Support for treating vascular bifurcations

Abstract

A prosthesis is disclosed for placement across an ostium opening from a main body lumen to a branch body lumen. The prosthesis has a radially expansible support and a bifurcation traversing portion. The radially expansible support is configured to be deployed in at least a portion of the branch body lumen. The bifurcation traversing portion has a biostable portion having a first end and a second end. The first end is located adjacent to the radially expansible support. The bifurcation traversing portion also has a biodegradable portion having a first end coupled with the second end of the biostable portion. The biodegradable portion has a second end disposed at an end of the prosthesis opposite the radially expansible support. When deployed, the bifurcation traversing portion extends from the radially expansible support across a bifurcation and into a main body lumen such that the carina is supported thereby.

What is claimed is: 
     
         1 . A prosthesis for placement at an ostium opening from a main body lumen to a branch body lumen, the prosthesis comprising:
 a radially expansible support configured to be deployed in at least a portion of the branch body lumen;   a bifurcation traversing portion having a biostable portion having a first end and a second end, the first end being located adjacent to the radially expansible support and a biodegradable portion having a first end coupled with the second end of the biostable portion and a second end disposed at an end of the prosthesis opposite the radially expansible support;   wherein when deployed, the bifurcation traversing portion extends from the radially expansible support across a bifurcation and into a main body lumen such that the carina is supported thereby.   
     
     
         2 . The prosthesis of  claim 1 , wherein the second end of the biostable portion is mechanically coupled with the first end of the biodegradable portion. 
     
     
         3 . The prosthesis of  claim 1 , further comprising an interlock device disposed between the biodegradable and biostable portions for mechanically connecting the biodegradable and biostable portions. 
     
     
         4 . The prosthesis of  claim 3 , wherein the bifurcation traversing portion comprises a plurality of elongate members, each elongate member comprising an axially extending biostable zone, an axially extending biodegradable zone, a first locking member disposed on the biostable zone and a second locking member disposed on the biodegradable zone, the first and second locking members being configured to mechanically couple the axially extending biostable and biodegradable zones. 
     
     
         5 . The prosthesis of  claim 1 , wherein the bifurcation traversing portion comprises a transition zone disposed adjacent to the first end of the biostable portion and being adapted to expand to cover the carina and a plurality of longitudinal members extending from the second end of the biodegradable portion toward the first end of the biostable portion. 
     
     
         6 . The prosthesis of  claim 5 , further comprising a circumferential member extending between at least two of the longitudinal members to stabilize or position the longitudinal members within the main body lumen during a deployment procedure. 
     
     
         7 . The prosthesis of  claim 6 , wherein at least one of the longitudinal members comprises a frond. 
     
     
         8 . The prosthesis of  claim 7  wherein the at least one frond comprises a transition portion having a first end coupled with the support and a plurality of second ends spaced apart from each other and from the support. 
     
     
         9 . The prosthesis of  claim 1 , wherein a portion of the bifurcation traversing zone comprises an axially oriented pattern of undulating filaments and an interlock structure disposed between two filaments at the junction of the biostable and biodegradable portions. 
     
     
         10 . The prosthesis of  claim 1 , wherein the support has a first wall pattern, and the bifurcation traversing portion has a second wall pattern different from the first wall pattern. 
     
     
         11 . The prosthesis of  claim 10 , wherein the second pattern has a circumferential surface area that is lower toward a proximal end thereof than adjacent to the radially expansible support. 
     
     
         12 . The prosthesis of  claim 1 , wherein at least one of the biostable and the biodegradable portions comprises a serpentine or sinusoidal member. 
     
     
         13 . The prosthesis of  claim 12 , wherein the biodegradable portion comprises a dual serpentine member. 
     
     
         14 . A prosthesis for placement at an ostium opening from a first body lumen to a second body lumen, the prosthesis comprising:
 a radially expansible support configured to be deployed in at least a portion of the first body lumen;   at least two longitudinal members extending from an end of the support, all of the longitudinal members configured to be positioned in the second body lumen when deployed;   wherein at least one of the longitudinal members comprises a first portion coupled with the radially expansible support and a second portion mechanically coupled with the first portion, one of the first and second portions adapted to degrade more rapidly in a patient than the other of the first and second portions.   
     
     
         15 . The prosthesis of  claim 14 , further comprising a connection device disposed between the at least one longitudinal member having the first and second portions mechanically coupled together, the connection device having a first member disposed on a proximal end of the first portion and a second member disposed on a distal end of the second portion, one of the first and second members configured to secure the other of the first and second portions. 
     
     
         16 . The prosthesis of  claim 15 , wherein the first member comprises a jaw member and the second portion comprises a protrusion configured to be received in the jaw member, the jaw member frictionally engaging the protrusion to couple the first and second portions together during deployment. 
     
     
         17 . The prosthesis of  claim 16 , wherein the first member comprises a jaw member comprising an axial extension of each of a pair of longitudinal sinusoidal member of the first portion and the protrusion comprises an axial extension disposed between a pair of longitudinal sinusoidal members of the second portion. 
     
     
         18 . The prosthesis of  claim 14 , wherein the second portion is biodegradable and the first portion is biostable. 
     
     
         19 . A prosthesis for placement at an opening from a main body lumen to a branch body lumen, the prosthesis comprising:
 a radially expansible support configured to be deployed in at least a portion of the branch body lumen, the support adapted to provide a radial force to support the branch body lumen;   a plurality of longitudinal members extending from an end of the support, the longitudinal members configured to reach into the main body lumen when deployed;   a coupler disposed proximal of the radially expansible support for connecting a first segment of the prosthesis from a second segment of the prosthesis, the first segment having a higher degradation rate in situ than the second segement; and   a circumferential member spaced apart from the support and connected to at least one of the longitudinal members.   
     
     
         20 . The prosthesis of  claim 19 , wherein at least one frond has a distal end connected to the radially expansible support and proximal end free from connection to the circumferential link.