[go: up one dir, main page]

WO2012049197A1 - Dispositif médical, en particulier endoprothèse - Google Patents

Dispositif médical, en particulier endoprothèse Download PDF

Info

Publication number
WO2012049197A1
WO2012049197A1 PCT/EP2011/067772 EP2011067772W WO2012049197A1 WO 2012049197 A1 WO2012049197 A1 WO 2012049197A1 EP 2011067772 W EP2011067772 W EP 2011067772W WO 2012049197 A1 WO2012049197 A1 WO 2012049197A1
Authority
WO
WIPO (PCT)
Prior art keywords
mesh
wire element
widening
medical device
wire
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/EP2011/067772
Other languages
German (de)
English (en)
Inventor
Giorgio Cattaneo
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Acandis GmbH and Co KG
Original Assignee
Acandis GmbH and 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 and Co KG filed Critical Acandis GmbH and Co KG
Publication of WO2012049197A1 publication Critical patent/WO2012049197A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/88—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure the wire-like elements formed as helical or spiral coils
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0036—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness

Definitions

  • the invention relates to a medical device, in particular a stent.
  • the invention relates in particular to a medical device or a stent with a rotationally symmetrical grid mesh.
  • Stents formed from interwoven wires are well known. In general, with a suitable design of the stent on the one hand a
  • the wall thickness of the stent or the mesh is set as small as possible in order not to unnecessarily obstruct the blood flow within the blood vessel.
  • the mesh of the stent is made up of round wires, the reduction of the wall thickness is limited, since the use of thinner wires reduces the radial force at the same time.
  • stents are therefore also known, whose braid wires are band-like.
  • the mesh of the known stents is thus formed by interwoven bands.
  • a particularly thin-walled design of the mesh is achieved, whereby a hindrance of blood flow through a blood vessel is reduced and the risk of thrombogenicity is reduced.
  • bands have a comparatively large ratio between the width of the band and the thickness of the band or wall thickness of the lattice mesh. Due to the relatively large width of the bands compared to their height or thickness, a sufficient radial force is provided with simultaneously reduced wall thickness.
  • the minimum diameter of the grid mesh so the crimp diameter or the diameter, which is taken in a feeding system, determined from the number of Ribbons and their width.
  • the minimum crimp diameter thus corresponds ideally to the formula
  • the number of belts is limited at given diameters of the delivery system because a relatively large width of the belts is required to achieve the desired radial force.
  • the comparatively small number of bands or band-like widths prevents the use of the stent for influencing flow conditions in one
  • Blood vessel in particular for covering an aneurysm. Due to the small number of bands, the meshes of the stent or the openings provided between the bands are relatively large, so that the openings can be flowed through substantially without resistance. Thus, the possibilities for retaining particles moving with the blood flow, for example particles which can detach from soft plaque or carotid stenoses, are limited.
  • the known stent is unsuitable for flow influencing and / or filtration of particles.
  • the invention is based on the object, a medical device,
  • a stent in particular a stent, specify that allows for small wall thickness and sufficient radial force an efficient flow control.
  • the invention is based on the idea of specifying a medical device, in particular a stent, with a rotationally symmetrical grid mesh.
  • the mesh is from a radially compressed state to a radially expanded one Condition convertible.
  • the grid mesh comprises at least a first
  • Wire element which is intertwined to form at least one crossing point with at least one second wire element.
  • At least the first wire element is band-shaped and has at least one widening, which is arranged at a distance from the point of intersection.
  • the idea of the invention is to form at least one wire element of the lattice mesh band-shaped or as a band, wherein the band-shaped wire element at least partially has a broadening.
  • the band-shaped first band element has a profiling or a variable width.
  • the second wire element may be designed differently, in particular comprising a round wire element.
  • the second wire element may also be formed band-shaped.
  • At least the first wire element comprises the broadening.
  • the broadening is arranged at a distance from the point of intersection. This means that the first wire element is substantially narrower in the region of the crossing point than in a section outside the crossing point.
  • the widening or the variable width of the wire element on the one hand enables the crimping or compression of the mesh to a relatively small cross-sectional diameter. Since the first wire element is formed at the crossing point substantially relatively narrow, so the crimpability is improved.
  • the broadening causes, in the expanded state, in particular in the implanted state, the rotationally symmetrical grid mesh to have a relatively large contact surface with a body hollow organ or that a relatively large surface of the grid mesh is covered.
  • broadening contributes significantly to improving flow control or particulate filtering.
  • the first wire element has a cross-sectional profile having a width and a height, wherein the width is greater than the height that substantially determines the wall thickness of the grid mesh.
  • the wall thickness of the grid mesh is determined by the height of the first wire element in conjunction with the height of the second wire element. In the crossing point, the first wire element and the second wire element lie on one another, so that the sum of the heights of the first wire element and the second wire element form the maximum wall thickness of the grid mesh.
  • the determination of the height of the first wire element takes place substantially in the radial direction with respect to the Rotation axis of the lattice braid.
  • the width of the first wire element is determined substantially in the circumferential direction of the grid mesh.
  • the width and the height of the first wire element are different, so that the contribution of the height or thickness of the wire element to the radial force of the mesh is reduced or attenuated.
  • the first wire element thus makes it possible to reduce the wall thickness or the height of the wire element without negatively influencing the radial force.
  • the broadening is between two immediately adjacent ones
  • the crossing points are formed on the one hand by the first wire element and on the other hand by the second wire element or another wire element.
  • the medical device according to the invention enables on the one hand a
  • the widening extends at least partially into a mesh of the mesh.
  • the grid mesh has at least one mesh, which is delimited at least by the first wire element and the second wire element.
  • the mesh of the mesh is limited by at least four wire elements, wherein one of the wire elements forms a first wire element according to the invention.
  • the mesh of the lattice braid thus preferably comprises four crossing points, two crossing points being formed by the first wire element. In particular, a first intersection point through the first wire element and the second wire element and a second intersection point through the first
  • the widening of the first wire element is preferably arranged such that the widening extends at least partially into the mesh.
  • the broadening thus allows at least partially covering the mesh of the mesh, so that the formed by the mesh free opening is reduced.
  • the widening contributes favorably to the flow control.
  • the first wire element substantially has a non-round, in particular quadrangular, cross-sectional profile.
  • a rectangular cross-sectional profile of the first wire element since in this way on the one hand, the wall thickness of the mesh braid efficiently reduced and at the same time an increased radial force can be provided.
  • the first wire element may further include edges that are bevelled or rounded.
  • the side or side surfaces of the first wire element which extend substantially in the radial direction, curved, in particular with respect to the wire element arched outward, are.
  • the band-shaped wire element can thus essentially form a flat profile with mutually parallel outer and inner surfaces and outwardly curved side surfaces.
  • the extension may be radially deflectable like a flap.
  • the widening can therefore be flexible at least in sections. This applies in particular to the part of the broadening which forms the extension or projects beyond the width of the first wire element.
  • the extension or part of the widening, which projects into the mesh of the grid mesh or projects beyond the width of the first wire element in the region of the crossing point, can in particular be designed so flexible that the widening, in particular the extension is radially deflectable.
  • Defensibility of the broadening can also be effected by a torsion of the first wire element.
  • the first wire element can be so flexible that the broadening or extension can be deflected radially by twisting the first wire element, that is to say rotating about its longitudinal axis.
  • the broadening, in particular the extension is entrained by a twist of the first wire element or follows the torsion of the first wire element. This manifests itself in a flap-like arrangement or radial deflection of the extension or the entire broadening.
  • the radial deflection of the extension or the broadening can also by a combination of a twist of the first
  • the broadening can essentially form a flap.
  • This has the advantage that medical functional elements can be passed through the meshes of the mesh.
  • the grid mesh has a comparatively large covered surface, so that the flow of a body fluid, in particular of blood, can be influenced efficiently, the flexible or flap-like radially deflectable extension creates the possibility of medical functional elements, for example a coil catheter to pass the meshes of the mesh braid.
  • the medical device according to the invention can be used advantageously for covering aneurysms, wherein the possibility is maintained of introducing coils into the aneurysm by means of a coil catheter through the meshes of the lattice mesh.
  • the extension can assume one side of the first wire element.
  • the broadening preferably has at least one projection which projects beyond the width of the first wire element.
  • the first wire element may comprise an asymmetrical or a symmetrical broadening.
  • the broadening in one direction proceeds starting from the longitudinal extension of the first wire element.
  • the broadening forms an extension that protrudes on one side over the first wire element.
  • two extensions may extend circumferentially from both sides of the first wire member. The widening can thus be symmetrical, so that the same profiling is shown on both sides of the first wire element.
  • the extensions can also be formed on both sides of the first wire element in an asymmetrical design.
  • the extension may have a smaller height than the first wire element.
  • the projection may extend substantially wing-like laterally from the first wire element, wherein the extension is formed substantially thinner than the first wire element. It is generally provided that the broadening with the first wire element in one piece or
  • the broadening is due to a profiling formed of the first wire element. Due to the reduced height of the extension of the widening with respect to the first wire element, an improved flexibility of the extension is achieved, so that the extension on the one hand in the radially compressed state of the grid structure can extend over other wire elements to improve the crimpability of the medical device. On the other hand, the increased flexibility of the extension by the reduced compared to the first wire element height allows an improvement of the flap function.
  • the widening, in particular the extension can extend along an outer circumference and / or along an inner circumference.
  • the broadening can be seen both on the outer circumference, as well as on the inner circumference of the grid mesh, wherein the extension preferably has the same height as the first wire element.
  • the extension extends in the same circumferential plane, which also includes the first band-shaped wire element.
  • the extension may have a smaller height than the first wire element, wherein the extension can be aligned flush with an outer surface of the first wire element.
  • the broadening extends over the outer circumference of the grid mesh.
  • An extension which has a smaller height relative to the first wire element, are aligned with an inner surface of the first wire element, so that the widening is arranged substantially on the inner circumference of the lattice braid.
  • the broadening extends along a central circumferential plane which is arranged between the outer circumference and the inner circumference of the lattice braid.
  • at least one extension of the broadening can be arranged radially offset inwards relative to the outer peripheral surface of the lattice structure.
  • at least one extension of the widening can be arranged offset radially outward.
  • At least one extension can be arranged centrally between the inner and the outer peripheral surface of the lattice structure.
  • the extension can be arranged further inwards or farther out in each case at a distance from the inner or outer circumferential surface, ie between the middle position and the outer or inner position.
  • the position of the extension in the radial direction can be achieved by etching the lattice structure on both sides.
  • the extension preferably radially inwards or radially outwards bendable or twistable.
  • a curvature of the broadening or the extension is advantageous in order to ensure a smooth transition of the mesh braid from a radially compressed to a radially expanded state.
  • the curvature or torsion may vary depending on the condition of the
  • the compression of the mesh may cause a bowing of the extension of the broadening or a twist of the broadening.
  • compression broadening for insertion into a catheter or generally a delivery system may be curved or twisted so that the broadening adapts to the curved inner surface of the delivery system.
  • the torsion of the overall broadening or the curvature of the extension can also be effected in the expanded state or at least in the implanted state, for example by the action of a coil catheter.
  • the broadening can be twisted like a flap or curved to release a mesh of the mesh, especially for the purpose of performing a
  • the broadening can also have at least two extensions, wherein a first extension radially inwardly and a second extension are curved radially outward or are curvable. Both extensions can be bendable in the same direction, ie radially inward or radially outward. In the curvature of the extensions, the band-shaped wire element remains substantially flush in the wall plane of the mesh.
  • the torsion causes a rotation of the wire element, in particular the widening, about a longitudinal axis of the wire element, wherein the extensions projecting from the wire element on both sides can be arranged in a common, aligned plane.
  • the common plane of the projections is deflected or rotated relative to the circumferential plane or peripheral surface of the mesh.
  • a combined curvature / torsion of the broadening in the compression of the mesh may also be provided. It is possible that the wire element in Regions outside the broadening twisted about its own longitudinal axis, so that the broadening is arranged substantially flat in a plane which is set against the peripheral plane of the rotationally symmetrical grid mesh.
  • the broadening or the first wire element in the region of the widening can have an S-shaped cross-sectional contour.
  • the S-shaped cross-sectional contour can be created by a curvature of the extensions of the broadening of the first wire element.
  • the extension in the compressed state overlaps at least the second wire element or a further wire element.
  • the extension or, in general, the widening does not contribute to the width of the first wire element.
  • the overlapping of the second and further wire elements by the extension of the widening allows a relatively small crimp diameter, while at the same time an improved flow control is achieved in the expanded state by the enlarged surface, which is provided by the widening.
  • the extension In the expanded state of the mesh, the extension can overlap at least one mesh of the mesh.
  • the overlap can be partial or
  • the broadening can protrude into the mesh of the mesh and thus partially close the mesh.
  • the widening can be designed in such a way that, in the expanded state of the lattice braid, a partial covering or a partial closure of at least individual meshes of the lattice braid is made possible.
  • the partial coverage can also be achieved in particular in that at least the extension of the
  • Widening pores includes. Alternatively or additionally, the extension of the
  • Broadening is designed such that the surface of the extension is smaller than the opening area of the mesh of the mesh in the expanded state. Thus, a portion of the mesh of the mesh in the expanded state is not covered by the extension of the widening. Due to the partial closure of the mesh in the expanded state of the mesh braid endothelialization is favored and also allows the meshes of the mesh are at least partially fluid-flow, which in particular in the arrangement of the medical Device in vessel branches is advantageous. Lateral body vessels can thus continue to be acted upon by a fluid flow, which penetrates through the open, so not covered, opening area of the mesh.
  • the extension completely overlaps the mesh in the expanded state of the mesh. If a plurality of widenings are provided over the entire lattice mesh, it is possible in this way to achieve a partial or even complete coverage of the lattice mesh or of the meshes of the lattice mesh. For example, at least in a central region of the lattice braid, which is positioned, for example, in the region of an aneurysm, complete coverage of the lattice braid or meshes can be provided by a plurality of widenings. Thus, a body fluid flow can be completely prevented in some areas. Due to the flexibility of broadening still remains the possibility of penetrating mechanically through the mesh of the mesh, for example with a coil catheter.
  • a plurality of band-shaped first wire elements may be provided, each having at least one broadening.
  • the first wire elements can each have several widenings.
  • the first wire elements in each area between two crossing points may each comprise a widening.
  • the plurality of first wire elements can on the one hand in
  • the plurality of first wire elements may be arranged crossing each other in the mesh.
  • both the first and the second or further wire elements may comprise spacers.
  • the widenings can be arranged such that each mesh of the mesh is assigned at most a broadening, which covers the mesh at least partially. It is also possible that a part of the mesh of the lattice mesh has a widening, in particular only a broadening. Another part of the mesh of the mesh may be formed without widening.
  • the meshes of the mesh may each be associated with a plurality of widenings, which together lead to an at least partial, in particular complete, coverage of the mesh.
  • the mesh can be partially covered in the expanded state of the mesh by several widenings or extensions of widening.
  • the extensions of the spacers may together comprise a surface area smaller than the opening area of the mesh in the expanded state of the Grid mesh is.
  • the extensions or in general the widenings may have pores, so that partial coverage of the mesh is achieved.
  • the spacers may overlap. This ensures that the widenings do not or at least only slightly affect the crimpability of the mesh. It is also possible that the widenings in the expanded state of the grid mesh overlap, in particular to ensure complete coverage of one or more meshes of the grid mesh.
  • the first wire element is connected to the second wire element at at least one axial end of the mesh braid to form an end loop.
  • free wire element ends are avoided at the axial ends or at least one axial end of the mesh braid.
  • the first and second wire elements connected to an end loop reduce the risk of injury emanating from free wire element ends.
  • the end loop allows the atraumatic design of the axial ends of the grid mesh.
  • the first wire element and / or the second wire element may have a taper in the region of a tip of the end loop.
  • a transition region may be provided between the first and the second wire element at the tip of the end loop, which comprises the taper.
  • the transition region has a smaller width than the first wire element and / or the second wire element.
  • the connection of the first wire element with the second wire element in the connection area causes an increased radial force.
  • the taper at the tip of the end loop reduces the radial force so that the radial force is equal over the entire length of the mesh. Further, the taper at the tip of the end loop causes the end loop to be crimped without being radially deployed.
  • the end loop when compressing the mesh, the end loop does not deviate in the radial direction, but remains substantially in the circumferential plane of the mesh. Due to the taper in the region of the tip of the end loop, the local radial force at the axial end of the mesh can be reduced so much that over the entire Length of the mesh braid sets substantially the same radial force. This prevents the axial ends of the lattice mesh from being pressed more strongly into a vessel wall of a hollow body of the body than, for example, a central region of the lattice mesh.
  • the invention does not exclude that the wire elements on at least one axial end of the mesh braid comprise open wire ends.
  • the widening is asymmetrical with respect to a longitudinal extent of the first wire element, so that a first extension of the widening projects further beyond the width of the first wire element than a second extension of the widening.
  • first and / or second extensions of adjacent first wire elements overlap. Due to the asymmetrical design of the broadening or asymmetric profiling of the first wire element to form the asymmetric broadening, the overlap of the extensions can be improved.
  • the grid mesh may have at least one circumferential segment of immediately adjacent meshes. At least a portion of the stitches, in particular all stitches, of the circumferential segment can each be assigned at least one widening.
  • the circumferential segment is preferably formed as a ring of immediately adjacent meshes of the mesh.
  • the first extensions of the widenings of the circumferential segment can be oriented essentially in the same circumferential direction, so that the widenings overlap in a scale-like manner in the compressed state of the lattice mesh.
  • the first extensions in the compressed state of the mesh may overlap the second extensions.
  • the first extensions are oriented in the same or alternately in different axial directions.
  • the extensions have a peripheral component and an axial component with respect to their extension from the wire element.
  • the first extensions of the widenings of the circumferential segment are arranged such that the first extensions have substantially the same peripheral component or are oriented in the same circumferential direction.
  • the axial component of immediately adjacent extensions of the circumferential segment may be different.
  • the orientation of the projections in the same circumferential direction has the advantage that the extensions during compression of the grid mesh uniformly and roof tile-like overlap, whereby a substantially uniform outer diameter of the mesh is achieved. If the first extensions of the widenings of the circumferential segment are oriented in the same axial direction or have the same axial component, a ring segment comprising the extensions or extensions and a ring segment adjacent in the axial direction results in the compressed state of the mesh
  • the first extensions can also be oriented alternately in different axial directions or have alternately different axial components.
  • the first extensions are axially oriented in a distal direction relative to a delivery system for the medical device. This has the advantage that the supply of a coil catheter is facilitated by a mesh of the mesh, since the first extensions are oriented substantially in the same direction, which also corresponds to the feeding direction of the coil catheter. An entanglement of the coil catheter when penetrating a mesh of the mesh is thus avoided.
  • the extension of the first wire element in the expanded state can overlap at least one extension of another wire element at least in sections.
  • the extension of the first wire element can overlap or cover one or more meshes of the mesh braiding in the expanded state. The other or additionally covered
  • Maschen may have wire elements without a broadening or be formed completely widening.
  • FIG. 1 shows a detail view of a grid mesh known from practice with band-shaped wire elements.
  • Fig. 2 is a detail view of a medical invention
  • a band-shaped wire elements has a ei n worne broadening, which overlaps a mesh of the grid mesh; in each case a medical device according to FIG. 2, at which the
  • Spacers are arranged on different circumferences of the mesh, during manufacture on differently structured braided spines; a cross-sectional view of a first wire member of a medical device according to the invention according to a preferred embodiment, wherein the broadening is curved in a deformed state in different directions; a cross-sectional view of a first wire element of
  • FIG. 10a a cross-sectional view of FIG. 10a, wherein the wire element has a smaller height at a crossing point than remote from a crossing point;
  • Fig. Ia is a detail view of a medical invention
  • I Ib the detail view of FIG. I Ia, wherein in the region of a tip of the
  • End loop is arranged a taper
  • FIG. 11a wherein the connection between the first wire element and the second wire element is produced by a rivet; in each case a detailed view of a medical device according to the invention with a plurality of band-shaped wire elements, each having a plurality of asymmetric extensions, according to a preferred embodiment; and in each case a detailed view of a medical device according to the invention with a plurality of band-shaped wire elements, each having a plurality of extensions with a single, one-sided extension, according to a preferred embodiment.
  • a section of a known from practice mesh braid 10 ' is shown, wherein the mesh 10' comprises a plurality of interwoven wire elements 11 ', 12'.
  • the wire elements 11 ', 12' intersect, whereby crossing points 15 'are formed.
  • the wire elements 11 ', 12' are band-shaped. This means that the wire elements 11 ', 12' each have a cross-sectional profile with a height and a width, wherein the height is smaller than the width.
  • the mesh 10 'of FIG. 1 is shown in the compressed state.
  • the arrow in Fig. 1 represents the braid axis.
  • the Minimum crimp diameter so the cross-sectional diameter of the rotationally symmetrical grid mesh 10 'in the highest possible compressed state, by the width of the wire elements 11', 12 'is determined.
  • the width of the wire elements 11 ', 12' in the region of the crossing points 15 ' has a limiting effect here.
  • the width of the band-shaped wire elements 11 ', 12' causes either the minimum crimp diameter is not sufficiently small to introduce the grid mesh 10 in a feed system, or if the width of the wire elements 11 ', 12' chosen to be correspondingly small the mesh 10 'does not include sufficient radial force.
  • the first wire element 11 has at least one widening 13, which is spaced from a crossing point 15 which is formed by the first wire element 11 with a second wire element 12. It is not excluded that the thinnest region of the first wire element 11 is arranged with respect to the width of the wire element outside of the crossing point 15.
  • the first wire element 11 can, for example, have a section between the widening 13 and the crossing point 15, which section has a smaller width than the widening 13 and a smaller width than the first wire element 11 in the region of the crossing point 15.
  • the broadening 13 in the sense of the application is arranged at a distance from at least one intersection point 15 of the lattice braid 10.
  • the widest point or the widest region of the first wire element 11 is arranged outside a crossing point 15.
  • the widest point or the widest region of the first wire element 11 forms the widening 13 or is at least part of the widening 13.
  • FIG. 2 shows a detail of a corresponding mesh braid 10 for a medical device, in particular a stent, wherein the mesh braid 10 comprises a plurality of wire elements 11, 12.
  • the mesh braid 10 comprises a plurality of wire elements 11, 12.
  • the first wire element 11 forms at least one of the second wire element 12
  • the wire elements 11, 12 shown in FIG. 2 are each formed band-shaped.
  • the first wire elements 11 and the second wire elements 12 thus each have a cross-sectional profile with a width and a height, wherein the width is greater than the height.
  • the height is determined in the radial direction relative to the axis of rotation of the rotationally symmetrical grid mesh.
  • the width extends predominantly in the circumferential direction of the grid mesh 10.
  • the basic structure of the band-shaped wire elements 11, 12 is also disclosed in connection with the other examples. Overall, each wire element 11, 12 are assigned a plurality of spacers 13.
  • the wire elements 11, 12 comprise symmetrical widenings.
  • the width of the wire elements 11, 12 between two crossing points 15 changes symmetrically.
  • the wire elements 11, 12 have, between two crossing points 15, which are immediately adjacent, a wire element section which has a greater width than a further wire element section, which is arranged at the intersection point 15.
  • the widened wire element section, which in particular comprises the widest point of the wire element 11, 12 between two crossing points 15, is referred to as widening 13.
  • first wire elements 11 are parallel to each other.
  • second wire elements 12 extend parallel to each other, wherein the second wire elements 12, the first wire elements 11 intersect at substantially right angles.
  • the first wire elements 11 and the second wire elements 12 can intersect to form different angles.
  • the first wire elements 11 intersect with the second wire elements 12 at an angle of greater than 0 ° and at most 180 °. All angles between these values are possible. This generally results in a diamond-shaped geometry of the mesh 14.
  • Fig. 2 corresponds to the manufacturing state or fully expanded state of the mesh 10.
  • a mesh 14 of the mesh is formed.
  • the broadening 13 at least partially protrude into the mesh 14.
  • the spacers 13 are substantially all of the same shape. It is also possible that the spacers 13 have different shapes or profiles.
  • the wire elements 11, 12 may have a cross-sectional profile that changes in the longitudinal direction of the wire elements 11, 12.
  • the band-shaped wire elements 11, 12 in the crossing points 15 comprise a concave curvature. Outside the crossing points 15, in particular in the region of the widenings 13, the wire elements 11, 12 form a convex curvature.
  • the wire elements 11, 12 each have side edges 21 which extend substantially rectilinearly in the region or in the vicinity of the points of intersection 15. Remote from the crossing points 15 or between two crossing points 15, the side edges of the wire elements 11, 12 each have a curvature directed outwardly with respect to the longitudinal direction of the wire element 11, 12.
  • the curvature or curvature can be substantially continuous.
  • the widening 13 essentially has a rectangular profile, wherein the side edge 21 assumes a discontinuous course.
  • FIG. 3 shows a detailed view of a medical device according to a preferred embodiment, wherein a single widening 13 of a wire element 11, 12 is shown.
  • the wire element 11, 12 has a perforation 19 in the region of the widening 13. This ensures that the endotelialization and the flow of blood through the wall of the medical device or through the rotationally symmetrical grid 10 is favored.
  • the perforation 19 allows blood flow into branching blood vessels.
  • a different type of structuring in the region of the widening 13 can be provided.
  • the wire element 11, 12 in the region of the broadening 13 grooves and / or projections include to increase the adhesion of the mesh 10 on a vessel wall, or to favor the attachment of endothelial cells.
  • the grooves and / or projections may also be formed in the wire elements 11, 12.
  • the wire elements 11, 12 In general, the wire elements 11, 12 comprise a perforation in order to support the attachment of endothelial cells or the blood flow into branching blood vessels.
  • the perforation, the grooves and / or the projections are therefore not limited to the widening 13 or an extension 13a, 13b of the widening 13, but may also extend over further regions or sections of the wire elements 11, 12.
  • FIG. 4 the grid mesh 10 is shown in FIG. 2, wherein the grid mesh 10 is shown in FIG. 4 in the compressed state. It can be seen that the spacers 13 of the first wire elements 11 and the second wire elements 12 can overlap in the compressed state. This further reduces the minimum crimp diameter. At the same time, the widening 13 makes it possible to increase the radial force of the mesh 10.
  • all wire elements 11, 12 each comprise a plurality of widenings 13.
  • the widening 13 is provided only on the first wire elements 11.
  • the second wire elements 12 may be formed without widening.
  • a plurality of widenings 13 can be arranged distributed over the entire circumferential surface or the peripheral wall of the grid mesh 10.
  • a part of the wire elements 11, 12 comprise widenings 13.
  • the wire elements 11, 12 may have different sections in themselves, which are partially equipped with spacers 13 and partially without spacers 13.
  • the mesh 10 may have a total of areas comprising a plurality of mesh 14 and wire element portions of the wire elements 11, 12, wherein the mesh 10 may have different areas, which may differ by the size, shape and / or number of spacers 13.
  • the size of the spacers 13, starting from the center of the mesh braid 10 may become smaller in the longitudinal direction towards the axial ends of the mesh braid 10.
  • Smaller widenings 13 are provided in the edge regions or axial end regions of the lattice braid 10 than in a middle region of the lattice braid 10.
  • the number of widenings 13 per circumferential segment 23 can decrease towards the axial ends, in particular in such a way that the axial end regions of the mesh braid 10 are widened without widening.
  • the perfusion of secondary vessels and the Endothelialization of the lattice braid 10 are supported at least in the axial end regions of the lattice braid 10.
  • the different regions of the lattice braid 10 may also differ by the presence of widenings 13 per se.
  • the ratio of meshes 14 with widenings 13 to mesh 14 without widenings 13 per ring segment or circumferential segment 23 can change longitudinally along the mesh 10.
  • the mesh 10 it is also possible for the mesh 10 to be provided with spacers 13 only on one side, ie in a region delimited in the circumferential direction or in a region which does not extend over the entire circumference of the mesh 10.
  • Such a design of the mesh 10 is particularly advantageous for the treatment of aneurysms, wherein the area 13 with widening covers the aneurysm.
  • the widening 13 comprises at least one extension 13a, 13b, which extends from the wire element 11, 12 into the mesh 14 of the mesh.
  • the extension 13a, 13b thus projects beyond the wire element 12.
  • the extension 13a, 13b protrudes beyond the wire element 11, 12 in the circumferential direction.
  • the extension 13a, 13b forms together with the wire element 11, 12, the widening 13.
  • the widening 13 has a width which is the sum of the width of the wire member 11, 12 and the extension 13a, 13b corresponds.
  • the widening 13 has two extensions 13 a, 13 b which extend on both sides from the wire element 11, 12.
  • the two projections 13a, 13b are similarly shaped, so that overall a symmetrical profiling of the wire element 11, 12 or a symmetrical widening 13 results.
  • the widening 13 has a first extension 13a and a second extension 13b, wherein the first extension 13a corresponds to a reflection of the second extension 13b along a longitudinal axis of the wire element 11, 12.
  • the first extension 13a and the second extension 13b may have different geometric shapes.
  • the first extension 13a can project further beyond the wire element 11, 12 than the second extension 13b. This results in an asymmetrical broadening 13 or profiling of the wire element 11, 12th
  • the projections 13a, 13b of the widening 13 can not only be formed on both sides of the wire element 11, 12, as shown in FIGS. 2 and 4. Rather, it is also possible that the widening 13 unilaterally emanates from the wire element 11, 12 or comprises a single extension 13a. Such a broadening 13 is shown in Fig. 5, wherein Fig. 5 shows the compressed state of the mesh 10.
  • the single extension 13a of the widening 13 thereby overlaps at least one second wire element 12, in particular a second wire element 12 and two further first wire elements 11.
  • the minimum crimp diameter in the medical device according to the invention is determined by the width of the strip-shaped wire element 11, 12 in the region of Intersection point or points of intersection 15.
  • the extensions 13a of the widenings 13 substantially do not contribute to the minimum crimp diameter.
  • the width of the wire elements 11, 12 can be chosen so small at least in the region of the crossing points 15, that the medical device can be introduced into a feed system.
  • the widening 13 or the plurality of widenings 13 fulfills the flow control and particle filtration function of the medical device, so that the number of ribbon-shaped wire elements 11, 12 of the lattice braid 10 can be reduced.
  • the band-shaped wire elements 11, 12 are formed in the invention wider than known medical devices. This is possible because the number of band-shaped wire elements 11, 12 can be reduced in the medical device according to the invention.
  • the filter function or the function of influencing the flow is still fulfilled, since the band-shaped wire elements 11, 12 have a profiling which forms the widening 13. Since the wire elements 11, 12 are generally wider than in known medical devices, the stability of the mesh braid 10 according to the invention increases, in particular in the region of the crossing points 15. Thus, the mesh 10 has an improved radial force in the region of the crossing points 15.
  • the extension 13a of the widening 13 according to FIG. 5 is substantially tongue-like and extends on one side from the first wire element 11.
  • a similar configuration of the widening 13 is shown in FIG. 6, wherein according to FIG. 6 two first wire elements 11 each comprise a widening 13 , The extensions 13a of the widenings 13 of the first wire elements 11 are oriented in different directions. The minimum crimp diameter is thus also not adversely affected.
  • the spacers 13 are arranged substantially pattern-like over the grid mesh 10.
  • the extension 13a of the widening 13 covers in each case further wire elements 11, 12 or regions of the wire elements 11, 12 which do not comprise widening 13.
  • Spacers 13 may be advantageous not only in the compressed state, but also in the expanded state. Such a configuration is shown in FIG. 7, for example.
  • FIG. 7 shows a mesh 14 of a mesh braid 10, wherein the mesh 14 is formed by two first wire elements 11 and two second wire elements 12.
  • the first wire elements 11 and the second wire elements 12 intersect each other at a point of intersection 15.
  • a first wire element 11 comprises a widening 13 with a one-sided extension 13a which in use extends over the loop 14 and the loop 14 substantially completely, but at least mostly covers.
  • the extension 13a is unilaterally from the first wire member 11 and is formed substantially rectangular with rounded edges.
  • extension 13a of the widening 13 is chosen so large that the extension 13a overlaps the mesh 14 of the mesh 10 in the expanded state, the crimping of the mesh 10 is simplified and the tilting of several widening 13 in the transition of the mesh 10 from the radially expanded in the radially compressed state, avoided.
  • An alternative in which the crimping is facilitated by a sliding movement of the extensions 13 a, 13 b of the spacers 13 on the mesh 10, can be effected by a suitable deformation of the widening 13.
  • FIG. 8 shows an exemplary embodiment of such a medical device, wherein the mesh braid 10 comprises a plurality of wire elements 11, 12 each having a plurality of widenings 13.
  • the spacers 13 have, on the one hand, different geometries and, on the other hand, a different radial position relative to the longitudinal axis of the lattice braid 10.
  • the widenings 13 correspond in form essentially to the widenings 13 according to FIG. 2.
  • the spreading ments 13 have in particular an onion-like profile.
  • the widenings arranged in the gray areas are arranged at a different altitude or in a different radial position than the marked widenings 13, which are not gray shaded
  • Broadening 13 are thus located in different peripheral surfaces or at different levels, for example, based on a cylindrical shell reference surface or relative to the central axis.
  • the configuration according to FIGS. 8a, 8b and 8c can be achieved, for example, by virtue of the fact that the rectangular widenings 13 during braiding of the lattice braid 10 rest on a braiding mandrel on raised areas or projections 24 of the braiding mandrel.
  • the projections 24 form regions of elevations of the braiding mandrel, the wire elements 11, 12 provided with the spacers 13 being wound on the braiding mandrel such that at least individual extensions 13 are arranged on the projections 24.
  • the shape of the lattice braid 10 can be fixed with the widening 13 increased compared to other widenings 13.
  • the heat treatment carried out after the braiding of the lattice braid 10 can also be used to set which regions or which widenings 13 of the lattice braid 10 in the compressed state slide on the outer circumference of the lattice braid 10 or the inner periphery of the lattice braid 10.
  • the curvature of the cylindrical lattice braid 10 refers to the expanded state, in particular to the expanded state in the vessel.
  • the extensions 13a, 13b are curved in accordance with the curvature of the lattice structure or lattice braid 10 and are thus substantially in the peripheral surface arranged the grid mesh 10.
  • the extensions 13a, 13b are curved to different degrees, ie have different radii of curvature.
  • the radii of curvature are set so that adjacently arranged projections 13a, 13b, resulting in a relative movement of the extensions 13a, 13b, in particular when crimping move over one another, can slide on each other.
  • projections 13a, 13b have a smaller radius of curvature or are more curved than the curvature of the lateral surface of the lattice braid 10.
  • Other extensions 13a, 13b have the same or a greater radius of curvature than the curvature of the lattice braid 10.
  • the different radii of curvature of the various extensions 13a, 13b, as described above, can each be combined with each other.
  • Another advantage of the inwardly curved extensions 13a, 13b is that they are well adapted to the curvature of the vessel wall.
  • the mesh 10 is made of a metal, in particular a
  • Shape memory metal for example nitinol
  • Grid mesh 10 and the wire elements 11, 12 can also be effected by a physical vapor deposition method, for example sputtering.
  • the deformation of the individual wire elements 11, 12 or of the widenings 13, in particular in the radial direction relative to the longitudinal axis of the lattice braid 10, can be accomplished by the use of a corrugated or otherwise structured substrate.
  • Wire elements 11, 12 and the widening 13 take place.
  • the broadening 13 or at least one or two extensions 13a, 13b of the broadening in the radial direction relative to the longitudinal axis of the lattice braid 10 are deformed.
  • the widening 13 may be twisted with the first wire element 11.
  • 9 shows a first wire element 11 in cross-section with a widening 13 (dashed line), which is essentially twisted in an S-shape or slightly twisted.
  • the widening 13 has two side surfaces 21, wherein a first side surface 21a is positioned radially outward relative to the mesh 10 and a second side surface 21b is deflected radially inward. In this way, the sliding of the widening 13 above or below other wire elements 11, 12 or
  • the braiding mandrel has a corresponding surface structuring.
  • the braiding mandrel thus preferably has a structuring, so that during braiding of the mesh braid 10, the spacers 13 are arranged on the structuring such that the employed or radially deflected configuration results.
  • the braiding mandrel or heat treatment mandrel can be profiled or structured in such a way that the spacers 13 are formed with an angle of attack relative to the longitudinal axis of the mesh braid 10.
  • the radial deflection of the widenings 13 or at least one extension 13a, 13b of the widening 13 can also take place with an asymmetrical design or profiling of the wire elements 11, 12.
  • the widening 13 may have a single extension 13a, which extends from the wire element 11, 12 on one side.
  • the single extension 13a may be radially deflected or radially deflectable.
  • the deflection can be effected by torsion of the wire element 11, 12, wherein a simple, in particular not S-shaped, torsion is possible. This applies to both symmetrical and asymmetrically shaped spacers 13.
  • the extension 13a, 13b of the widening 13 has a smaller height than the associated wire element 11, 12.
  • the sliding of the extension 13a, 13b over the grid mesh 10, in particular at a transition of the mesh braid 10 of a radially expanded state in a radially compressed state is improved in this way.
  • the extension 13a, 13b which is designed to be thinner-walled than the wire element 11, 12, has increased flexibility or deformability or torqueability in the expanded state. In this way it is possible that the widening 13, in particular the extension 13a, 13b is deflectable like a flap.
  • the extension 13a, 14b extends into a mesh 14 of the mesh 10.
  • the extension 13a, 13b covers at least a portion of the mesh 14.
  • the mesh 14 of the Stent or the lattice braid 10 at least for the introduction of a coil catheter in the aneurysm are continuous.
  • the meshes 14 should be covered to prevent blood flow into the aneurysm.
  • the flexible extension 13a, 13b has both properties.
  • the extension 13a, 13b partially covers the mesh 14, so that blood flow into the aneurysm is reduced or at least reduced.
  • the flexibility of the widening 13 allows a flap-like Function of the widening 13 and the extension 13a, 13b, so that a coil catheter can be passed through the mesh 14 in an aneurysm.
  • the extension 13a, 13b deflected radially.
  • the extension 13a, 13b takes the original position again and covers the mesh 14.
  • the aforementioned function of the spacers 13 can be effected by torsion of the wire element 11, 12.
  • the widening 13 is at least partially deflected radially out of the wall plane of the lattice braid and in the opposite direction again in alignment
  • extension 13a, 13b has a smaller wall thickness or height than the wire element 11, 12, a sufficient radial force is ensured.
  • FIG. 10 shows a cross section through a wire element 11, 12 with a widening 13, wherein the extension 13 a, 13 b of the widening has a smaller wall thickness or height than the wire element 11, 12.
  • the wire element 11, 12 has in
  • Area of broadening 13 essentially a T-shaped cross section.
  • the extensions 13a, 13b extend in a wing-like manner away from the wire element 11, 12.
  • the widening 13 can, as shown in FIG. 10 a, be arranged on an outer circumference of the lattice braid 10. In this case, the projections 13a, 13b are aligned with a radially outer surface of the wire element 11, 12.
  • Wire element 11, 12 go out.
  • the projections 13a, 13b are then aligned with an inner surface of the wire element 11, 12. It can also be provided that the
  • the projections 13a, 13b can therefore extend substantially between the outer circumference of the mesh 10 and the inner periphery of the mesh 10 in the circumferential direction of the wire element 11, 12 away.
  • the extensions 13a, 13b may have the same height or thickness as the wire element 11, 12.
  • Fig. 10b shows a cross section through a wire element 11, 12 of the mesh braid 10 with a widening 13, wherein the dashed line a
  • the wire member 11, 12 in the region of the widening 13 has a greater wall thickness or height than at a crossing point 15, wherein the wall thickness or height of the wire element 11, 12 in the region of the intersection point 15 is shown by the dashed line. It is preferably provided that the wire elements 11, 12 at the intersection points 15 each have a height which is half as large as the height of the wire elements 11, 12 outside of the intersection point 15. In this way, over the entire length or over the entire Scope of the mesh braid 10 essentially a uniform wall thickness can be adjusted.
  • the different wall thicknesses of the wire elements 11, 12 or the widening 13 can preferably be produced by a combined sputter etching process.
  • the thickness or height of the spacers 13 can be reduced by etching.
  • the etching process is preferably set such that a thin material layer remains, which forms the widening 13.
  • the smaller wall thickness or height of the wire element 11, 12 in the crossing points 15 can also be done by etching the wire elements 11, 12 in the areas of the crossing points 15.
  • the wire elements 11, 12 can be etched on their own side, so that recesses are formed on one side.
  • the recesses are preferably shaped such that in the braided configuration another, in particular intersecting, wire element 12, 11 can be arranged in the recess.
  • the recesses may have a length that is greater than the width of the band-shaped wire element 11, 12. This will ensure that the
  • Wire element 11, 12 in the intersection point 15 both in the compressed state of the mesh braid 10, as well as in the expanded state, are located within the recess.
  • the recesses preferably have a length which allows the first wire element 11 to slide on the second wire element 12 within the frame
  • the wall thickness of the mesh 10 is thus reduced. It is also possible that recesses are formed on both sides of the wire element 11, 12.
  • the wire element 11, 12 can thus each have a recess on both an outer circumference and on an inner circumference of the lattice braid 10. This has the advantage that, in the case of a braiding type, wherein the wire element 11, 12 is guided in each case via a further wire element 12, 11 and subsequently under a further wire element 12, 11 (1-over-1 braiding), the further wire elements 12, 11 are each arranged in one of the two recesses. If the wire elements 11, 12 basically with several
  • Recesses are formed on both sides (outer surface and inner surface), different types of braid can be realized.
  • an I-over-2 plait, an I-over-3 plait, a 2-over-2 plait, a 2-over-3 plait, or other plaits may be provided.
  • the wire elements 11, 12 may be arranged freely.
  • the mesh 10 may thus comprise free wire ends at the axial ends.
  • the first wire element 11 may be connected to a second wire element 12 in the region of an axial end of the mesh 10 to an end loop 16, as shown in Fig. I Ia.
  • the connection can be made in a positive, non-positive or cohesive manner.
  • the wire elements 11, 12 in the region of the end loop 16 are integrally formed.
  • the end loop 16 includes a tip 17, which is a-traumatic for lack of free wire element ends.
  • spacers 13 may be formed, wherein the
  • Spacers 13 are arranged between the tip 17 and in each case a crossing point 15.
  • Wire element 11, 12 done on a braiding mandrel.
  • the braiding mandrel preferably has a pin around which the wire element 11, 12 is deflected.
  • the end loop 16 may already arise during the production of the wire element 11, 12.
  • the wire element 11, 12 can be produced by a combined sputter etching process, wherein the end loop 16 is simultaneously formed.
  • the end loop 16 has proved to be advantageous to reduce the width of the band-shaped wire element 11, 12 in the region of the tip 17 of the end loop 16.
  • the end loop 16 has a taper 18 in the region of the tip 17.
  • the taper 18 corresponds to a position of the wire element 11, 12, which has a smaller width than the remaining portions of the wire element 11, 12.
  • An end loop with such a taper 18 is shown in Fig. I Ib.
  • Wire elements 11, 12 be prepared, as shown in Fig. 11c.
  • the band-shaped wire elements 11, 12 may comprise recesses or openings at the wire ends, wherein the wire elements 11, 12 are connected to one another by a separate, additional element.
  • the connection of the wire elements 11, 12 by a rivet 20.
  • the rivet 20 forms a
  • Rotary axis so that the wire elements 11, 12 are on the one hand connected to each other and on the other hand to each other pivotable or rotatable.
  • a relative angular movement between the wire elements 11, 12 is made possible by the rivet 20.
  • the rivet 20 may also fix the wire elements 11, 12, so that no rotation axis is formed by the rivet 20.
  • a bending of the wire elements 11, 12 may be sufficient to compress the grid mesh 10.
  • Other types of connection for example, with sleeves, by welding or soldering or other additional fasteners are possible.
  • FIG. 12 a shows a detail of a mesh braid 10 with a plurality of wire elements 11, 12, wherein the wire elements 11, 12 are in each case band-shaped.
  • the wire elements 11, 12 each comprise a plurality of spacers 13, which are arranged between each two crossing points 15.
  • the spacers 13 are asymmetrical. This means that the widenings 13 each comprise a first extension 13a and a second extension 13b, the first extension 13a projecting further beyond the wire element 11, 12 than the two extension 13b.
  • the asymmetrical arrangement facilitates an overlapping of the extensions 13a, 13b of the widenings 13 in the circumferential direction during the compression of the lattice braid 10.
  • the asymmetric design of the widenings 13 ensures that the first extensions 13a in the compressed state of the lattice braid 10 shingles the second extensions 13b overlap, as shown in Fig. 12b. It can be provided that the first and second extensions 13a, 13b overlap in the compressed state of the mesh 10 and in the expanded state of the mesh 10 no overlap occurs.
  • the overlapping of the extensions 13a, 13b can also be shown in the implanted state of the mesh 10. In the implanted state, the mesh 10 has essentially a smaller cross-sectional diameter than in the production state.
  • the geometry or size of the projections 13a, 13b may be set such that there is no overlap in the production state and an overlap in the implanted state.
  • the size of the extensions 13a, 13b can also be dimensioned such that the extensions 13a, 13b overlap in the production state of the mesh 10. In any case, the projections 13a, 13b overlap in the compressed state of the mesh 10.
  • each mesh 14 of the mesh 10 comprises a total of four widenings 13, wherein two first extensions 13 a of two opposing widenings 13 extend into the mesh 14.
  • the other two spacers 13 have two second extensions 13b which extend into the associated loop 14.
  • two first extensions 13a extend opposite one another into a common loop 14
  • the stability of the grid mesh 10 is increased overall. It is also possible that one stitch 14 has more than two first extensions 13a
  • each mesh 14 may be associated with a single first extension 13a.
  • the first extensions 13a according to FIGS. 12a and 12b are tongue-like or form tongues which project into a respective mesh 14.
  • the first extensions 13a or tongues have a higher flexibility compared to the second extensions 13b due to their geometric extension. Therefore, the asymmetric design of the widening 13 facilitates the insertion of a coil catheter through the mesh 14.
  • the second extensions 13b which have a smaller width than the first extensions 13, can facilitate the sliding of the first projections 13a when compressing the mesh 10 via the further wire elements 11, 12.
  • the second extensions 13b can be radially inwardly curved so that the first extensions 13a can easily slide on the wire elements 11, 12 in the compression of the mesh 10 on the inwardly curved second extensions 13b.
  • FIG. 13 a shows a detail of a mesh braid 10 having a plurality of first and second wire elements 11, 12, which each comprise a plurality of widenings 13.
  • the spacers 13 comprise a single extension 13a, which is unilaterally of the respective
  • Wire element 11, 12 extends into a mesh 14 inside.
  • the extension 13a covers the mesh 14 largely.
  • the extensions 13a are substantially the same
  • the projections 13a each have a peripheral component, wherein the peripheral component of all projections 13a is identical.
  • the mesh 10 may have a peripheral segment 23 formed by circumferentially adjacent meshes 14. All projections 13a of the widenings 13 of the peripheral segment 23 point in the same circumferential direction.
  • the first extension 13a is larger than the second extension 13b.
  • the larger first extensions 13a of a circumferential segment or of the entire mesh braid 10 preferably point in the same direction, in particular circumferential direction, which is oriented counter to the circumferential direction of the smaller, second extensions 13b.
  • the single extensions 13a of the widenings 13 have an axial component or are oriented in an axial direction, wherein in the exemplary embodiment according to FIG. 13a the axial components directly in the circumferential direction of adjacent extensions 13a are different.
  • the extensions 13a of the circumferential segment 23 are each oriented alternately in different axial directions.
  • the axial direction of the mesh 10 is indicated in FIGS. 13a and 13b by the arrow labeled AR.
  • a second axial section of the circumferential segment 23 is formed by sections of the wire elements 11, 12 which do not comprise extensions 13a or extensions 13.
  • Axially in the distal direction relative to a delivery system of the medical device is aligned to facilitate the supply of a coil catheter through the mesh 14 of the mesh 10 through.
  • Grid mesh 10 the circumferential segment 23 projections 13a, each extension 13a each overlapping a portion of a wire element 11, 12, which has no widening 13.
  • a free wire element section is arranged in the circumferential direction, which has no widening 13.
  • Grid mesh 10 may be favored by a corresponding manufacturing process.
  • 8a, 8b, 8c show a section of the lattice structure 10 according to FIG. 2, wherein at least a part of the widenings 13 on projections 24 of a
  • the braiding mandrel for producing the raised spacers 131 has essentially right-corner-shaped projections which have a width between the longer side edges, which corresponds at least to the width of the spacers 13.
  • the projections 24 of the braiding mandrel are arranged such that in the axial direction of the mesh braid 10 each form rows of raised spacers 131.
  • the braiding mandrel can each have one projection 24 per increased broadening 131.
  • the braid mandrel may extend in the axial direction elongate, substantially rib-like, projections
  • each having a plurality of increased spacers 131 receive, as shown in Fig. 8b.
  • the braiding mandrel has a plurality of projections 24, which are each associated with an increased broadening 131.
  • the projections 24 may be arranged distributed in a spiral over the braiding mandrel such that, for example, only the widenings 13 of the first wire elements 11 or only the widenings 13 of the second wire elements 12 are formed into increased widenings 131.
  • This configuration is shown in Fig. 8c.
  • the increased widenings 131 in the compressed state overlap the lower widenings 132.
  • the overlapping of the widenings 13 in the compressed state of the mesh 10 as indicated by the curved arrows can also occur when the mesh 10 is on a braid mandrel without projections 24 is made.
  • the overlapping of the widenings 13 or at least of the extensions 13a, 13b of the widenings 13 may also be caused by a bending or curvature of the
  • the wall thickness of the band-shaped wire elements 11, 12 may preferably be at most 100 pm, in particular at most 80 pm, in particular at most 60 pm, in particular at most 40 pm, in particular at most 30 pm, in particular at most 20 pm, in particular at most 15 pm, in particular at most 10 pm , If the widening 13 has a smaller wall thickness or height than the associated wire element 11, 12, is a widening height or
  • the rotationally symmetrical grid 10 is preferably compressible such that it into a delivery system or a catheter having an inner diameter of at most 2 mm, in particular at most 1.6 mm, in particular at most 1.4 mm, in particular at most 1.2 mm, in particular at most 1.0 mm, in particular at most 0.9 mm, in particular at most 0.8 mm, in particular at most 0 7 mm, in particular at most 0.6 mm, in particular at most 0.5 mm, in particular at most 0.4 mm, is insertable.
  • the wire elements 11, 12 may have a width outside the broadening 13, preferably at most 200 ⁇ , in particular at most 150 ⁇ , in particular at most 120 ⁇ , in particular at most 100 ⁇ , in particular at most 80 ⁇ , in particular at most 60 ⁇ , in particular at most 50 ⁇ , in particular at most 40 ⁇ , is.
  • the widening 13, however, may have a width which is at least 100 ⁇ m, in particular at least 150 ⁇ m, in particular at least 200 ⁇ m, in particular at least 300 ⁇ m, in particular at least 500 ⁇ m, in particular at least 800 ⁇ m, in particular at least 900 ⁇ m, in particular at least 1 mm, in particular is at least 1.2 mm, in particular at least 1.5 mm, in particular at least 2.0 mm, in particular at least 2.5 mm, in particular at least 3.0 mm.
  • the wire element 11, 12 preferably has in the region of the taper 18 in the tip 17 of an end loop 16 has a width which is at most 20 ⁇ , in particular at most 10 ⁇ , in particular at most 5 ⁇ .
  • the wire elements 11, 12, in particular the first wire element 11, can have a ratio between width and height or thickness which is at least 1.2, in particular at least 1.4, in particular at least 1.6, in particular at least 1.8, in particular at least 2.0, in particular at least 2.5, in particular at least 3.0, in particular at least 3.5, in particular at least 4.0, in particular at least 4.5, in particular at least 5.0, in particular at least 5.5, in particular at least 6.0, in particular at least 7.0, in particular at least 8.0, in particular at least 9.0, in particular at least 10, in particular at least 12, in particular at least 15,
  • Wire element 11 in the crossing point 15 is preferably at least 1.2, in particular at least 1.5, in particular at least 2.0, in particular at least 3.0, in particular at least 4.0, in particular at least 5.0, in particular at least 6.0, in particular at least 7.0, in particular at least 8.0, in particular at least 9.0, in particular at least 10, in particular at least 12, in particular at least 15, in particular at least 20, in particular at least 25, in particular at least 30, in particular at least 35,
  • the upper limit for the above ratios may be, for example, 50,
  • the grid mesh preferably has a closed peripheral surface, that is covered by wire elements 11 including widenings 13
  • Peripheral area on, smaller than the total area, including the
  • the mesh 10 preferably has a closed peripheral surface which is at least 20%,
  • the total area of the lattice braid 10 makes in particular at least 30%, in particular at least 40%, in particular at least 50%, in particular at least 60%, in particular at least 70%, in particular at least 80%, in particular at least 90%, the total area of the lattice braid 10 makes.
  • a single widening 13 preferably has an area of at least 0.01 mm 2 , in particular at least 0.05 mm 2 , in particular at least 0.1 mm 2 , in particular at least 0.2 mm 2 , in particular at least 0.3 mm 2 , in particular at least 0.5 mm 2 , in particular at least 0.8 mm 2 , in particular at least 1 mm 2 , in particular at least 1.2 mm 2 , in particular at least 1.5 mm 2 , in particular at least 2 mm 2 , in particular at least 2.5 mm 2 , in particular at least 3 mm 2 , in particular at least 3.5 mm 2 , in particular at least 4 mm 2 , on.
  • the mesh 10 may be at least 2, in particular at least 4, in particular at least 6, in particular at least 8, in particular at least 10, in particular at least 12, in particular at least 16, in particular at least 20, in particular at least 24, in particular at least 32, in particular at least 36, in particular at least 40 , In particular at least 48, wire elements 11, 12 include.
  • the medical device, in particular the grid mesh 10, is preferably adapted such that a treatment of body vessels with a
  • Cross-sectional diameter of at least 1 mm and at most 30 mm is possible.
  • the cross-sectional diameter of the lattice braid 10 for use in comparatively larger body vessels is preferably at least 2.0 mm, in particular at least 3.0 mm, in particular at least 4.0 mm, in particular at least 5.0 mm, in particular at least 6.0 mm, in particular at least 8.0 mm, in particular at least 10.0 mm, in particular at least 12.0 mm, in particular at least 15.0 mm, in particular at least 20.0 mm.
  • the production of the grid mesh 10 or the wire elements 11, 12 is advantageously carried out by a forming process, for example by drawing or flat rolling, wherein the profiling or widening 13 is then formed by laser cutting.
  • the wire elements 11, 12 are preferably produced from a rolled flat strip, wherein the shape of the wire element 11, 12 including the widening 13 is cut out of the flat strip by laser cutting or a punching method.
  • the wire element 11, 12 including the widening 13 can be produced by roll forming or a thin-film process, in particular a sputtering process or a combined sputter etching process.
  • a thin-film method it is also possible to form recesses in relation to the material thickness or the wall thickness,
  • the wire elements 11, 12 and the widening 13, which is advantageously formed integrally with the wire element 11, 12, are shape memory materials, in particular shape memory metals or shape memory plastics.
  • the wire element 11, 12 may be made of a nickel-titanium alloy.
  • the nickel-titanium alloy may additionally further alloying additives, for example chromium, platinum, niobium, palladium or the like.
  • cobalt-chromium alloys for example ELGILOY, PHYNOX or the like is possible.
  • Wire elements 11, 12 may also titanium or titanium alloys, platinum or
  • Platinum alloys, tantalum or tantalum alloys and magnesium alloys, in particular with alloy components of zinc and / or calcium include.
  • the wire elements 11, 12 may also comprise a plastic, in particular a polymer, preferably a shape memory polymer.
  • the medical device can be used as a stent or flow diverter to influence the flow in the area of aneurysms.
  • a stenosis stent or for the treatment of plaque is possible, wherein the
  • Filtration effect of the grid mesh 10 according to the invention can be used particularly advantageously.
  • Grid mesh 10 only in a central region with spacers 13 equip, so that the axial ends of the grid mesh 10 have a higher fluid permeability. In the arrangement of the mesh 10 in the range of
  • Vascular branches are thus ensured that the branching vessels sufficiently with a body fluid, in particular blood, flows through.
  • the medical device can be used as a filter, in particular as a temporary filter.
  • the rotationally symmetrical grid may therefore not only have a cylindrical or tubular structure, but also, for example, a conical or truncated cone-shaped structure.
  • all free wire ends are connected to one another at one axial end of the grid mesh.
  • the connection can be made by twisting, welding or by crimping with sleeves. In this way, a basket-like shape of the medical device is essentially produced. Due to the widenings 13 in the lattice mesh 10, the efficiency of the filtration is increased since the flow-through surface portion of the basket or of the mesh mesh 10 is comparatively small.
  • the basket protects against distal embolism through the widenings 13 and thus the largely closed wall of the lattice braid 10.
  • the medical device can be positioned during the treatment of a stenosis, for example in the region of the carotid artery, distal to the treatment site.
  • the medical device, in particular the mesh 10 may be connected proximally fixed or releasably connected to a guide wire.
  • the mesh 10 or generally the medical device may be fixed or releasably or detachably connected to a guide wire, so that a time-limited application of the medical device is possible.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'invention concerne un dispositif médical, en particulier une endoprothèse, comprenant un réseau grillagé symétrique en rotation (10), lequel peut passer d'un état comprimé radialement à un état expansé radialement et qui comporte au moins un premier élément filaire (11) entrelacé avec au moins un deuxième élément filaire (12) en formant au moins un point de croisement (15). Le premier élément filaire (11) au moins est réalisé en forme de bande et présente au moins un élargissement (13) qui est disposé à distance du point de croisement (15).
PCT/EP2011/067772 2010-10-13 2011-10-12 Dispositif médical, en particulier endoprothèse Ceased WO2012049197A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102010048368A DE102010048368A1 (de) 2010-10-13 2010-10-13 Medizinische Vorrichtung, insbesondere Stent
DE102010048368.0 2010-10-13

Publications (1)

Publication Number Publication Date
WO2012049197A1 true WO2012049197A1 (fr) 2012-04-19

Family

ID=44785866

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2011/067772 Ceased WO2012049197A1 (fr) 2010-10-13 2011-10-12 Dispositif médical, en particulier endoprothèse

Country Status (2)

Country Link
DE (1) DE102010048368A1 (fr)
WO (1) WO2012049197A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104507419A (zh) * 2012-06-07 2015-04-08 波士顿科学国际有限公司 用于置换原生心脏瓣膜的装置
CN113453647A (zh) * 2018-12-21 2021-09-28 阿坎迪斯有限公司 医疗装置，特别是支架

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102020133096B4 (de) * 2020-12-11 2025-10-16 Acandis Gmbh Verfahren zur Herstellung eines Stents sowie computerlesbares Speichermedium

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19516060A1 (de) * 1995-05-04 1996-11-07 Feichtinger Heinrich K Implantat-Körper zur selektiven endovaskulären Beeinflussung der Strömungsverhältnisse in einem Blutgefäß und Verfahren zur Herstellung eines Implantat-Körpers
WO1999055256A1 (fr) * 1998-04-28 1999-11-04 Intratherapeutics, Inc. Stent tresse

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5758562A (en) * 1995-10-11 1998-06-02 Schneider (Usa) Inc. Process for manufacturing braided composite prosthesis
US7331993B2 (en) * 2002-05-03 2008-02-19 The General Hospital Corporation Involuted endovascular valve and method of construction
US6761731B2 (en) * 2002-06-28 2004-07-13 Cordis Corporation Balloon-stent interaction to help reduce foreshortening

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19516060A1 (de) * 1995-05-04 1996-11-07 Feichtinger Heinrich K Implantat-Körper zur selektiven endovaskulären Beeinflussung der Strömungsverhältnisse in einem Blutgefäß und Verfahren zur Herstellung eines Implantat-Körpers
WO1999055256A1 (fr) * 1998-04-28 1999-11-04 Intratherapeutics, Inc. Stent tresse

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104507419A (zh) * 2012-06-07 2015-04-08 波士顿科学国际有限公司 用于置换原生心脏瓣膜的装置
CN113453647A (zh) * 2018-12-21 2021-09-28 阿坎迪斯有限公司 医疗装置，特别是支架

Also Published As

Publication number Publication date
DE102010048368A1 (de) 2012-04-19

Similar Documents

Publication Publication Date Title
EP3427703B1 (fr) Stent et systeme pour sa mise en place
EP2349128B1 (fr) Implant médical et procédé de fabrication d'un implant
DE102008010507B3 (de) Stent und Verfahren zum Herstellen eines derartigen Stents
DE102005016103B4 (de) Duodenumstent
EP2628455B1 (fr) Dispositif médical doté d'une structure de grille et système de traitement équipé d'un tel dispositif médical
EP3000445B1 (fr) Implant destine a influencer la circulation sanguine par malformations arterio-veineuses
EP2506808B1 (fr) Dispositif médical à introduire dans un organe creux et procédé pour la fabrication d'un tel dispositif
DE60021836T2 (de) Herstellungsverfahren eines Monoblockblutfilters
DE102009056449A1 (de) Medizinische Vorrichtung
EP2150211A1 (fr) Endoprothèse vasculaire et procédé pour produire une endoprothèse vasculaire
DE102009042121B3 (de) Medizinisches Gerät zum Einführen in ein Körperhohlorgan
WO2012136403A1 (fr) Dispositif médical et procédé pour la fabrication d'un tel dispositif
EP2355754B1 (fr) Implant
WO2012049197A1 (fr) Dispositif médical, en particulier endoprothèse
DE102005040214A1 (de) Mehrdrahteinheit und Herstellungsverfahren hierfür
DE102010046408B4 (de) Zuführsystem
EP2713963B1 (fr) Dispositif médical destiné à être introduit dans un organe creux
EP2675404B1 (fr) Dispositif médical doté d'une maille tressée extensible
EP2338420B1 (fr) Implant médical destiné à la fermeture d'ouvertures de récipients
DE102015122678A1 (de) Medizinisches Implantat
WO2014064181A1 (fr) Stent tressé et procédé de fabrication dudit stent tressé
DE102011056760A1 (de) Medizinische Vorrichtung zur Einfuhr in ein Körperhohlorgan

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 11767713

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 11767713

Country of ref document: EP

Kind code of ref document: A1