Apparatus and methods for dilating and modifying ostia of paranasal sinuses and other intranasal or paranasal structures

Abstract

Sinusitis and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches with flexible or rigid instruments. Various methods and devices are used for remodeling or changing the shape, size or configuration of a sinus ostium or duct or other anatomical structure in the ear, nose or throat; implanting a device, cells or tissues; removing matter from the ear, nose or throat; delivering diagnostic or therapeutic substances or performing other diagnostic or therapeutic procedures. Introducing devices (e.g., guide catheters, tubes, guidewires, elongate probes, other elongate members) may be used to facilitate insertion of working devices (e.g. catheters e.g. balloon catheters, guidewires, tissue cutting or remodeling devices, devices for implanting elements like stents, electrosurgical devices, energy emitting devices, devices for delivering diagnostic or therapeutic agents, substance delivery implants, scopes etc.) into the paranasal sinuses or other structures in the ear, nose or throat.

1 .- 10 . (canceled) 
     
     
         11 . A method, comprising:
 (a) inserting a catheter into a nasal cavity of a patient, the catheter including a balloon and a stent positioned over the balloon;   (b) positioning the balloon and the stent in a targeted anatomical passageway in the nasal cavity   (c) expanding the balloon within the targeted anatomical passageway while the stent is positioned over the balloon, the stent engaging adjacent tissue in the targeted anatomical passageway; and   (d) removing the catheter from the nasal cavity, the stent remaining engaged with the adjacent tissue in the targeted anatomical passageway after the catheter is removed from the nasal cavity.   
     
     
         12 . The method of  claim 11 , the balloon being in a non-expanded state during the act of inserting the catheter into the nasal cavity. 
     
     
         13 . The method of  claim 11 , the targeted anatomical passageway comprising an ostium of a sinus. 
     
     
         14 . The method of  claim 11 , the act of expanding the balloon resulting in dilation of the targeted anatomical passageway. 
     
     
         15 . The method of  claim 11 , the stent including a therapeutic substance, such that the stent elutes the therapeutic substance while being engaged with the adjacent tissue in the nasal cavity after the catheter is removed from the nasal cavity. 
     
     
         16 . The method of  claim 11 , the stent defining a cylindrical shape. 
     
     
         17 . The method of  claim 11 , the stent being formed of a resilient material. 
     
     
         18 . The method of  claim 11 , further comprising inserting an introducing device in the nasal cavity, the act of inserting the catheter into the nasal cavity comprising advancing the catheter along the introducing device. 
     
     
         19 . The method of  claim 18 , the introducing device comprising a guidewire. 
     
     
         20 . The method of  claim 11 , the stent comprising a metallic material. 
     
     
         21 . The method of  claim 11 , the stent comprising a polymeric material. 
     
     
         22 . The method of  claim 11 , the stent comprising a foam material. 
     
     
         23 . The method of  claim 11 , the stent comprising a plastically deformable material. 
     
     
         24 . The method of  claim 11 , the stent comprising a super elastic material. 
     
     
         25 . The method of  claim 11 , the stent comprising a chain-link structure. 
     
     
         26 . The method of  claim 11 , the stent comprising polyurethane. 
     
     
         27 . The method of  claim 11 , the stent comprising polyethylene. 
     
     
         28 . The method of  claim 11 , the stent comprising a radiopaque coating. 
     
     
         29 . A method, comprising:
 (a) inserting a catheter into a nasal cavity of a patient, the catheter including a balloon and a stent positioned over the balloon, the balloon and the stent each being in a non-expanded state during the act of inserting the catheter into the nasal cavity of the patient;   (b) positioning the balloon and the stent in a targeted anatomical passageway in the nasal cavity;   (c) expanding the balloon within the nasal cavity while the stent is positioned over the balloon in the targeted anatomical passageway, thereby expanding the stent, the expanded stent engaging adjacent tissue in the targeted anatomical passageway;   (d) transitioning the balloon to a non-expanded state, the expanded stent remaining engaged with the adjacent tissue in the targeted anatomical passageway during the act of transitioning the balloon to the non-expanded state; and   (e) removing the catheter from the nasal cavity with the balloon in the non-expanded state, the expanded stent remaining engaged with the adjacent tissue in the targeted anatomical passageway after the catheter is removed from the nasal cavity.   
     
     
         30 . An apparatus, comprising:
 (a) a catheter, the catheter comprising:
 (i) a balloon, and 
 (ii) a shaft extending proximally from the balloon, the shaft having a length sufficient to enable positioning of the balloon in a targeted anatomical passageway in a nasal cavity of the patient while a proximal end of the shaft remains external to the patient; and 
   (b) a metallic stent, the metallic stent being configured to fit over the balloon of the catheter,   the balloon being operable to inflate to thereby transition the metallic stent from a contracted state to an expanded state,   the metallic stent in the expanded state being operable to bear against a sidewall of the targeted anatomical passageway in the nasal cavity.