Patent Description:
The disclosure also relates to such an anchor member, which may be provided separately from the implant.

An occluder is a medical product or implant used for occluding defects, e.g. in the human heart. Defects may occur in various regions of the heart and have different forms. Defects in the septum of the atrium are common.

The occluders can be inserted using minimally invasive cardiac catheter techniques, more precisely by means of a transvenous, catheter-interventional access.

Being projections from the atria, auricles are parts of the heart and not defects.

In the case of patients who are susceptible to atrial fibrillation or suffering from arrhythmia, the auricle may be the origin of blood clots. Thus, occluding the left auricle can prevent the creation of thrombi and reduce the risk of a stroke.

There are some left atrial appendage (LAA) occluders known for this purpose. However, it may be difficult to make the LAA occluders stay in the right position once implanted.

The LAA occluder in <CIT> solves this by the use of barbs that are formed integral with a frame, i.e. the frame including barbs is monolithic. The frame is covered by a membrane that is attached to a portion of the frame. The membrane can be attached to the frame with stitching, hooks, tangs or stakes. However, the use of a membrane is not favourable in all situations.

Another LAA occluder is known from <CIT>. In this document, the occluder comprises a braided structure. The positioning of the occluder is secured by the use of hooks. The hooks are sutured or woven to the braided structure, as is illustrated by a zig-zag structure in <FIG> of the document.

However, the use of stitching, suturing, weaving, etc. of hooks or barbs, or a membrane to a frame with such hooks or barbs, may be unreliable. The suture, thread, etc. used for the attachment may become loose, with the associated risk of the hooks or barbs dislodging from the other structure, and the occluder losing its position relative the defect or structure to which it is attached. There is also the risk that the hooks or bars damage the catheter when the implant is collapsed and positioned in the catheter for delivery to the target site.

Hence, an improved occluder, which upon implantation may be reliably anchored to a vascular structure, is desired.

<CIT> discloses an elongate resilient tube of a mesh of shape memory alloy that is used to therapeutically occlude an opening in body tissue. The tube is compressible so that it can be delivered to the opening in the body within a catheter. The tube self-expands as it is released from the catheter to continuously form, sequentially, the following shapes: an outer bell-shaped structure; an inner bell-shaped structure disposed within the outer bell-shaped structure to conformingly engage an inner side of the outer bell-shaped structure; a tubular connector having a diameter substantially smaller than the inner bell-shaped structure the tubular connector ex - tending away from an apex of the inner bell-shaped structure; an inner plate- shaped structure; an outer plate-shaped structure; and a releasable connector. The bell shape is placed on one side of the opening, and the plate shape is placed on the other side of the opening, the connector passing through the opening.

<CIT> discloses a medical device in which one or both ends of the device encourage the formation of tissue across substantially the entire area of the respective end that is exposed to the blood flow for reducing the risk of a thrombotic embolism. The medical device further includes stabilizing wires configured to engage tissue at a target site when the medical device is in an expanded configuration and to at least partially retract into the medical device when the medical device is in a collapsed configuration.

<CIT> discloses a medical device including a medical device body that includes a first support structure, the medical device further comprising a first fixation anchor that includes a first anchor body extending between a first end and an opposing second end, and a hook portion extending from the first end, wherein the first anchor body engages the first support structure, and wherein the first fixation anchor is fabricated separate and apart from the medical device body.

<CIT> discloses methods and an apparatus for the endoluminal positioning of an intraluminal prosthesis at a target location within a body lumen. The device may comprise a porous, multi-layer prosthesis that can include several different tubular mesh components such as an everted tubular component, a tubular component that expands to various different sizes, a bifurcated tubular component, and a tubular component with an undulating expanded shape, among others. Various components can have different densities or pore sizes and can be overlaid on each other to selectively block different regions of a vessel.

<CIT> discloses a device frame includes a plurality of elongate frame members, first and second hub members substantially aligned along a longitudinal axis of the device frame, and a coupling element that couples the first hub member to the second hub member. The device frame includes a face section, a laterally facing skirt section, and an inverted section. First portions of the elongate members define the face section and extend radially from the first hub member. Second portions of the elongate members define the laterally facing skirt section and extend in a distal, axial, and helical direction along a first rotational direction from the face section. Third portions of the elongate members define the inverted section and extend in a generally proximal direction from a distal portion of the laterally facing skirt section to the second hub member along a rotational direction opposite the first rotational direction. <CIT>and published after the priority date of the present application, thus being prior art pursuant to Art. <NUM>(<NUM>) EPC, discloses a vascular implant that has anchor members that have free ends that extend outwardly from the implant and are interlaced with the implant through loops of the anchor member passing through openings in the implant.

Accordingly, embodiments of the present invention preferably seek to mitigate, alleviate or eliminate one or more deficiencies, disadvantages or issues in the art, such as the above-identified, singly or in any combination by providing a vascular expandable implant with an anchor member, as well as a method for attaching the anchor member to the implant, in accordance with the enclosed independent claims. The disclosure also includes at least one anchor member.

The invention is defined by the appended claims only.

The invention comprises an expandable vascular implant, which comprises a framework, at least one anchor member for anchoring the implant to a vascular structure and having a proximal portion and a distal portion. The distal portion of the anchor member comprises at least one free end configured to extend outwardly from the framework. The anchor member is at least partly interlaced with the framework of the implant, such as between the proximal portion and the distal portion, such that the anchor member is fixed to the framework.

The anchor member may comprise an intermediate section between the proximal portion and the distal portion. The intermediate section may be interlaced with the framework, such as in the longitudinal direction of the implant. The intermediate section may be curved, such as in the longitudinal direction of the implant when attached to the framework. It may be curved such that one part of the intermediate section is located closer to the center of the implant compared to a second part. Hence, a proximal part of the intermediate section may be configured to extend along a first side of the framework. A distal part of the intermediate section may be configured to extend along a second side of the framework. The first side and the second side of the framework may be opposite sides of the framework. Hence, the intermediate section may be curved to follow the profile of each side of the framework. A curve of the intermediate section may extend through an opening of the framework such that the first and second parts conform to the profile or shape of each side of the framework.

The anchor member comprises an anchor strand formed into the anchor member. A proximal end of the anchor strand forms at least one loop or knot extending around a portion of the framework. The anchor strand may comprise two free ends forming a distal end of the anchor member. The loop is positioned between the two free ends, such as centered therebetween.

The proximal end of the anchor strand forms two loops that extend around the portion of the framework. A first loop and a second loop of the two loops extend through the same openings of the framework.

The anchor strand may comprise a first distal end portion and a second distal end portion. At least one loop or bend may be located between the first distal end portion and the second distal end portion. The first distal end portion and the second distal end portion may a form a hook with a free end directed proximally of the implant. The hook may comprise a barb.

The anchor member and the implant may be separate components. Hence, in some embodiments, the anchor member disclosed herein is provided as a separate component and may form an independent embodiment.

The invention also comprises a method of attaching at least one anchor member to an expandable vascular implant. The method comprises providing an expandable vascular implant comprising a framework; providing at least one anchor member having a proximal portion and a distal portion; and interlacing at least a portion of the anchor member, such as between the proximal portion and the distal portion, with the framework. The method comprises attaching an anchor member such that at least one free end of the anchor member, such as at the distal portion or the proximal portion of the anchor member, extends outwardly from the framework.

Providing the anchor member may comprise providing the anchor member in a shape memory material that has been pre-treated to its relaxed shape. Interlacing the anchor member with the framework may comprise interlacing the anchor member, made of the pre-treated shape memory material, with said framework.

Providing the anchor member comprises providing the anchor member as an anchor strand. Interlacing at least a portion of the anchor member with the framework comprises interlacing at least a portion of the anchor strand and forming at least one loop or knot with the anchor strand around a portion of the framework.

Some embodiments of the invention provide for an expandable vascular implant that provides for stability of the implant when attached to the vascular structure. Particularly, the anchor member, which may be interlaced with the framework, can be reliably attached to the framework, which provides for the stability, particularly prevents the anchor member from loosening from the framework. Furthermore, the anchor member may have a slim profile in a collapsed configuration, such that damaging a catheter during delivery is prevented. This also contributes to the safety of the implant and delivery of the implant. Delivery of the anchor member as a separate component provides for flexibility during production at the same time as the design of the anchor member may be optimised separately from the design of the framework, which also may optimize production processes.

These and other aspects, features and advantages of which embodiments of the invention are capable of, will be apparent and elucidated from the following description of embodiments of the present invention, reference being made to the accompanying drawings, in which.

Specific embodiments of the invention now will be described with reference to the accompanying drawings.

The present description of the current invention is given with reference to an occluder for a defect in the heart as an example only. It should be born in mind, however, that the present invention is not limited strictly to an occluder but can be easily adapted to other expandable vascular implants, such as a valve replacement stent, or a vascular stent, to be anchored in a vascular structure of the vascular system of a patient. The expandable vascular implant may be delivered via a catheter and a delivery wire in a collapsed configuration, and be expanded to a pre-set or relaxed configuration at the target side. Once deployed, the expandable vascular implant should remain at the target site. The invention is particularly useful for vascular structures that move with the contraction and expansion of the vascular system, such as with heart movements. For example, the invention is particular useful for a left auricular appendix (LAA) occluder. Such occluders have a tendency to be pushed out of the LAA unless the occluder is anchored in the vascular structure as the heart contracts and expands. The present invention provides for reliable anchoring in vascular structures while being collapsible to a small diameter for delivery in a catheter and expansion at the target site. In the following reference will be made to an implant when referring to the expandable vascular implant.

<FIG> and <FIG> illustrate embodiments of the implant <NUM>, <NUM>, which comprises a framework <NUM>, <NUM> with openings <NUM>, <NUM>. The framework may form an exterior surface of the implant <NUM>, <NUM>. At least one anchor member <NUM>, <NUM> is attached to the framework <NUM>, <NUM>, and is configured to anchor the implant <NUM>, <NUM> to the vascular structure.

<FIG> illustrates aspects of the anchor member <NUM> of the embodiment of <FIG> illustrates attaching the anchor member of <FIG> to the framework <NUM> of the embodiment of <FIG> illustrates the anchor member <NUM> attached to the framework <NUM>.

Similarly, <FIG> illustrates aspects of the anchor member <NUM> of the example not part of the claimed invention of <FIG> illustrate examples of the anchor member <NUM> attached to the framework <NUM>.

As illustrated in <FIG> and <FIG>, the anchor member <NUM>, <NUM> has a proximal portion <NUM>, <NUM> and a distal portion <NUM>, <NUM>. The distal portion <NUM>, <NUM> comprises at least one free end <NUM>, <NUM> configured to extend outwardly from the framework <NUM>, <NUM>.

As illustrated in <FIG> illustrating the invention, and <FIG> not showing the claimed invention , the anchor member <NUM>, <NUM> is at least partly interlaced with the framework <NUM>, <NUM> between the proximal portion <NUM>, <NUM> and the distal portion <NUM>, <NUM> such that the anchor member <NUM>, <NUM> is fixed or attached to the framework <NUM>, <NUM>. In this context, proximal is a position located closer to an end of the implant <NUM>, <NUM>, to which a delivery device, such as a delivery wire may be attached to the implant. Similarly, distal is a position located closer to a location located further away from the point of attachment of the delivery device to the implant <NUM>, <NUM> than the proximal position. Interlaced in this context means that a portion of the anchor member <NUM>, <NUM> extends alternatively on opposite sides of the framework <NUM>, <NUM>, such as on a side facing inwardly towards the center of the implant <NUM>, <NUM> and a side facing outwardly away from the implant <NUM>, <NUM>. The interlacing may be in the longitudinal direction of the implant. The framework <NUM>, <NUM> may form boundaries of the openings <NUM>, <NUM>. A portion of the anchor member <NUM>, <NUM> extends through multiple openings <NUM>, <NUM> such that the portion extends on at least one of the opposing sides of the framework <NUM>, <NUM> between the openings <NUM>, <NUM> through which the portion of the anchor member <NUM>, <NUM> extends, such as is illustrated in detail in the embodiments of <FIG>, <FIG>.

In some embodiments, the framework <NUM>, <NUM> comprises a mesh formed by at least one strand. The mesh may be formed by weaving and/or braiding. The mesh may also be formed by a monolithic structure, such as from a hollow tube in which the openings have been formed, e.g., by laser cutting. Examples of strands are Nitinol wires, which may be heat set to a pre-defined shape. Such strands are super-elastic, such that the implant <NUM>, <NUM> is collapsible for delivery though a catheter, and self-expandable when unconstrained to the relaxed shape, as illustrated in <FIG>, and <FIG>, respectively.

As is illustrated in <FIG> showing the claimed invention and 2d not showing the claimed invention, embodiments and examples of the anchor member <NUM>, <NUM> comprises an intermediate section <NUM>, <NUM> that may be located between the proximal portion <NUM>, <NUM> and the distal portion <NUM>. The intermediate section <NUM>, <NUM> may be interlaced with the framework <NUM>, <NUM>, as is illustrated in <FIG> and <FIG>. As can be seen in these figures, a first part 8a, 108a, which may be a proximal part, of the intermediate section <NUM>, <NUM> may be located on a first side of the framework <NUM>, <NUM>, and a second part 8b, 108b, which may be a distal part, of the intermediate section <NUM>, <NUM> may be located on a second side of the framework <NUM>, <NUM>. The first side and the second side may be opposing sides of the framework <NUM>, <NUM>, such as an inner side and an outer side of the framework <NUM>, <NUM>. The first part 8a, 108a, may be distal of the second part 8b, 108b, or vice versa. The first part 8a, 108a, and the second part <NUM>, 108b may be radially aligned but axially spaced apart relative a longitudinal axis <NUM>, <NUM> of the implant <NUM>, <NUM>. Hence, the intermediate section <NUM>, <NUM> may be interlaced with the framework <NUM>, <NUM> in the longitudinal direction of the implant <NUM>, <NUM>. Thus, the anchor member <NUM>, <NUM> may be supported by the framework <NUM>, <NUM> in the radial as well as the axial direction. This provides for reliably anchoring of the implant <NUM>, <NUM> to the vascular structure.

As can be seen in <FIG> and <FIG>, the intermediate section <NUM>, <NUM> may be curved, such as in its longitudinal direction when mounted in the longitudinal direction of the framework <NUM>, <NUM>. The first part 8a, 108a, of the intermediate section <NUM>, <NUM> may be configured to extend along a first side of said framework <NUM>, <NUM>, and the second part 8b, 108b of the intermediate section <NUM>, <NUM> may be configured to extend along the second side of the framework <NUM>, <NUM>. Again, the first side and the second side of the framework <NUM>, <NUM> may be opposite sides of the framework <NUM>, <NUM>. The first part 8a, 108a may be curved to be located closer to the centre of the implant <NUM>, <NUM> than the second part 8b, 108b when fixed to the framework <NUM>, <NUM>. The second part 8b, 108b may be curved to be located further away from the centre of the implant <NUM>, <NUM> than the first part 8a, 108a when fixed to the framework <NUM>, <NUM>. A bend or curve may be located between the first part 8a, 108a, and the second part 18b, 108b. The bend or curve may be positioned at an opening of the framework <NUM>, <NUM>. Hence, the anchor member <NUM>, <NUM> is configured to substantially not affect the relaxed shape of the framework <NUM>, <NUM>. At the same time, the anchor member <NUM>, <NUM> may extend along the inner and outer surface of the framework <NUM>, <NUM>, and may even abut these surfaces even when the implant is in the relaxed or expanded shape. Hence, the profile of the anchor member <NUM>, <NUM>, may closely follow the profile of the framework <NUM>, <NUM>. When collapsed for delivery, the implant will assume a slim profile, which facilitates using a catheter with a relatively small diameter. Also, the curved profile of the anchor member <NUM>, <NUM> avoids damaging the inside of the catheter, which prevents particles from a damaged catheter entering into the vascular system during delivery. Hence, the curved profile may also enhance the safety of the implant <NUM>, <NUM>.

<FIG> illustrate embodiments of the anchor member <NUM> comprising an anchor strand formed into the anchor member <NUM>. The anchor strand may be made of a shape memory material, such as a shape memory metal, e.g. Nitinol. The anchor strand may be heat or otherwise treated to assume a pre-configured shape with the proximal portion <NUM>, the distal portion <NUM>, and the intermediate section <NUM>. Also, the anchor strand may be heat treated separately from the framework <NUM> before it is attached to the framework <NUM>. The anchor member <NUM> may be double sided, i.e. have mirrored sides having the same configuration between the free end <NUM> to a centre of the strand, which is located in the middle between the free ends of the strand.

As is illustrated in <FIG>, when the anchor strand is attached to the framework <NUM>, a proximal end <NUM> of the anchor strand forms at least one loop or knot extending around a portion of the framework <NUM>. The anchor strand comprises two free ends <NUM> forming a distal end of the anchor member <NUM>. The loop(s) or knot are positioned between the two free ends, such as centred between the free ends <NUM>. Hence the anchor strand may extend in the distal direction from a first free end 7a towards the distal end <NUM> of the anchor member <NUM>: in the proximal direction from the distal end <NUM> of the anchor member <NUM> towards the proximal end <NUM> of the anchor member <NUM> and interlaced with the framework <NUM>; form at least one loop or knot around the framework <NUM>; in the distal direction from the proximal end <NUM> of the anchor member <NUM> towards the distal end <NUM> of the anchor member <NUM> and interlaced with the framework <NUM>; and in the proximal direction from the distal end <NUM> of the anchor member <NUM> to a second free end 7b. In other embodiments, the second free end 7b of the anchor strand ends at the proximal end of the anchor member <NUM> after a loop or knot has been formed. Hence, the anchor strand may form one or two legs of the anchor member <NUM>.

<FIG> illustrates forming a loop or knot around the framework. Other examples of knots are illustrated in <FIG> and <FIG>. In its pre-configured shape, the anchor strand may be folded. The free ends 7a, 7b may be held together, as indicated in <FIG>. A loop <NUM> is formed where the anchor strand is folded. The loop <NUM> may be bent towards the distal end <NUM> such that it is spaced apart from the proximal end <NUM> of the anchor member and towards the distal end <NUM> of the anchor member. Hence, the anchor strand may extend from the first free end 7a to the fold <NUM> and may return to the second free end 7b. In order to attach the anchor member <NUM> to the framework <NUM>, the free ends 7a, 7b may be inserted from a first side of the framework <NUM> through a first opening 3a of the framework <NUM> to a second side of the framework <NUM>, returned to the first side of the framework <NUM> via a second opening 3b of the framework <NUM>, and through the loop <NUM>. Hence, when tied, two loops, one by each leg, may form a knot around the framework <NUM>. In order to further attach the anchor member <NUM> to the framework <NUM>, the free ends 7a, 7b are inserted from the first side of the framework into an opening <NUM> of the framework, which is the second opening 3b of the framework <NUM>, and is interlaced with the framework <NUM>. After being returned to the first side through a third opening 3c, the free ends 7a, 7b may be spaced apart. The free ends may be interlaced with the framework <NUM> when held together. Inserting the free ends 7a, 7b into the same second opening 3b after forming the knot will push the loop <NUM> towards the second side of the framework. This in turn will provide a tight knot or loop, such that the loop <NUM> does not damage surrounding tissue.

Iln the illustrated embodiment, the proximal end <NUM> of the anchor strand forms two loops or a knot that extend around a portion of the framework <NUM>. Also, the loops or knot is formed at an intersection of the framework <NUM>, such as at a crossing of two wires of the framework <NUM> when formed by wires, such as when the framework <NUM> is braided. The loops or knot may be formed holding the free ends 7a, 7b together and starting at the proximal end <NUM> of the anchor strand. In other embodiments, the anchor strand is interlaced with the framework <NUM> using only one end of the free ends 7a, 7b starting from the distal end <NUM> of the anchor strand. One free end 7a may be positioned at the distal end <NUM> of the anchor strand, and the other free end 7b may be interlaced with the framework <NUM>, one or more loops formed around the framework <NUM>. Then, the free end 7b of the anchor strand being interlaced is either cut at the proximal end <NUM>, or again interlaced with the framework to return to the distal end <NUM> to form the second leg and before ending or being cut at the distal end <NUM>, e.g. such that the free end 7b extends from the framework as illustrated in Fig. did.

According to the invention, a first loop 14a and a second loop 14b that form two loops extend through the same openings 3a, 3b of the framework <NUM>. Hence, first and second legs of the anchor member <NUM> extend through the same openings 3a, 3b, 3c of the framework <NUM>. Furthermore, the legs may be located closer together at the proximal end <NUM> of the anchor member <NUM> than at the distal end <NUM> of the anchor member <NUM>, as is illustrated in <FIG>. This may be achieved with heat setting the anchor strand such that is has a relaxed configuration where the legs are spaced apart a larger distance at the distal end <NUM> than at the proximal end <NUM>. Hence the free ends 7a, 7b are spaced apart in the relaxed configuration, such that reliable anchoring into the vascular structure may be achieved. At the same time, the legs extend through the same openings 3a, 3b, 3c such that the legs receive a slim profile and extend substantially parallel when received into a catheter for delivery to the vascular structure. This avoids damaging the catheter, as discussed above.

As illustrated in <FIG>, the anchor strand comprise a first distal end portion 15a and a second distal end portion 15b. The loop(s) 14a, 14b or knot may be located between the first distal end portion 15a and the second distal end portion 15b. At least one of the first distal end portion 15a, and said second distal end portion 15b may be hook shaped with the free ends 7a, 7b being directed proximally of said implant <NUM>. Hence, the free ends 7a, 7b may be directed proximally towards an attachment member <NUM> (described below) of the implant <NUM>. The distal end portions 15a, 15b may comprise a bend when the anchor strand returns towards the proximal end from the distal most portion of the anchor member. This may provide a hook shape, which prevents the implant from dislodging after implantation of the implant <NUM> at the target site.

The anchor member <NUM>, <NUM> may be monolithic. In the embodiments of <FIG>, each anchor member is monolithic, and the implant <NUM> comprises a plurality of anchor members <NUM>, such as <NUM>-<NUM> anchor members <NUM> attached to the framework <NUM>.

In the examples of <FIG>, not showing the claimed invention, the anchor member <NUM> is monolithic and comprises a plurality of interconnected bars <NUM>. At least a portion of the interconnected bars <NUM> may be interlaced with the framework <NUM>. For example and as is illustrated in <FIG>, the interconnected bars may comprise a cross-bar <NUM>, such as located at an intersection or at ends of two interconnected bars <NUM>. The cross bar <NUM> may extend transverse to the longitudinal axis <NUM> of the implant <NUM>, such as substantially perpendicularly to the longitudinal axis <NUM>. Hence, the cross-bar <NUM> may be interlaced with said framework <NUM> in a radial direction of the implant <NUM>. For example, each end 121a, 121b of the cross bar may be positioned on one side of the framework <NUM>, whereas at least a portion between said ends 121a, 121b is positioned at an opposite side of the framework <NUM>, such as is illustrated in <FIG>. The ends 121a, 121b may be arranged substantially flat against the framework <NUM>. In the example of <FIG>, the cross-bar forms the anchor member <NUM>, which may extend substantially in the longitudinal direction <NUM> of the implant when attached to the framework <NUM>. As is illustrated, one end of the cross-bar 121c (which may form the proximal end <NUM> of the anchor member <NUM>), may be located on one side of the framework <NUM>, whereas a second end, which may form the free end <NUM>, may be located on the opposite side of the framework <NUM>. At least one intermediate section between the ends of the cross-bar, which may form the intermediate sections 108a, 108b discussed above, may be interlaced with the framework <NUM>. Hence, a first intermediate section 108a may be located one side of the framework <NUM> whereas a second intermediate section 108b may be located on an opposite side of the framework <NUM>.

As is illustrated in <FIG>, the interconnected bars <NUM> may form a circumference of the anchor member <NUM>. The circumference forms a plurality of peaks <NUM> with a valley <NUM> between adjacent peaks of the plurality of peaks120. An anchor 102a may be located at a peak and/or a valley of the circumference. At the anchors 102a, such as is illustrated in <FIG>, the anchor member <NUM> may comprise or form a fixation tab. A plurality of fixation tabs may be spaced around the circumference. The fixation tabs may extend in the longitudinal direction of the implant and on opposite sides of said framework, and may be formed as the cross-bar discussed above.

The bars <NUM> of the framework <NUM> may extend between the peaks <NUM> and the valley <NUM> and on an inner side of the framework <NUM>. At least one of the proximal portion <NUM> and the distal portion <NUM> of the anchor member <NUM> may extend on an exterior side of the framework <NUM>. The proximal portion may extend on the exterior side as is illustrated in <FIG>. The distal portion <NUM> may extend of the exterior side as is illustrated in <FIG>. The anchors 102a may be positioned at either a valley <NUM>, as is illustrated in <FIG>, or at a peak <NUM>, as is illustrated in <FIG>.

The framework <NUM> illustrated in <FIG> may be formed e.g. from a tubular structure of shape memory material, which is cut into the desired shape before being heat treated to the pre-configured shape. Alternatively, separate elements may be welded together, such as from rods of the shape memory material, to a desired shape before being heat treated to the pre-configured shape.

In the embodiments of <FIG> (showing the claimed invention) and examples of <FIG> (not showing the claimed invention), the anchor member <NUM>, <NUM> and the implant <NUM>, <NUM> are separate components. This facilitates production and makes the implant more flexible. The framework may be used with either multiple anchor members <NUM>, as is illustrated in <FIG>, or with a monolithic anchor member <NUM> comprising a plurality of anchors 102a, as is illustrated in <FIG>.

Embodiments may comprise a method of attaching at least one anchor member <NUM>, <NUM> to an expandable vascular implant <NUM>, <NUM>, such as disclosed above and as disclosed below. The expandable vascular implant comprising the framework <NUM>, <NUM> is provided. The anchor member <NUM>, <NUM> and the framework <NUM>, <NUM> may be provided as separate components. The anchor member <NUM>, <NUM> having the proximal portion <NUM>, <NUM> and the distal portion <NUM>, <NUM> is also provided. The distal portion <NUM>, <NUM> of the anchor member <NUM>, <NUM> comprises at least one free end <NUM>, <NUM> configured to extend outwardly from the framework <NUM>, <NUM>. At least a portion of the anchor member <NUM>, <NUM> is interlaced with the framework <NUM>, <NUM>, such as between the proximal portion <NUM>, <NUM> and the distal portion <NUM>, <NUM>. The interlacing is provided as has been discussed with regard to the various embodiments disclosed above.

The anchor member <NUM>, <NUM> may be provided in a shape memory material that has been pre-treated to its relaxed pre-configured shape, such as disclosed above. The interlacing with the framework may comprise interlacing the anchor member <NUM>, <NUM>, which is pre-treated before interlacing and made of the shape memory material, with said framework <NUM>, <NUM>. The framework <NUM>, <NUM> may also be treated to its relaxed shape before the anchor member <NUM>, <NUM> is attached to the framework <NUM>, <NUM>.

As discussed, the anchor member <NUM> is provided as an anchor strand. Interlacing at least the proximal portion <NUM> of the anchor member <NUM> with the framework <NUM> may comprise threading at least a portion the anchor strand through openings 103a, 103b, 103c of the framework and forming at least one loop with the anchor strand around a portion of the framework <NUM>.

The framework <NUM>, <NUM> may be a tubular braided framework. The braid of the framework <NUM>, <NUM> may be closed at one end by the braid, i.e. be sack shaped, and by an attachment member at the other end. The attachment member may e.g. be a clamp or a weld, which a delivery wire of the catheter may engage for delivery of the implant <NUM>, <NUM> to the target site. Alternatively, the braid is tubular and closed at both ends with an attachment member, such as a clamp or weld.

In the embodiments of <FIG>, the anchor member <NUM> may be attached before or after closing the ends of the implant. In the examples (not showing the claimed invention) of <FIG>, the anchor member <NUM> may be introduced into the tubular braid while at least one of the ends of the braid is still open. Hence, one or both ends of the braid may be closed after the anchor member <NUM> has been inserted into the tubular braid.

One embodiment of the implant <NUM>, <NUM> without the anchor member <NUM>, <NUM> attached is depicted in <FIG> is a side view of an implant <NUM>, such as an LAA occluder. This figure shows an implant <NUM> comprising strand loops <NUM> forming the framework <NUM>,<NUM>. The strand loops <NUM> may contribute to preventing the implant <NUM> from slipping and/or moving from the position once implanted, since the strand loops can fixate the implant to a body wall. These strand loops further enhances the stability of the implant <NUM>, <NUM> and adds to the stability provided by the anchor member <NUM>, <NUM>. The strand loops <NUM> may be made from strands. The strands may be made of shape-memory materials, metal, super elastic alloys, Nitinol, or polymers, such as biodegradable polymers. Thus, the strands may be wires. If the strands are made of Nitinol, then the strands may be heat-treated and a very flexible self-expanding wire-mesh can be obtained. The strands may also be formed from a monolithic starting material, such as a tubular member which may be formed into the strands, e.g. by laser cutting.

As can be seen in <FIG>, strand the loops <NUM> may be located at one side, such as the distal side, of the implant <NUM> and a coupling or attachment member <NUM> on the opposite side, such as the proximal side, of the implant <NUM>, <NUM>. However in embodiments, the strand loops <NUM> may be positioned on the same side of the implant as the coupling or attachment member <NUM>. The coupling or attachment member may be formed by a laser or plasma weld, which also attaches free ends of a braid that forms the framework <NUM>, <NUM>.

As can be seen in <FIG>,the strand loops <NUM> forming part of the framework <NUM>, <NUM> may have of a shape that extends out of a plane perpendicular to the longitudinal axis of the implant <NUM>, <NUM>. The peripheral edges may be bent out of the perpendicular direction towards an end of the implant <NUM>, <NUM>, such as towards the proximal end of the implant <NUM>, <NUM>. The strand loops <NUM> may be triangular with rounded corners. However, the shape may round or oval and bent into a desired 3D shape. By shaping the strand loops <NUM> in this manner, the stabilization of the implant <NUM>, <NUM> will be further improved, and thus the implant <NUM>, <NUM> is further prevented from slipping and/or moving from the position once implanted, which contributes to the stability together with the anchor member <NUM>, <NUM>. Hence, the retention and stability may be improved. The bent peripheral edges of the strand loops <NUM> provide for a defined outwardly oriented spring like force when implanted. The spring force is preferably much lower than the force of the implant for returning to an expanded shape from a collapsed shape. In addition, the loops provide for a controllable spring force irrespective of the main body of the implant <NUM>, <NUM> being fully expanded.

The spring force of the loops may be provided in a radial direction and an axial direction thanks to the advantageous bending of the peripheral edge. As the number and shape of the loops may be varied, a large flexibility and adaptability to different defects to be occluded is provided in a cautious and reliable manner by embodiments of the device <NUM>.

As can also be seen in <FIG>, a distal end of the framework <NUM> may be curved from a circumference of the distal end <NUM> of the implant <NUM> towards a centre of the distal end of the framework <NUM> and towards the proximal end <NUM> of the implant <NUM>. For example, the distal end of the framework <NUM> may be at least partly concave in a direction towards the proximal end <NUM> of the implant <NUM>. Alternatively or additionally, the distal end of the framework <NUM> may form an angle relative a longitudinal axis of the implant <NUM> and in a direction towards the proximal end <NUM> of the implant <NUM>. The curved shape of the distal end of the framework <NUM> facilitates reduction of the length of the implant <NUM> when compressed, which enables easier placement and allows for implanting the device deeper into a body cavity, such as the LAA. Furthermore, curved shape of the distal end of the framework <NUM> increases the stiffness of the implant <NUM>, <NUM> at the distal end. This gives the hooks more stability and prevents the rotation of the implant <NUM>, <NUM> when implanted.

<FIG> is a top view of an implant <NUM>, <NUM> without the anchor members <NUM>, <NUM> attached. In this embodiment the strand loops <NUM> are of a round shape. By giving the strand loops <NUM> a round shape, the strand loops <NUM> are less prone to break. Hence, together with the anchor member <NUM>, <NUM> when attached, this also contributes to the reliability of the implant <NUM>, <NUM>. The embodiment of <FIG> may be combined with the embodiment of <FIG>, such as the shape of the distal end of the framework <NUM>.

<FIG> is a side view of an implant, in this case an LAA occluder, showing another embodiment <NUM>, <NUM> without the anchor members <NUM>, <NUM> attached. A longitudinal section <NUM> of the framework is in this figure shaped as a frustum of a hollow cone-shaped cylinder. The strand loops <NUM> surround the rim of the hollow cone-shaped cylinder and are extendable outwardly from the hollow cone-shaped cylinder substantially perpendicularly to a centre axis of the hollow cone-shaped cylinder. The cone shape provides for a reliable positioning avoiding embolization of the device in a defect, such as the LAA. The principle may be compared to a cork that has a larger diameter at one end. The larger diameter of the implant shown in <FIG> is upon implantation positioned at or towards the proximal end. Hence, this together with the anchor member <NUM>, <NUM> contributes to the stability and reliability of the implant <NUM>, <NUM>. The embodiment of <FIG> may be combined with the embodiment of <FIG>, such as the shape of the distal end of the framework <NUM>.

The implant <NUM>, <NUM> may also be of another shape, such as cylindrical. It can comprise different sections, some of which may be cone-shaped and some of which may be cylindrical.

<FIG> is a top view of an implant <NUM>, <NUM> without the anchor members <NUM>, <NUM> attached. In one embodiment, shown in <FIG>, half of the strands, which will also be used for the longitudinal section <NUM>, form a cover for the implant on the distal end <NUM>. The remaining strands, which will also be used for the longitudinal section <NUM>, project outwards on the edge of the cover as strand loops <NUM>. Thus, on the distal side <NUM>, strands which form the strand loops <NUM> are not integrated in the braid. On a proximal end <NUM>, opposite to the distal end <NUM>, as well as along the longitudinal section <NUM>, all strands from the outer edge up to the rotation axis are braided or intertwined. Thus, the configuration or distribution of strands to strand loops can be said to be <NUM>:<NUM>. However, it is also possible to have other distributions, such as <NUM>:<NUM>, <NUM>:<NUM>, <NUM>:<NUM>, <NUM>:<NUM> etc. It is also possible to make the implant, which has only strand loops on the proximal side <NUM>, i.e. forming an open mesh or a round longitudinal braid, closed on one side only. The embodiment of <FIG> may be combined with the embodiment of <FIG>, such as the shape of the distal end of the framework <NUM>.

<FIG> is a cross-sectional view of an implant with a membrane <NUM> and without the anchor member <NUM>, <NUM> attached. The membrane <NUM> is also illustrated in <FIG> and <FIG>. The membrane <NUM> may be attached to the implant <NUM>, <NUM> with a strand or thread <NUM>. In this embodiment, the membrane <NUM> is attached to the outer surface of the implant <NUM>, <NUM>, on the same side as the coupling <NUM>. The membrane <NUM> can cover the whole circumference of the implant <NUM>, <NUM> and is then also stitched to the implant <NUM> with a seam <NUM>. The use of membranes or inner membranes results in improved occlusion and rapid endothelialisation. The use of a membrane <NUM> also results in an ideal closure of e.g. the left atrial appendage, since it seals the gap instantly. In other embodiments, the membrane <NUM> may cover only a portion of circumference of the framework, such as illustrated in <FIG>, and <FIG>. The membrane <NUM> may cover the proximal portion of the anchor member <NUM>, <NUM>. Hence, any part of the anchor member <NUM>, <NUM> may be covered by the membrane <NUM>, e.g. to protect the catheter or vascular tissue from damage during delivery to the target site. Yet, the legs of the anchor member <NUM>, <NUM> may be exposed such that they may be collapsed during delivery of the implant.

<FIG> is an enlarged sectional view of a thread used for attaching a membrane <NUM> to the implant <NUM>, <NUM>. The thread <NUM> is wound around at least one strand of the implant.

<FIG> is a top view of an implant <NUM>, <NUM> with strand loops <NUM>. The strand loops <NUM> are located all around the circumference of the implant <NUM>, <NUM>. Also, the membrane <NUM> can be seen in <FIG>. Here the membrane <NUM> covers the whole circumference of the implant <NUM>.

<FIG> shows the strand loops <NUM> of the implant <NUM> in more detail and without the anchor member <NUM>, <NUM> attached. The strand loops <NUM> in <FIG> have a rounded shape, i.e. a somewhat rectangular shape with rounded corners. Rounded corners are tissue friendly avoiding deep tissue penetration and possible ruptures or leakages.

<FIG> is a view of different knots used for attaching the membrane to the implant <NUM>, <NUM>. These knots may also be used to attach the anchor member <NUM> to the framework <NUM>. The thread <NUM> can be secured to the framework <NUM>, <NUM> with a single knot or with a double knot. The ends of the thread <NUM> can be thermally treated to provide further reliability of the fixation.

<FIG> is cross-sectional view of an implant <NUM>, <NUM> without the anchor member <NUM>, <NUM> attached and with a coupling or attachment member <NUM>. The coupling or attachment member <NUM> may be formed into the shape of a ball pivot. The ball pivot can be connected to a flexible pusher of a delivery device, which can be used to move the implant in a sheath of a catheter, e.g. for delivery of the implant <NUM>, <NUM> and/or retrieval of the implant <NUM>, <NUM> prior to being decoupled. The coupling or attachment member <NUM> is in this embodiment sunk or lowered into the implant <NUM> and will not impede blood flow at the target site, e.g. in a body vessel, where it is situated after having been delivered. In this embodiment, the framework <NUM>, <NUM> of the implant <NUM>, <NUM> has been formed with a hollow space for the coupling or attachment member <NUM>. Hence, the coupling or attachment member <NUM> may be located at least partially distal of a top or proximal surface of the implant. The top surface may form the proximal most portion of the implant. The lowered coupling or attachment member <NUM> provides for a shorter overall length compared to positioning the coupling or attachment member <NUM> at the top surface. This may prevent dislodging the implant after implantation and provides for reliable anchoring of the implant <NUM>, <NUM> together with the anchoring member <NUM>, <NUM>. The coupling or attachment member <NUM> will therefore not impede blood flow that may dislodge the implant <NUM>, <NUM>. In another embodiment according to <FIG>, the proximal end or surface <NUM> is instead given a concave or curved shape to position the coupling or attachment member <NUM> at least partially distal of the proximal most part of the implant <NUM>, <NUM>. With the coupling or attachment member <NUM>, the flexibility during delivery is increased, since the implant <NUM>, <NUM> is retrievable.

In the embodiment depicted in <FIG>, the implant <NUM>, <NUM> has a membrane. This membrane may also be provided with the embodiments of <FIG>, and <FIG>. The membrane is an inner membrane <NUM>. The inner membrane <NUM> may be a special thermo-treated PET-knit fabric. The inner membrane <NUM> may be attached to the inner surface of the framework <NUM>, <NUM>, such as after attachment of the anchoring member <NUM>, <NUM> to the framework <NUM>, <NUM>. The inner membrane <NUM> may be attached to the implant <NUM> with a strand or thread. In this embodiment, the inner membrane <NUM> is attached to the inner surface of the implant <NUM>, on the same end of the implant <NUM>, <NUM> as the coupling or attachment member <NUM>, i.e. the proximal end <NUM>. The inner membrane <NUM> may extend in a longitudinal direction at least partially along the longitudinal sides <NUM> of the implant <NUM>, <NUM>. The inner membrane <NUM> can cover the whole circumference of the implant <NUM>, <NUM> and may be also stitched to the implant with seams <NUM>, <NUM>. It may also only cover the proximal portion <NUM>, <NUM> of the anchor member <NUM>, <NUM>, whereas the distal portion <NUM>, <NUM> is exposed, i.e. not covered by the inner membrane <NUM>. The use of a membrane <NUM> and/or inner membrane <NUM> may provide for improved occlusion and rapid endothelialisation.

In another embodiment depicted in <FIG>, an outer membrane <NUM> is attached outside the implant <NUM>, <NUM> in a similar manner as the inner membrane <NUM>. Also the outer membrane <NUM> may be a special thermo-treated PET-knit fabric. In one embodiment, the implant <NUM>, <NUM> is covered with membranes <NUM>, <NUM> both on the inside and the outside of the framework <NUM>, <NUM>. As an alternative of using a membrane <NUM>, <NUM>, the implant <NUM>, <NUM> may instead be covered or coated using polymer spinning technology, such as solution blow spinning or electrospinning, or a dipping method. The coating as well as the membrane <NUM>, <NUM> may be made of a biocompatible and implantable material, such as PTE, PTFE or PUR. The inner and/or outer membrane <NUM>, <NUM> or coating may be provided as a fibrous or non-fibrous film membrane that may have an initial controllable fluid retention by perforations or microperforations thereof. The membrane may cover the entire expanded diameter of the implant. Alternatively, it may only cover portions thereof, such as illustrated in <FIG>, and <FIG>. The portions may be as small as the cell structure of the fabric of the implant <NUM>. For instance one or more cells of a braiding may be provided with a coating extending the space between adjacent strand portions forming the cells. The coating may cover the proximal portion <NUM>, <NUM> of the anchor member <NUM>, <NUM>, as is illustrated in <FIG> and <FIG>. Hence, the distal portion <NUM>, <NUM> of the anchor member <NUM>, <NUM> may be exposed, i.e. not covered by the coating.

In this manner, different perfusion rates may be adjusted to different areas of the device. It may for instance be desired to obtain an inflow of blood into the inner of the expanded implant <NUM>, <NUM> from a distal end thereof to enhance integration of the implant <NUM>, <NUM> with surrounding blood upon clotting thereof. A reduced or prohibited outflow of blood through the proximal end may however be provided by a tighter membrane or larger diameter/surface/cells of the device being covered than those of another section of the implant <NUM>, <NUM>.

The coating or membrane <NUM>, <NUM>, <NUM> may be affixed to the implant <NUM>, <NUM> in its expanded shape. In this manner, the coating or membrane is free of tension which advantageously avoids pre-mature fatigue thereof allowing for a reliable ingrowth.

The coating or external membrane may alternatively be affixed to the implant <NUM>, <NUM> in its collapsed shape.

Patterns of covered cells may be provided to efficiently control a desired flow pattern upon implantation. In this manner, the occlusion is not abrupt upon implantation. A certain blood flow may still occur after implantation and gradually decline upon blood coagulation and/or endotheliazation of the implanted device.

It should be noted that the aforementioned principles of coatings/membranes may be provided with other implants than the examples shown herein, e.g. ASD, PFO, PLD or VSD occluders, stents or other implants for a vascular structure.

<FIG> is an enlarged sectional view of a thread <NUM> used for attaching a membrane to an implant <NUM>, <NUM>. The thread <NUM> is wound around the framework <NUM>, <NUM>, such as at least one strand thereof, for attaching the membrane to the implant <NUM>, <NUM>.

<FIG> is an enlarged sectional view of strand loops <NUM> of the implant <NUM>, <NUM> of <FIG>. The view in <FIG> corresponds to section F in <FIG>.

<FIG> is a top view of an implant <NUM>, <NUM> shown without the anchor member <NUM>, <NUM> attached. The triangular strand loops <NUM> are located all along the perimeter of the implant <NUM>, <NUM>. Also in <FIG>, the inner membrane <NUM> can be seen.

<FIG> is a view of different knots 102a, 102b, 102c for the implant. The thread <NUM> can be secured to the framework <NUM>, <NUM>, such as a strand thereof, of the implant <NUM>, <NUM> with a loop 102a around a portion of the framework, a single knot 102b or with a double knot 103c. The ends of the thread <NUM> can be thermally treated.

<FIG> is a lateral view of an implant with a coupling <NUM> or attachment member and without the anchor member <NUM>, <NUM> attached to the implant <NUM>, <NUM>. As can be seen from this figure, the braiding of the implant <NUM>, <NUM> is at the proximal end <NUM> of the implant <NUM>, <NUM> formed so that the proximal end <NUM> can be positioned towards the distal end <NUM> of the implant <NUM>, <NUM> compared to the proximal most portion of the implant <NUM>, <NUM>.

Thus, the coupling or attachment member <NUM> extends less from proximal most portion of the implant <NUM>, <NUM> and will impede the blood flow, such as in the atrium when the implant is an LAA implant, to a lower extent at the target site when the proximal end <NUM> faces the atrium of the heart.

<FIG> is an enlarged sectional view of a coupling or attachment member <NUM> of the implant <NUM>, <NUM>. The coupling or attachment member <NUM> may be formed by welding a portion of the framework <NUM>, <NUM>, such as strand ends, together after the framework has been formed, such as by a braiding machine has finished the braiding or intertwining of the implant <NUM>, <NUM>. The coupling <NUM> or attachment member may be formed by welding it into a ball pivot. The strands are merging into the welded clot in a not-straight, i.e. not parallel manner in the example shown in <FIG>. The ball pivot can be connected to a socket of the flexible pusher, which can be used to move the implant <NUM>, <NUM> in a sheath of a catheter for delivery. The pusher may be able to rotate the implant <NUM> degrees, when the ball pivot is connected to the socket. The framework <NUM>, <NUM> of the implant <NUM>, <NUM> can be compressed so that the implant can be inserted into the sheath. After leaving the sheath, the implant <NUM>, <NUM> independently reassume the predetermined shape and ensure an interlocking hold.

<FIG> is a side view of an implant <NUM>, <NUM> being manufactured and before the anchor member <NUM>, <NUM> has been attached to the framework <NUM>, <NUM>. This figure shows the implant <NUM>, <NUM> after the framework has been formed. In the figure, the framework is illustrated as formed by strands <NUM>. These strands <NUM> are cut to an appropriate length and may be welded together to form the coupling or attachment member <NUM> shown in, e.g., <FIG>.

<FIG> is a side view of an implant <NUM>, <NUM> being manufactured and before the anchor member <NUM>, <NUM> has been attached to the framework <NUM>, <NUM>. This figure illustrates the implant <NUM>, <NUM> after the framework <NUM>, <NUM> has been formed. In the figure, the strands <NUM> are shown as forming the framework <NUM>, <NUM>. The framework <NUM>, <NUM> of the implant <NUM>, <NUM> is positioned at least partially distal of the proximal end of the implant <NUM>, <NUM> to accommodate a hollow space for the coupling or anchor member <NUM>. The strands <NUM> may be cut to an appropriate length and welded together to form the coupling <NUM> or attachment member shown in, e.g., <FIG>.

An implant <NUM> with a conical shape can be seen in <FIG>. Due to the conical shape of the implant, higher radial forces from the body walls are possible. Therefore, the risk of perforation is lowered.

Other possible shapes of the occluder are elongated, round, cylindrical, flat or dumbbell-shaped.

Although, the strand loops <NUM> are depicted in the figures as situated in one row i.e. are axially aligned along the longitudinal axis. However, it is possible to have strand loops <NUM> in multiple rows, e.g. two rows, axially spaced apart along the longitudinal axis <NUM>, <NUM> of the implant <NUM>, <NUM>.

The strand loops <NUM> may be situated either on the proximal end <NUM> or the opposite side, i.e. the distal end <NUM>. It is further possible to have strand loops <NUM> on both the proximal end <NUM> and the distal end. This results in a fixation of the implant in both directions, and contributes to stability together with the anchoring member <NUM>, <NUM>.

In an embodiment the implant <NUM>, <NUM> may be provided with a coating. The coating may be applied to an external surface of the implant <NUM>, <NUM>. The implant may be coated on the outside by a method, in which the implant <NUM>, <NUM> is dipped in a solution with a specific viscosity, while the implant <NUM> is in an expanded shape. By applying the coating to the implant <NUM>, <NUM> while is in an expanded shape, the coating will be free of tension, which advantageously avoids pre-mature fatigue thereof and thus allows a reliable ingrowth. Application of a coating to the implant <NUM>, <NUM> while the implant <NUM>, <NUM> is in an expanded shape, may also be advantageous for other reasons, such as the fact that the implant <NUM>, <NUM> can be made very flexible and that a particularly large expansion/contraction ratio, i.e. a ratio of a size or diameter of the implant <NUM>, <NUM> in its expanded shape and the size or diameter of the implant <NUM>, <NUM> in its contracted shape, can be obtained for the implant <NUM>, <NUM>.

In another embodiment, the end and part of or the whole side are dipped into the solution, so as to be provided with coating, such as illustrated in <FIG>, and <FIG> such that the anchoring member <NUM>, <NUM> is partially covered with the coating. Thereby, a large portion of the implant <NUM> is covered with the coating. In yet another embodiment, only the ends of the implant <NUM> are dipped into the solution, wherein the anchoring member is exposed. However, the implant may be covered with the coating at both ends. This can be done by first dipping the end into the solution, then retracting the implant <NUM> from the solution. Thereafter, the implant is turned around and with the other end facing the solution, the device is again dipped into the solution. A coating applied to the implant <NUM>, <NUM> provides for an improved occlusion, improved sealing of a defect, such as a heart defect, an improved endothelialization and/or for slowing down the blood flow through the defect.

According to an embodiment, in order to provide some body liquid to pass through the implant <NUM> once implanted, the coating may be provided with perforations or microperforations. Thus, by the use of perforations or microperforations, the occlusion is not abrupt, but formed gradually over time.

The membrane <NUM> or coating may comprise a polymer, such as polyurethane, polytetrafluoroethylene (PTFE) or expanded polytetrafluoroethylene (ePTFE). The use of e.g. PTFE or ePTFE may provide for low friction. The polymer may be applied to the implant <NUM>, <NUM> by e.g. dipping, spraying, such as electro-spraying, or polymer spinning technology, such as electro-spinning or solution blow spinning. For example, the membrane may be formed by a fibrous polymeric covering, e.g. formed by applying the polymer as indicated. The membrane <NUM>, e.g. the fibrous polymeric covering, may at least partially cover the framework <NUM>, <NUM>, as is illustrated in <FIG> and <FIG> and discussed above. Additionally or alternatively, the membrane <NUM>, e.g. the fibrous polymeric covering, may at least partially cover at least one anchor member <NUM>, as is illustrated in <FIG> and discussed above. As another alternative, instead of coating the implant <NUM>, <NUM> a non-fibrous film membrane may be sewed onto the external surface of the implant <NUM>, <NUM>. Such a non-fibrous film membrane may be manufactured by applying a film on a substrate and then removing the substrate. a film can be applied by dipping a substrate into a solution and thereafter removing the substrate. As an alternative, a substrate can be sprayed and thereafter removed from the coating formed by the spray, so that a non-fibrous film membrane is obtained.

The embodiments presented in <FIG> may be combined with each of the embodiments presented with regard to <FIG>. Furthermore, such combinations may also be combined with the embodiments presented with regard to <FIG>, and particularly with regard to the shape of the distal end of the framework <NUM>.

Claim 1:
An expandable vascular implant (<NUM>), comprising
a framework (<NUM>) with openings and forming an exterior surface of said implant (<NUM>);
at least one anchor member (<NUM>) for anchoring the implant to a vascular structure and having a proximal portion (<NUM>) and a distal portion (<NUM>);
wherein
the distal portion of the anchor member (<NUM>) comprises at least one free end configured to extend outwardly from said framework (<NUM>); and
the anchor member (<NUM>) is at least partly interlaced with said framework (<NUM>) between said proximal portion and said distal portion such that said anchor member (<NUM>) is fixed to said framework (<NUM>),
wherein said anchor member (<NUM>) comprises an anchor strand formed into said anchor member (<NUM>), wherein a proximal end of said anchor strand forms at least one loop (14a, 14b) extending around a portion of said framework, and wherein said anchor strand comprises two free ends (7a, 7b) forming a distal end of said anchor member, said loop being positioned between said two free ends,
wherein said proximal end of said anchor strand forms two loops extending around said portion of said framework,
characterised in that
a first loop (14a) and a second loop (14b) of said two loops extend through the same openings (3a, 3b, 3c) of said framework,
wherein the free ends (7a, 7b) extend from a first side of the framework (<NUM>) through a first opening (3a) of the framework to a second side of the framework, return to the first side of the framework via a second opening (3b) of the framework and through a loop (<NUM>) formed by a folding in the anchor strand, the free ends (7a, 7b) further extending from the first side of the framework into the second opening (3b) of the framework and be interlaced with the framework, the free ends (7a, 7b) returning to the first side through a third opening (3c) in the framework.