Medical implant

Abstract

A medical implant for treating a local lesion (100) in a bifurcation of a vessel, in particular for treating a bifurcation aneurysm, having a support body (10) which is compressible and expandable, wherein the support body (10) comprises a proximal portion (11) and a distal portion (12) which are connected to each other, characterized in that - the distal portion (12) for anchoring in the vessel is tubular, in particular cylindrical, and - the proximal portion (11) is conical and has an opening angle (α) with respect to a longitudinal axis (L) of the support body (10), wherein the proximal portion (11) can be positioned in the vessel in such a manner that the vessel and / or the lesion (100) is accessible in the implanted state through the proximal portion (12) with a supply device, in particular a micro-catheter, and - a covering (13) is arranged on the proximal and / or distal portion in such a way that the lesion (100) can be at least partially covered by the covering (13).

Description

[0001] Medical implant

[0002] Description

[0003] The invention relates to a medical implant for treating a local lesion in a bifurcation of a vessel, in particular for treating a bifurcation aneurysm, comprising a compressible and expandable support body, wherein the support body comprises a proximal portion and a distal portion that are connected to one another. A medical implant according to the preamble of claim 1 is known, for example, from DE 102015122679 A1.

[0004] To treat vascular lesions such as aneurysms, medical implants such as flow diverters are used. These reduce blood flow into the aneurysm, allowing the blood within it to coagulate, possibly assisted by an embolic agent. The position of the flow diverter can limit interventional access to the vessels.

[0005] The invention is therefore based on the object of providing a medical implant for treating a lesion in a bifurcation of a vessel, which on the one hand enables the treatment of a lesion and on the other hand enables accessibility to the vessel, in particular to branching vessel arms.

[0006] According to the invention, this object is achieved by a medical implant having the features of claim 1.

[0007] Specifically, this problem is solved by a medical implant for treating a local lesion in a bifurcation of a vessel, in particular for treating a bifurcation aneurysm, having a compressible and expandable support body, wherein the support body comprises a proximal section and a distal section that are connected to one another. The distal section is tubular, in particular cylindrical, for anchoring in the vessel. The proximal section is conical and has an opening angle relative to a longitudinal axis of the support body. The proximal section can be positioned in the vessel such that the vessel and / or the lesion, in the implanted state, is accessible through the proximal section with a delivery device, in particular a microcatheter.A cover is arranged on the proximal and / or distal section in such a way that the lesion can be at least partially covered by the cover.

[0008] The invention offers several advantages. The invention allows the lesion to be shielded from the bloodstream at the bifurcation, while largely preserving accessibility to the vessels and / or the lesion.

[0009] In order to shield the lesion from the blood flow, a cover is arranged on the proximal and / or distal section. This means that the cover can only be arranged on the distal section. Alternatively, the cover can extend over both the proximal and the distal region. The arrangement of the cover is adapted to the specific application. It is advantageous, but not absolutely necessary, that the lesion is completely covered by the cover. When implanted, the blood flow can be deflected away from the lesion by the cover in such a way that the blood flow into the lesion is reduced, allowing the blood in the lesion to coagulate.

[0010] If the cover is arranged on the proximal section, the proximal section fulfills a dual function. The proximal section can both divert blood flow away from the lesion and be penetrated by a delivery device to enable interventional access to distal vessel regions. For this purpose, the cover can be arranged on the proximal section in such a way that a portion of the proximal section, in particular the proximal end of the proximal section, is free of the cover. Consequently, the cover-free region ensures accessibility to the vessel and / or the lesion in the implanted state, so that the delivery device, in particular a microcatheter, can be passed through the proximal section. The region spanned by the cover serves to treat the lesion.

[0011] If the cover is positioned at the distal portion, the distal portion serves to cover the lesion or shield it from blood flow. The proximal portion is free of cover, allowing access to the vessel and / or lesion in the implanted state.

[0012] To treat the lesion itself, the delivery device can advantageously be guided through the cover in the area of ​​the lesion. In other words, the cover can be pierced with the delivery device.

[0013] The conical shape of the proximal section allows the proximal section of the support body to adhere to the vessel wall in the bifurcation area, particularly in the lesion area. The conical section follows the vessel wall in the bifurcation or lesion area, ensuring good wall apposition of the support body and / or good coverage of the lesion.

[0014] In addition, the conical shape provides a certain anchoring of the proximal section in the area of ​​the bifurcation, as the conical shape can adhere to the vessel wall in the area of ​​the feeding vessel.

[0015] Preferred embodiments of the invention are specified in the subclaims.

[0016] The cover preferably has at least one electrospun section. In particular, the cover can be designed as an electrospun cover. In other words, the cover can be designed entirely as an electrospun cover or only have one or more electrospun sections. In other words, the cover advantageously has at least one section made of an electrospun fabric. The cover is particularly preferably formed from a plastic material, in particular from a polymer, and preferably from polyurethane. Such materials can be produced particularly well in fine threads using an electrospinning process. Consequently, the cover can be formed from threads arranged irregularly in a net-like manner. The plastic material thus makes it possible to produce a particularly fine or thin cover.Furthermore, the cover, in particular the at least one electrospun section of the cover, can be porous enough to at least partially divert blood flow from the lesion when implanted. This means that the covering of an aneurysm can be enabled while simultaneously ensuring a certain degree of blood permeability. This permeability is advantageous for supplying the cells of the aneurysm wall with nutrients. This prevents cell degeneration and a potentially resulting rupture of the aneurysm.

[0017] In general, the pores of electrospun fabrics are irregularly shaped. The manufacturing process certainly doesn't allow for a patterned arrangement or design of pores. However, the pore sizes can be adjusted using the process parameters to ensure that at least some of the pores have a certain minimum size. For example, the minimum pore size can be adjusted by changing the process duration during electrospinning.

[0018] Furthermore, the cover is advantageously firmly connected to the proximal and / or distal section of the support body. In other words, the cover is fixed to the proximal and / or distal section. The electrospinning process can take place directly on the support body or the proximal and distal sections, so that a connection to the support body is established simultaneously during the formation of the cover. Alternatively, the cover can be firmly bonded to the support body. For example, the cover can be bonded to the support body by an adhesive bond. The adhesive bond can be established using an adhesion promoter. The adhesion promoter can, for example, comprise or consist of polyurethane.

[0019] Further advantageously, the cover has an antithrombogenic coating, which in particular comprises heparin and / or fibrin. In other words, the cover can be coated with a material that has antithrombogenic properties. The coating can exert an anticoagulant effect, so that the adhesion of blood proteins is favorably influenced. Thus, a layer of cells, in particular endothelial cells, can form over the cover. The material of the cover is thus masked by a blood protein layer, which also prevents or reduces the deposition of platelets and coagulation proteins, for example fibrinogen, which are primarily responsible for the formation of thrombi. Overall, this results in a reduction in the tendency for thrombi to form. Particularly preferably, the antithrombogenic coating comprises heparin and / or fibrin, whereby heparin can be covalently bound to fibrin.

[0020] The coating preferably completely surrounds the cover. In particular, the coating can completely enclose all threads of the electrospun cover.

[0021] In a particularly preferred embodiment, the wall of the proximal section is concave so that the wall can be adapted to the curvature of the vessels in a bifurcation. In other words, the wall of the proximal section can be concave so that the curvature of the wall corresponds to the curvature of the vessels. In other words, the wall can preferably be designed so that the wall follows the curvature of the vessels. In general, in a vascular bifurcation, an angle forms between branching vessels and consequently a curvature at the transition from one branching vessel to the other. A concave wall of the proximal section therefore enables optimal adaptation to the vascular anatomy in the region of a bifurcation or a lesion.

[0022] Further preferably, the wall of the proximal section has an angle of curvature between 70° and 190°, in particular at least 90°, in particular at least 110°, in particular at least 130°, in particular at least 150°, in particular at least 170°. Furthermore, the angle of curvature can in particular be a maximum of 190°, in particular a maximum of 180°, in particular a maximum of 170°. This is to be understood as meaning that the wall is designed such that the wall is adaptable to a curvature that forms in a vascular bifurcation, ie between two branching vessels that are at an angle of between 70° and 190° to one another. Such an angular range of curvature is particularly advantageous, for example, in bifurcations of the middle cerebral artery, the basilar artery, the internal carotid artery or the anterior cerebral artery. Preferably, the proximal portion has a larger cross-sectional diameter than the distal portion.This makes it possible to achieve optimal coverage of a lesion in a vessel bifurcation. The larger cross-sectional diameter of the proximal section allows for a good adaptation of the support body to the anatomy in the bifurcation area. This ensures secure anchoring of the support body close to the lesion.

[0023] In a further preferred embodiment, the proximal section comprises a proximal longitudinal end and the distal section comprises a distal longitudinal end of the support body, wherein the cross-sectional diameter of the proximal longitudinal end is at least 1.5 times, in particular 2 times, in particular 2.5 times, in particular 3 times larger than the cross-sectional diameter of the distal longitudinal end. It is advantageous here that the size or cross-sectional diameter of the proximal section can be selected such that the implant can be adapted to different anatomies in the region of a bifurcation.

[0024] Further preferably, the proximal section has an opening angle of at least 45°, in particular 50°, in particular 55°, in particular 60°, in particular 65°, in particular 70°, in particular 75°. The opening angle forms between the longitudinal axis and the wall of the proximal section. In other words, the conical shape of the proximal section can be described by the opening angle. Particularly preferably, the opening angle is 45°, 50°, 55°, 60°, 65°, 70°, 75°, or 80°. Alternatively, it is possible for the proximal section to have a different opening angle. The conicity of the proximal section can therefore advantageously be adapted to different anatomies.

[0025] Furthermore, the proximal section preferably has a length of at least 4 mm, in particular 5 mm, in particular 6 mm, in particular 7 mm, in particular 8 mm, in particular 9 mm, in particular 10 mm, in particular 12 mm in the axial direction. The length of the proximal section describes the distance between the proximal and distal ends of the proximal section that forms along the longitudinal axis of the support body. The length of the proximal section is particularly preferably 4 mm, 5 mm, 6 mm, 7 mm, 8 mm, 9 mm, 10 mm, 11 mm or 12 mm. Alternatively, it is possible for the proximal section to have a different length. This allows the length of the proximal section to be adapted to different anatomies in the region of a bifurcation.

[0026] The following table shows exemplary preferred parameter ranges for the length, cross-sectional diameter and opening angle of the proximal section:

[0027] In general, statements regarding the geometry of the implant, such as the cross-sectional diameter and / or the opening angle, refer to the implant in the expanded resting state, i.e. in the unloaded state.

[0028] In a further preferred embodiment, the proximal section, in particular the proximal longitudinal end of the proximal section, is porous in such a way that the vessel and / or the lesion, in the implanted state, is accessible through the porosity with the delivery device. This is to be understood as meaning that the proximal section, in particular at its proximal end, is highly porous. The advantage here is that the delivery device can penetrate the high porosity particularly easily. This ensures optimal accessibility to the vessels and / or the lesion. The support body advantageously has a lattice structure made of webs that are connected to one another and form closed, in particular diamond-shaped, cells, with three to ten cells, in particular six cells, being arranged on a circumferential segment of the lattice structure.Several circumferential segments are arranged in the axial direction of the lattice structure and connected to one another. The cell webs can be connected to one another by web connectors, which are particularly X-shaped. It is advantageous that the support body can be easily manufactured from a tube by laser cutting.

[0029] It is conceivable to provide a connecting web which bridges the cells, in particular those which are diamond-shaped, diagonally. This achieves a particularly high supporting force. The diagonal arrangement means that the connecting web runs obliquely with respect to a longitudinal axis of the cell or generally deviates from the position of the longitudinal axis, i.e. the longitudinal axis is intersected by the connecting web. For example, in the case of a diamond-shaped cell, the longitudinal axis of the cell runs between the two tips of the diamond-shaped cell, which are the greater distance apart. The diagonally arranged connecting web can be straight or curved, in particular S-shaped. Preferably, the connecting web is connected to the webs of the diamond-shaped cell in each case by a Z-shaped web connector. This has the advantage that the bending flexibility is further improved.

[0030] Furthermore, the lattice structure of the support body can be customized for each patient. Various imaging diagnostic techniques, such as MRI or CT scans, can be used to visualize the vessel or lesion to be treated. Based on these images, it is possible to produce a support body that is tailored to the patient's anatomy.

[0031] The webs are further preferably formed from a shape-memory material, in particular a nickel-titanium alloy, in particular nitinol. This is advantageous because the shape-memory material makes the implant self-expanding or has self-expanding properties. Furthermore, marker elements, such as marker sleeves, can be applied or crimped onto the webs. For example, it is possible to attach a marker element to the proximal section in such a way that, when implanted, it is positioned in the bifurcation or at the transition between branching vessels. This ensures correct placement of the implant, in particular of the proximal section, through optimal radiopacity.

[0032] Preferably, the bars have a width and / or height between 0.05 mm and 0.15 mm. The bar width and / or height can be adjusted to suit the specific application. For example, the support effect and / or flexibility of the implant can be influenced by the bar width and / or height.

[0033] Alternatively, the support body can be manufactured by braiding wires. The support body can thus be formed from wires or consist of wires. The wires can form closed loops at the proximal longitudinal end of the braided structure. The advantage here is that the loops increase the erection force at the proximal longitudinal end of the braided structure, thereby ensuring secure anchoring of the support body near the lesion. Furthermore, the closed loops can preferably form an enlarged diameter of the proximal longitudinal end of the support body. Such a radial expansion of the proximal longitudinal end can, for example, reduce the risk of stent migration.

[0034] Furthermore, the wires can be formed from an X-ray-opaque core material, in particular platinum or a platinum alloy, and a shape memory material, in particular a nickel-titanium alloy. It is advantageous that the wires exhibit optimal X-ray visibility due to the core material. For example, the position of the implant can be easily determined by a surgeon during insertion of the implant or in the implanted state. The core material is particularly preferably formed from platinum or a platinum alloy, as these materials exhibit optimal X-ray resistance and consequently good X-ray visibility. The X-ray-opaque core material can be encased in a shape memory material. Such wires are generally known as DFT wires. The invention will be explained in more detail using exemplary embodiments in conjunction with the schematic drawings.

[0035] In these show

[0036] Fig. 1 shows an embodiment of a medical implant according to the invention, wherein the cover is arranged on the distal section;

[0037] Fig. 2 shows a medical implant according to the invention as shown in Fig. 1 in the implanted state;

[0038] Fig. 3 shows an embodiment of a medical implant according to the invention, wherein the cover is arranged on the proximal and distal portions;

[0039] Fig. 4 shows a medical implant according to the invention according to Fig. 3 in the implanted state;

[0040] In the following, the same reference numbers are used for identical or equivalent parts.

[0041] Fig. 1 shows an embodiment of a medical implant according to the invention for treating a local lesion 100 in a vascular bifurcation. This involves the use of the implant for treating a bifurcation aneurysm. Other applications are conceivable. For example, the implant is generally suitable for treating vascular lesions 100 located in the region of a vascular branching.

[0042] The embodiments shown in Fig. 1 and 3 show the implant in the expanded resting state, i.e. in the unloaded state of the support body 10. This means that no external forces act on the implant and it is not in use.

[0043] Figs. 2 and 4 show the implant in the implanted state. It can be seen that the implant is positioned in a bifurcation of a vessel to cover a vascular lesion 100. In the specific examples according to Figs. 2 and 4, the lesion 100 or the neck of the lesion 100 is completely covered by the support body 10 of the implant. Alternatively, it is possible for the implant to only partially cover the lesion 100.

[0044] Figures 2 and 4 further show that a single implant is positioned in a bifurcation of a vessel. Alternatively, it is possible, for example, to position two implants according to the invention in one bifurcation.

[0045] It can be seen in Figs. 1 and 3 that the implant comprises a support body 10 with a proximal and a distal section 11, 12 that are connected to each other. In other words, the proximal section 11 transitions into the distal section 12. In the transition region, the proximal and distal sections 11, 12 have the same cross-sectional diameter.

[0046] Furthermore, it is evident from Figs. 1 and 3 that the distal section 12 is essentially cylindrical. In other words, the distal section 12 has a substantially constant cross-sectional diameter. A different geometry of the distal section 12 is conceivable. For example, the distal section 12 can have a concave wall to improve adaptation to the vascular anatomy.

[0047] 1 and 3 show that the proximal section 11 is conical. In other words, the proximal section 11 is conically widened. The proximal section 11 has a geometry that tapers in the distal direction. It can also be seen that the proximal section 11 has an opening angle α relative to the longitudinal axis L. This means that the conical shape of the proximal section 11 can be described or defined by the opening angle α. Due to the conical shape, the proximal section 11, as shown in FIGS. 2 and 4, is positioned in a vascular bifurcation in such a way that a lesion 100 is covered in order to reduce the blood flow into the lesion 100.

[0048] 1 and 2 further show that a cover 13 is arranged on the distal section 12 of the support body 10. The arrangement or position of the cover 13 on the support body 10 is adapted to the anatomy of the patient. It can be seen in Fig. 2 that the lesion 100 is located in a branching vessel of the bifurcation. Consequently, the medically effective region of the implant, i.e. the cover 13, is positioned on the support body 10 in such a way that the treatment of a lesion 100 in a branching vessel of a bifurcation is possible. In the implanted state, the blood flow is deflected away from the lesion 100 by the cover 13 in such a way that the blood flow into the lesion 100 is reduced, whereby the blood in the lesion 100 can coagulate.

[0049] Fig. 2 further illustrates that the vessels and the lesion 100 are accessible through the proximal section 11 using a delivery device. The proximal section 11 is essentially free of any covering. For example, the proximal section 11 allows interventional access to the vessels of the bifurcation and the lesion 100 itself using a microcatheter.

[0050] Consequently, the position of the cover 13 on the support body 10 in the embodiment according to Figs. 1 and 2 is selected such that both functions are fulfilled: accessibility to the lesion 100 and / or vessels, as well as diverting blood flow away from the lesion 100. By arranging the cover 13 on the distal section 12, the proximal section 11 serves to provide access to the vessels and the lesion 100, and the distal section 12 serves to cover the lesion 100.

[0051] Figures 3 and 4 show that the cover 13 is arranged on the proximal and distal sections 11, 12. Furthermore, Figure 4 shows that the lesion 100 extends from a branching vessel into the bifurcation.

[0052] Consequently, the medically effective region in the embodiment according to Figs. 3 and 4, ie the cover 13, is positioned on the support body 10 in such a way that the treatment of a lesion 100 extending into the bifurcation is possible.

[0053] Fig. 4 further illustrates that the vessels and the lesion 100 are accessible through the proximal section 11 with a delivery device. For this purpose, the proximal end of the proximal section 11 is cover-free. Thus, the proximal end of the proximal section 11 enables interventional access to the vessels of the bifurcation and the lesion 100 itself. Consequently, the position of the cover 13 on the support body 10 in the embodiment according to Figs. 3 and 4 is selected such that both functions—accessibility to the lesion 100 and / or vessels, as well as diverting blood flow away from the lesion 100—are fulfilled. By arranging the cover 13 on the proximal section 12, the proximal section 11 serves both to provide access to the vessels and the lesion 100 and to cover the lesion 100.

[0054] Alternatively, it is conceivable that the cover 13 is arranged only on the proximal section 11 of the support body 10.

[0055] From Figs. 1 to 4, it is also clear that the cover 13 is designed as an electrospun cover 13. Specifically, the cover 13 is made of a plastic material by electrospinning. Other configurations of the cover 13 are conceivable. For example, the cover 13 can be made of a textile.

[0056] Furthermore, the cover 13 in the embodiments according to Figs. 1 to 4 is porous, so that the blood flow in the implanted state is deflected from the lesion 100. The cover 13 enables the reduction of the blood flow into a lesion 100, while at the same time ensuring a certain permeability for blood. The cover 13 has an area of ​​100,000 pm 2 at least 10 pores with a size of at least 15 pm 2This combination of a certain minimum number of pores and a minimum size of these pores has proven in practice to be particularly beneficial for sufficient blood permeability of the cover 13 while simultaneously providing a good covering effect. Alternatively, it is conceivable for the electrospun cover 13 to have a different number of pores or pores of a different size. For example, the cover 13 can have a porosity of at most 70%, in particular at most 50%. It is also possible for the cover 14 to have a porosity of at least 5%, in particular at least 10%, in particular at least 20%, in particular at least 30%, in particular at least 40%, in particular at least 45%.

[0057] In the embodiment shown in Figs. 1 to 4, the cover 13 has an antithrombogenic coating. Specifically, the cover 13 is coated with a coating of heparin and fibrin, with heparin covalently bonded to fibrin. Other coatings that impart antithrombogenic properties to the cover 13 are conceivable. For example, the coating may comprise fibronectin.

[0058] Furthermore, Figures 1 to 4 show that the wall of the proximal section 11 is concave in order to adapt the wall to the curvature of the vessels in a bifurcation. It can be seen that the wall has a curvature or is curved. Figures 2 and 4 further illustrate that a concave wall of the proximal section 11 enables optimal adaptation to the anatomy.

[0059] In the exemplary embodiment shown in Figs. 1 to 4, the wall of the proximal section 11 has a curvature angle between 90° and 170°. Other angle ranges are conceivable. Specifically, the curvature of the wall can be adapted to the specific application or the anatomy of a bifurcation.

[0060] Figs. 1 to 4 show that the implant, or rather the proximal and distal sections 11, 12 of the support body 10, are rotationally symmetrical. It is conceivable that the implant may have a different geometry. Thus, the implant, or rather the proximal and / or distal sections 11, 12, may have a curved geometry. This is to be understood as meaning that the longitudinal axis L of the implant has a curvature, with the proximal and distal sections 11, 12 being aligned along this curvature.

[0061] It can be seen in Fig. 1 to 4 that the proximal section 11 has a larger cross-sectional diameter than the distal section 12. In other words, the proximal section 11 has a larger cross-sectional area than the distal section 12. Due to its conical shape, the proximal section 11 has a larger cross-sectional diameter than the distal section 12 at every position along the longitudinal axis L. It can be seen that the cross-sectional diameter increases in the proximal direction of the proximal section 11.

[0062] 1 to 4 show that the proximal section 11 comprises a proximal longitudinal end 14, and the distal section 12 comprises a distal longitudinal end 15 of the support body 10. In the illustrated embodiments, the cross-sectional diameter of the proximal longitudinal end 14 is at least 1.5 times larger than the cross-sectional diameter of the distal longitudinal end 15. Other size ratios between the proximal and distal longitudinal ends 14, 15 are conceivable. For example, the proximal longitudinal end 15 can be 2 times, 2.5 times, or 3 times larger than the cross-sectional diameter of the distal longitudinal end 15.

[0063] Figs. 1 and 3 further show that the proximal section 11 has an opening angle α of at least 45°. It can be seen that the opening angle α is formed between the longitudinal axis L and the wall of the proximal section 11. It is also conceivable for the proximal section 11 to have a different, in particular larger, opening angle α. For example, the opening angle α can be 50°, 55°, 60°, 65°, 70°, 75°, or 80°.

[0064] Furthermore, in the embodiments according to Figs. 1 to 4, the proximal section 11 has a length of at least 4 mm in the axial direction. The length of the proximal section 11 is understood to mean the length between the proximal and distal longitudinal ends 14, 15 of the proximal section 11, which is measured along the longitudinal axis L. For example, the length of the proximal section 11 can be 5 mm, 6 mm, 7 mm, 8 mm, 9 mm, 10 mm, 11 mm, or 12 mm. Other lengths of the proximal section 11 are conceivable.

[0065] In Figs. 1 and 2, it can be seen that the proximal section 11 is porous, so that the vessel and / or the lesion is accessible through the porosity with the delivery device in the implanted state. The proximal section is cover-free. The delivery device can therefore be guided through any region of the proximal section 11 to reach the lesion 100 and / or the vessel. It is advantageous to guide the delivery device through the proximal longitudinal end 14 of the proximal section 11, since the proximal longitudinal end 14 can have a greater porosity than the distal region of the proximal section 11.

[0066] Figs. 1 and 2 further show that the porosity of the proximal section 11 changes in the axial direction. The porosity of the proximal section 11 decreases in the distal direction. This means that the greatest porosity is present at the proximal end, while the distal end has the lowest porosity of the proximal section 11.

[0067] In Figs. 3 and 4, it can be seen that the proximal longitudinal end 14 of the proximal section 11 is porous. The cover 13 extends partially over the proximal section 11. The proximal longitudinal end 14 of the proximal section 11 is free of any cover. The free end of the proximal section allows access to distal vascular areas and the lesion itself. To reach the lesion itself, it is also necessary to pierce the cover with the delivery device.

[0068] From Fig. 1 to 4 it can also be seen that the support body 10 has a lattice structure made up of webs 16. The webs 16 are connected to one another and form closed, in particular diamond-shaped, cells 17. In the exemplary embodiments according to Fig. 1 to 4, six cells 17 are arranged on a circumferential segment of the lattice structure. A different number of cells 17 per circumferential segment is conceivable. For example, a circumferential segment of the lattice structure can have three cells 17. It can be seen that several circumferential segments are arranged in the axial direction of the lattice structure and are connected to one another. Furthermore, the webs 16 of the cells 17 are connected to one another by X-shaped web connectors.

[0069] The webs 16 in the exemplary embodiment according to Figs. 1 to 4 are formed from a shape memory material. It is conceivable that the webs 16 are formed from a different material. For example, the webs 16 can be formed from a cobalt-chromium alloy or a comparable material.

[0070] Furthermore, the webs 16 have a width and height between 0.05 mm and 0.15 mm. Other web widths and heights are possible.

[0071] Alternatively, the support body 10 can have a braided structure of wires, each wound around a longitudinal axis L of the braided structure and crossing over and under each other. The braided structure is produced by braiding the wires, with the wires forming meshes of the braided structure. The wires can form closed end loops at the proximal longitudinal end 14 of the braided structure to enable good accessibility to the vessels and / or the lesion through the end loops.

[0072] All embodiments and examples are designed to be delivered or positioned in the vessel using a suitable delivery system, such as a catheter. Different sizes and

[0073] Cross-sectional diameter of the implant, various catheter systems can be used.

[0074] List of reference symbols

[0075] 10 support bodies

[0076] 11 proximal section

[0077] 12 distal section

[0078] 13 Cover

[0079] 14 proximal longitudinal end

[0080] 15 distal longitudinal end

[0081] 16 bridges

[0082] 17 cells

[0083] 100 lesion o opening angle

[0084] L Longitudinal axis

Claims

Claims 1. A medical implant for treating a local lesion (100) in a bifurcation of a vessel, in particular for treating a bifurcation aneurysm, comprising a support body (10) which is compressible and expandable, wherein the support body (10) comprises a proximal portion (11) and a distal portion (12) which are connected to one another, characterized in that - the distal section (12) is tubular, in particular cylindrical, for anchoring in the vessel, and - the proximal section (11) is conical and has an opening angle (o) relative to a longitudinal axis (L) of the support body (10), wherein the proximal section (11) can be positioned in the vessel such that the vessel and / or the lesion (100) in the implanted state is accessible through the proximal section (12) with a delivery device, in particular a microcatheter, and - a cover (13) is arranged on the proximal and / or distal section such that the lesion (100) can be at least partially covered by the cover (13).

2. Medical implant according to claim 1, characterized in that the cover (13) has at least one electrospun section, in particular is designed in the form of an electrospun cover.

3. Medical implant according to claim 1 or 2, characterized in that the cover (13), in particular the at least one electrospun section of the cover (13), is porous in such a way that the blood flow in the implanted state can be at least partially deflected from the lesion (100).

4. Medical implant according to one of the preceding claims, characterized in that the cover (13) has an antithrombogenic coating, which in particular comprises heparin and / or fibrin.

5. Medical implant according to one of the preceding claims, characterized in that the wall of the proximal section (11) is concave, so that the wall can be adapted to the curvature of the vessels in a bifurcation.

6. Medical implant according to one of the preceding claims, characterized in that the wall of the proximal section (11) has an angle of curvature between 70° and 190°, in particular at least 90°, in particular at least 110°, in particular at least 130°, in particular at least 150°, in particular at least 170°.

7. Medical implant according to one of the preceding claims, characterized in that the proximal section (11) has a larger cross-sectional diameter than the distal section (12).

8. Medical implant according to one of the preceding claims, characterized in that the proximal section (11) comprises a proximal longitudinal end (14) and the distal section (12) comprises a distal longitudinal end (15) of the support body (10), wherein the cross-sectional diameter of the proximal longitudinal end (14) is at least 1.5 times, in particular 2 times, in particular 2.5 times, in particular 3 times larger than the cross-sectional diameter of the distal longitudinal end (15).

9. Medical implant according to one of the preceding claims, characterized in that the proximal section (11) has an opening angle (o) of at least 45°, in particular 50°, in particular 55°, in particular 60°, in particular 65°, in particular 70°, in particular 75°, in particular 80°.

10. Medical implant according to one of the preceding claims, characterized in that the proximal section (11) has a length of at least 4 mm, in particular 5 mm, in particular 6 mm, in particular 7 mm, in particular 8 mm, in particular 9 mm, in particular 10 mm, in particular 11 mm, in particular 12 mm in the axial direction.

11. Medical implant according to one of the preceding claims, characterized in that the proximal section (11), in particular the proximal longitudinal end (14) of the proximal section (11), is porous in such a way that the vessel and / or the lesion (100) is accessible to the delivery device through the porosity in the implanted state.

12. Medical implant according to one of the preceding claims, characterized in that the support body (10) has a lattice structure of webs (16) which are connected to one another and form closed, in particular diamond-shaped, cells (17), wherein three to ten cells (17), in particular six cells (17) are arranged on a circumferential segment of the lattice structure.

13. Medical implant according to one of the preceding claims, characterized in that the webs (16) are formed from a shape memory material, in particular from a nickel-titanium alloy.

14. Medical implant according to one of the preceding claims, characterized in that the webs (16) have a width and / or height between 0.05 mm and 0.15 mm.

Images