form. Concretely, in each case at least 8, in particular at least 16, in particular at least 24, first or second wires 11, 12 can be transferred into an outer edge 21, 22, 23, 24, respectively. Correspondingly, the number of deflection points 16 increases. In the figures, the change in the number of wires in the outer edges 21, 22, 23, 24 is shown by different line thicknesses. In the embodiment according to FIG. 1, it is provided that the mesh 10 has a diamond shape. In particular, the mesh 10 has four outer edges 21, 22, 23, 24, each extending between two corners 41, 42, 43, 44 of the mesh 10. The mesh 10 has a total of four corners 41, 42, 43, 44. Between the first corner 41 and the second corner 42 extends the first outer edge 21. The second outer edge 22 extends between the second corner 42 and the third corner 43. The third corner 43 and the fourth corner 44 define the third outer edge 23. The fourth outer edge 24 extends between the fourth corner 44 and the first corner 41. In other words, the fourth outer edge 24 and the first outer edge 21 meet in the first corner 41. The first outer edge 21 strikes the second outer edge 22 in the second corner 42. The second outer edge 22 in turn strikes the third outer edge 23 in the third corner 43. The third outer edge 23 strikes the fourth outer edge 24 in the fourth corner 44.

The first corner 41 and the third corner 43 are formed in the embodiment of FIG. 1 as reinforcing corners 45, 46. The first corner 41 forms a first reinforcement corner 45 and the third corner 43 forms a second reinforcement corner 46. The reinforcement corners 45, 46 are characterized in that the number of wires 11, 12 of the respective outer edges 21, 22, 23, 24, which in the reinforcing corners 45, 46 meet, in the direction of the respective reinforcing corner 45, 46 increases. In the reinforcement corners 45, 46 so is the maximum number of wires of the outer edges 21, 22, 23, 24 before. Concretely, for example, the first outer edge 21 and the fourth outer edge 24 are constructed so that the number of wires 11, 12, respectively fed from the braid interior to form the respective outer edge 21, 24 of the outer edge 21, 24, toward the first Corner 41 increased. In the region of the first corner 41, both the number of deflected second wires 12, which form the first outer edge 21, and the number of deflected first wires 11, which form the fourth outer edge 24, maximum. The first corner 41 thus forms the first reinforcement corner 45.

In the exemplary embodiment according to FIG. 1, a first or wire 11, 12 is in each case fed to the first or fourth outer edge 21, 24 at each deflection point 16. In the area of the first corner 41 or first reinforcement corner 45, the first outer edge 21 has a total of four second wires 12 and the fourth outer edge 24 a total of four first wires 11. Thus, in the first reinforcement corner 45, all the first wires 11 strike all the second wires 12. The same applies to the second reinforcement corner 46, which is formed analogously to the first reinforcement corner 45. In the embodiment of FIG. 1, the stitches 15 bounded by the first and second wires 11, 12 are substantially square in shape. Another diamond-like shape is possible.

In the embodiment shown in FIG. 1, a holding element 50 is further provided, which is arranged at a corner 41, 42, 43, 44 of the mesh 10. Specifically, it is provided that the wires 11, 12 of the second outer edge 22 and the third outer edge 23 continue beyond the third corner 43 and form a holding element. The continued over the third corner 43 wires 11, 12 are connected by a sleeve 55 together. The first and second wires 11, 12 of the second and third outer edges 22, 23 thus form beyond the third corner 43 also an extension, which can serve as a holding element 50. Alternatively, it can be provided that the extension 13 is connected by the sleeve 55 with an additional or separate holding element 50. The sleeve 55 in particular connects the open wire ends of the first wires 11 and the second wires 12.

The lattice braid 10 according to FIG. 1 can thus be formed in total from four first wires 11 and four second wires 12 whose wire ends are brought together in a single corner 41, 42, 43, 44 of the lattice braid 10 and form the extension 13. In general, the wire ends are brought together in a reinforcement corner 45, 46.

The embodiment according to FIG. 2 has essentially the same structure as the implant according to FIG. 1, at least concerning the interior of the braiding. In contrast to the exemplary embodiment according to FIG. 1, four retaining elements 50 are provided in the implant according to FIG. 2, which are each arranged at one of the four corners 41, 42, 43, 44 of the diamond mesh grid 10. In particular, it is provided that at the reinforcement corners 45, 46 respectively the wire ends of the first and second wires 11, 12 are brought together and form an extension 13. In the extension 13, the first and second wires 11, 12, in particular the wire ends, are connected to one another by a sleeve 55. In addition to the two reinforcement corners 45, 46, two further corners are provided, which are arranged diametrically opposite one another. The other corners are formed by the second corner 42 and the fourth corner 44. In the area of the second corner 42 and the fourth corner 44, a single first wire 11 and a single second wire 12 from different outer edges 21, 22, 23, 24 are brought together and set over the second one and fourth corner 42, 44, respectively. The first wire 11 and the second wire 12, which continues on the second and fourth corner 42, 44, respectively forms an extension 13. In particular, at the second corner 42 and the fourth corner 44 are each wire ends of the first wire 11 and second wire 12 is provided, which form the extension 13 and are connected by a sleeve 55.

FIG. 3 shows a further exemplary embodiment of the medical implant, the implant having four holding elements 50. In contrast to the embodiment according to FIG. 2, in which likewise four retaining elements 50 are provided, the retaining elements 50 according to FIG. 3 are not formed by open wire ends. Rather, the holding elements 50 according to FIG. 3 holding loops 53, which are formed by deflecting a wire 11, 12. Specifically, it can be provided that only in a single holding element 50 wire ends of the first wires 11 and the second wires 12 are arranged. For example, the support members 50 disposed on the reinforcement corners 45, 46 may include open wire ends of the first and / or second wires 11, 12. The holding elements arranged at the second corner 42 and the fourth corner 44 are preferably formed by a single wire which continues from an outer edge 21, 22, 23, 24 beyond the respective corner 42, 44, deflected in a retaining loop 53 and twisted. The individual wire forming the holding element 50 is subsequently continued into an adjacent outer edge 21, 22, 23, 24. For example, in the region of the second corner 42, a second wire 12 may be guided out of the second outer edge 22 into the holding element 50. The second wire 12 is deflected and forms a retaining loop 53. Starting from the retaining loop 53, the second wire 12 extends back to the second corner 42 and then merges into the first outer edge 21. Between the second corner 42 and the retaining loop 53, the second wire 12 is twisted. The same applies to the structure of the retaining element 50, which is arranged on the fourth corner 44.

FIG. 4 shows a further exemplary embodiment of the medical implant or occlusion device according to the invention, which likewise has four outer edges 21, 22, 23, 24, which are formed smooth. Analogous to the aforementioned embodiments, the outer edges 21, 22, 23, 24 of the mesh 10 are formed by deflected first or second wires 11, 12 along each outer edge 21, 22, 23, 24 such that the number of wires within the respective outer edge 21, 22, 23, 24 successively increased. In particular, the first and second wires 11, 12 of two adjacent outer edges 21, 22, 23, 24 in such Transition from the interior of the braid into the outer edge 21, 22, 23, 24 deflected, that the wire number of the two adjacent outer edges 21, 22, 23, 24 toward a common corner 41, 42, 43, 44 of the two outer edges 21, 22, 23rd , 24 increased. The common corner 41, 42, 43, 44 forms a reinforcing corner 45, 46, in which the number of wires is maximum.

The exemplary embodiment according to FIG. 4 differs from the preceding exemplary embodiments in that the outer contour of the lattice braid 10 is diamond-shaped in the preceding exemplary embodiments. The lattice braid 10 in this case has a diamond-shaped braid edge, which is only provided by the smooth outer edges

21, 22, 23, 24 is formed. The smooth outer edges 21, 22, 23, 24 are circumferentially connected to each other. In the previous embodiments, the mesh 10 has a total of four corners 41, 42, 43, 44. In the embodiment of FIG. 4, the gusset edge is not formed exclusively by smooth outer edges 21, 22, 23, 24. The outer edges 21, 22, 23, 24 form the edge of the mesh only in sections. In other words, at least two outer edges 21,

22, 23, 24 unconnected. The circumferential chain of outer edges 21, 22, 23, 24, as provided in Figures 1 to 3, in the embodiment of FIG. 4 so broken.

According to FIG. 4, the mesh 10 comprises six corners 41, 42, 42 ', 43, 44, 44'. Specifically, the mesh 10 according to FIG. 4, two reinforcing corners 45, 46 disposed diametrically opposite each other, over which wire ends of the first and second wires 11, 12 continue to form an extension 13, respectively. The wire ends are connected to each other in the extensions 13 by a sleeve 55. The mesh 10 according to the embodiment of FIG. 4 may have more than two extensions 13. In particular, further extensions 13 may be provided at the second corner 42, the fourth corner 44, the fifth corner 42 'and the sixth corner 44'. Preferably, all corners 41, 42, 42 ', 43, 44, 44' have an extension 13.

The first corner 41 of the mesh braid 10 is formed as a first reinforcement corner 45 and connects the fourth outer edge 24 with the first outer edge 21. The third corner 43 is formed as a second reinforcement corner 46 and connects the second outer edge 22 with the third outer edge 23. The second outer edge 22 and the third outer edge 23 and the third outer edge 23 and the fourth outer edge 24 are not connected to each other. Specifically, the first outer edge 21 on the one hand by first corner 41 and first reinforcing corner 45 and a second corner 42 limited. However, the second corner 42 does not connect two outer edges 21, 22, 23, 24 with each other, but essentially forms a deflection point 16, at which a second wire 12 is deflected and guided into the first outer edge 21. Likewise, the second outer edge 22 is limited on the one hand by the second reinforcing corner 46 and on the other hand by a fifth corner 42 ', wherein the fifth corner 42' connects the second outer edge 22 with a first wire 11 from the braid interior. The second corner 42 and the fifth corner 42 'are arranged on a line which is arranged substantially parallel to a connecting line between the two reinforcement corners 45, 46.

On the opposite side of the mesh 10, two corners, a fourth corner 44 and a sixth corner 44 'are also arranged. The fourth corner 44 and the sixth corner 44 'lie on a line which is likewise arranged parallel to the connecting line between the two reinforcement corners 45, 46.

4, all the first and second wires 11, 12 running in the braid interior are deflected only at the transition to the outer edges 21, 22, 23, 24. In the interior of the braid, the first and second wires 11, 12 are rectilinear. In particular, the first wires 11 in the interior of the braid run in a straight line from the first outer edge 21 to the third outer edge 23. Likewise, the second wires 12 in the interior of the braid are straight from the second outer edge 22 to the fourth outer edge 24.

FIG. 5 shows the implant according to FIG. 3 in the implanted state within an aneurysm. The aneurysm 60 adjoins a blood vessel 61, wherein the blood vessel 61 and the aneurysm 60 are shown in cross-section. The flexibility of the lattice braid 10 or overall of the implant can be clearly seen. The mesh 10 is in particular so flexible that it can adapt to the inner wall of the aneurysm 60. In this case, the holding elements 50 protrude into the aneurysm 60, and thus stabilize the grid mesh 10. Preferably, the grid mesh 10 is adapted directly to the ruptured wall of the aneurysm 60 or placed in the region of the rupture. In particular, it is provided to arrange the mesh 10 in the region of the rupture of the aneurysm 60 such that the rupture is covered by the mesh 10. In order to avoid a displacement of the mesh 10, the holding elements 50 are provided, which extend into the lumen or the interior of the aneurysm 60. The mesh 10 may bulge three-dimensionally in use. That is, the grid mesh 10 may be curved about at least two axes that are oriented at an angle to each other. In particular, it is provided that the grid mesh 10 has a longitudinal axis, which is arranged substantially on a parallel to the connecting line between the reinforcement corners 45, 46. Furthermore, a transverse axis is provided, which is aligned perpendicular to the longitudinal axis. In particular, the transverse axis can be arranged parallel to a connecting line between the second corner 42 and the fourth corner 44. The mesh 10 may be curved both about the longitudinal axis and about the transverse axis. It is also possible that the grid mesh to curve both about the longitudinal axis, as well as about the transverse axis, so that sets a total of a three-dimensional curvature. The curvature or curvature of the lattice braid 10 or in general of the medical implant can already be predetermined during the production. In other words, the lattice structure 10 of the medical implant according to the invention can be bulged or precurved.

In Figures 6 and 7, the process of implantation of the medical implant is shown. The implantation of the medical implant or occlusion device is effected by a delivery system, in particular a catheter 65, which is introduced into the aneurysm 60. In the catheter 65, the implant is arranged in a compressed state. Specifically, it is envisaged that the grid mesh 10 is stretchable or compressible by means of an oppositely directed movement away from the reinforcement corners 45, 46. The mesh 10 is inserted into the catheter 65 such that the reinforcement corners 45, 46 are spaced apart along the catheter axis.

For compressing the mesh 10 in a catheter 65, the mesh 10 is stretched. In this case, the first outer edge 21 and the fourth outer edge 24 and the second outer edge 22 and the third outer edge 23 approach each other. The braid angle or the angle between the first and second wires 11, 12 decreases. As a result, the diamond shape of the individual stitches 15 or of the entire grid mesh 10 is narrower and longer overall than in the idle state or production state. It is possible that the intrinsically flat or bulging grid mesh 10 in the compressed state within the catheter 65 rolls or takes a tube-like shape. In this case, the first and fourth outer edge 21, 24 and the second and third outer edge 22, 23, in particular the second corner 42 and the fourth corner 44, overlap. It is also possible that the inner diameter of the catheter 65 and the dimensions of the compressed mesh 10 are coordinated so that the mesh 10 within the catheter 65 remains substantially in the planar shape.

Within the catheter 65, the mesh 10 may be coupled to a guide element. Preferably, the guide element is releasably connected by a sleeve to the third corner 43 of the mesh 10. By the guide member, the grid mesh 10 can be moved within the catheter 65, in particular discharged from the catheter 65.

When the implant is released from the catheter 65, first, as shown in FIG. 6, a holding element 50 is released, which is arranged on the first reinforcement corner 45. In the further course of the release, the holding elements 50 are exposed, which are arranged on the second corner 42 and the fourth corner 44 (FIG. 7). The release of the second reinforcement corner 46 and the holding element 50 connected to the second reinforcement corner 46 takes place as the last discharge process.

FIG. 8 shows a bulging variant of the lattice braid 10 according to FIG. 1. It can be clearly seen that the lattice braid 10 is substantially dish-shaped or cup-shaped or parabolic-like. This form has the advantage that it applies relatively easily and gefäßwandon to the inner wall of an aneurysm 60.

In the embodiment according to FIGS. 9 and 10, the release from the catheter 65 takes place substantially analogously to the procedure described in FIGS. 6 and 7. The difference is that in the release according to FIGS. 9 and 10, the implant is aligned in such a way that a buffer area is formed between the aneurysmal wall and the mesh 10. In this case, the pearled mesh 10 is curved in such a way that it does not lie against the aneurysm wall substantially, in particular not completely. Rather, the mesh has a reverse to the Aneurysmenwandwölbung buckle.

The implant according to FIGS. 9 and 10 has in each case two holding elements 50 which are arranged at diametrically arranged corners 41, 42, 43, 44 of the lattice braid 10. The holding elements 50 comprise sleeves 55. Two further diametrically arranged corners 41, 42, 43, 44 are free of holding elements. The mesh 10 has otherwise substantially the same braid structure as explained in connection with FIGS. 1-3.

In the embodiment according to FIG. 11, it is provided that the mesh 10 has three corners 41, 42, 43, 44, which are formed free of holding elements. One of the corners, in particular a reinforcing corner 45, 46, has a holding element 50. The holding element 50 is designed so long that it can be arranged spirally in the aneurysm in the implanted state. At the end of the holding member 50, a sleeve 55 is arranged, which connects the wires of the holding member 50.

The embodiment according to FIG. 12 essentially builds on the implant according to FIG. 11, wherein all corners 41, 42, 43, 44 comprise a holding element 50. In particular, a respective holding element 50 is arranged on the first corner 41, the second corner 42 and the third corner 43. The holding elements 50 arranged at the first, second and third corners 41, 42, 43 have a relatively small length. At the fourth corner 44, however, a longer retaining element 50 is arranged. The holding elements 50 at the first, second and third corners 41, 42, 43 each have holding loops 53. At the fourth corner 44 of the mesh 10, a further, long retaining element 50 is attached, which extends through the holding loops 53 of the remaining three holding elements 50 therethrough. The holding element 50 at the fourth corner 44 has a sleeve 55 in contrast to the other holding elements 50. The holding member 50 at the fourth corner 44 is arranged spirally in the aneurysm.

FIG. 13 shows an exemplary embodiment of the medical implant with four holding elements 50. In essence, the implant according to FIG. 13 corresponds to the implant according to FIG. 3. However, according to FIG. 13, two diametrically opposite holding elements 50, in particular the holding elements 50, are attached to the second corner 42 and the fourth corner 44 are formed longer than the holding member 50, which are arranged at the first corner 41 and the third corner 43. In particular, the holding elements 50 are formed at the second corner 42 and the fourth corners 44 so long that the holding loops 53 of the two holding elements 50 protrude into the adjacent blood vessel 61 when the implant is placed in the aneurysm 60. This is illustrated in FIG. 13.

In this context, it should be noted that the comparatively longer holding elements 50 not only at the second and fourth corners 42, 44, but can also be arranged at the first and third corner 41, 43, in particular the first reinforcement corner 45 or second reinforcement corner 46. This applies to all embodiments.

In general, in the exemplary embodiment according to FIG. 13, the stability and position of the implant can be fixed well by the holding elements 50, which project into the adjacent blood vessel 61.

The embodiment according to FIG. 14 essentially corresponds to a combination of the exemplary embodiments according to FIGS. 2 and 3. In particular, the implant illustrated in FIG. 14 has a mesh 10 comprising a total of four sides 31, 32, 33, 34, all sides 31 , 32, 33, 34 are each formed by a smooth outer edge 21, 22, 23, 24. In total, four holding elements 50 are provided, wherein in each case a holding element 50 is connected to a corner 41, 42, 43, 44 of the lattice braid 10 or integrally emerges from the wires 11, 12 of the lattice braid 10. Three of the four holding elements 50 are provided with holding loops 53. In particular, in the region of the first, the second and the fourth corner 41, 42, 44 is in each case arranged a holding element 50, which is produced by one or more wires 11, 12 of the lattice braid 10. At the third corner 43 of the mesh 10, however, wire ends of the first and second wires 11, 12 are brought together and form an extension 13, which acts as a holding element 50. The wire ends of the first and second wires 11, 12 and the extension 13 are interconnected by a sleeve 55. The sleeve 55 is preferably rounded at an end face or at the end of the holding element 50, so that no sharp edges protrude, which could cause a vascular injury.

FIG. 15 shows a variant of the medical implant, wherein the sleeve 55 is used not only for connecting the wire ends of the first and second wires 11, 12 in the region of an extension 13, but also for connecting the extension 13 to a holding element 50. The sleeve 55 in particular connects the extension 13 with a core wire 51 of the holding element 50. The core wire 51 is wound by a coil 52, whereby the flexibility of the holding element 50 is increased.

Alternatively, it can be provided that the holding element 50 comprises one or more core wires 51, which directly, in particular in one piece, emerge from the first and second wires 11, 12 of the lattice braid 10, as shown in FIG. 16. In particular, special is provided according to the embodiment of FIG. 16 that at the first corner 41 a plurality of first wires 11 from the fourth outer edge 24 and a plurality of second wires 12 are brought together from the first outer edge 21 and continue over the first corner 41. The merged and continued wires 11, 12 go directly into core wires 51 of the holding member 50, which are covered by a coil 52. The coil 52 assumes on the one hand the function of increasing the flexibility of the retaining element 50 and on the other hand, the connection of the wire ends of the first and second wires 11, 12th

For all embodiments, the sleeve 55 may comprise a radiopaque material. In this way, the positioning of the implant can be easily observed and controlled.

In the embodiments according to FIGS. 1-3 and 5-16, the lattice structure 10 has a diamond shape. Concretely, the grid structure 10 thus comprises four outer edges 21, 22, 23, 24, which are smooth and all sides 31, 32, 33, 34 of the mesh 10 form. The four outer edges 21, 22, 23, 24 thus essentially form a closed frame 25 of the mesh 10. The frame 25 has a diamond-shaped geometry. The frame corresponds in these embodiments, the braid edge of the grid mesh 10. The edge of the braid is thus formed only by the four outer edges and sets the diamond-shaped outer contour of the mesh 10.

It can be provided that the frame or the peripheral edge of the braid is additionally formed by a reinforcing wire whose cross-sectional diameter is greater than the cross-sectional diameter of the first and second wires 11, 12. Alternatively it can be provided that one or more of the first and / or second wires 11, 12 form a reinforcing wire. Basically, the reinforcing wire has a higher cross-sectional diameter than the other wires of the grid mesh.

In a specific embodiment, the reinforcing wire may have a cross-sectional diameter which is greater than the first wires 11 and / or the second wires 12 by at least 50%, in particular by at least 100%, in particular by at least 150%, in particular by at least 200%. The reinforcing wire extends at least partially along an outer edge 21, 22, 23, 24. It is also possible for the reinforcing wire to extend in sections through the groove. braided interior extends. Alternatively or additionally, a reinforcing wire may be provided which runs exclusively in the braid interior. For example, the reinforcing wire in the interior of the braid can surround at least 2, in particular at least 3, in particular at least 4, in particular at least 8, loops 15. The reinforcement wire in the interior of the braid can likewise have a cross-sectional diameter which is at least 50%, in particular at least 100%, in particular at least 150%, in particular at least 200% greater than the cross-sectional diameter of the first wires 11 and / or the second wires 12 ,

The mesh 10 preferably has at least six, in particular at least twelve, in particular at least twenty-four, in particular at least thirty-six, in particular at least forty-eight first and second wires 11, 12. The first and second wires 11, 12 thus intersect within the mesh braid 10 in the interior of the braid, preferably at an angle of less than 90 ° (braiding angle less than 45 °), in order to increase the crimpability of the mesh braid 10. Alternatively, it can be provided that the angle between the first and second wires 11, 12 is greater than 90 ° (braiding angle greater than 45 °), so that the force applied by the mesh braid 10 expansion force is increased.

Basically, the mesh 10 may comprise a biodegradable material. This allows the mesh 10 to be decomposed after implantation so that the aneurysm 60 can recover. It is not mandatory that the retaining elements 50 comprise a biodegradable material. The holding elements 50 may remain in the aneurysm after the lattice braid 10 has been removed. It is also possible that the holding elements 50 are biodegradable. Overall, the entire implant may comprise a biodegradable material or consist of a biodegradable material.

In general, it should be noted that the accompanying drawings illustrate the individual embodiments very schematically. For example, the type of connection of the individual wires in the outer edges 21, 22, 23, 24 is not recognizable. Preferably, the first and second wires 11, 12 run along the outer edges 21, 22, 23, 24 substantially parallel to one another. It is also possible that the first and second wires 11, 12 are twisted together or otherwise connected along the outer edges 21, 22, 23, 24. For all embodiments, the grid mesh 10 has a length determined by the distance between the first corner 41 and the third corner 43. The distance between the second corner 42 and the fourth corner 44 determines the width of the mesh 10. Preferably, the mesh 10 has a length substantially equal to the width of the mesh 10. In particular, it can be provided that the ratio between length and width is at least 0.5, in particular at least 0.6, in particular at least 0.7, in particular at least 0.8, in particular at least 0.9.

LIST OF REFERENCE NUMBERS

10 grid mesh

11 first wire

12 second wire

13 extension

15 mesh

16 deflection point

21 first outer edge

22 second outer edge

23 third outer edge

24 fourth outer edge

25 frames

31 first page

32 second page

33 third page

34 fourth page

41 first corner

42 second corner

42 'fifth corner

43 third corner

44 fourth corner

44 'sixth corner

45 first reinforcing corner

46 second reinforcement corner

50 retaining element

51 core wire 52 coil

53 retaining loop 55 sleeve

60 aneurysm

61 blood vessel 65 catheter

Rl first direction R2 second direction

Claims

claims

1. A medical implant for placement within a hollow body with a mesh braid (10) of first wires (11) extending in the braid inside in each case in a first direction Rl, and of second wires (12), each in the braid inside in a second direction R2 and the first wires (11) intersect to form meshes (15) of the mesh (10), as shown in FIG

the lattice braid (10) is embodied in the shape of a sail and has a braid edge which at least partially comprises smooth outer edges (21, 22, 23, 24) which are respectively formed by the first and / or second wires (11, 12) and the lattice braid ( 10) at least four sides (31, 32, 33, 34) limit, wherein

- The first wires (11) and the second wires (12) in each case at the transition from the interior of the braid at deflection points (14) in the outer edges (21, 22, 23, 24) are deflected such that the first wires (11) along the outer edge (21, 23) in the second direction R2 and the second wires (12) along the outer edge (22, 24) extend in the first direction Rl, and

- The outer edges (21, 22, 23, 24) each individual first wires (11) or second wires (12) are supplied from the Wickelninnern such that the number of the respective outer edge (21, 22, 23, 24) forming Wires (11, 12) along the outer edge (21, 22, 23, 24) successively changed,

and wherein the wires (11, 12), which are deflected at the edge of the braid, are deflected only in smooth outer edges (21, 22, 23, 24).

2. Implant according to claim 1,

d a d u rc h e ke n ze i c h n et that

the grid mesh (10) has at least two corners (41, 42, 43, 44), in each of which two outer edges (21, 22, 23, 24) are brought together.

3. Implant according to claim 2,

d a d u rc h e ke n ze i c h n et that

two diametrically opposite arranged corners (41, 43) of the lattice braid (10) reinforcing corners (45, 46) form, wherein the number of wires (11, 12) of the two outer edges (21, 22, 23, 24), in the reinforce kungsecke (45, 46) are merged, in each case in the direction of the reinforcement corner (45, 46) increased and in the region of the reinforcement corner (45, 46) is maximum.

4. Implant according to claim 2 or 3,

d a d u rc h e ke n ze i c h n et that

at least one corner (41, 42, 43, 44) of the mesh (10) a holding element (50) is arranged, which are adapted for fixing the mesh braid (10) in the hollow body.

5. Implant according to claim 4,

d a d u rc h e ke n ze i c h n et that

the holding element (50) is connected to the first and / or second wires (11, 12) or is made in one piece from the first and / or second wires (11, 12).

6. Implant according to claim 4 or 5,

d a d u rc h e ke n ze i c h n et that

the first and / or second wires (11, 12) continue beyond the corner (41, 42, 43, 44) of the mesh braid (10) and are connected to one another, in particular twisted and / or with one to form the retaining element (50) Sleeve (55) coupled are.

7. Implant according to one of claims 4 to 6,

d a d u rc h e ke n ze i c h n et that

the holding element (50) has a length which is at least the simple, in particular at least twice, in particular at least 3 times, in particular at least 4 times, in particular at least 5 times, in particular at least 7 times, in particular at least 10 times, in particular at least 15 times, in particular at least 20 times, the width of the mesh (15) of the mesh (10) corresponds.

8. Implant according to one of claims 1 to 7,

d a d u rc h e ke n ze i c h n et that

the meshes (15) of the mesh braid (10) have substantially the same size, in particular width.

9. Implant according to one of claims 1 to 8,

d a d u rc h e ke n ze i c h n et that

the lattice braid (10) comprises a total of four corners (41, 42, 43, 44), wherein in each case two diametrically opposite arranged corners (41, 42, 43, 44), in particular all corners (41, 42, 43, 44), respectively a holding element (50).

10. Implant according to one of claims 1 to 9,

d a d u rc h e ke n ze i c h n et that

the outer edges (21, 22, 23, 24) together form a closed frame (25) delimiting the mesh (10) to all sides.

11. The medical implant according to one of claims 1 to 10,

d a d u rc h e ke n ze i c h n et that

the grid mesh (10) is curved in a quiescent state about a longitudinal axis, which is arranged parallel to a connecting line between the two diametrically opposite reinforcing corners (45, 46).

12. Implant according to claim 11,

d a d u rc h e ke n ze i c h n et that

the grid mesh (10) is curved in a quiescent state about a transverse axis, which is arranged at right angles to the longitudinal axis.

13. Implant according to one of claims 4 to 12,

d a d u rc h e ke n ze i c h n et that

the holding element (50) in each case has at least one core wire (51) which is connected to a first and / or second wire (11, 12) at a corner (41, 42, 43, 44) of the mesh braid (10) or formed in one piece wherein the core wire (51) is at least partially encased by a coil (52).

14. Implant according to one of claims 1 to 13,

d a d u rc h e ke n ze i c h n et that

the outer edge (21, 22, 23, 24) is formed by at least one reinforcing wire having a larger cross-sectional diameter than the remaining wires (11, 12) of the grid mesh (10).

15. Implant according to claim 14,

d a d u r c h e c e n c i n e s that

the cross-sectional diameter of the reinforcing wire is at least 50%, in particular at least 100%, greater than the cross-sectional diameter of the remaining wires (11, 12).

16. A method for producing a medical implant, in particular an implant according to claim 1, with a goblet mesh (10) comprising the following steps:

- Providing a wicker thorn;

Braiding at least one first wire (11) and at least one second wire (12) from a common first holding pin of the braiding mandrel such that at least two smooth outer edges (21, 24) are formed;

- diverting the first wire (11) and the second wire (12) respectively to a second and third retaining pin of the braiding mandrel, wherein the second retaining pin and the third retaining pin are arranged at the same height of the braiding mandrel;

- braiding the first wire (11) and the second wire (12) in the direction of a fourth retaining pin, which is arranged in the axial direction of the braiding mandrel spaced from the first retaining pin, such that two further, smooth outer edges (22, 23) are formed ,

17. The method of claim 17, wherein the second retaining pin and the third retaining pin are disposed immediately adjacent.