DE102012102240A1 - Implantation system for intravascular intervention, has independent implant with hollow-cylinder-shaped grating structure that is extended by supply element, such that implants are compressed and located behind other on supply element - Google Patents

Abstract

The implantation system has two independent implants that are compressed and expanded radially from each other. An essentially hollow-cylinder-shaped grating structure of independent implant is extended by a supply element (10), such that the implants are compressed and located behind the other on the supply element. A holder unit for implant is arranged along a wire of supply element. A sleeve (14) of holder unit is arranged proximally to a sleeve (16) such that the force acting in distal direction (RD) is transferred to the implant.

Description

The invention relates to an implantation system for intravascular intervention.

Out US 6,120,522 For example, an implantation system is known which comprises a stent and a wire which is used to transport the stent to a treatment site, in particular into the region of a stenosis in a blood vessel. The wire has a holding device with a sleeve, which is delimited at a distal end by an annular flange. At a proximal end of the sleeve a plurality of radially projecting projections are provided which can engage in end cells of the stent and thus fix the stent in the compressed state on the wire. The annular flange serves as a stop via which a proximally acting force can be exerted on the stent, for example in order to retract the stent into a catheter. The radially projecting projections, however, form a stop, via which a distally acting force can be applied to the stent. In this way, the stent can be released from the catheter. Between the annular flange and the radially projecting projections, the sleeve has a cylindrical portion which encloses the wire. The stent can therefore be compressed to a maximum of a compressed inner diameter corresponding to the outer diameter of the cylindrical portion.

The described system thus has the disadvantage that relatively much space is required for the placement of the components in the catheter, in particular with respect to the catheter diameter.

From medical practice, it is known to use so-called stent-in-stent implants, for example, to cover an aneurysm. In this case, first a first stent is discharged into the blood vessel and the delivery system then removed from the blood vessel. Subsequently, a second stent is introduced through a second delivery system which is expanded within the first stent. The second stent may serve, for example, as additional support or to increase the fine mesh of the stent-in-stent system.

The described surgical procedure requires a relatively high amount of time. In addition, changing the delivery systems increases the risk of infection and the risk of vascular trauma. When inserting the second delivery system there is also the risk that the wire or the catheter of the second delivery system is guided along the vessel wall and touches the already implanted stent. This can lead to a dislocation of the first stent or at least to irritation of the vessel wall.

The invention has for its object to provide an implantation system that allows a simple and safe implantation of at least two implants.

This object is achieved by the subject of claim 1.

The invention is based on the idea of providing an implantation system for an intervascular intervention with a delivery element and at least two independent implants, which are radially compressible and expandable and each having a substantially hollow cylindrical lattice structure through which the delivery member extends, the implants compressing and are arranged one behind the other on the feed element.

In the system according to the invention, the surgeon can freely decide during the procedure whether one, two or more implants are to be released. A change of the implantation system, in particular a catheter replacement, is not required because the implants are guided on a single feed element. Moreover, the surgeon can decide on the nature of the release of the individual implants or implant segments. For example, at least two implants can be released into one another or at least partially overlapping or spaced from one another in the blood vessel.

In one embodiment of the invention it is provided that the feed element has at least two holding devices for the implants arranged one behind the other along the wire. The at least two holding devices or generally a plurality of holding devices makes it possible for a plurality of implants, in particular a plurality of stents, which are preferably relatively short, to be placed one behind the other on the feeding element and fixed at least temporarily. This increases the flexibility, in particular bending flexibility, of the implantation system, since the free sections of the delivery element act as an articulation between two implants or stents.

In a preferred embodiment, the holding device has a first sleeve with at least one nose, which extends radially outwards and forms a first stop for the implant in such a way that a force acting in the proximal direction RP can be transmitted to the implant. Furthermore, the holding device may have a second sleeve which is arranged proximal to the first sleeve and forms a second stop such that a force acting in the distal direction RD can be transmitted to the implant. Between the first sleeve and the second sleeve may be arranged a space for receiving an eyelet of the implant.

In a further preferred embodiment of the invention, the delivery element has a distal section which projects axially to stabilize the implant in the distal direction RD via the first sleeve. Furthermore, it can be provided that the feed element has a wire which has a smaller cross-sectional diameter at a distal end of the feed element, in particular in the region of the distal section, than at a proximal end of the feed element, in particular in a region proximal to the distal section. The wire may substantially correspond to the core or core wire of the delivery member and extend from the proximal end to the distal end of the delivery member. The wire has a smaller cross-sectional diameter and thus a higher flexibility than the entire feed element.

The distal portion is preferably formed solely by the wire so that the distal portion has a higher flexibility than the other wire portion following the distal portion. In this way, the distal portion serves as a guide tip, which is easily inserted or threadable in vessel curvatures.

Preferably, the first sleeve has at least 2, in particular at least 3, in particular at least 4, in particular at least 5, in particular at least 6, in particular at least 7, in particular at least 8, in particular at least 9, in particular at least 10, in particular at least 12, lugs. Further, the second sleeve to each other may have a number of lugs corresponding to the number of lugs of the first sleeve, which extend radially outward and form the second stop. In particular, the second sleeve comprises at least 1, in particular at least 2, in particular at least 3, in particular at least 4, in particular at least 5, in particular at least 6, in particular at least 7, in particular at least 8, in particular at least 9, in particular at least 10, in particular at least 12, noses ,

This embodiment has the advantage that the lugs of the first sleeve and the lugs of the second sleeve are arranged in alignment, when the number of lugs of the first sleeve corresponds to the number of lugs of the second sleeve. Due to the aligned arrangement of the noses also automatically aligned between the noses intermediate spaces.

The first and second sleeves preferably each have the same mean diameter in the region of the intermediate spaces. Generally, the sleeves have an inner diameter, an average diameter and an outer diameter. The inner diameter refers to the circumference of the bore of the sleeves, which represent the passage opening for the wire. The mean diameter refers to the circumference of the sleeve in the area of the spaces between the noses. The outer diameter refers to the circumference of the sleeve passing through the bridge of the nose, i. H. formed by the radial outer surfaces of the lugs.

The aligned arrangement together with the matching average diameter has the manufacturing advantage that the same laser parameters can be used to attach the first and second sleeves to the wire by spot welding.

In a further preferred embodiment of the implantation system according to the invention, the feed element has at least one loose sleeve, which is arranged as an X-ray marker proximal to the second sleeve in order to improve the visibility of the delivery element under X-ray control.

In general, it is preferred if the delivery element is arranged to be longitudinally displaceable in a catheter sheath or a sheath which limits the clearance radially outward. The eyelets of the implants or implant segments are fixed in this way both in the axial direction, as well as in the radial direction in the free space. Through the catheter sheath or the lock, at least one axial end of the implant is held in the compressed state.

With regard to the implants of the implantation system according to the invention, it can be provided that at least one eyelet, which carries an x-ray marker, is formed at least at one axial end of the grid structure.

Preferably, the grid structure has end cells at the axial end. The eyelet can project in the axial direction over the end cells, at least in the compressed state of the lattice structure.

The implants may each have different lattice structures, in particular different ridge widths and / or different ridge thicknesses and / or different cell sizes.

In an advantageous embodiment, it is provided that each implant has three eyelets, which are arranged at an angle of 120 ° to each other. In each eyelet an x-ray marker is placed. With this arrangement of the eyelets, the positionability of the implant is improved, since position-independent virtually the entire circumference of the implant is visible.

The individual implants can be used together, in particular be used at a common treatment site. By different lattice structures, which differ for example by different cell sizes, for example, a stent-in-stent system can be provided in which a first implant has sufficient radial force to support a blood vessel, in particular expand, and at least one second implant Lattice structure having a comparatively small cell size and small wall thickness, wherein the second implant is arranged at least partially overlapping with the first implant.

By overlapping arrangement of the implants in the vessel both a high radial force, as well as a high fine mesh is provided. The blood vessel is thus sufficiently supported and at the same time, for example, an aneurysm efficiently covered. In particular, the fine mesh positively influences the blood flow in the aneurysm. Another advantage of a stent-in-stent arrangement in which the implants overlap is that the pushing forces of the compressed implants in the catheter or in the sheath are relatively small, since the implants only at radial overlap the appropriate radial force for the support function produce.

In principle, the implantation system according to the invention forms the possibility for the placement of a stent or flow diverter, in which the surgeon directly during the procedure, d. H. when releasing the implants, the degree of overlap and the number of implants to be used can determine itself, since the total implant is not one piece, but has individual segments.

Since the implants or implant segments are independent of one another, the overall implant, which can be created from the implant segments or individual implants during the surgical procedure, has an overall higher flexibility than known implants, which are produced from a single piece of tube. Furthermore, the implant segments can move in the implanted state to each other or into each other. This avoids that the entire implant, especially when placed in vessel curvatures, buckles and at least partially loses contact with the vessel wall.

In general, the implantation system may comprise lattice structures formed of intersecting wires, as well as lattice structures formed from, for example, laser cutting, a tubular solid material. Consequently, each implant may have a lattice structure that is either formed as a mesh with interwoven wires or made by laser cutting from a solid tube. In the laser-cut lattice structure, the individual webs of the lattice structure integrally form the entire lattice structure. In other words, all the webs are in the same wall level of the lattice structure.

The arrangement of the implants on the feed element preferably takes place in such a way that the eyelet of a respective compressed implant is arranged in the free space of one of the holding devices of the feed element. In each case a holding device fixes a single implant.

The shape of the noses of the first and / or second sleeve may be adapted to the shape of the end cells of the compressed implant. As a result, a secure connection between the nose of the first sleeve and the webs is generated and achieved a good power transmission.

The invention will be explained in more detail below with reference to an embodiment with reference to the accompanying schematic drawings. In these show:

1 a side view of a holding device of the implantation system according to the invention according to a preferred embodiment;

2 a side view of the holding device of the implantation system according to the invention according to 1 wherein an eyelet of an implant is fixed in the holding device;

3 a side view of the implantation system according to the invention according to a preferred embodiment;

4 a side view of the implantation system according to 3 wherein the individual implants are arranged intravascularly spaced from each other; and

5 a side view of the implantation system according to 3 , wherein the individual implants are arranged intravascularly overlapping.

1 shows a side view of a feeding element 10 in use for transporting a compressed implant 21 , for example a stent, within a catheter sheath 27 , is used (transport wire). In this case, a catheter of size 5 French, in particular 3 French, in particular 2.5 French, in particular 2 French, in particular 1 French, is preferably used, with 1 French corresponding to a value of 0.33 millimeters.

The feeding element 10 has a wire 15 on, extending from the proximal end 11 to the distal end 19 of the feeding element 10 extends. The wire 15 is preferably made of nitinol or spring steel. The wire 15 indicates at its distal end 19 a smaller cross-sectional diameter than at its proximal end 11 on. In other words, the wire tapers 15 towards the distal end 19 , In this way it is achieved that the wire 15 or in total the feed element 10 at the distal end 11 a higher flexibility than at the proximal end 19 having.

The diameter of the wire 15 is less than 1.25 mm, in particular less than 1.0 mm, in particular less than 0.75 mm, in particular less than 0.6 mm, in particular less than 0.5 mm, in particular less than 0.4 mm, in particular smaller than 0.3 mm, in particular less than 0.25 mm. The lower limit can be 0.24 mm.

Furthermore, the feed element comprises 10 coils 12 that are both at the proximal end 11 as well as at the distal end 19 are arranged. The coils 12 support the feeding element 10 or lend to the feed element 10 a stable shape, so that tilting of the feed element 10 in the catheter or in the catheter sheath 27 is avoided. The same applies to the risk of tilting within a lock. Single or multiple components of the feed element 10 like the coils 12 , may be hydrophilic and / or hydrophobic coated. Preferably, a biocompatible coating, in particular comprising PTFE or parylene, is used.

The feeding element 10 comprises at least two holding devices 26 for eyelets 22 an implant 21 , in particular a stent, are adapted. In the embodiment according to 3 are a total of three holding devices 26 intended. Another number of holding devices, in particular at least three, in particular at least four, in particular at least five, holding devices 26 , is possible.

Each of the holding devices 26 includes two sleeves 14 . 16 , which are preferably produced by laser cutting and / or etching. The material of the two sleeves 14 . 16 preferably comprises nitinol or a noble metal, in particular platinum. Furthermore, the sleeves can 14 . 16 a carbide or a plastic.

The pods 14 . 16 have a thickness, ie axial depth, which is less than 0.75 mm, in particular less than 0.5 mm, in particular less than 0.4 mm, in particular less than 0.3 mm, in particular less than 0.25 mm, in particular less than 0.2 mm, in particular less than 0.15 mm, in particular less than 0.1 mm. The lower limit can be 0.05 mm.

In addition, the sleeves include 14 . 16 three noses each 18 , In general, the sleeves can each have at least one nose 18 , in particular at least 2 lugs, in particular at least 3 lugs, in particular at least 4 lugs, in particular at least 5 lugs, in particular at least 6 lugs, in particular at least 7 lugs, in particular at least 8 lugs, in particular at least 9 lugs, in particular at least 10 lugs and in particular at least 12 lugs which extend radially outward and parallel to the central axis of the respective sleeve. The width of the nose 18 a first sleeve 16 is preferably less than 0.3 mm, in particular less than 0.25 mm, in particular less than 0.2 mm, in particular less than 0.15 mm, in particular less than 0.125 mm, in particular less than 0.1 mm, in particular less than 0.09 mm, in particular less than 0.08 mm, in particular less than 0.07 mm, in particular less than 0.06 mm, in particular less than 0.05 mm. The lower limit can be 0.04 mm. The noses 18 a second sleeve 14 are wider than the noses 18 the first sleeve 16 , In particular, the noses can 18 form substantially ribs, wherein the rib width of the ribs of the first sleeve 16 smaller than the rib width of the ribs of the second sleeve 14 is.

The pods 14 . 16 have one on the radial outer surfaces of the noses 18 outer diameter, which is less than 1.0 mm, in particular less than 0.8 mm, in particular less than 0.75 mm, in particular less than 0.7 mm, in particular less than 0.6 mm, in particular less than 0.5 mm, in particular less than 0.45 mm, in particular less than 0.4 mm, in particular less than 0.35 mm, in particular less than 0.3 mm, in particular less than 0.25 mm. The lower limit can be 0.2 mm. The on the through hole of the sleeve 14 . 16 the inside diameter is less than 0.5 mm, in particular less than 0.4 mm, in particular less than 0.3 mm, in particular less than 0.25 mm, in particular less than 0.2 mm, in particular less than 0.15 mm, in particular less than 0.1 mm. The lower limit can be 0.05 mm.

As in 2 recognizable is the nose 18 the first sleeve 16 on the soul or the wire 15 of the feeding element 10 arranged or with the wire 15 firmly connected to the implant 21 for transmitting force in the proximal direction RP engages and forms a first stop for the implant 21 , The second sleeve 14 , which is proximal to the first sleeve 16 is arranged, forms a second stop for power transmission in the distal direction RD. There is also a free space 17 for receiving the implant 21 provided, the distal through the first sleeve 16 and proximally through the second sleeve 14 is limited.

Both sleeves include noses 18 that on the wire 15 in the open space 17 are arranged that the noses 18 the first sleeve 16 and the noses 18 the second sleeve 14 aligned. In addition, the spaces between the noses are aligned 18 that the mean diameter of the pods 14 . 16 form. Due to the same average diameter of the two sleeves 14 . 16 can be used to attach the sleeves 14 . 16 on the soul 15 the same welding parameters, in particular laser welding parameters are used. This simplifies the manufacturing process. The two sleeves 14 . 16 Alternatively, by soldering or gluing on the wire 15 be attached.

The second sleeve 14 has noses 18 on, which have a larger width than the noses 18 the first sleeve 16 include. This ensures that the front sides of the noses 18 the second sleeve 14 a sufficiently large stop surface for the individual implant 21 , especially the eyelet 22 of the implant. In particular, the noses are 18 the second sleeve 14 formed so wide that the distance between the lugs of the second sleeve 14 just enough for the second sleeve 14 with the guide wire or the feed element 10 , especially the wire 15 to weld.

On the proximal side of the second sleeve 14 is at least a loose sleeve 13 on the wire 15 fixed so that the loose sleeve 13 on the second sleeve 14 is applied. Preferably, two loose sleeves 13 on the wire 15 arranged.

The loose sleeve 13 serves as an x-ray marker and preferably has a material that allows for increased radiopacity. The X-ray visible material ensures that the two loose sleeves 13 under X-ray control are visible and the "point of no return" is set. This means that the surgeon sees exactly where the implant is 21 or implant segment from the wire 15 solves.

Along the wire 15 are several holding devices 26 arranged, each holding device 26 a different number of loose pods 13 can have. The loose pods 13 serve as x-ray markers, so that the individual holding devices 26 easy to distinguish under X-ray control. This facilitates the work of the surgeon. In particular, it can be provided that the first holding device 26 near the distal end of the wire 15 is arranged, a single loose sleeve 13 , the proximally adjacent holding device 26 two loose pods 13 and the more proximal to the second holding device 26 arranged third holding device 26 more than two loose pods 13 includes. The loose pods 13 are preferably formed of gold or platinum. The first and second sleeve 14 . 16 preferably have a nickel titanium alloy, in particular Nitinol on.

In the 4 and 5 Each is a set of implants 21 , in particular in each case a set of stents, shown in the implanted state. The individual implants 21 each have a compressible and expandable, in particular self-expandable, lattice structure 29 with cells 30 on, through the bridges 25 are limited. The grid structure 29 is hollow cylindrical or tubular. In other words, the implant forms 21 essentially a stent, in particular a stent whose length is at most 1.5 times, in particular at most 1.2 times, in particular at most 1 times, the cross-sectional diameter of the expanded lattice structure 29 equivalent.

At least one axial end of the lattice structure 29 are end cells 28 arranged. The end cells 28 form one over the circumference of the lattice structure 29 extending ring of cells 30 that is one-sided with another ring of cells 30 connected is.

As in 4 Well recognizable, the individual implants can 21 or the individual stents spaced from each other in a blood vessel 32 be released.

Because the individual implants 21 are relatively short, the entire set adapts well to the curvature of the blood vessel 32 at. In particular, by the spaced arrangement of the individual implants 21 That achieves that from the individual implants 21 applied radial force not on the other implants 21 transfers. This ensures that every single implant 21 has a good contact with the vessel wall.

Alternatively, the implants can 21 are arranged overlapping each other to provide a continuous grid structure. This variant is in 5 shown. Accordingly, the implants can 21 or individual stents are telescopically arranged one inside the other. The degree of overlap can be set differently along the set or overall implant. For example, the implants may be 21 in the area of an aneurysm 31 or aneurysm neck more closely than outside the aneurysm area. Thereby, an implant section with increased fine mesh may be provided to the aneurysm neck to block or at least reduce blood flow into the aneurysm. Due to the individual, independent, in particular independently implantable, implants 21 has the overall implant still has a high flexibility and can adapt well to the vessel curvature.

The individual implants 21 are on the feed element 10 usually arranged in the compressed state. The compressed state adjusts itself by the fact that the individual implants 21 through a catheter sheath 27 or a lock are prevented from expanding radially. The catheter sheath 27 or the lock thus has an inner diameter which is at least twice the wall thickness of the lattice structure 29 of the implants 21 larger than the outer diameter of the feed element 10 is.

The individual implants 21 or stents preferably each have three eyelets 22 at one axial end, in each of which an x-ray marker 23 is arranged. The eyelets 22 form the proximal end of the implant 21 , Inside the catheter sleeve 27 or the lock are the eyelets 22 in the open space 17 arranged. This means that the eyelets 22 in the open space 17 at least partially sunk, leaving the eyelets 22 with the first and second sleeves 16 . 14 at least partially overlap. At the proximal end has the eyelet 22 a rounded shape 24 on that a stop with the second sleeve 14 forms. The implant 21 includes webs at the distal end 25 that are at the noses 18 the first sleeve 16 issue ( 2 ).

The shape of the cell 30 between the bridges 25 is the shape of the nose 18 customized. The nose 18 forms a stop with the webs 25 , so that the force transmission takes place in the proximal direction RP. At the distal end 19 of the feeding element 10 there is a distal section 20 which essentially forms a continuation wire.

In the context of the application is also a medical delivery system with a feeding 10 discloses a holding device 26 for an implant 21 having, wherein the holding device 26 a first sleeve 16 with at least one nose 18 which extends radially outward and a first stop for the implant 21 forms such that acting in the proximal direction RP force on the implant 21 is transferable. The holding device 26 further includes a second sleeve 14 , which is proximal to the first sleeve 16 is arranged and forms a second stop such that a force acting in the distal direction RD force on the implant 21 is transferable. Between the first sleeve 16 and the second sleeve 14 is a free space 17 for receiving an eyelet 22 of the implant 21 arranged. The medical delivery system has at least two holding devices 26 on that along the feed element 10 one behind the other, in particular spaced from each other, are arranged. The distance between the holding devices 26 is preferably chosen such that associated implants 21 spaced from each other, in particular not overlapping, but rather aligned, can be arranged.

The delivery system allows easy implantation of multiple implants 21 or stents, whereby it can be decided during the surgical procedure how many implants 21 and in which arrangement the implants 21 to be discharged from the feed system.

LIST OF REFERENCE NUMBERS

10

feeding

11

proximal end

12

coil

13

loose sleeve

14

second sleeve

15

wire

16

first sleeve

17

free space

18

nose

19

distal end

20

distal section

21

implant

22

eyelet

23

X-ray markers

25

Stege

26

holder

27

catheter sheath

28

end cells

29

lattice structure

30

cell

31

aneurysm

32

blood vessel

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• US 6120522 [0002]

Claims (18)

Implantation system for intravascular intervention with a delivery element ( 10 ) and at least two independent implants ( 21 ) which are radially compressible and expandable and each having a substantially hollow cylindrical lattice structure ( 29 ), through which the feed element ( 10 ), wherein the implants ( 21 ) and successively on the feed element ( 10 ) are arranged. Implantation system according to claim 1, characterized in that the feeding element ( 10 ) at least two along the wire ( 10 ) holding devices arranged one behind the other ( 26 ) for the implants ( 21 ) having. Implantation system according to claim 2, characterized in that the holding device ( 26 ) a first sleeve ( 16 ) with at least one nose ( 18 ) which extends radially outward and a first stop for the implant ( 21 ) forms such that a force acting in the proximal direction RP on the implant ( 21 ) is transferable. Implantation system according to claim 3, characterized in that the holding device ( 26 ) a second sleeve ( 14 ) which is proximal to the first sleeve ( 16 ) is arranged and forms a second stop such that a force acting in the distal direction RD force on the implant ( 21 ) is transferable. Implantation system according to claim 3 or 4, characterized in that between the first sleeve ( 16 ) and the second sleeve ( 14 ) a free space ( 17 ) for receiving the eyelet ( 22 ) of the implant ( 21 ) is arranged. Implantation system according to one of claims 3 to 5, characterized in that the feed element ( 10 ) a distal portion ( 20 ), which is used to stabilize the implant ( 21 ) distally RD via the first sleeve ( 16 ) projects axially. Implantation system according to one of the preceding claims, characterized in that the delivery element ( 10 ) a wire ( 15 ), which at a distal end of the feed element ( 10 ), in particular in the region of the distal section ( 20 ), a small cross-sectional diameter than at a proximal end of the delivery member (FIG. 10 ), in particular in a region proximal to the distal section ( 20 ), having. Implantation system according to one of claims 3 to 7, characterized in that the first sleeve ( 16 ) at least 2, in particular at least 3, in particular at least 4, in particular at least 5, in particular at least 6, in particular at least 7, in particular at least 8, in particular at least 9, in particular at least 10, in particular at least 12, lugs ( 18 ) having. Implantation system according to one of claims 4 to 8, characterized in that the second sleeve ( 14 ) one of the number of noses ( 18 ) of the first sleeve ( 16 ) corresponding number of noses ( 18 ) which extend radially outward and form the second stop. Implantation system according to one of claims 4 to 9, characterized in that the second sleeve ( 14 ) at least 1, in particular at least 2, in particular at least 3, in particular at least 4, in particular at least 5, in particular at least 6, in particular at least 7, in particular at least 8, in particular at least 9, in particular at least 10, in particular at least 12, lugs ( 18 ) having. Implantation system according to one of claims 4 to 10, characterized in that the feed element ( 10 ) at least one loose sleeve ( 13 ), which as X-ray marker proximal to the second sleeve ( 14 ) is arranged. Implantation system according to one of the preceding claims, characterized in that the feed element ( 10 ) is longitudinally displaceably arranged in a catheter sheath or a lock, which the free space ( 17 ) bounded radially outward. Implantation system according to one of the preceding claims, characterized in that at least at one axial end of the lattice structure ( 29 ) at least one eyelet ( 22 ) is formed, which is an x-ray marker ( 23 ) wearing. Implantation system according to claim 13, characterized in that the lattice structure at the axial end end cells ( 28 ), wherein the eyelet ( 22 ) at least in the compressed state of the lattice structure ( 29 ) in the axial direction via the end cells ( 28 ) protrudes. Implantation system according to one of the preceding claims, characterized in that the implants ( 21 ) each have different lattice structures ( 29 ), in particular different web widths and / or different web thicknesses and / or different cell sizes. Implantation system according to one of the preceding claims, characterized in that the lattice structure ( 29 ) is formed from intersecting wires or in one piece from grid bars. Implantation system according to one of claims 13 to 16, characterized in that the eyelet ( 21 ) each of a compressed implant ( 21 ) in open space ( 17 ) one of the holding devices ( 26 ) is arranged such that in each case a holding device ( 26 ) a single implant ( 21 ) fixed. Implantation system according to one of claims 3 to 17, characterized in that the shape of the nose ( 18 ) of the first and / or second sleeve ( 16 . 14 ) the shape of the end cells ( 28 ) of the compressed implant ( 21 ) is adjusted.

Images