Devices, systems and methods useable for treating frontal sinusitis
Devices, systems and methods wherein a dilator, such as a balloon or other expandable member, is positionable within the frontal sinus ostium and adjacent frontal recess and useable to dilate the frontal sinus ostium and substantially all of the frontal sinus recess without requiring repositioning and repeated re-expansion of the dilator. One balloon catheter device of the invention comprises a catheter body that is less than about 50 cm in length (and in some embodiments less than 25 cm in length and a semi-compliant or non-compliant balloon on the catheter body. The balloon may have a working length of about 12 mm to about 30 mm and a width at its widest point when fully inflated of about 2 mm to about 7 mm. Such balloon may be constructed to withstand inflation pressures of about 12 atmospheres. In some embodiments, the dilator is advanced through or over a guide (e.g., guidewire or guide catheter) that has a preformed shape.
1. A system comprising:
(a) a dilation catheter, comprising:
(i) a catheter shaft having a proximal portion and a distal portion that is more flexible than the proximal portion,
(ii) a dilator disposed along the distal portion of the catheter shaft and having a length of at least about 12 mm to about 24 mm so as to have sufficient length to extend through the frontal sinus ostium and substantially all of the frontal recess, and
(iii) a guidewire lumen extending from an open proximal end of the catheter shaft to an open distal end of the catheter shaft, wherein the guidewire lumen is configured to accommodate a guidewire and enable the dilation catheter to slide along the guidewire; and
(b) a guide having a proximal portion and a distal portion, wherein the distal portion of the guide is sized to fit and stop within or adjacent to the frontal recess;
wherein the dilator is configured to be advanced relative to the guide to position the dilator within the frontal sinus ostium and frontal recess such that a single expansion of the dilator will result in dilation of the frontal sinus ostium and substantially all of the adjacent frontal recess.
2. A system according to claim 1 , further comprising a guidewire, wherein the guidewire lumen of the dilation catheter is sized to receive said guidewire such that the dilator may be advanced over the guidewire.
3. A system according to claim 1 , wherein the distal portion of the guide comprises a curve located within 2 mm of a distal end of the guide.
4. A system according to claim 3 wherein the curve is between 30 degrees and 110 degrees.
5. A system according to claim 3 wherein the curve is approximately 70 degrees.
6. A system according to claim 1 wherein the dilator comprises a balloon.
7. A system according to claim 6 wherein the balloon is non-compliant.
8. A system according to claim 6 wherein the balloon is semi-compliant.
9. A system according to claim 6 wherein the balloon is formed substantially of polyethylene terephthalate having a calculated radial tensile strength of greater than about 25,000 psi.
10. A system according to claim 1 wherein the distal portion of the guide is more flexible than the proximal portion.
11. A system according to claim 1 wherein the distal portion of the guide is malleable such that it may be bent to a curved shape prior to insertion into the patient's body, and such that the curved shape is substantially retained during use.
12. A system according to claim 1 wherein the distal portion of the guide is formed to have a curved shape at the time of manufacture and is sufficiently rigid to maintain said substantially fixed shape until and during use.
13. The system of claim 1 , wherein the guide comprises a tubular guide catheter.
14. The system of claim 1 , wherein the guide has a guide lumen.
15. The system of claim 14 , wherein the dilator is configured to be advanced through the guide lumen.