WO2012163882A1 - Medical implant for arrangement within a hollow body, in particular an aneurysm - Google Patents

Abstract

The invention relates to a medical implant for arrangement within a hollow body, said implant comprising a lattice (10) consisting of first wires (11), each of which runs in a first direction R1 in the interior of the lattice, and of second wires (12), each of which runs in a second direction R2 in the interior of the lattice and intersects the first wires (11) to form meshes (15) in the lattice(10). The invention is characterised in that the lattice (10) takes the form of a sail and has smooth external edges (21, 22, 23, 24), each of which is formed by the first wires or the second wires (11, 12). The lattice (10) has at least one corner (41, 42, 43, 44) at which two external edges (21, 22, 23, 24) run together enclosing an angle, and an elongate retaining element (50) is provided and arranged at the corner (41, 42, 43, 44), and adapted to hold the lattice (10) in place within the hollow body.

Description

 Medical implant for placement within a hollow body,

 especially an aneurysm

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 A1.

In the past practice, aneurysms are treated by inserting coils. Coils are small, flexible wires that freely deform within the aneurysm and form a tangle that affects the blood flow in the aneurysm. Due to the irregular rippling of the coils in the aneurysm, the influence of the coils on the flow is difficult to predict. The rippling of the coils thus largely depends on the external environmental conditions, in particular the shape of the aneurysm. It is therefore difficult to estimate how the blood flow within the aneurysm develops after the use of a coil.

In a ruptured aneurysm, the aneurysmal wall is already broken, which can lead to uncontrolled blood loss. 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 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.

However, the known treatment method with the use of coils has

Disadvantages in the treatment of already ruptured aneurysms or in aneurysms on whose vascular walls are weakened. Experience has shown that coils in ruptured aneurysms usually position themselves in the area of the rupture. Since the coils are free to move within the aneurysm, the treatment of such aneurysms by coils is dangerous. The free mobility is the Density of coils, ie the number of coils per unit volume, reduced in the area of rupture. In the vicinity of the rupture unpredictable, unfavorable bloodstreams can develop, which prevent the formation of a thrombus and thus promote a renewed rupture of the aneurysm.

Essentially, the known treatment methods are based on supporting the formation of the largest possible blood clot in the area of rupture. It has been found that the blood clots or thrombi forming in the aneurysm usually do not fill the entire aneurysm. Especially in the region of the aneurysm neck, ie in the region of the opening of the aneurysm to the adjacent blood vessel, 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. When using coils to thrombule within the aneurysm, stents are often inserted into the adjacent blood vessel to hold the coils in the aneurysm. This is especially true for the treatment of aneurysms, which due to their shape do not provide sufficient support for the coils. The use of stents in the adjacent blood vessel, however, may favor 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.

In principle, when using implants that are used in the region of the aneurysm neck or the adjacent blood vessel, for example stents or flow diverters, it is expedient from a medical point of view to carry out a lasting treatment with antithrombotic medicaments in order to avoid a vessel occlusion. At the same time, however, the risk of aneurysm rupture is increased.

The aforementioned WO 99/05977 AI discloses a device for closing an aneurysm, in particular a Occlusionsdevice 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. Furthermore, second wires are provided, which are annular around extend the center of the dish-shaped grid structure and intersect to form stitches with the first wires.

The known occlusion device can be connected to a delivery device and, in particular, compressed 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 occlusion device is placed in the aneurysm such that the neck of the aneurysm 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 aneurysm rupture is reduced.

Further devices for the treatment of aneurysms, which are based on occluding the aneurysm neck in order to prevent or at least reduce the flow of blood into the aneurysm, are known from the publications WO 02/069783 A2, WO 2008/151204 Al, US Pat. No. 6,669,721 Bl , US 2008/0221600 AI, WO 97/26939 AI and DE 10 2006 050 385 AI known.

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 Pat. No. 6,589,265 B1, WO

2010/030991 AI, WO 99/08743 AI and WO 2007/006139 AI known. The disadvantage of such spherical Occiusionsdevices is that they are difficult to adapt to the anatomy of the respective aneurysm. Thus, even with spherical Occiusionsdevices, similar to coils, there is a risk that a part of Occiusionsdevices protrudes into the bloodstream of the adjacent blood vessel and there leads to clot formation. Therefore, even with the use of such Occiusionsdevices a drug antithrombogenic treatment appropriate, which in turn increases the risk of rupture.

The invention has for its object to provide a medical implant for placement within a hollow body, in particular an aneurysm, which allows a reproducible flow influencing within the hollow body and reduces the risk of rupture. This object is solved by the subject matter of patent claim 1.

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 smooth outer edges, each formed by the first or second wires. The first wires and the second wires are each deflected at the transition from the mesh inside to the outer edges 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 grid mesh comprises at least one corner, at the two outer edges are merged at an angle. Furthermore, an elongated retaining element is provided, which is arranged at the corner and adapted for fixing the mesh braid within the hollow body.

According to the invention, the grid mesh has at least one corner, in each of which two outer edges are brought together. The two outer edges merged in a corner have different directions. Specifically, the two outer edges are merged at an angle or arranged at an angle to each other. 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 mesh, runs, meets. Preferably, the two outer edges are connected together in the corner.

At the at least one corner of the grid mesh, a holding element is arranged, which is adapted for fixing the mesh in the hollow body. The retaining element not only allows for improved fixation of the implant in the hollow body, but also accurate positioning. For example, the retaining element may be partially arranged within the catheter when the Grid mesh is already completely dismissed. The position of the grid can be adjusted exactly in this way.

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.

The implant according to the invention also 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 Occlusionsdevices that close the aneurysm in the region of the opening to adjacent blood vessels, the implant of the invention is well suited for placement directly in the rupture of the aneurysm, without risking a renewed rupture. In particular, the smooth outer edges act atraumatic. 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.

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 aneurysm. 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 grid mesh is flexibly adaptable to different shapes of a hollow body or adapted in such a way that the grid mesh bears against the wall of the hollow body over its entire surface.

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. 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.

In particular, it can be provided that the holding element has a length which is at least the simple, in particular at least twice, in particular at least three times, in particular at least four times, in particular at least five times, in particular at least seven times, in particular at least ten times, in particular at least fifteen- times, in particular at least twenty times, corresponds to the width of the mesh of the 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 distance to one another, in particular over the entire grid mesh. 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.

According to a further preferred embodiment, the retaining element is at least partially formed by a wire strand comprising at least a first wire and at least one second wire. The first wire and the second wire are each brought together from different outer edges of the mesh braid and continued beyond the grid mesh. In other words, it can be provided that the first wires and / or the second wires of two outer edges which are brought together in a corner continue beyond the corner and are connected to one another to form the retaining element. The interconnected wires form the wire strand, which may be part of the retaining element. The first wires and / or the second wires may be twisted and / or coupled to a sleeve for forming the wire strand, in particular of the retaining element. Specifically, it can 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 as a common wire strand. The wire strand can be used for connection to a separately produced holding element. Preferably, the first wire and / or second wire are connected together within the holding element or merge integrally into one another. The connection of the first wire to the second wire may be by twisting, welding, or by a sleeve that surrounds the first and second wires. The second wire may also be formed as a continuation of the first wire extending in the first direction. The first wire is deflected within the retaining element and continued as a second wire (in the second direction). 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.

The first wire and / or the second wire may be parallel to each other or twisted together within the wire strand. The parallel arrangement of the wires within the wire strand increases the flexibility of the retaining element. By contrast, the twist increases the stability of the holding element.

A particularly preferred embodiment of the implant according to the invention has at least two grid meshes, each comprising a first corner and a second corner. At the first corner, the holding element and at the second corner, a connecting element is arranged, which connects the grid meshes with each other. The connecting means is preferably flexible.

It is particularly preferred if at least a first grid mesh and a second grid mesh are provided, which are interconnected by a connecting element. In this way, a multi-part implant or an implant with a plurality of grid meshes is provided. The multi-part implant in the implanted state fills a relatively large space within an aneurysm. The flow influencing, in particular the formation of a blood clot, is thus improved.

The connecting element preferably connects a corner of the first mesh with a corner of the second mesh. The mesh braids of the multi-part implant are advantageously connected to their corners. The connecting elements can be flexible, so that the mesh braids of the multi-part implant can move relative to each other. In particular, it is provided that the grid meshes of the multi-part implant fold against each other can, wherein the folding point is arranged in the region of the connecting element. The connecting element thus couples the grid meshes in such a way that the grid meshes can fold around the connecting element.

The connecting element may be formed by a holding element in an advantageous embodiment. Specifically, a retaining element may be provided which is not only adapted for anchoring or fixing the mesh in the aneurysm, but is also suitable for connecting a plurality of mesh braids to one another. The retaining element preferably connects the corners of the mesh braids with each other. In this way, a particularly compact construction of the implant is possible.

In a particularly preferred embodiment, the first grid mesh and the second grid mesh are arranged like a chain or fan-like or parallel to each other.

In a chain-like arrangement, the individual grid meshes are arranged downstream of each other and connected by a single connecting element. In particular, in each case a single connecting element is provided between each two grid meshes, so that the grid meshes are arranged substantially in series or in series one behind the other. The serial arrangement of the mesh braids has advantages in terms of increased flexibility, so that the implant can be easily inserted into an aneurysm.

In a fan-like arrangement, a single connecting element is preferably provided, which connects all grid meshes with each other. The connecting element can be formed by a holding element and connects in each case one corner of the first grid mesh with a corner of the second grid mesh such that the grid meshes are arranged one above the other, thus overlapping like a fan or scaly.

In a parallel arrangement of the mesh braids is provided that connect at least two connecting elements two adjacent grid mesh. In particular, the connecting elements are arranged on respectively diametrically opposite arranged corners. The grid meshes connected by the at least two connecting elements are thus arranged substantially parallel or one above the other. The parallel arrangement and the fan-like arrangement tion has the advantage of increased stability. The implant thus contributes well to the support of the aneurysm wall.

The multi-part implant with multiple lattice plexuses both in a chain-like, fan-like or parallel arrangement enables improved flow control of the blood flow within the aneurysm. For example, first grid mesh may be spaced from the aneurysmal wall, in particular at a distance greater than the maximum wire thickness of the wires of the second grid so that not only the blood flow along the aneurysmal wall but also in the center of the aneurysm can be influenced.

In order to influence the blood flow along the aneurysm wall and in the center of the aneurysm differently and specifically, it can be provided that the first grid mesh has a different braiding angle and / or a different braiding and / or other dimensions than the second grid mesh. For example, the first grid mesh may have a 1-over-1 weave and the second grid mesh may have an I-over-2 weave. Other types of braids are possible. Alternatively or additionally, the mesh size between the first grid mesh and the second grid mesh may be set differently.

Preferably, the first grid mesh and the second grid mesh differ by their braiding angle. The braiding angle refers to the angle formed between the connecting line between the first corner and the second corner and a first or second wire of the grid mesh. A braid angle of 45 ° is present, for example, in a square shape of the mesh of the mesh. At a braid angle greater than 45 °, the meshes of the mesh braid are diamond-shaped with a greater width than length. A braid angle of less than 45 ° results in diamond-shaped meshes having a greater length than width. The longitudinal direction of the grid mesh is determined by the first and second corner. The connecting line between the first and second corner thus determines the longitudinal direction of the grid mesh or runs in the longitudinal direction.

Between the first grid mesh and the second grid mesh or generally between the two grid meshes arranged parallel to one another, a buffer area is preferably arranged. Specifically, the first lattice braid and the second grid mesh at least in the implanted state be spaced from each other, so that forms a buffer area between the grid meshes. The buffer area further improves the flow control within the aneurysm.

The implant may be designed in such a way that the buffer area only forms in the implanted state. This can be done by different types of braiding and / or braid angles and / or dimensions of the at least two interconnected mesh braids. In particular, due to different types of braiding in the lattice meshes arranged in parallel, the lattice meshes expand differently upon release from a delivery system, so that a spacing between the parallel lattice meshes can be established. The distance between the grid mesh forms the buffer area.

In a further variant of the invention it is provided that a longitudinal edge is arranged between two smooth outer edges of the lattice braid, which extends substantially parallel to a longitudinal axis of the lattice braid. The longitudinal axis runs in the longitudinal direction of the grid, ie parallel to the connecting line between the first corner and the second corner. Overall, the grid mesh is stretched or extended by the longitudinal edge. The elongated grid mesh covers a larger area of the aneurysmal wall than a diamond-shaped grid so that an improvement in the flow control within the aneurysm and in the stabilization of the aneurysmal wall is achieved.

In a diamond-shaped variant of the grid mesh, the first wires and the second wires are each only, in particular exclusively, deflected in the transition from the interior of the braid into the outer edges. The first wires and the second wires can each extend in the interior of the braid between two spaced apart, in particular arranged in parallel, outer edges rectilinearly, in particular without direction change. In the context of the invention, two wires run in different directions when an angle is formed between the wires which is at least 25 °, in particular at least 30 °, in particular at least 45 °. In other words, 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 outer edges are thus either only by first wires or only by second wires ge forms, which are each deflected in the transition from the interior of the braid into the outer edge.

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 in that the reinforcing corners, in particular the first corner and the diametrically opposite arranged second corner, are moved 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.

With regard to the outer edges of the lattice braid, it can be provided that at least one outer edge, in particular all outer edges, is formed by at least one reinforcing wire, which has a larger cross-sectional diameter than the remaining wires of the lattice braid. The reinforcing wire may advantageously form a frame or a closed frame that 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.

The invention will be explained in more detail below by means of embodiments with reference to the accompanying schematic drawings. Show in it

1 is a plan view of an inventive medical implant according to a preferred embodiment;

FIG. 2 shows a side view of the implant according to FIG. 1. FIG

Planned condition within an aneurysm Fig. 3 u. 4 different stages in the discharge of the implant of Figure 1 in an aneurysm.

5 is a plan view of an implant according to the invention according to a further preferred embodiment, wherein the implant has a plurality of grid meshes, which are interconnected by connecting elements;

FIG. 6 shows a side view of the implant according to FIG. 5 in a folded state; FIG.

FIG. 7 shows a side view of the implant according to FIG. 5 in the implanted state within an aneurysm; FIG.

8 is a side view of an implant according to the invention according to a further preferred embodiment, wherein two grid meshes are arranged parallel to each other;

9 shows a plan view of an implant according to the invention in accordance with a further preferred exemplary embodiment, wherein two grid meshes are arranged parallel to one another and have different braiding angles;

10 is a side view of the implant of FIG. 9 in the

 Release within an aneurysm;

11 is a side view of an implant according to the invention according to a further preferred embodiment, wherein a plurality of grid meshes are arranged like a fan to each other;

FIG. 12 shows a side view of the implant according to FIG. 11 in the implanted state within an aneurysm; FIG. 13 is a side view of an implant according to the invention according to a further preferred embodiment in the implanted state, wherein two interconnected grid meshes are formed substantially opposite to each other in the opposite direction; and

14 shows a plan view of an implant according to the invention in accordance with a further preferred exemplary embodiment, wherein between each two outer edges of the lattice braid a longitudinal edge is arranged, which extends substantially parallel to a longitudinal axis of the lattice braid.

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. At the outer edge of the mesh, the meshes are bounded either by two first wires 11, a second wire 12 and an outer edge 22, 24 or by two second wires 12, a first wire 11 and an outer edge 21, 23. The mesh 10 has a plurality of stitches 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. Concretely, the mesh 10 has a flexibility that allows adaptation of the mesh 10 to an aneurysm 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 take place only within the aneurysm 60. It is also possible that the grid mesh 10 is bulged, that is, in the state of rest has a curvature or at least a two-dimensional curvature. The pearled mesh has smooth outer edges 21, 22, 23, 24 formed respectively by the first wires 11 and / or the second wires 12.

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 identical in all 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 are 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 the deflected second wires 12 extend 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 construction of the braid end of the tubular or basket-shaped grid structure described in the subsequently published German patent application no. 10 2009 056 450.0. The aforementioned patent application, in particular pages 15 to 23 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. Specifically, in each case at least 8, in particular at least 16, in particular at least 24, first or second wires 11, 12 in each case an outer edge 21, 22, 23, 24 transferred. 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 such that the number of wires 11, 12 respectively supplied 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 second wire 11, 12 is in each case supplied 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 according to FIG. 1, holding elements 50 are provided, which are arranged at the corners 41, 42, 43, 44 of the lattice braid 10. The implant has four holding elements 50, each corner 41, 42, 43, 44 each having a holding element 50 associated therewith. Another number of retaining elements is possible. In particular, at least one retaining element 50 is arranged at a corner 41, 42, 43, 44 of the mesh 10.

At the first corner 41, a holding element 50 is arranged. In particular, the wires 11, 12 of the first outer edge 21 and the fourth outer edge 24 continue beyond the first corner 41 and thereby form the retaining element 50. The wires 11, 12 continued over the first corner 41 are connected together in a retaining loop 53. Specifically, the first wires 11 and the second wires 12 integrally merge inside the holding member 50 to form the holding loop 53. Starting from the first corner 41 where the first and second wires 11, 12 converge, the first and second wires extend 11, 12 as a wire strand. The wire strand is thus formed by at least one first wire 11 and at least one second wire 12, the first wire 11 and the second wire 12 touching each other. In particular, the first wire 11 and the second wire 12 may be parallel to each other or twisted together. The first and second wires 11, 12 of the first and fourth outer edges 21, 24 thus form, beyond the first corner 41, an extension which forms the retaining element 50. Instead of a retaining loop 53 it can be provided that the retaining element 50 comprises a sleeve which connects the wire ends of the first and second wires 11, 12 or of the wire strand. The construction of the diametrically opposed holding element 50 at the third corner 43 may be identical to the structure of the holding element 50 at the first corner 41. It is also possible that the wire strand or the first and second wires 11, 12 at the first corner 41 has open wire ends which are connected to a sleeve and the wire strand is integrally formed on the third corner 43 and forms a retaining loop 53. The two diametrically opposite holding elements 50 at the first and third corners 41, 43 may also both be formed by a wire strand with free wire ends.

The mesh 10 of FIG. 1 is substantially diamond-shaped. In particular, the meshes 15 of the mesh 10 have a diamond shape, in particular a square diamond shape. Two diametrically opposite arranged corners 41, 43, in particular the first and third corner 41, 43, preferably form reinforcing corners 45, 46, at each of which the wire ends of the first and second wires 11, 12 are brought together and form an extension or a holding element 50 , In the holding element 50, the first and second wires 11, 12, in particular the wire ends, are looped around or form a retaining loop 53.

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 are brought together from different outer edges 21, 22, 23, 24 and continue over the second and fourth corners 42, 44, respectively. The first wire 11 and the second wire 12 continuing over the second and fourth corners 42, 44, respectively, form a holding element 50. In particular, at the second corner 42 and the fourth corner 44, wire ends of the first wire 11 and of the first wire 11 are respectively connected second wire 12 is provided, which form a wire strand of two wires and are continued as a holding element 50 via the respective corner 42, 44 addition. At the ends of the holding elements 50 holding loops 53 are formed.

FIG. 2 shows the implant according to FIG. 1 in the implanted state within an aneurysm. The aneurysm 60 adjoins a blood vessel 61, whereby the blood barrel 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 into it.

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. The mesh 10 may in particular be pre-curved already during production such that the mesh 10 is substantially plate-like or cup-shaped. This form has the advantage that the grid mesh 10 applies relatively easy and vessel wall gentle to the inner wall of an aneurysm 60.

In Figures 3 and 4, the process of implantation of the medical implant is shown. The implantation of the medical implant or occlusion device is effected by means of a delivery system, in particular a catheter 65, which in FIG the aneurysm 60 is introduced. 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 an opposing movement of the reinforcing corners 45, 46 in the opposite direction. 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 for the inner diameter of the catheter 65 and the dimensions of the compressed mesh 10 to be coordinated with one another such that the mesh 10 within the catheter 65 remains substantially in the planar form.

Within the catheter 65, the mesh 10 may be coupled to a guide element. Preferably, the guide element is detachably connected by a sleeve to the third corner 43 or the holding element 50 at the third corner 43 of the mesh braid 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. 3, 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. 4). 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. 5 shows a further exemplary embodiment of the implant according to the invention, which is constructed from a plurality of mesh braids 10. In particular, a first mesh 101, a second mesh 102 and a third mesh 103 are provided, wherein the meshes 101, 102, 103 are coupled together by connecting elements 30. The first grid mesh 101 is essentially constructed in accordance with the grid mesh 10 according to FIG. 1 with the difference that instead of the holding element 50, a connecting element 30 is arranged on the third corner 43 or the second reinforcement corner 46. Conveniently, the first and second wires 11, 12 of the second and third outer edges 22, 23 are brought together in the third corner 43 and form a wire strand comprising the first mesh 101 with the second mesh 102 connects. The first and second wires 11, 12 of the first mesh 101 may be integrally formed into the second mesh 102. In particular, all of the mesh braids 10 of the implant may be formed by the same first and second wires 11, 12. In the region of the connecting element 30, the first and second wires 11, 12 can run parallel to one another or run parallel to one another. Alternatively, the wire strand forming the connecting element 30 may also be formed by twisted first and second wires 11, 12.

In the exemplary embodiment according to FIG. 5, the second grid 102 has no holding elements or is formed free of holding elements. The two outer edges 21, 22, 23, 24, which meet each other at the second corner 42 and the fourth corner 44 of the second mesh 102, in the embodiment of FIG. 5 do not go over into holding elements. Rather, the first wires 11 and the second wires 12 are deflected at the second corner 42 and the fourth corner 44 and transferred into the adjacent outer edge 21, 22, 23, 24. The second corner 42 and the fourth corner 44 of the second lattice braid 102 thus essentially form deflection points 16 between two outer edges 21, 22, 23, 24. It is also possible for the second lattice braid 102 to be provided at the second corner 42 and the fourth corner 44 a holding element 50 has.

The third grid 103 is constructed in correspondence with the first grid 101, with the single connection 30, that is, the third grid 103 connects to the second grid 102, is disposed at the first corner 41 of the third grid 103 mesh.

Overall, the implant according to FIG. 5 is formed by three grid meshes 101, 102, 103, which are arranged substantially in the manner of a chain. In other words, the grid meshes 101, 102, 103 are arranged in series or in series one behind the other. Specifically, it is provided that the first grid mesh 101 has a third corner 43 which is coupled by the connecting element 30 with the first corner 41 of the second grid mesh 102. The third corner 43 of the second mesh 102 is further coupled by the further connecting element 30 with the first corner 41 of the third mesh 103. In principle, the implant can have more than three mesh braids 10, wherein in each case a connecting element 30 is arranged between the third corner 43 of a mesh braid 10 and the first corner 41 of an adjacent mesh braid 10.

The connecting element 30 is flexible. This will allow the implant to fold in use. In particular, it is provided that the mesh braids 10 fold into one another like a zigzag in use such that the mesh braids 10 are arranged substantially one above the other. This is exemplified in Fig. 6. Concretely, in use, the implant is folded on the connecting elements 30 in such a way that the second mesh 102 is arranged between the first mesh 101 and the third mesh 103, the lattice structures being superimposed. In the cross-sectional view according to FIG. 7, it can be clearly seen that when the multi-part implant according to FIG. 5 is released, the lattice meshes 10 are arranged like an accordion within the aneurysm 60. In this way, the aneurysm 60 can be filled by a plurality of mesh braids 10, which leads to a particularly good flow control with low risk of rupture.

Instead of arranging a plurality of mesh braids in series or serially, it can be provided that at least two mesh braids 10 are arranged parallel to one another. An example of this is shown in FIG. 8. The implant according to FIG. 8 comprises two grid meshes 101, 102, wherein the first grid mesh 101 has a holding element 50 at the corners 41, 42, 43, 44. The second grid 102 is arranged parallel to the first grid 101 and connected to the holding elements 50 of the first grid 101. In particular, it is provided that between the first grid mesh 101 and the second grid 102 a total of four connecting elements 30 are arranged, which are formed by the holding elements 50. The connecting elements 30 and holding element 50 respectively connect the corners 41, 42, 43, 44 of the two mesh braids 101, 102. Each corner 41, 42, 43, 44 of the first mesh 101 is connected to a corner 41, 42, 43, 44 of FIG coupled second grid 102. The holding elements 50 have holding loops 53.

In the embodiment according to FIG. 8, the holding elements 50 are extended beyond the second grid 102 and have free ends. The free ends are limited by the straps 53. It can be provided in principle that the holding element 50 is connected at its two ends to a respective mesh 101, 102, in particular in each case a corner 41, 42, 43, 44 of a mesh braid 101, 102. The retaining element 50 in this variant of the implant according to the invention has essentially the same structural design as a connecting element 30 (FIG. 5), but the retaining element 50 has a length which gives the retaining element 50 the property of fixing the implant in the hollow body or To cause aneurysm 60. In other words, the mesh braids 101, 102 may be coupled by connecting elements 30 that have a length such that the connecting elements 30 have a holding function or forming holding elements 50. Preferably, all four corners 41, 42, 43, 44 of the grid mesh 101, 102 connected by such connecting elements 30, the holding elements 50, respectively. In the implanted state, the connecting elements 30 or holding elements 50 bulge or spread outwards and thus fix the implant in the aneurysm. For this purpose, the connecting element 30 or holding element 50 has a corresponding flexibility or clamping force.

The implant according to FIG. 8 has two mesh braids 101, 102, which are bulged. The grid mesh 101, 102 was thus given a curved structure in the manufacture of the implant, for example by a heat treatment. The grid meshes 101, 102 are furthermore arranged at a distance from one another, so that a buffer area 70 is formed between the grid meshes 101, 102. The buffer region 70 advantageously contributes to influencing the flow within an aneurysm.

It is also possible to form the implant with lattice meshes arranged in parallel in such a way that the buffer area 70 only becomes in the implanted state established. For this purpose, it may be provided that the mesh braids 101, 102 have different braiding angles, as can be seen in the embodiment according to FIG. 9. FIG. 9 shows a plan view of an implant according to the invention, wherein a first mesh 101 is connected to a second mesh 102. In particular, the first grid mesh 101 has a first corner 41 and a third corner 43, wherein the first corner 41 and third corner 43 are formed as reinforcement corners 45, 46. The holding elements 50 on the reinforcing corners 45, 46 simultaneously serve as connecting elements 30 between the two mesh braids 101, 102. In particular, the second mesh 102 also has two reinforcing corners 45, 46, which respectively pass into the same holding element 50, that of the corresponding reinforcing corner 45, 46 of the first grid 101 is assigned. The two mesh braids 101, 102 each have a second corner 42 and a fourth corner 44, wherein the second corners 42 and the fourth corners 44 are not connected to each other. Specifically, both the first grid mesh 101 and the second grid 102 have two diametrically opposite free corners 42, 44. At the free corners 42, 44 of the mesh braids 101, 102 each holding elements 50 are arranged. The diametrically opposite free corners 42, 44 make it possible for the two mesh braids 101, 102 to behave differently during expansion, that is to say when they are inserted into an aneurysm 60. In particular, due to the different braiding angle, in each case a different curvature arises in the case of the first mesh 101 and the second mesh 102.

The implant according to FIG. 9 is shown in the implanted state in FIG. 10. It can be clearly seen that the first mesh 101 is more curved than the second mesh 102 due to the difference in the braid angle. The first mesh 101 attaches to the aneurysm wall in particular. In contrast, the second grid 102 stretches distanced from the aneurysm wall or from the first grid 101 in the interior of the aneurysm between the reinforcement corners 45, 46 of the first grid 101. Due to the distance between the two mesh braids 101, 102, the buffer region 70 is formed. The buffer area 70 only forms during the expansion of the mesh braids 101, 102. In the compressed state of the implant, the mesh braids 101, 102 are preferably directly adjacent to one another.

Another variant of a multi-part implant or an implant with a plurality of interconnected mesh braids 10 is shown in FIG. 11. In this case, a total of three grid meshes 101, 102, 103 are provided, each having a corner 41, wherein the converging in the corner 41 first and second wires 11, 12 merge into a common holding element 50. Concretely, the implant according to FIG. 11 has a retaining element 50, which simultaneously forms a connecting element 30. In each case, the first corners 41 of the three meshes 101, 102, 103 are connected to the holding element 50 or connecting element 30. In this way, the grid meshes 101, 102, 103 are arranged substantially fan-like or scale-like on each other. In the exemplary embodiment according to FIG. 11, the first grid mesh 101 has three further holding elements 50, which are each assigned to one corner of the first grid grid 101. The other mesh braids, in particular the second mesh 102 and the third mesh 103, however, each have three free corners 42, 43, 44. At the free corners 42, 43, 44 no holding elements 50 are arranged. Rather, the free corners 42, 43, 44 deflecting points 16 between two adjacent outer edges 21, 22, 23, 24th

FIG. 12 shows the implant according to FIG. 11 in the implanted state within an aneurysm 60. It can clearly be seen that the first mesh 101 is stretched within the aneurysm 60 and anchors the implant with the retaining elements 50 in the aneurysm 60. The second grid 102 and the third grid 103 are substantially above the first grid

101 and fill the space between the first grid 101 and the aneurysm wall.

A further exemplary embodiment of an implant according to the invention with a plurality of mesh braids 10 is shown in FIG. 13. The implant according to FIG. 13 comprises two mesh braids 101, 102, which are coupled to one another by a connecting element 30. The connecting element 30 connects in each case one corner of the first mesh braid 101 with a corner of the second mesh braid 102. In the embodiment according to FIG. 13, the connecting element 30 is designed essentially as a long helically wound wire strand. Specifically, the connecting element 30 according to FIG. 13 has a length which is adapted such that the connecting element 30 in the implanted state within an aneurysm 60 spirals between the two mesh braids 101,

102 can wind. Specifically, it is provided in the embodiment according to FIG. 13 that a first mesh 101 has a first corner 41, which is coupled to a third corner 43 of the second mesh 102 by the connecting element 30. The first grid mesh 101 further has a second corner 42, a third corner 43 and a fourth corner 44, on each of which a holding element 50 is arranged. The holding elements 50 each have a retaining strap 53. The second grid 102 has a second corner 42 and a fourth corner 44, which are formed free of holding elements or deflecting points 16 between two adjacent outer edges 21, 22, 23, 24 form. A third corner 43 of the second mesh 102 comprises a retaining element 50 with a retaining loop 53. In the implanted state, the first mesh 101 is arranged in the region of a dome of the aneurysm 60. In particular, it is provided to arrange the first grid mesh 101 against the aneurysm wall, preferably in the region of the rupture. On the other hand, the second grid 102 is preferably arranged in the area of the aneurysm neck in order to prevent blood flow into the aneurysm. As a result of the helically wound connecting element 30 arranged between the two mesh braids 101, 102, the distance between the mesh braids 101, 102 is variable. Thus, the implant can be adapted well to the size of the respective aneurysm 60 to be treated. The spiral-shaped connecting element 30 can act spring-like. In particular, the helical connector 30 may form a compression spring which urges the first mesh 101 to the aneurysm wall and the second mesh 102 to the aneurysm neck.

In general, the connecting element 30 according to FIG. 13 can act as a holding element 50 or have a holding function. Due to the spiral shape, the connecting element 30 can expand radially and apply a holding force against the aneurysm wall. In the embodiment according to FIG. 13, therefore, only the connecting element 30 can be provided as a holding element 50. In particular, the first grid 101 and the second grid 102 or the entire implant can have only one holding element 50, which is designed as a spiral connecting element 30. In this case, the connecting element 30 is sufficiently long and flexible to apply a radial holding force.

For all of the aforementioned exemplary embodiments, the first corner 41 of the mesh braid 10 of the third corner 43 of the mesh braid 10 is arranged diametrically opposite one another. The second corner 42 is diametrically opposite the fourth Corner 44 arranged. Furthermore, for all the aforementioned exemplary embodiments, the grid mesh essentially has a diamond-shaped outer contour, that is, the outer edges 21, 22, 23, 24 meet one another directly at an angle, and two outer edges 21, 22, 23, 24 each have a corner 41, 42, 43, 44 form.

FIG. 14 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 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 a way during the transition from the braid inside to the outer edge 21, 22,

23, 24 deflected, that increases the number of wires of the two adjacent outer edges 21, 22, 23, 24 in the direction of a common corner 41, 42, 43, 44 of the two outer edges 21, 22, 23, 24. The common corner 41, 42, 43, 44 forms a reinforcing corner 45, 46, in which the number of wires is maximum.

In contrast to the diamond-shaped lattice meshes 10 according to the preceding embodiments, the lattice mesh 10 according to FIG. 14 has an elongate shape. In particular, two longitudinal edges 17, 18 are provided which each extend between two smooth outer edges 21, 22, 23, 24. A first longitudinal edge 17 blanks between the first outer edge 21 and the second outer edge 22. A second longitudinal edge 18 extends between the third outer edge 23 and the fourth outer edge 24. The longitudinal edges 17, 18 extend parallel to a longitudinal axis of the lattice braid 10, wherein the longitudinal axis again parallel to a connecting line between the first corner 41 and the second corner 42 extends.

The longitudinal edges 17, 18 have a wavy or toothed or serrated edge line. Specifically, a plurality of deflection points 16 are provided along the longitudinal edges 17, 18, at which in each case the first or second wires from a first or second direction Rl, R2 are deflected in a second or first direction R2, Rl. Here, the deflection points 16 are not as in the outer edges 21, 22, 23, 24 along the first or second direction Rl, R2 nachgeordord- net, but in the longitudinal direction of the grid mesh 10. The longitudinal edges 17, 18 are therefore in contrast to the outer edges 21, 22, 23, 24 not smooth. In particular, the longitudinal edges 17, 18 have no edge sections in which at least two first wires 11 or two second wires 12 run together along the longitudinal edge 17, 18. The longitudinal edges 17, 18 are rather continuously formed by individual wires.

In the embodiment according to FIG. 14, six corners 41, 42, 42 ', 43, 44, 44' are provided. Concretely, the grid mesh 10 according to FIG. 4 has two reinforcing corners 45, 46 arranged diametrically opposite one another, over which wire ends of the first and second wires 11, 12 continue to form a holding element 50 in each case. The wire ends are connected to each other in the holding elements 50 by a sleeve 55. 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 as well as the third outer edge 23 and the fourth outer edge 24 are connected to each other by longitudinal edges 17, 18 arranged therebetween. Specifically, the first outer edge 21 on the one hand by first corner 41 and first reinforcing corner 45 and a second corner 42 is limited. The second corner 42 connects the first outer edge 21 with the first longitudinal edge 17. Likewise, the second outer edge 22 is bounded on the one hand by the second reinforcement corner 46 and on the other by a fifth corner 42 ', wherein the fifth corner 42' the second outer edge 22 with the first Longitudinal edge 17 connects. 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. The fourth corner 44 connects the fourth outer edge 24 to the second longitudinal edge 18. The second longitudinal edge 18 is further connected to the third outer edge 23 by the sixth corner 44 '. In the exemplary embodiment according to FIG. 14, too, all the first and second wires 11, 12 extending in the interior of the braid are deflected during the transition into the outer edges 21, 22, 23, 24. Moreover, the first and second wires 11, 12 are deflected at the longitudinal edges 17, 18 and returned to the interior of the mesh. In the interior of the braid, the first and second wires 11, 12 are preferably rectilinear.

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.

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.

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 biode gradable. Overall, the entire implant may comprise a biodegradable material or consist of a biodegradable material. 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 of at least 0.5, especially at least 0.6, and in particular we ^¬ nigstens 0.7, especially at least 0.8, especially at least 0.9.

LIST OF REFERENCE NUMBERS

10 grid mesh

 101 first grid mesh

 102 second grid

 103 third grid

 11 first wire

 12 second wire

 15 mesh

 16 deflection point

 17 first longitudinal edge

 18 second longitudinal edge

 21 first outer edge

 22 second outer edge

 23 third outer edge

 24 fourth outer edge

 30 connecting element

 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

 53 holding loop

55 sleeve Aneurysm blood vessel catheter buffer area first direction 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 run and the first wires (11) to form meshes (15) of the grid mesh (10) intersect,  d a d u rc h e ke n ze i c h n et that  the mesh braid (10) is bubble-shaped and has smooth outer edges (21, 22, 23, 24) each formed by the first or second wires (11, 12), wherein  the first wires (11) and the second wires (12) in each case at the transition from the interior of the braid 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) extend along the outer edge (22, 24) in the first direction Rl, and the outer edges (21, 22, 23, 24) each have 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 where  the lattice braid (10) comprises at least one corner (41, 42, 43, 44) at which two outer edges (21, 22, 23, 24) are joined together at an angle, and  an elongate retaining element (50) is provided which is arranged at the corner (41, 42, 43, 44) and adapted for fixing the mesh braid (10) within the hollow body. 2. Implant according to claim 1,  d a d u rc h e n c e s n e s c h n et that the holding element (50) with the first and second wires (11, 12) fixedly connected, in particular integrally formed. 3. Implant according to claim 1 or 2,  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 three times, in particular at least four times, in particular at least five times, in particular at least seven times, in particular at least 10 times, in particular at least 15 times, in particular at least 20 times, the size, in particular the width, of the meshes (15) of the lattice braid (10). 4. Implant according to one of claims 1 to 3,  d a d u rc h e ke n ze i c h n et that  the holding element (50) is formed, at least in sections, by a wire strand which comprises at least one first wire (11) and at least one second wire (12) each made up of different outer edges (21, 22, 23, 24) of the lattice braid (10). merged and continue on the grid mesh (10) continues. 5. Implant according to claim 4,  d a d u rc h e ke n ze i c h n et that  the first wire (11) and / or second wire (12) within the holding element (50) are interconnected or merge into one another in one piece. 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 wire (11) and / or the second wire (12) run parallel to one another within the wire strand or are twisted together. 7. Implant according to one of claims 1 to 6,  d a d u rc h e ke n ze i c h n et that at least a first grid mesh (101) and a second grid mesh (102) are provided, which are interconnected by a connecting element (30). 8. Implant according to claim 7,  d a d u rc h e ke n ze i c h n et that  the connecting element (30) connects a corner (41, 42, 43, 44) of the first mesh braid (101) to a corner (41, 42, 43, 44) of the second mesh braid (102). 9. Implant according to claim 7 or 8,  d a d u rc h e ke n ze i c h n et that  the connecting element (30) is formed by a retaining element (50). 10. Implant according to one of claims 7 to 9,  d a d u rc h e d e n c tio n that  the first grid mesh (101) and the second grid mesh (102) are arranged in a chain-like or fan-like manner or parallel to one another. 11. Implant according to one of claims 7 to 10,  d a d u rc h e n c t n o n c t that  the first grid braid (101) has a different braid angle or different braiding or other dimensions than the second grid braid (102). 12. Implant according to one of claims 7 to 11,  d a d u rc h e ke n ze i c h n et that  between the first grid mesh (101) and the second grid mesh (102) a buffer area (70) is arranged is. 13. Implant according to one of claims 1 to 12,  d a d u rc h e n c t n o n c t that  between two smooth outer edges (21, 22, 23, 24) of the mesh braid (10) a longitudinal edge (17, 18) is arranged, which extends substantially parallel to a longitudinal axis of the mesh (10).