WO2012163880A1 - Implant médical à disposer à l'intérieur d'un corps creux, en particulier d'un anévrisme, et procédé de fabrication d'un implant médical - Google Patents

Implant médical à disposer à l'intérieur d'un corps creux, en particulier d'un anévrisme, et procédé de fabrication d'un implant médical Download PDF

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Publication number
WO2012163880A1
WO2012163880A1 PCT/EP2012/059944 EP2012059944W WO2012163880A1 WO 2012163880 A1 WO2012163880 A1 WO 2012163880A1 EP 2012059944 W EP2012059944 W EP 2012059944W WO 2012163880 A1 WO2012163880 A1 WO 2012163880A1
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WO
WIPO (PCT)
Prior art keywords
wires
mesh
braid
corner
wire
Prior art date
Application number
PCT/EP2012/059944
Other languages
German (de)
English (en)
Inventor
Giorgio Cattaneo
Original Assignee
Acandis Gmbh & Co. Kg
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Acandis Gmbh & Co. Kg filed Critical Acandis Gmbh & Co. Kg
Publication of WO2012163880A1 publication Critical patent/WO2012163880A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00632—Occluding a cavity, i.e. closing a blind opening

Definitions

  • Medical implant for placement within a hollow body, in particular an aneurysm, and method for producing a medical implant
  • 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.
  • a medical implant is known, for example, from WO
  • 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.
  • 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.
  • WO 02/069783 A2 WO 2008/151204 A1, US Pat. No. 6,669,721 B1, US 2008/0221600 A1 and WO 97/26939 A1.
  • 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.
  • 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.
  • coils are 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 can promote thrombus formation in the bloodstream, so that usually a drug, antithrombotic treatment is required.
  • 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.
  • 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.
  • the coils can be positioned so as to avoid protruding coils into the adjacent blood vessel.
  • 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.
  • the density of coils ie the number of coils
  • 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.
  • an implantable device 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.
  • 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.
  • the grid mesh is formed like a sail.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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 °.
  • 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.
  • 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.
  • damage to the vessel wall is avoided by the smooth outer edges, since the smooth outer edges can easily slide along the vessel wall.
  • 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.
  • 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.
  • the smooth outer edges act atraumatic.
  • 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.
  • 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.
  • the two outer edges are connected together in the corner.
  • each outer edge 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.
  • the number of wires forming the outer edge increases or decreases.
  • the number of wires increases successively toward the reinforcement corner.
  • the number of wires that together form an outer edge is therefore maximum.
  • two reinforcing corners are provided, which are arranged diametrically opposite one another. This contributes to the stability of the mesh braid.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • first wires and / or the second wires continue beyond the corner of the mesh braid and are interconnected to form the retaining element.
  • first wires and / or the second wires can be twisted and / or coupled with a sleeve to form the retaining element.
  • a joining region is provided which allows easy connection of the retaining element to the wires of the mesh braid.
  • 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.
  • the continued wires can also be used for connection to a separately produced holding element.
  • 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.
  • 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.
  • 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.
  • the grid mesh comprises a total of four corners.
  • 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.
  • 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.
  • 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.
  • the grid may be substantially flat or flat at rest.
  • the mesh is so flexible that it is in the
  • 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.
  • 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.
  • 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.
  • the reinforcing wire specifies the basic shape of the lattice braid.
  • 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%.
  • 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.
  • 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:
  • the second retaining pin and the third retaining pin are arranged directly adjacent to each other.
  • 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.
  • Fig. 1 is a plan view of an inventive medical
  • Fig. 2 is a plan view of an inventive medical
  • Fig. 3 is a plan view of an inventive medical
  • 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. 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. 11 is a side view of the medical invention
  • FIG. 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;
  • FIG. 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
  • 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;
  • 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.
  • 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.
  • a plurality of first wires 11 are provided, which extend in the first direction Rl, that are arranged parallel to each other.
  • 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.
  • 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 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.
  • 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.
  • 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.
  • 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.
  • 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 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.
  • 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.
  • first outer edge 21 applies to all outer edges 21, 22, 23, 24 mentioned in the context of this application.
  • more than four first or second wires 11, 12 can be provided, which cover the respective outer edge 21, 22, 23 , 24 form.
  • 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.
  • the number of deflection points 16 increases.
  • the change in the number of wires in the outer edges 21, 22, 23, 24 is shown by different line thicknesses.
  • the mesh 10 has a diamond shape.
  • 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.
  • the reinforcement corners 45, 46 so is the maximum number of wires of the outer edges 21, 22, 23, 24 before.
  • 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.
  • the first corner 41 thus forms the first reinforcement corner 45.
  • 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.
  • 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.
  • all the first wires 11 strike all the second wires 12.
  • the second reinforcement corner 46 which is formed analogously to the first reinforcement corner 45.
  • the stitches 15 bounded by the first and second wires 11, 12 are substantially square in shape. Another diamond-like shape is possible.
  • a holding element 50 is further provided, which is arranged at a corner 41, 42, 43, 44 of the mesh 10.
  • 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.
  • 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.
  • 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.
  • 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.
  • the first and second wires 11, 12, in particular the wire ends are connected to one another by a sleeve 55.
  • 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.
  • 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.
  • 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.
  • the retaining elements 50 according to FIG. 3 are not formed by open wire ends.
  • the holding elements 50 according to FIG. 3 holding loops 53, which are formed by deflecting a wire 11, 12.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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
  • the mesh 10 has a total of four corners 41, 42, 43, 44.
  • 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,
  • the mesh 10 comprises six corners 41, 42, 42 ', 43, 44, 44'.
  • 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.
  • further extensions 13 may be provided at the second corner 42, the fourth corner 44, the fifth corner 42 'and the sixth corner 44'.
  • 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.
  • the first outer edge 21 on the one hand by first corner 41 and first reinforcing corner 45 and a second corner 42 limited.
  • 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.
  • 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.
  • 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.
  • 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.
  • the first and second wires 11, 12 are rectilinear.
  • 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.
  • 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.
  • the holding elements 50 protrude into the aneurysm 60, and thus stabilize the grid mesh 10.
  • the grid mesh 10 is adapted directly to the ruptured wall of the aneurysm 60 or placed in the region of the rupture.
  • the mesh 10 in the region of the rupture of the aneurysm 60 such that the rupture is covered by 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.
  • 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.
  • 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.
  • FIGS 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.
  • the implant is arranged in a compressed state.
  • 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.
  • the mesh 10 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.
  • the mesh 10 may be coupled to a guide element.
  • the guide element is releasably connected by a sleeve to the third corner 43 of the mesh 10.
  • the grid mesh 10 can be moved within the catheter 65, in particular discharged from the catheter 65.
  • a holding element 50 is released, which is arranged on the first reinforcement corner 45.
  • 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.
  • the release from the catheter 65 takes place substantially analogously to the procedure described in FIGS. 6 and 7.
  • the implant is aligned in such a way that a buffer area is formed between the aneurysmal wall and the mesh 10.
  • 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.
  • the mesh 10 has three corners 41, 42, 43, 44, which are formed free of holding elements.
  • the holding element 50 is designed so long that it can be arranged spirally in the aneurysm in the implanted state.
  • 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.
  • 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.
  • 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.
  • 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.
  • the implant according to FIG. 13 corresponds to the implant according to FIG. 3.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • a holding element 50 which is produced by one or more wires 11, 12 of the lattice braid 10.
  • 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.
  • 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.
  • 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.
  • 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
  • the sleeve 55 may comprise a radiopaque material. In this way, the positioning of the implant can be easily observed and controlled.
  • the lattice structure 10 has a diamond shape.
  • 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.
  • 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.
  • a reinforcing wire whose cross-sectional diameter is greater than the cross-sectional diameter of the first and second wires 11, 12.
  • one or more of the first and / or second wires 11, 12 form a reinforcing wire.
  • the reinforcing wire has a higher cross-sectional diameter than the other wires of the grid mesh.
  • 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.
  • 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.
  • 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.
  • 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.
  • the accompanying drawings illustrate the individual embodiments very schematically.
  • the type of connection of the individual wires in the outer edges 21, 22, 23, 24 is not recognizable.
  • 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.
  • 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.
  • the mesh 10 has a length substantially equal to the width of the mesh 10.
  • 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.

Abstract

L'invention concerne un implant médical à disposer à l'intérieur d'un corps creux, comprenant un treillis constitué de premiers fils métalliques qui s'étendent chacun à l'intérieur du treillis dans une première direction R1 et de seconds fils métalliques qui s'étendent chacun à l'intérieur du treillis dans une seconde direction R2 et croisent les premiers fils métalliques pour former des mailles du treillis. Selon l'invention, le treillis se présente sous la forme d'une voile et comporte une bordure comprenant des bords extérieurs lisses qui sont formés chacun par les premiers et/ou seconds fils métalliques et qui délimitent le treillis au moins sur quatre côtés, les premiers et seconds fils métalliques étant chacun déviés au niveau de points de déviation servant de transition entre l'intérieur du treillis et les bords extérieurs, les premiers ou seconds fils métalliques étant chacun amenés de l'intérieur du treillis vers les bords extérieurs de telle sorte que le nombre de fils métalliques formant le bord extérieur respectif varie progressivement le long du bord extérieur, et les fils métalliques qui sont déviés au niveau de la bordure du treillis étant uniquement ceux qui peuvent former des bords extérieurs lisses. L'invention concerne également un procédé de fabrication d'un implant médical.
PCT/EP2012/059944 2011-05-31 2012-05-29 Implant médical à disposer à l'intérieur d'un corps creux, en particulier d'un anévrisme, et procédé de fabrication d'un implant médical WO2012163880A1 (fr)

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DE102011102955.2A DE102011102955B4 (de) 2011-05-31 2011-05-31 Medizinisches Implantat zur Anordnung eines Hohlkörpers, insbesondere eines Aneurysmas, und Verfahren zum Herstellen eines medizinischen Implantats
DE102011102955.2 2011-05-31

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11284901B2 (en) 2014-04-30 2022-03-29 Cerus Endovascular Limited Occlusion device
US11406404B2 (en) 2020-02-20 2022-08-09 Cerus Endovascular Limited Clot removal distal protection methods
US11471162B2 (en) 2015-12-07 2022-10-18 Cerus Endovascular Limited Occlusion device
US11648013B2 (en) 2016-03-11 2023-05-16 Cerus Endovascular Limited Occlusion device
US11812971B2 (en) 2017-08-21 2023-11-14 Cerus Endovascular Limited Occlusion device

Families Citing this family (22)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11076860B2 (en) 2014-03-31 2021-08-03 DePuy Synthes Products, Inc. Aneurysm occlusion device
US11154302B2 (en) 2014-03-31 2021-10-26 DePuy Synthes Products, Inc. Aneurysm occlusion device
RU2019129526A (ru) 2017-02-23 2021-03-23 Депуи Синтез Продактс, Инк. Устройство и система доставки для лечения аневризмы
US10905430B2 (en) 2018-01-24 2021-02-02 DePuy Synthes Products, Inc. Aneurysm device and delivery system
US11058430B2 (en) 2018-05-25 2021-07-13 DePuy Synthes Products, Inc. Aneurysm device and delivery system
US11596412B2 (en) 2018-05-25 2023-03-07 DePuy Synthes Products, Inc. Aneurysm device and delivery system
US10939915B2 (en) 2018-05-31 2021-03-09 DePuy Synthes Products, Inc. Aneurysm device and delivery system
US11051825B2 (en) 2018-08-08 2021-07-06 DePuy Synthes Products, Inc. Delivery system for embolic braid
US11123077B2 (en) 2018-09-25 2021-09-21 DePuy Synthes Products, Inc. Intrasaccular device positioning and deployment system
US11076861B2 (en) 2018-10-12 2021-08-03 DePuy Synthes Products, Inc. Folded aneurysm treatment device and delivery method
US11406392B2 (en) 2018-12-12 2022-08-09 DePuy Synthes Products, Inc. Aneurysm occluding device for use with coagulating agents
US11272939B2 (en) 2018-12-18 2022-03-15 DePuy Synthes Products, Inc. Intrasaccular flow diverter for treating cerebral aneurysms
US11134953B2 (en) 2019-02-06 2021-10-05 DePuy Synthes Products, Inc. Adhesive cover occluding device for aneurysm treatment
US11337706B2 (en) 2019-03-27 2022-05-24 DePuy Synthes Products, Inc. Aneurysm treatment device
US11672542B2 (en) 2019-05-21 2023-06-13 DePuy Synthes Products, Inc. Aneurysm treatment with pushable ball segment
US11602350B2 (en) 2019-12-05 2023-03-14 DePuy Synthes Products, Inc. Intrasaccular inverting braid with highly flexible fill material
US11607226B2 (en) 2019-05-21 2023-03-21 DePuy Synthes Products, Inc. Layered braided aneurysm treatment device with corrugations
US11497504B2 (en) 2019-05-21 2022-11-15 DePuy Synthes Products, Inc. Aneurysm treatment with pushable implanted braid
US11413046B2 (en) 2019-05-21 2022-08-16 DePuy Synthes Products, Inc. Layered braided aneurysm treatment device
US10653425B1 (en) 2019-05-21 2020-05-19 DePuy Synthes Products, Inc. Layered braided aneurysm treatment device
US11278292B2 (en) 2019-05-21 2022-03-22 DePuy Synthes Products, Inc. Inverting braided aneurysm treatment system and method
US11457926B2 (en) 2019-12-18 2022-10-04 DePuy Synthes Products, Inc. Implant having an intrasaccular section and intravascular section

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6346117B1 (en) * 2000-03-02 2002-02-12 Prodesco, Inc. Bag for use in the intravascular treatment of saccular aneurysms
US20030195553A1 (en) * 2002-04-12 2003-10-16 Scimed Life Systems, Inc. System and method for retaining vaso-occlusive devices within an aneurysm
DE10301600A1 (de) * 2003-01-16 2004-07-29 Dendron Gmbh Kombination von Stents
WO2006074032A2 (fr) * 2005-01-07 2006-07-13 Boston Scientific Limited Dispositifs d'intra-anevrisme
WO2008022327A2 (fr) * 2006-08-17 2008-02-21 Nfocus Neuromedical, Inc. Dispositifs d'isolement pour le traitement des anévrismes
WO2009132045A2 (fr) * 2008-04-21 2009-10-29 Nfocus Neuromedical, Inc. Dispositifs d’embolisation à balle tressée et systèmes de mise en place
WO2010049123A1 (fr) * 2008-10-29 2010-05-06 Acandis Gmbh & Co. Kg Implant médical et procédé de fabrication d'un implant

Family Cites Families (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE69529338T3 (de) 1994-07-08 2007-05-31 Ev3 Inc., Plymouth Intravaskuläre Filtereinrichtung
ES2272007T3 (es) 1997-08-04 2007-04-16 Boston Scientific Limited Sistema de oclusion para preparacion de un aneurisma.
US5916235A (en) 1997-08-13 1999-06-29 The Regents Of The University Of California Apparatus and method for the use of detachable coils in vascular aneurysms and body cavities
AU756080B2 (en) 1998-06-04 2003-01-02 New York University Endovascular thin film devices and methods for treating and preventing stroke
US6689150B1 (en) 1999-10-27 2004-02-10 Atritech, Inc. Filter apparatus for ostium of left atrial appendage
EP1335772A4 (fr) 2000-10-24 2008-04-09 Concentric Medical Inc Dispositifs et procedes servant a traiter des malformations vasculaires
US6589265B1 (en) 2000-10-31 2003-07-08 Endovascular Technologies, Inc. Intrasaccular embolic device
WO2007006139A1 (fr) 2005-07-12 2007-01-18 Smart Biotech Inc. Dispositif d’occlusion d’anévrisme
DE102006050385A1 (de) 2006-10-05 2008-04-10 pfm Produkte für die Medizin AG Implantierbare Einrichtung
EP2157937B1 (fr) 2007-06-04 2017-03-22 Sequent Medical, Inc. Dispositifs pour le traitement de défauts vasculaires
KR101652804B1 (ko) 2008-09-05 2016-08-31 펄사 배스큘라, 아이엔씨. 생리적 구멍 또는 공동을 지지하거나 또는 폐쇄하기 위한 시스템과 방법
US20100069948A1 (en) 2008-09-12 2010-03-18 Micrus Endovascular Corporation Self-expandable aneurysm filling device, system and method of placement
DE102009056450A1 (de) 2009-12-01 2011-06-09 Acandis Gmbh & Co. Kg Medizinische Vorrichtung zur Einfuhr in ein Hohlorgan und Verfahren zur Herstellung einer solchen Vorrichtung
EP2407129B1 (fr) 2010-07-15 2013-01-23 A.M.I. Agency for Medical Innovations GmbH Obturation stomacale chirurgicale dotée d'une protection intégrée contre des hernies para-stomacales et surveillance de l'alimentation terminale en sang de l'organe creux

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6346117B1 (en) * 2000-03-02 2002-02-12 Prodesco, Inc. Bag for use in the intravascular treatment of saccular aneurysms
US20030195553A1 (en) * 2002-04-12 2003-10-16 Scimed Life Systems, Inc. System and method for retaining vaso-occlusive devices within an aneurysm
DE10301600A1 (de) * 2003-01-16 2004-07-29 Dendron Gmbh Kombination von Stents
WO2006074032A2 (fr) * 2005-01-07 2006-07-13 Boston Scientific Limited Dispositifs d'intra-anevrisme
WO2008022327A2 (fr) * 2006-08-17 2008-02-21 Nfocus Neuromedical, Inc. Dispositifs d'isolement pour le traitement des anévrismes
WO2009132045A2 (fr) * 2008-04-21 2009-10-29 Nfocus Neuromedical, Inc. Dispositifs d’embolisation à balle tressée et systèmes de mise en place
WO2010049123A1 (fr) * 2008-10-29 2010-05-06 Acandis Gmbh & Co. Kg Implant médical et procédé de fabrication d'un implant

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11284901B2 (en) 2014-04-30 2022-03-29 Cerus Endovascular Limited Occlusion device
US11389174B2 (en) 2014-04-30 2022-07-19 Cerus Endovascular Limited Occlusion device
US11471162B2 (en) 2015-12-07 2022-10-18 Cerus Endovascular Limited Occlusion device
US11648013B2 (en) 2016-03-11 2023-05-16 Cerus Endovascular Limited Occlusion device
US11812971B2 (en) 2017-08-21 2023-11-14 Cerus Endovascular Limited Occlusion device
US11406404B2 (en) 2020-02-20 2022-08-09 Cerus Endovascular Limited Clot removal distal protection methods

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