Devices and methods for treatment of the eustachian tube and sinus cavity

Abstract

A polymeric stent can be implanted for treatment of the Eustachian tube. The stent can be designed to have length-dependent radial strength to allow it to stay within the Eustachian tube and to allow normal closing and opening of the Eustachian tube. A balloon can be used to implant the stent, and the balloon can be coated with a therapeutic agent. A coated balloon can also be used to transfer therapeutic agents to the sinus cavity during a balloon sinus dilation procedure.

1 - 10 . (canceled) 
     
     
         11 . A system for delivering a stent in the Eustachian tube, the system comprising:
 a catheter including a body and a balloon at an end of the body, the balloon configured to carry a stent for delivery through a nasopharynx cavity and into a Eustachian tube of a patient.   
     
     
         12 . The system of  claim 11 , further comprising a stent mounted onto the balloon. 
     
     
         13 . The system of  claim 11 , further comprising a guidewire having an end segment sized for insertion into the Eustachian tube and a plurality of wire marks applied or etched on an exposed surface of the end segment, and the catheter includes a passageway configured to receive the guidewire. 
     
     
         14 . The system of  claim 13 , wherein each of the wire marks has a characteristic which distinguishes the wire mark from an adjacent wire mark, and the characteristic is a color, a shade, a shape, an alphanumeric character, or a combination thereof. 
     
     
         15 . The system of  claim 13 , wherein each of the wire marks is a band that encircles the end segment of the guidewire, and each band has an axial size that is at least 2 mm. 
     
     
         16 . The system of any one of  claims 13 , wherein the end segment of the guidewire is configured to emit light. 
     
     
         17 . The system of any one of  claims 13 , wherein the end segment of the guidewire includes a stabilization feature configured to expand and engage a surface of the Eustachian tube. 
     
     
         18 . (canceled) 
     
     
         19 . (canceled) 
     
     
         20 . The system of any one of  claims 11 , wherein the catheter further includes a collapsible spring and an indicator device coupled to the collapsible spring, the collapsible spring configured to collapse when pushed against a tympanic membrane or other tissue in a middle ear of the patient, and the indicator device is configured to generate an alarm when the collapsible spring is collapsed. 
     
     
         21 . (canceled) 
     
     
         22 - 33 . (canceled) 
     
     
         34 . A method of treating a Eustachian tube with a stent, the method comprising:
 placing a stent in a Eustachian tube of a patient.   
     
     
         35 . The method of  claim 34 , further comprising allowing a segment of the stent to collapse to allow the Eustachian tube to close. 
     
     
         36 . The method of  claim 34 , wherein placing the stent in the Eustachian tube includes carrying the stent into the Eustachian while the stent is crimped, followed by deploying the stent to an enlarged state. 
     
     
         37 . The method of any one of  claims 34 , wherein placing the stent in the Eustachian tube includes moving the stent into the nasopharynx cavity and into the Eustachian tube while viewing an image of stent marks on the stent, and stopping the movement of the stent into the Eustachian tube based on the image of the stent marks. 
     
     
         38 . The method of any one of  claims 34 , further comprising placing a gauge catheter in the Eustachian tube to determine a travel depth for the stent before placing the stent in the Eustachian tube. 
     
     
         39 . The method of any one of  claims 34 , further comprising:
 placing a guidewire in the Eustachian tube; followed by selecting a wire mark on the guidewire based on an image taken from within the Eustachian tube,   wherein placing the stent in the Eustachian tube includes carrying the stent on a catheter, moving the catheter over the guidewire, and stopping the movement of the catheter into the Eustachian tube based on a position of the catheter relative to the selected wire mark.   
     
     
         40 . The method of any one of  claims 34 , further comprising:
 placing a guidewire in the Eustachian tube; followed by   viewing an image of a plurality of wire marks on the guidewire taken from within the Eustachian tube;   determining a size of a treatment zone of the Eustachian tube based on the image of the plurality of wire marks; and   selecting a stent based on the size of the treatment zone,   wherein the selected stent is the stent that is then placed in the Eustachian tube.   
     
     
         41 . The method of any one of  claims 34 , wherein placing the stent in the Eustachian tube includes expanding the stent by inflating a balloon, and then allowing a therapeutic agent to transfer from the inflated balloon to the Eustachian tube. 
     
     
         42 . (canceled) 
     
     
         43 . A method of treating a Eustachian tube or sinus cavity with a balloon, the method comprising:
 inflating a balloon in a Eustachian tube or a sinus cavity of a patient; and   allowing at least one therapeutic agent to transfer from the inflated balloon to a wall of the Eustachian tube or the sinus cavity.   
     
     
         44 . The method of  claim 43 , wherein the at least one therapeutic agent includes an antibiotic and an anti-inflammatory substance. 
     
     
         45 . (canceled) 
     
     
         46 . (canceled) 
     
     
         47 . (canceled) 
     
     
         48 . (canceled) 
     
     
         49 . The method of any one of  claims 43 , wherein the balloon is inflated in the Eustachian tube, and a stent is deployed by the inflation of the balloon. 
     
     
         50 . The method of any one of  claims 43 , wherein the balloon is inflated in the sinus cavity while a coating is disposed on the balloon, the coating includes the at least one therapeutic agent, and the therapeutic agent is not carried in a polymer matrix.