Patent Description:
In the context of Eustachian tube dilation, a dilation catheter or other dilation instrument may be inserted into the Eustachian tube and then be inflated or otherwise expanded to thereby dilate the Eustachian tube. The dilated Eustachian tube may provide improved ventilation from the nasopharynx to the middle ear and further provide improved drainage from the middle ear to the nasopharynx. Methods and devices for dilating the Eustachian tube are disclosed in <CIT>; and <CIT>. An example of such a system is the Aera® Eustachian Tube Balloon Dilation System by Acclarent, Inc. of Irvine, California.

While a variable direction view endoscope may be used to provide visualization within the anatomical passageway, it may also be desirable to provide additional visual confirmation of the proper positioning of the balloon before inflating the balloon. This may be done using an illuminating guidewire. Such a guidewire may be positioned within the target area and then illuminated, with light projecting from the distal end of the guidewire. This light may illuminate the adjacent tissue (e.g., hypodermis, subdermis, etc.) and thus be visible to the naked eye from outside the patient through transcutaneous illumination. For instance, when the distal end is positioned in the maxillary sinus, the light may be visible through the patient's cheek. Using such external visualization to confirm the position of the guidewire, the balloon may then be advanced distally along the guidewire into position at the dilation site. Such an illuminating guidewire may be provided in accordance with the teachings of <CIT>. An example of such an illuminating guidewire is the Relieva Luma Sentry° Sinus Illumination System by Acclarent, Inc. of Irvine, California.

Image-guided surgery (IGS) is a technique where a computer is used to obtain a real-time correlation of the location of an instrument that has been inserted into a patient's body to a set of preoperatively obtained images (e.g., a CT or MRI scan, <NUM>-D map, etc.), such that the computer system may superimpose the current location of the instrument on the preoperatively obtained images. An example of an electromagnetic IGS navigation systems that may be used in IGS procedures is the CARTOR <NUM> System by Biosense-Webster, Inc. , of Irvine, California. In some IGS procedures, a digital tomographic scan (e.g., CT or MRI, <NUM>-D map, etc.) of the operative field is obtained prior to surgery. A specially programmed computer is then used to convert the digital tomographic scan data into a digital map. During surgery, special instruments having sensors (e.g., electromagnetic coils that emit electromagnetic fields and/or are responsive to externally generated electromagnetic fields) are used to perform the procedure while the sensors send data to the computer indicating the current position of each surgical instrument. The computer correlates the data it receives from the sensors with the digital map that was created from the preoperative tomographic scan. The tomographic scan images are displayed on a video monitor along with an indicator (e.g., crosshairs or an illuminated dot, etc.) showing the real-time position of each surgical instrument relative to the anatomical structures shown in the scan images. The surgeon is thus able to know the precise position of each sensor-equipped instrument by viewing the video monitor even if the surgeon is unable to directly visualize the instrument itself at its current location within the body.

An example of an electromagnetic IGS systems that may be used in ENT and sinus surgery is the CARTOR <NUM> System by Biosense-Webster, Inc. , of Irvine, California. When applied to functional endoscopic sinus surgery (FESS), balloon sinuplasty, and/or other ENT procedures, the use of IGS systems allows the surgeon to achieve more precise movement and positioning of the surgical instruments than can be achieved by viewing through an endoscope alone. As a result, IGS systems may be particularly useful during performance of FESS, balloon sinuplasty, and/or other ENT procedures where anatomical landmarks are not present or are difficult to visualize endoscopically. In order to enable use of an IGS system in an ENT procedure, the instrumentation used in the ENT procedure may include a guidewire that has a position sensor that cooperates with the IGS system to provide data indicating the position of the distal end of the guidewire in real time. Such an IGS system navigation guidewire may be used in addition to, or in lieu of, the navigating guidewire referred to above. Examples of use of an IGS system in an ENT procedure are described in <CIT>; and <CIT>.

<CIT> describes a cannula or catheter assembly having a cannula or catheter tube in a socket with a straight passageway. In order to equip such an assembly with a cheap and safe closure device which is easy to manoeuvre without causing any movements injurious to the assembly, a connecting housing is fixedly or releasably connected to the socket and has a straight through-channel which is connected to the passageway of the socket and accommodates a hose section which seals against the channel wall and, to permit closing the through-channel, can be compressed at a location between its ends by means of at least one pressure body disposed in an opening in the wall of the through-channel and operable by means of a slide member movable in the axial direction of the through-channel on the outer side of the connecting housing.

<CIT> describes a catheter introducer sheath assembly, for introduction into a body passage of a catheter containing a filter, which comprises a flexible introducer sheath joined to the distal end of a closure device forming a through-passage with a diameter sufficient to pass the catheter therethrough. The closure device has a resilient member in the through-passage and two rotatable body portions, one stationery with respect to the resilient member, and the other rotatable about the axis of the resilient member with an internal cam circumferentially spaced around the axis. A compression member positioned radially in an extending aperture makes contact with both the resilient member and the cam surface to vary the through-passage allowing the operator to manually control the passage of the device. The sheath assembly receives a cathetory guidewire that slides through and extends beyond the closure device and the sheath.

While several systems and methods have been made and used to position a balloon of a dilation catheter in an anatomical passageway, it is believed that no one prior to the inventors has made or used the invention described in the appended claims.

While the specification concludes with claims which particularly point out and distinctly claim the invention, it is believed the present invention will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which like reference numerals identify the same elements. Embodiments of the invention are illustrated by <FIG>.

Embodiments of the invention are illustrated by <FIG>.

Embodiments of the invention are described in section II. For example, while various.

It will be appreciated that the terms "proximal" and "distal" are used herein with reference to a clinician gripping a handpiece assembly. Thus, an end effector is distal with respect to the more proximal handpiece assembly. It will be further appreciated that, for convenience and clarity, spatial terms such as "circumferentially" and "radially" also are used herein with respect to the longitudinal axis. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and absolute.

It is further understood that any one or more of the teachings, expressions, versions, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, versions, examples, etc. that are described herein. The following-described teachings, expressions, versions, examples, etc. should therefore not be viewed in isolation relative to each other.

<FIG> show an exemplary dilation instrument (<NUM>) that may be used to dilate the ostium of a paranasal sinus, to dilate another passageway associated with drainage of a paranasal sinus, to dilate a Eustachian tube, or to dilate some other anatomical passageway (e.g., within the ear, nose, or throat, etc.). Dilation instrument (<NUM>) of the present example provides adjustability that enables the operator to use dilation instrument (<NUM>) in different scenarios, without requiring the operator to switch between different instruments. For instance, dilation instrument (<NUM>) may be used to dilate various different anatomical passageways (e.g., frontal sinus ostium, frontal recess, maxillary sinus ostium, sphenoid sinus ostium, ethmoid sinus ostium, Eustachian tube, etc.) by making simple adjustments to structural features of the instrument.

Dilation instrument (<NUM>) of this example includes a handle assembly (<NUM>), a guide shaft assembly (<NUM>) extending distally from handle assembly (<NUM>); a guidewire actuation assembly (<NUM>) slidably coupled with handle assembly (<NUM>); and a dilation catheter actuation assembly (<NUM>) slidably coupled with handle assembly (<NUM>). A guidewire module (<NUM>) (<FIG>) is coupled with a guidewire (<NUM>) of dilation instrument (<NUM>) via a connector (<NUM>). An inflation fluid source (<NUM>) and an irrigation fluid source (<NUM>) are coupled with a dilation catheter (<NUM>) of dilation instrument (<NUM>) via a connector (<NUM>). A suction source (<NUM>) is coupled with a suction conduit (not shown) of dilation instrument (<NUM>) via a suction port (<NUM>).

Handle assembly (<NUM>) is sized and configured to be grasped and operated by a single hand of an operator. The operator may selectively operate guidewire actuation assembly (<NUM>) and dilation catheter actuation assembly (<NUM>) with the same single hand that grasps handle assembly (<NUM>). As shown in the transition from <FIG>, the operator may advance guidewire actuation assembly (<NUM>) distally along handle assembly (<NUM>) to thereby advance guidewire (<NUM>) distally, such that distal end (<NUM>) of guidewire (<NUM>) is positioned distal to distal end of guide shaft assembly (<NUM>). As shown in the transition from <FIG>, the operator may advance dilation catheter actuation assembly (<NUM>) distally along handle assembly (<NUM>) to thereby advance dilation catheter (<NUM>) distally, such that distal tip (<NUM>) of dilation catheter (<NUM>) is positioned distal to distal end of guide shaft assembly (<NUM>). With dilation catheter (<NUM>) advanced to a distal position, the operator may then inflate a dilator (<NUM>) of dilation catheter (<NUM>) to achieve an expanded state as shown in <FIG>, to thereby dilate an anatomical passageway in which dilator (<NUM>) is positioned.

Guide shaft assembly (<NUM>) of this example includes a rigid shaft member (<NUM>), a flexible shaft member (<NUM>), and a deflection control knob (<NUM>). Deflection control knob (<NUM>) is operable to cause guide shaft assembly (<NUM>) to flex laterally at flexible guide shaft member (<NUM>), to thereby allow the operator to vary the exit angle of dilation catheter (<NUM>) relative to the longitudinal axis of rigid shaft member (<NUM>). A rotation control knob (<NUM>) is operable to rotate guide shaft assembly (<NUM>) about the longitudinal axis of rigid shaft member (<NUM>), thereby providing additional control to the operator to facilitate access to various anatomical passageways within the head of a patient.

In the present example, dilation catheter (<NUM>) is coaxially disposed within guide shaft assembly (<NUM>), and guidewire (<NUM>) is coaxially disposed within dilation catheter (<NUM>). In some other versions, guide shaft assembly (<NUM>) is coaxially disposed within dilation catheter (<NUM>), and guidewire (<NUM>) is coaxially disposed within guide shaft assembly (<NUM>). Also, in some versions, guidewire (<NUM>) is omitted.

As shown in <FIG>, the proximal end of dilation catheter (<NUM>) includes a connector (<NUM>) that is configured to couple with an inflation fluid source (<NUM>) and an irrigation fluid source (<NUM>). By way of example only, connector (<NUM>) may be connected and operable in accordance with at least some of the teachings of <CIT>. Inflation fluid source (<NUM>) (<FIG>) is operable to provide an inflation fluid (e.g., saline) via connector (<NUM>) to selectively inflate and deflate dilator (<NUM>) of dilation catheter (<NUM>). In some versions, inflation fluid source (<NUM>) is constructed and operable in accordance with at least some of the teachings of <CIT>. As another merely illustrative example, inflation fluid source (<NUM>) may be constructed and operable in accordance with at least some of the teachings of <CIT>. Other suitable forms that inflation fluid source (<NUM>) may take will be apparent to those skilled in the art in view of the teachings herein.

In addition to being capable of providing dilation, dilation catheter (<NUM>) of the present example is also configured to provide irrigation of a site within a patient. By way of example only, dilation catheter (<NUM>) may be constructed and operable in accordance with at least some of the teachings of <CIT>. Dilation catheter (<NUM>) receives irrigation fluid (e.g., saline) from irrigation fluid source (<NUM>) via connector (<NUM>) of connector (<NUM>) as described above. By way of example only, irrigation fluid source (<NUM>) may provide gravity-fed irrigation fluid, may include a syringe, may include an electrically activated pump, or may take any other suitable form as will be apparent to those skilled in the art in view of the teachings herein.

By way of further example only, dilation instrument (<NUM>) may be further configured and operable in accordance with the teachings of <CIT>; or in accordance with the teachings of any other patent reference cited herein. Other variations of the features and functionalities described herein will be apparent to those skilled in the art in view of the teachings herein.

<FIG> show various components of guidewire actuation assembly (<NUM>) in greater detail. These components include a spin actuator (<NUM>) and a slide actuator (<NUM>). Spin actuator (<NUM>) is operable to rotate guidewire (<NUM>) relative to handle assembly (<NUM>) (<FIG>), about longitudinal axis of guidewire (<NUM>); while slide actuator (<NUM>) is operable to translate guidewire (<NUM>) relative to handle assembly (<NUM>), along the longitudinal axis of guidewire (<NUM>).

In some versions, guidewire (<NUM>) includes one or more optical fibers and a distal end (<NUM>) that is configured to emit visible light. In some such versions, guidewire module (<NUM>) (<FIG>) includes a light source, and connector (<NUM>) is operable to communicate light from the light source of guidewire module (<NUM>) to guidewire (<NUM>). Illuminating versions of guidewire (<NUM>) may be used to provide position confirmation through observation of transillumination effects. By way of example only, illuminating versions of guidewire (<NUM>) may be constructed and operable in accordance with at least some of the teachings of <CIT>.

In addition to providing illumination, or as an alternative to providing illumination, guidewire (<NUM>) may provide position sensing capabilities. In some such versions, the distal end of guidewire (<NUM>) may include a position sensor. By way of example only, such a guidewire (<NUM>) may be constructed and operable in accordance with at least some of the teachings of <CIT>; <CIT>; <CIT>. In some such versions, guidewire module (<NUM>) includes an IGS navigation system, and connector (<NUM>) is operable to communicate position-indicative signals from the sensor of guidewire (<NUM>) to guidewire module (<NUM>).

In some versions, connector (<NUM>) is in the form of a slip coupling. Such a slip coupling may be configured to provide tensile strain relief for guidewire (<NUM>) while allowing guidewire (<NUM>) to freely rotate between connector (<NUM>) and any coupled components associated with guidewire module (<NUM>) (e.g., an additional cable coupled between connector (<NUM>) and guidewire module (<NUM>), etc.). This may prevent the build-up of torsion along any components that are proximal to connector (<NUM>) while guidewire (<NUM>) is rotated about the longitudinal axis of guidewire (<NUM>). In versions where guidewire (<NUM>) includes one or more optical fibers or other light-communicating features, connector (<NUM>) includes features allowing light to pass freely through connector (<NUM>), such that connector (<NUM>) maintains optical continuity between guidewire module (<NUM>) and guidewire (<NUM>). In versions where guidewire (<NUM>) includes one or more position sensors, connector (<NUM>) includes features that provide electrical continuity between guidewire module (<NUM>) and guidewire (<NUM>).

As best seen in <FIG>, spin actuator (<NUM>) of the present example includes a plurality of thumbwheel engagement features (<NUM>), a proximal shaft (<NUM>), and a distal shaft (<NUM>). Proximal shaft (<NUM>) includes a collet chuck feature (<NUM>) formed by a pair of collet leaves (<NUM>) that are separated by diametrically opposed longitudinally extending slots (<NUM>). Slots (<NUM>) are configured to provide clearance to allow collet leaves (<NUM>) to deflect inwardly toward each other to thereby grip guidewire (<NUM>). Each collet leaf (<NUM>) includes a fin (<NUM>) extending longitudinally and radially outwardly. Each fin (<NUM>) includes a proximally positioned detent feature (<NUM>).

As shown in <FIG>, a collet collar (<NUM>) is configured to translate along proximal shaft (<NUM>) between a proximal position (<FIG>) and a distal position (<FIG>) to thereby transition collet chuck feature (<NUM>) between a locked state (<FIG>) and an unlocked state (<FIG>). The interior of collet collar (<NUM>) includes features that are operable to provide camming to drive leaves (<NUM>) inwardly toward each other as collet collar (<NUM>) is translated from the distal position to the proximal position. Detent features (<NUM>) of collet chuck feature (<NUM>) cooperate with notches (<NUM>) of collet collar (<NUM>) to selectively maintain the longitudinal position of collet collar (<NUM>) along proximal shaft (<NUM>) when collet collar (<NUM>) is in the proximal position. Detent features (<NUM>) thus cooperate with notches (<NUM>) to selectively maintain collet chuck feature (<NUM>) in the locked state.

When collet chuck feature (<NUM>) is in the locked state (<FIG>), collet leaves (<NUM>) are deformed inwardly to grip guidewire (<NUM>) disposed in the central longitudinal bore (<NUM>) of spin actuator (<NUM>). When collet chuck feature (<NUM>) is in the unlocked state (<FIG>), collet leaves (<NUM>) resiliently return to their natural position, thereby releasing their grip on guidewire (<NUM>). Thus, when collet chuck feature (<NUM>) is in the unlocked state, the operator may selectively adjust the longitudinal position of guidewire (<NUM>) relative to spin actuator (<NUM>). In some instances, the operator may wish to remove guidewire (<NUM>) from spin actuator (<NUM>) when collet chuck feature (<NUM>) is in the unlocked state. In some such instances, the operator may wish to exchange one guidewire (<NUM>) for another guidewire (<NUM>) (e.g., to exchange an illuminating guidewire (<NUM>) for a guidewire (<NUM>) having a position sensor, or vice-versa, etc.).

As best seen in <FIG>, slide actuator (<NUM>) of the present example comprises a distal nose portion (<NUM>), a lower base portion (<NUM>), and a proximal yoke (<NUM>). Distal nose portion (<NUM>) is configured to rotatably support distal shaft (<NUM>) of spin actuator (<NUM>). Proximal yoke (<NUM>) includes a pair of fork tines (<NUM>) that are configured to rotatably support proximal shaft (<NUM>) of spin actuator (<NUM>). Lower base portion (<NUM>) includes a pair of longitudinally extending recesses (<NUM>) that are configured to slidably receive corresponding rails (not shown) defined by housings (<NUM>) of handle assembly (<NUM>). Slide actuator (<NUM>) is operable to slide longitudinally relative to housings (<NUM>), to thereby translate guidewire (<NUM>) and spin actuator (<NUM>) longitudinally, while also allowing spin actuator (<NUM>) to rotate guidewire (<NUM>) relative to slide actuator (<NUM>). Distal nose portion (<NUM>) is also configured to redirect guidewire (<NUM>) from a first longitudinal axis (associated with the proximal portion of guidewire (<NUM>)) to a second longitudinal axis (associated with dilation catheter (<NUM>) (<FIG>) and the distal portion of guidewire (<NUM>)), with second longitudinal axis being parallel with the first longitudinal axis.

As noted above with reference to <FIG>, an operator may translate guidewire (<NUM>) longitudinally relative to handle assembly (<NUM>) by engaging guidewire actuation assembly (<NUM>) and sliding guidewire actuation assembly (<NUM>) longitudinally along handle assembly (<NUM>). Due to the position and configuration of guidewire actuation assembly (<NUM>), the operator may accomplish such motion by simply engaging guidewire actuation assembly (<NUM>) with the thumb (or another finger) of the hand that is grasping handle assembly (<NUM>). In some instances, the operator may also wish to rotate guidewire (<NUM>) about longitudinal axis of guidewire (<NUM>). This may be particularly desirable when distal end of guidewire (<NUM>) includes a preformed bend, as rotation of guidewire (<NUM>) may be used to advantageously reorient the bent distal end of guidewire (<NUM>) to thereby align the bent distal end of guidewire (<NUM>) with a targeted passageway. To provide such rotation, the operator may engage one or more thumbwheel engagement features (<NUM>) (<FIG>) with the thumb (or another finger) of the hand that is grasping handle assembly (<NUM>). Guidewire actuation assembly (<NUM>) is thus configured to facilitate single-handed use including translation and rotation of guidewire (<NUM>). The elongate configuration of guidewire actuation assembly (<NUM>) may further facilitate single-handed use regardless of whether guidewire actuation assembly (<NUM>) is positioned distally or proximally along handle assembly (<NUM>).

As described above, spin actuator (<NUM>) of guidewire actuation assembly (<NUM>) is transitioned between an unlocked state and a locked state relative to guidewire (<NUM>) by translating collet collar (<NUM>) proximally and distally over proximal shaft (<NUM>). In some instances, it may be desirable to integrate the locking features into the spin actuator (<NUM>) and to have a plurality of locking positions to facilitate the use of spin actuator (<NUM>) with guidewires (<NUM>), or other inserted instruments, with varying outer diameters. Integrating the locking features into the spin actuator (<NUM>) may also simplify manufacturing among other advantages. The following describes exemplary variations of spin actuator (<NUM>) that facilitate use with guidewires and other inserted instruments with various outer diameters, such that the variations of spin actuator (<NUM>) may readily accommodate and selectively lock relative to various instruments with various outer diameters.

<FIG> shows an exemplary guidewire actuation mechanism (<NUM>) suitable for use with dilation instrument (<NUM>) (<FIG>) in place of spin actuator (<NUM>) (<FIG>) and collet collar (<NUM>) (<FIG>). Though not shown, it will be appreciated that guidewire actuation mechanism (<NUM>) may be incorporated within a guidewire actuation assembly (not shown) having a slidable support structure similar to slide actuator (<NUM>) (<FIG>) described above, to which guidewire actuation mechanism (<NUM>) is rotatably mounted, as described in greater detail below. As shown in <FIG>, guidewire actuation mechanism (<NUM>) includes an engagement member (<NUM>), a hollow shaft (<NUM>), a resilient gripping member (<NUM>), a compression element (<NUM>), and a compression member (<NUM>). In the current example, compression element (<NUM>) is in the form of a ball. Alternatively, compression element (<NUM>) may take various other forms as will be apparent to those skilled in the art in view of the teachings herein.

Guidewire actuation mechanism (<NUM>) is configured to lock and unlock upon various outer diameter elongate members (<NUM>, <NUM>), as shown in <FIG> and described in greater detail below. In the present example, elongate member (<NUM>) is a guidewire, though other versions of elongate member (<NUM>) may include (but are not limited to) a dilation catheter, a suction instrument cannula, an endoscope, and/or various other kinds of elongate members as will be apparent to those skilled in the art in view of the teachings herein. Elongate member (<NUM>) translates along longitudinal axis (A1) through guidewire actuation mechanism (<NUM>) when guidewire actuation mechanism (<NUM>) is in an unlocked state (<FIG>). To reach the locked state, compression member (<NUM>) is translated distally in relation to engagement member (<NUM>). Compression member (<NUM>) urges compression element (<NUM>) radially inwardly against resilient gripping member (<NUM>), deforming resilient gripping member (<NUM>) radially inwardly to grip onto elongate member (<NUM>) (<FIG>), thereby locking elongate member (<NUM>). As shown in <FIG>, compression member (<NUM>) has a conical inner surface (<NUM>) having a detent feature (<NUM>) to resist the compression member (<NUM>) from translating proximally and unlocking retain compression element (<NUM>) due to resilient gripping member (<NUM>) being biased to an expanded state. Detent features (<NUM>) also enable guidewire actuation mechanism (<NUM>) to lock upon different diameter elongate members (<NUM>, <NUM>).

As shown best in <FIG>, engagement member (<NUM>) of the present example includes a generally tubular body (<NUM>) having a proximal engagement member end (<NUM>), and a distal engagement member end (<NUM>). Tubular body (<NUM>) includes a first through bore (<NUM>) extending axially along longitudinal axis (A1) (<FIG>). Tubular body (<NUM>) has a plurality of radially oriented finger engagement projections (<NUM>) angularly spaced apart from each other on an exterior of tubular body (<NUM>). Projections (<NUM>) are configured to be engaged by the operator. Tubular body (<NUM>) also has a proximal engagement member portion (<NUM>) proximate to proximal engagement member end (<NUM>). Proximate engagement member end (<NUM>) is configured to be rotatably supported by a first end portion of frame (<NUM>) (<FIG>). Tubular body (<NUM>) has a first counterbore (<NUM>) extending proximally from distal engagement member end (<NUM>). First counterbore (<NUM>) has a diameter that is greater than first through bore (<NUM>). First counterbore and first through bore define a projection (<NUM>) extending distally from a base of first counterbore (<NUM>). Projection (<NUM>) is configured to prevent resilient gripping member (<NUM>) from moving proximally along longitudinal axis (A1) (<FIG>).

<FIG> show hollow shaft (<NUM>) of the present example including a generally tubular body (<NUM>), a proximal shaft end (<NUM>), and a distal shaft end (<NUM>). Tubular body (<NUM>) has an annular ring (<NUM>), a keyway (<NUM>), a second through bore (<NUM>), a second counterbore (<NUM>), an angularly spaced array of radial apertures (<NUM>), and a distal shaft portion (<NUM>). Each radial aperture (<NUM>) is radially deposed through tubular sidewall (<NUM>) of a distal shaft portion (<NUM>). Each radial aperture (<NUM>) is sized to accept a corresponding compression element (<NUM>) (<FIG>). Distal shaft portion (<NUM>) is proximate to distal shaft end (<NUM>) and is configured to be rotatably supported by a second end portion of frame (<NUM>) (<FIG>).

Annular ring (<NUM>) is located on a tubular sidewall of tubular body (<NUM>) proximate to distal shaft portion (<NUM>). Annular ring (<NUM>) locates guidewire actuation mechanism (<NUM>) linearly along longitudinal axis (A1). Keyway (<NUM>) extends distally in tubular sidewall (<NUM>) and terminates at annular ring (<NUM>). Second counterbore (<NUM>) extends distally from proximate shaft end (<NUM>) to a base of second counterbore (<NUM>). Second counterbore (<NUM>) is sized to accept resilient gripping member (<NUM>). Second through bore (<NUM>) extends from distally from base of second counterbore (<NUM>) to distal shaft end (<NUM>).

<FIG> show compression member (<NUM>) of the present example having a generally annular body (<NUM>) having a proximal member end (<NUM>) and a distal member end (<NUM>). Annular body (<NUM>) has a plurality of radially extending finger engagement nubs (<NUM>) angularly spaced apart from each other on an exterior of annular body (<NUM>). Finger engagement nubs (<NUM>) are configured to be engaged by the operator. Compression member (<NUM>) is configured to be slidably disposed over hollow shaft (<NUM>) through a third through bore (<NUM>) extending distally from proximal member end (<NUM>) to distal member end (<NUM>). Third through bore (<NUM>) has a keyway projection (<NUM>) extending distally along longitudinal axis (A1). Keyway projection (<NUM>) is configured to slidably mate with keyway (<NUM>) (<FIG>) of hollow shaft (<NUM>). Compression member (<NUM>) selectively translates longitudinally along hollow shaft (<NUM>) between a locked and unlocked position. In the present example, compression member (<NUM>) is in the form of a collar. Compression member (<NUM>) includes a conical inner surface (<NUM>) configured to engage compression elements (<NUM>). Conical inner surface (<NUM>) extends distally from proximal member end (<NUM>) to distal member end (<NUM>). Proximal member end (<NUM>) has a smaller inner diameter in relation to distal member end (<NUM>). Conical inner surface (<NUM>) has a plurality of detent features (<NUM>) linearly displaced along conical inner surface (<NUM>) and configured to retain compression member (<NUM>) in a plurality of locked positions. Each detent feature (<NUM>) has an arcuate radius (<NUM>) configured to retain different sized elongate members (<NUM>, <NUM>) in the locked position by retaining compression elements (<NUM>) (<FIG>). Compression element (<NUM>) in the present example are in the form of balls. Detent features (<NUM>) require the operator to apply additional longitudinal force to transition compression element (<NUM>) from the locked position to the unlocked position or vice-versa. This additional longitudinal force provides tactile feedback to the operator. This feedback aids the operator in distinguishing whether compression element (<NUM>) has been retained by detent feature (<NUM>). Additionally, the detent features (<NUM>) prevent compression member (<NUM>) from inadvertently slipping longitudinally, thereby helping maintain the locked state.

<FIG> show guidewire actuation mechanism (<NUM>) in the unlocked position. It is to be noted that in <FIG> resilient gripping member (<NUM>) in an expanded state. In the present example, guidewire actuation mechanism (<NUM>) is configured to accommodate elongate members (<NUM>, <NUM>) (<FIG>) or other instruments having a diameter up to approximately <NUM> millimeters. This maximum diameter is governed by the diameter of resilient gripping member (<NUM>) (<FIG>) through bore (<NUM>) (<FIG>) when resilient gripping member (<NUM>) is in expanded state. Of course, <NUM> millimeters is just one merely illustrative example. Guidewire actuation mechanism (<NUM>) may alternatively be configured to accommodate elongate members (<NUM>, <NUM>) (<FIG>) or other instruments up to any other suitable maximum diameter.

<FIG> shows guidewire actuation mechanism (<NUM>) in the locked state. It is to be noted that resilient gripping member (<NUM>) is in a distorted state and resilient gripping member (<NUM>) is distorted towards longitudinal axis (A1). In the locked state the minimum diameter elongate member (<NUM>) that may be fitted is <NUM> millimeters. Minimum diameter is governed by resilient gripping member through bore (<NUM>) (when the resilient gripping member is in distorted state. Of course, <NUM> millimeters is just one merely illustrative example. Guidewire actuation mechanism (<NUM>) may alternatively be configured to accommodate elongate members (<NUM>, <NUM>) or other instruments down to any other suitable minimum diameter.

<FIG> shows guidewire actuation mechanism (<NUM>) transitioning spin actuator (<NUM>) from the locked position to the unlocked position. Compression member (<NUM>) is translated proximally along the longitudinal axis (A1) to unlock elongate member (<NUM>). Resilient gripping member (<NUM>) is biased to restore resilient gripping member (<NUM>) to an expanded state. Resilient gripping member (<NUM>) in the expanded state has generally cylindrical configuration. Resilient gripping member (<NUM>) moves radially away from elongate member (<NUM>) and thereby permits translation of elongate member (<NUM>) through guidewire actuation mechanism (<NUM>) when guidewire actuation mechanism (<NUM>) is in the unlocked state. A gripping member through bore (<NUM>) conforms to the size of first and second through bores (<NUM>, <NUM>) when resilient gripping member (<NUM>) in the unlocked position. In the unlocked state, resilient gripping member (<NUM>) is defined by second counterbore (<NUM>) of hollow shaft (<NUM>), gripping member through bore (<NUM>). Elongate member (<NUM>) may be freely translated through guidewire actuation mechanism (<NUM>).

<FIG> shows guidewire actuation mechanism (<NUM>) transitioning the spin actuator (<NUM>) from the unlocked position to the locked position. Compression member (<NUM>) is distally translated along longitudinal axis (A1) to the locked position. When compression member (<NUM>) is translated distally, conical inner surface (<NUM>) of compression member (<NUM>) urges compression elements (<NUM>) radially inwardly toward elongate member (<NUM>). Compression element (<NUM>) urges resilient gripping member (<NUM>) radially inwardly, elastically deforming resilient gripping member (<NUM>), causing resilient gripping member (<NUM>) to bear inwardly against elongate member (<NUM>), and locking elongate member (<NUM>) through friction. Detent features (<NUM>) on conical inner surface (<NUM>) hold compression elements (<NUM>) in the locked position on different sized elongate members (<NUM>, <NUM>) (<FIG>).

<FIG> shows guidewire actuation mechanism (<NUM>) fitted with a different elongate member (<NUM>) having a diameter that is larger than the diameter of elongate member (<NUM>). By way of example only, elongate member (<NUM>) may comprise a guidewire while elongate member (<NUM>) comprises a dilation catheter, suction cannula, endoscope, etc. In the example of <FIG>, elongate member (<NUM>) is disposed in bores (<NUM>, <NUM>, <NUM>) of guidewire actuation mechanism (<NUM>). <FIG> shows guidewire actuation mechanism (<NUM>) transitioning from the locked position to the unlocked position. <FIG> shows guidewire actuation mechanism (<NUM>) transitioning from the unlocked position to the locked position.

In the locked position, compression members (<NUM>) distally translates along longitudinal axis (A1). When compression member (<NUM>) is translated distally conical inner surface (<NUM>) of compression member (<NUM>) urges compression elements (<NUM>) radially inwardly toward guidewire (<NUM>, <NUM>). Compression element (<NUM>) urges resilient gripping member (<NUM>) radially inwardly, elastically deforming resilient gripping member (<NUM>) causing resilient gripping member (<NUM>) to bear inwardly against guidewire (<NUM>, <NUM>) and lock guidewire (<NUM>, <NUM>) through friction. Detent features (<NUM>) on conical inner surface (<NUM>) hold compression elements (<NUM>) in the locked position with different sized elongate members (<NUM>, <NUM>). It should be noted that compression member (<NUM>) will not be distally translated as far as compression member (<NUM>) when a larger elongate member (<NUM>) is fitted. Therefore, on larger elongate member (<NUM>), compression elements (<NUM>) will engage more distally located detent feature (<NUM>) than when fitted with a smaller elongate member (<NUM>).

<FIG> show another example of a guidewire actuation mechanism (<NUM>) that is substantially similar to guidewire actuation mechanism (<NUM>) described above. In the present example, guidewire actuation mechanism (<NUM>) includes an engagement member (<NUM>), a hollow shaft (<NUM>), a resilient gripping member (<NUM>), a compression element (<NUM>), and a compression member (<NUM>). Guidewire actuation mechanism (<NUM>) is also configured to lock and unlock upon different diameter elongate members (<NUM>, <NUM>). In the present example, hollow shaft (<NUM>) differs from hollow shaft (<NUM>) in that hollow shaft (<NUM>) has an integrated compression element (<NUM>) where compression element (<NUM>) is separate from hollow shaft (<NUM>). Hollow shaft (<NUM>) includes a plurality of compression elements (<NUM>) in the form of a flexible arm (<NUM>). Each flexible arm (<NUM>) has a flexible arm body (<NUM>) which extends distally from a base end of flexible arm (<NUM>) to an arcuate projection (<NUM>). The base end of each flexible arm (<NUM>) is integrally attached to hollow shaft (<NUM>). Each flexible arm (<NUM>) has an arcuate projection (<NUM>) located distally from base end of flexible arm (<NUM>). Each arcuate projection (<NUM>) is configured to engage conical inner surface (<NUM>) when compression member (<NUM>) is translated distally. Compression member (<NUM>) also has a conical inner surface (<NUM>) similar to conical inner surface (<NUM>). Conical inner surface (<NUM>) also has a plurality of detent features (<NUM>). Arcuate projections (<NUM>) are configured to be retained by plurality of detent features (<NUM>). Arcuate projections (<NUM>) perform similarly to compression elements (<NUM>). However, flexible arms (<NUM>), similar to resilient gripping member (<NUM>), are resiliently biased to an expanded state of rest.

<FIG> shows guidewire actuation mechanism (<NUM>) in the unlocked position. When in the unlocked position, flexible arms (<NUM>) resiliently return radially outwardly to straight configurations, and resilient gripping member (<NUM>) being biased to an expanded state. Resilient gripping member (<NUM>) in the expanded state has a larger diameter gripping member bore (<NUM>).

<FIG> shows guidewire actuation mechanism (<NUM>) in the locked position. When in the locked position, flexible arms (<NUM>) deform radially inwardly, engaging resilient gripping member (<NUM>) in response to being engaged by conical inner surface (<NUM>); and thereby deform resilient gripping member (<NUM>) to reduce the effective inner diameter of gripping member bore (<NUM>), thereby gripping elongate member (<NUM>).

While guidewire actuation mechanism (<NUM>, <NUM>) have been described above as selectively gripping, rotating, and translating a guidewire (<NUM>, <NUM>), it should be understood that guidewire actuation mechanism (<NUM>, <NUM>) may alternatively be used to selectively grip, rotate, and translate virtually any flexible instrument. Merely illustrative examples of flexible instruments or other elongate members (<NUM>, <NUM>) that may be used in combination with guidewire actuation mechanism in place of guidewire (<NUM>) include, but are not limited to, RF ablation catheters, balloon dilation catheters, biopsy instruments, and other flexible instruments. Other examples of flexible instruments or other elongate members (<NUM>, <NUM>) that may be used in combination with guidewire actuation mechanism (<NUM>, <NUM>) in place of guidewire (<NUM>) will be apparent to those skilled in the art in view of the teachings herein.

<FIG> show still another example of guidewire actuation mechanism (<NUM>) that is substantially similar to guidewire actuation mechanism (<NUM>) discussed above except as otherwise explicitly noted herein. Like guidewire actuation mechanism (<NUM>), guidewire actuation mechanism (<NUM>) is suitable for use with dilation instrument (<NUM>) (<FIG>) in place of spin actuator (<NUM>) (<FIG>) and collet collar (<NUM>) (<FIG>). Though not shown, it will be appreciated that spin actuator (<NUM>) may be incorporated within a guidewire actuation assembly (not shown) having a slidable support structure similar to slide actuator (<NUM>) (<FIG>) described above, to which guidewire actuation mechanism (<NUM>) is rotatably mounted.

As described above, guidewire actuation mechanism (<NUM>) fixes elongate member (<NUM>) relative to guidewire actuation mechanism (<NUM>) by translating compression member (<NUM>) longitudinally, which causes resilient gripping member to frictionally engage elongate member (<NUM>). Guidewire actuation mechanism (<NUM>), like guidewire actuation mechanism (<NUM>), is also configured to fix elongate member (<NUM>) relative to guidewire actuation mechanism (<NUM>). However, unlike guidewire actuation mechanism (<NUM>), which utilizes longitudinal movement to fix elongate member (<NUM>), guidewire actuation mechanism (<NUM>) of this example fixes elongate member (<NUM>) by utilizing rotational movement about a longitudinal axis (A1), as described in greater detail below.

Guidewire actuation mechanism (<NUM>) includes a first coupling member (<NUM>), a second coupling member (<NUM>), and a compressible body (<NUM>) arranged between confronting ends of first and second coupling members (<NUM>, <NUM>) along a longitudinal axis (A1) of assembly (<NUM>). As described in greater detail below, first and second coupling members (<NUM>, <NUM>) are configured to threadedly couple together via relative rotation about longitudinal axis (A1) to compress compressible body (<NUM>) radially inwardly to frictionally engage elongate member (<NUM>). Upon reaching a sufficiently compressed state in response to relative rotation between coupling members (<NUM>, <NUM>), compressible body (<NUM>) fixes elongate member (<NUM>) axially and rotationally relative to guidewire actuation mechanism (<NUM>).

As shown best in <FIG>, first coupling member (<NUM>) of the present example includes a generally tubular body (<NUM>) having a proximal end (<NUM>), a distal end (<NUM>), and a first through bore (<NUM>) that extends along longitudinal axis (A1) (<FIG>) between proximal and distal ends (<NUM>, <NUM>). Tubular body (<NUM>) of first coupling member (<NUM>) includes a collar (<NUM>) arranged at proximal end (<NUM>), a first proximal shaft portion (<NUM>) extending distally from collar (<NUM>), and a first distal shaft portion (<NUM>) extending distally from first proximal shaft portion (<NUM>). First distal shaft portion (<NUM>) has a plurality of finger engagement projections (<NUM>) arranged radially on the exterior of first distal shaft portion (<NUM>), and which are configured to be engaged by a user. Distal end (<NUM>) of first coupling member (<NUM>) includes a first threaded portion (<NUM>) configured to threadedly engage a second threaded portion (<NUM>) (<FIG>) of second coupling member (<NUM>) (<FIG>), as described in greater detail below. In the present version, first threaded portion (<NUM>) includes external right-hand threads. However, it will be appreciated that first threaded portion (<NUM>) may include left-hand threads and/or internal threads in other versions, provided that first threaded portion (<NUM>) is configured to threadedly engage second threaded portion (<NUM>). In some other variations, coupling members (<NUM>, <NUM>) are coupled together via a bayonet fitting instead of via threaded portions (<NUM>, <NUM>). Various suitable ways in which threaded portions (<NUM>, <NUM>) may be substituted with complementary bayonet fitting portions will be apparent to those skilled in the art in view of the teachings herein.

Distal end (<NUM>) of first coupling member (<NUM>) defines a first counterbore (<NUM>) in communication with first through bore (<NUM>). First counterbore (<NUM>) has a diameter that is larger than a diameter of first through bore (<NUM>). A conical shaped surface (<NUM>) is positioned at a proximal end of first counterbore (<NUM>) and tapers proximally from a larger first diameter (<NUM>) to a smaller second diameter (<NUM>). As described in greater detail below, conical shaped surface (<NUM>) is configured to cooperate with a cylindrical projection (<NUM>) (<FIG>) of second coupling member (<NUM>) (<FIG>) to axially compress compressible body (<NUM>) therebetween and thereby deform the compressible body radially inwardly against elongate member (<NUM>) (<FIG>).

As shown best in <FIG>, second coupling member (<NUM>) of the present example includes a generally tubular body (<NUM>) having a proximal end (<NUM>), a distal end (<NUM>), and a second through bore (<NUM>) extending axially along longitudinal axis (A1) (<FIG>) between proximal and distal ends (<NUM>, <NUM>). Second coupling member (<NUM>) includes a second proximal shaft portion (<NUM>) and a second distal shaft portion (<NUM>). Second proximal shaft portion (<NUM>) is larger in diameter relative to second distal shaft portion (<NUM>). Second proximal shaft portion (<NUM>) has a plurality of finger engagement projections (<NUM>) arranged radially on the exterior of second proximal shaft portion (<NUM>), and which are configured to be engaged by a user. Proximal end (<NUM>) of second coupling member (<NUM>) further includes a second counterbore (<NUM>). An inner wall defining second counterbore (<NUM>) has a second threaded portion (<NUM>) configured to threadedly engage first threaded portion (<NUM>) of first coupling member (<NUM>) when coupling members (<NUM>, <NUM>) are rotated relative to one another. In the present version, second threaded portion (<NUM>) includes internal right-hand threads. However, it will be appreciated that second threaded portion (<NUM>) may include left-hand threads and/or right-hand internal threads in other versions, provided that second threaded portion (<NUM>) is configured to threadedly engage first threaded portion (<NUM>). Proximal end (<NUM>) of second coupling member (<NUM>) further includes a cylindrical projection (<NUM>) extending proximally from a distal base surface of second counterbore (<NUM>), and which defines a proximal end of second through bore (<NUM>).

As shown best in <FIG>, compressible body (<NUM>) of the present example has a generally annular shape. Additionally, compressible body (<NUM>) may be composed of an elastomeric material that enables it to resiliently transition between a radially expanded, uncompressed state and a radially compressed state, such as a rubber or rubber-like material. As shown in <FIG>, compressible body (<NUM>) is positioned in first counterbore (<NUM>) of first coupling member (<NUM>), against conical shaped surface (<NUM>). Compressible body (<NUM>) of the present example defines a bore (<NUM>) configured to coaxially align along longitudinal axis (A1) with first through bore (<NUM>) and second through bore (<NUM>) to receive elongate member (<NUM>) axially through bore (<NUM>) of compressible body (<NUM>).

As shown in <FIG>, compressible body (<NUM>) is resiliently biased towards the radially expanded state in which elongate member (<NUM>) is freely translatable through first coupling member (<NUM>), second coupling member (<NUM>), and compressible body (<NUM>). As shown in <FIG>, compressible body (<NUM>) is configured to compress radially inwardly in response to relative rotation between first and second coupling members (<NUM>, <NUM>) so that bore (<NUM>) closes around elongate member (<NUM>). As described below, this radial compression causes compressible body (<NUM>) to frictionally engage elongate member (<NUM>) and thereby fix elongate member (<NUM>) axially and rotationally relative to first and second coupling members (<NUM>, <NUM>).

<FIG> shows guidewire actuation mechanism (<NUM>) in an exemplary unlocked state in which first threaded portion (<NUM>) of first coupling member (<NUM>) is at least partially de-threaded from second threaded portion (<NUM>) of second coupling member (<NUM>). In the unlocked state, the compressible body (<NUM>) is in the uncompressed state such that bore (<NUM>) is enlarged about elongate member (<NUM>), thereby permitting elongate member (<NUM>) to freely translate axially through guidewire actuation mechanism (<NUM>). While <FIG> shows an axial gap between compressible body (<NUM>) and conical shaped surface (<NUM>) when guidewire actuator assembly (<NUM>) is in the unlocked state, it will be appreciated that compressible body (<NUM>) may be in positioned in direct contact with conical shaped surface (<NUM>) while remaining uncompressed.

<FIG> shows guidewire actuation mechanism (<NUM>) in a locked state in which first and second coupling members (<NUM>, <NUM>) have compressed compressible body (<NUM>) axially so that compressible body (<NUM>) has elastically deformed radially inwardly to frictionally engage (or "grip") elongate member (<NUM>). Transitioning guidewire actuation mechanism (<NUM>) from the unlocked state shown in <FIG> to the locked state shown in <FIG> is achieved by providing relative rotation between first and second coupling members (<NUM>, <NUM>) so that first and second threaded portions (<NUM>, <NUM>) fully engage and drive coupling members (<NUM>, <NUM>) axially toward one another. In response to this threaded engagement of first and second threaded portions (<NUM>, <NUM>), cylindrical projection (<NUM>) of second coupling member (<NUM>) compresses compressible body (<NUM>) axially against conical shaped surface (<NUM>) of first coupling member (<NUM>). As cylindrical projection (<NUM>) advances closer to conical shaped surface (<NUM>), conical shaped surface (<NUM>) exerts a progressively increasing inward radial force on the outer diameter of compressible body (<NUM>), thus causing compressible body (<NUM>) to deform radially inwardly about elongate member (<NUM>). Continued threaded engagement of coupling members (<NUM>, <NUM>) with one another causes compressible body (<NUM>) to compress radially inwardly to the point that it frictionally engages and thereby fixes elongate member (<NUM>) axially and rotationally relative to first and second coupling members (<NUM>, <NUM>).

It will be appreciated that guidewire actuation assembly (<NUM>) may be returned to the unlocked state from the locked state by rotationally dethreading first and second coupling members (<NUM>, <NUM>) from each other. As used herein, the term "dethreading" should not be read as requiring coupling members (<NUM>, <NUM>) to be completely decoupled from each other. Instead, the term should be read to include the transition from the state shown in <FIG> to the state shown in <FIG>, where coupling members (<NUM>, <NUM>) remain coupled together yet no longer cooperate to compress compressible body (<NUM>) onto elongate member (<NUM>).

The relative rotation between first and second coupling members (<NUM>, <NUM>) for transitioning between the unlocked state (<FIG>) and the locked state (<FIG>) can be achieved by rotating one coupling member (<NUM>, <NUM>) while the opposing coupling member (<NUM>, <NUM>) remains stationary. In other versions, both coupling members (<NUM>, <NUM>) can be rotated relative to one another, in opposite directions. In either case, it will be understood that guidewire actuation assembly (<NUM>) is suitably mounted to a support structure, which may be similar to slide actuator (<NUM>) (<FIG>) as described above, such that both coupling members (<NUM>, <NUM>) are rotatable relative to the support structure, and such that at least one of coupling members (<NUM>, <NUM>) is translatable relative to the support structure. Such a configuration permits rotation of coupling members (<NUM>, <NUM>) relative to one another and relative to the support structure, as well as axial advancement and separation of coupling members (<NUM>, <NUM>) during rotational threading and dethreading of threaded portions (<NUM>, <NUM>) as described above. In some versions, first coupling member (<NUM>) may be rotatably and translatably mounted to a first end portion of the support structure (not shown) along first proximal shaft portion (<NUM>), and second coupling member (<NUM>) may be rotatably mounted to a second end portion of the support structure (not shown) at second distal shaft portion (<NUM>).

As described above, compressible body (<NUM>) of the exemplary version shown is compressed between a cylindrical projection (<NUM>) and a conical shaped surface (<NUM>). In other versions, various other suitable structures readily apparent to those of ordinary skill in the art may be implemented to compress compressible body (<NUM>). For instance, first and second coupling members (<NUM>, <NUM>) may include two opposed projections (<NUM>), or two opposed conical shaped surfaces (<NUM>).

While guidewire actuation mechanism (<NUM>) has been described above as selectively gripping, rotating, and translating an elongate member (<NUM>), it should be understood that guidewire actuation mechanism (<NUM>) may alternatively be used to selectively grip, rotate, and translate virtually any flexible instrument. Merely illustrative examples of flexible instruments or other elongate members (<NUM>, <NUM>) that may be used in combination with guidewire actuation mechanism (<NUM>) in place of guidewire (<NUM>) include, but are not limited to, RF ablation catheters, balloon dilation catheters, biopsy instruments, and other flexible instruments. Other examples of flexible instruments or other elongate members (<NUM>, <NUM>) that may be used in combination with guidewire actuation mechanism (<NUM>) in place of guidewire (<NUM>) will be apparent to those skilled in the art in view of the teachings herein.

<FIG> shows yet another exemplary alternative guidewire actuation mechanism (<NUM>) fitted within a guidewire actuation assembly (<NUM>). This exemplary alternative guidewire actuation mechanism (<NUM>) is substantially similar to guidewire actuation mechanism (<NUM>) (<FIG>) discussed above except as otherwise explicitly noted herein. Like guidewire actuation mechanism (<NUM>) (<FIG>), guidewire actuation mechanism (<NUM>) may be incorporated into dilation instrument (<NUM>) (<FIG>) in place of spin actuator (<NUM>) (<FIG>) and collet collar (<NUM>) (<FIG>). Both guidewire actuation mechanism (<NUM>) and guidewire actuation mechanism (<NUM>) have a resilient member (<NUM>, <NUM>) that grips elongate member (<NUM>). Guidewire actuation mechanism (<NUM>) grips elongate member (<NUM>) by exerting force on compressible body (<NUM>). In contrast, guidewire actuation mechanism (<NUM>) of the present example grips elongate member (<NUM>) by releasing force on a gripping member (<NUM>), discussed further below.

Guidewire actuation assembly (<NUM>) of this example comprises a slide actuator (<NUM>) and a guidewire actuation mechanism (<NUM>). Slide actuator (<NUM>) is configured to slidably couple with handle assembly (<NUM>) and thereby translate elongate member (<NUM>) longitudinally relative to handle assembly (<NUM>). Guidewire actuation mechanism (<NUM>) is operable to selectively grip elongate member (<NUM>) and rotate elongate member (<NUM>) about the longitudinal axis of elongate member (<NUM>).

Slide actuator (<NUM>) of the present example includes a grip feature (<NUM>), a first yoke (<NUM>), and a second yoke (<NUM>). In some versions, grip feature (<NUM>) and first yoke (<NUM>) are at the distal end of guidewire actuation assembly (<NUM>) while second yoke (<NUM>) is at the proximal end of guidewire actuation assembly (<NUM>). In some other versions, grip feature (<NUM>), and first yoke (<NUM>) are at the proximal end of guidewire actuation assembly (<NUM>) while second yoke (<NUM>) is at the distal end of guidewire actuation assembly (<NUM>). Slide actuator (<NUM>) is slidably coupled with handle assembly (<NUM>) and is thereby operable to translate guidewire actuation mechanism (<NUM>) and elongate member (<NUM>) longitudinally relative to handle assembly (<NUM>). Grip feature (<NUM>) is configured to facilitate engagement between an operator's thumb or finger and slide actuator (<NUM>).

As shown in <FIG>, guidewire actuation mechanism (<NUM>) comprises a first member (<NUM>), a second member (<NUM>), gripping member (<NUM>), a retainer (<NUM>), and a coil spring (<NUM>), all of which are coaxially aligned with each other. In some versions, first member (<NUM>) is positioned distally relative to second member (<NUM>). In some other versions, first member (<NUM>) is positioned proximally relative to second member (<NUM>). In the present example, first and second members (<NUM>, <NUM>) are configured to rotate together unitarily; while first and second members (<NUM>, <NUM>) are configured to translate longitudinally relative to each other. In some versions, guidewire actuation assembly (<NUM>) is configured to enable first member (<NUM>) to translate longitudinally while holding second member (<NUM>) longitudinally stationary. In some other versions, guidewire actuation assembly (<NUM>) is configured to enable second member (<NUM>) to translate longitudinally while holding first member (<NUM>) longitudinally stationary.

As shown in <FIG>, first member (<NUM>) includes a mount member (<NUM>), a pair of latch arms (<NUM>), a pair of keyways (<NUM>), and a pair of retainer recesses (<NUM>). As best shown in <FIG>, gripping member (<NUM>) comprises a cylindraceous body (<NUM>) that defines a central bore (<NUM>) and frusto-conical lead-in surface (<NUM>) that leads into central bore (<NUM>). Gripping member (<NUM>) of the present example is formed of an elastomeric material (e.g., silicone, rubber, etc.) and is resiliently biased to assume a configuration where central bore (<NUM>) has a diameter that is less than the outer diameter of elongate member (<NUM>). Thus, gripping member (<NUM>) is resiliently biased to assume a configuration where gripping member (<NUM>) will grip an elongate member (<NUM>) that is disposed in central bore (<NUM>). However, as will be described in greater detail below, gripping member (<NUM>) may be compressed longitudinally, which will effectively enlarge the diameter of central bore (<NUM>), which will allow gripping member (<NUM>) to release an elongate member (<NUM>) that is disposed in central bore (<NUM>).

Gripping member (<NUM>) is positioned in second bore region (<NUM>). Gripping member (<NUM>) is slightly press-fit into second bore region (<NUM>), such that the outer sidewall of gripping member (<NUM>) bears against splined surface (<NUM>). The configuration of splined surface (<NUM>) and gripping member (<NUM>), as well as the elastomeric properties of gripping member (<NUM>), prevent gripping member (<NUM>) from rotating within second bore region (<NUM>).

Retainer (<NUM>) is configured to fit against first shoulder surface (<NUM>) and an end of gripping member (<NUM>), such that gripping member (<NUM>) is longitudinally captured between retainer (<NUM>) and second shoulder surface (<NUM>). Retainer (<NUM>) includes a pair of outwardly extending tabs (<NUM>) (<FIG>), which are angularly spaced <NUM> degrees apart from each other and are configured to fit in retainer recesses (<NUM>) of first member (<NUM>). Tabs (<NUM>) (<FIG>) and retainer recesses (<NUM>) thus cooperate to retain retainer (<NUM>) in first member (<NUM>).

First member (<NUM>) defines a first bore region (<NUM>), a second bore region (<NUM>), and a third bore region (<NUM>). Second bore region (<NUM>) has a diameter that is larger than the diameter of first bore region (<NUM>); and third bore region (<NUM>) has a diameter that is larger than the diameter of second bore region (<NUM>). The interior of first member (<NUM>) further includes a first shoulder surface (<NUM>), a second shoulder surface (<NUM>), and an inner splined surface (<NUM>) extending longitudinally between shoulder surfaces (<NUM>, <NUM>) along second bore region (<NUM>). Latch arms (<NUM>), keyways (<NUM>), and retainer recesses (<NUM>) are positioned along third bore region (<NUM>).

Mount member (<NUM>) of the present example is cylindraceous and is configured to slidably fit in first yoke (<NUM>) (<FIG>). First yoke (<NUM>) (<FIG>) is configured to support first member (<NUM>) via mount member (<NUM>) while still permitting guidewire actuation mechanism (<NUM>) to rotate relative to slide actuator (<NUM>). In some versions, first yoke (<NUM>) (<FIG>) also allows first member (<NUM>) to translate longitudinally relative to first yoke (<NUM>), as will be described in greater detail below. Mount member (<NUM>) (<FIG>) is longitudinally positioned to correspond with first bore region (<NUM>).

As shown in <FIG>, second member (<NUM>) comprises an annular recess (<NUM>), an annular flange (<NUM>) adjacent to annular recess (<NUM>), pair of longitudinally extending keys (<NUM>), a pair of latch bosses (<NUM>), and a plunger feature (<NUM>). A central bore (<NUM>) extends along the full length of second member (<NUM>) and is configured to align with bore regions (<NUM>, <NUM>, <NUM>) (<FIG>) of first member (<NUM>). Annular recess (<NUM>) is configured for receipt in second yoke (<NUM>) (<FIG>). Second yoke (<NUM>) (<FIG>) is configured to support second member (<NUM>) via annular recess (<NUM>) while still permitting guidewire actuation mechanism (<NUM>) (<FIG>) to rotate relative to slide actuator (<NUM>) (<FIG>). In some versions, second yoke (<NUM>) and annular recess (<NUM>) are configured to allow second member (<NUM>) to translate longitudinally relative to second yoke (<NUM>), as will be described in greater detail below. In such versions, annular flange (<NUM>) may nevertheless restrict translation of second member (<NUM>) relative to second yoke (<NUM>). In some other versions, second yoke (<NUM>) and annular recess (<NUM>) are configured to prevent second member (<NUM>) from translating longitudinally relative to second yoke (<NUM>). In such versions, first member (<NUM>) is operable to translate longitudinally relative to first yoke (<NUM>).

Keys (<NUM>) of second member (<NUM>) are angularly spaced <NUM> degrees apart from each other and are configured to slidably fit within corresponding keyways (<NUM>) (<FIG>) of first member (<NUM>) (<FIG>). Keys (<NUM>) and keyways (<NUM>) (<FIG>) cooperate to prevent first and second members (<NUM>, <NUM>) (<FIG>) from rotating relative to each other; while allowing first and second members (<NUM>, <NUM>) to translate relative to each other. Latch bosses (<NUM>) of second member (<NUM>) are angularly spaced <NUM> degrees apart from each other and are configured to engage corresponding latch arms (<NUM>) (<FIG>) of first member (<NUM>). Latch bosses (<NUM>) are configured to cooperate with latch arms (<NUM>) to restrict translation of second member (<NUM>) relative to first member (<NUM>), thereby preventing inadvertent separation of second member (<NUM>) from first member (<NUM>). Coil spring (<NUM>) is configured to fit in third bore region (<NUM>) and resiliently bias first and second members (<NUM>, <NUM>) longitudinally away from each other.

<FIG> show guidewire actuation mechanism (<NUM>) transitioning between a locked state (<FIG>), in which gripping member (<NUM>) firmly grips elongate member (<NUM>); and an unlocked state (<FIG>), in which gripping member (<NUM>) releases elongate member (<NUM>). As shown in <FIG>, gripping member (<NUM>) is in a non-compressed state such that gripping member (<NUM>) maintains a firm grip on elongate member (<NUM>). Thus, as guidewire actuation mechanism (<NUM>) is translated along the longitudinal axis of elongate member (<NUM>), guidewire actuation mechanism (<NUM>) will drive elongate member (<NUM>) to translate along the longitudinal axis of elongate member (<NUM>). Similarly, as guidewire actuation mechanism (<NUM>) is rotated about the longitudinal axis of elongate member (<NUM>), guidewire actuation mechanism (<NUM>) will drive elongate member (<NUM>) to rotate about the longitudinal axis of elongate member (<NUM>).

<FIG> shows guidewire actuation mechanism (<NUM>) being transitioned to the unlocked state by second member (<NUM>) translating longitudinally while first member (<NUM>) remains longitudinally stationary. As noted above, in some other versions, guidewire actuation mechanism (<NUM>) may transition to the unlocked state by first member (<NUM>) translating longitudinally while second member (<NUM>) remains longitudinally stationary. In either case, when guidewire actuation mechanism (<NUM>) is in the unlocked state, plunger feature (<NUM>) bears against gripping member (<NUM>) and thereby compresses gripping member (<NUM>) against second shoulder surface (<NUM>). This compression of gripping member (<NUM>) enlarges the diameter of central bore (<NUM>), thereby causing gripping member (<NUM>) to release its grip on elongate member (<NUM>). <FIG> shows gripping member (<NUM>) defining a gap around elongate member (<NUM>). In some other versions, a compressed gripping member (<NUM>) may otherwise effectively release its grip on elongate member (<NUM>) without necessarily defining a gap around elongate member (<NUM>). In either case, with elongate member (<NUM>) released from gripping member (<NUM>), the operator may pull elongate member (<NUM>) from guidewire actuation mechanism (<NUM>) or otherwise adjust the longitudinal position of elongate member (<NUM>) relative to guidewire actuation mechanism (<NUM>).

By way of example only, after achieving the unlocked state shown in <FIG>, the operator may wish to remove a first kind of elongate member (<NUM>) (e.g., an illuminating guidewire) and replace it with a second kind of elongate member (<NUM>) (e.g., a guidewire with a position sensor that cooperates with an IGS system). Once the operator has replaced the elongate member (<NUM>) or otherwise adjusted the longitudinal position of elongate member (<NUM>) relative to guidewire actuation mechanism (<NUM>), the operator may release second member (<NUM>) (or release first member (<NUM>) in cases where the operator translated first member (<NUM>) relative to second member (<NUM>). The resilience of coil spring (<NUM>) will return first and second members (<NUM>, <NUM>) back to the relationship shown in <FIG>, such that plunger (<NUM>) no longer compresses gripping member (<NUM>). With gripping member (<NUM>) no longer being compressed, central bore (<NUM>) returns to its natural state with a smaller diameter, such that gripping member (<NUM>) will again grip elongate member (<NUM>) after compression from plunger (<NUM>) is removed. With guidewire actuation mechanism (<NUM>) back in the locked state of <FIG>, the operator may again manipulate guidewire actuation assembly (<NUM>) to translate elongate member (<NUM>) along the longitudinal axis of elongate member (<NUM>) and rotate elongate member (<NUM>) about the longitudinal axis of elongate member (<NUM>).

While the foregoing example describes guidewire actuation assembly (<NUM>) as selectively gripping, translating, and rotating elongate member (<NUM>) in the form of a guidewire (<NUM>), a similar configuration may be used to selectively grip, translate, and rotate other kinds of devices. By way of example only, guidewire actuation assembly (<NUM>) may be varied to accommodate an endoscope or other elongate instrument as will be apparent to those skilled in the art in view of the teachings herein.

While various examples described herein are provided in the context of instrumentation that is sized to pass through a paranasal sinus ostium, it should be understood that this is just a merely illustrative example. The teachings herein may be readily applied in the context of instrumentation that is positioned anywhere within a patient's head; or elsewhere within a patient's anatomy. Other examples of anatomical structures that may be reached by instrumentation configured in accordance with the teachings herein include, but are not limited to, cranial nerves, vidian nerves, etc. Still other examples of anatomical structures that may be reached by instrumentation configured in accordance with the teachings herein will be apparent to those skilled in the art in view of the teachings herein.

The following examples relate to various non-exhaustive ways in which the teachings herein may be combined or applied. It should be understood that the following examples are not intended to restrict the coverage of any claims that may be presented at any time in this application or in subsequent filings of this application. No disclaimer is intended. The following examples are being provided for nothing more than merely illustrative purposes. It is contemplated that the various teachings herein may be arranged and applied in numerous other ways. It is also contemplated that some variations may omit certain features referred to in the below examples. Therefore, none of the aspects or features referred to below should be deemed critical unless otherwise explicitly indicated as such at a later date by the inventors or by a successor in interest to the inventors. If any claims are presented in this application or in subsequent filings related to this application that include additional features beyond those referred to below, those additional features shall not be presumed to have been added for any reason relating to patentability.

An apparatus for use with an elongate member, the apparatus comprising: (a) an engagement member; (b) a hollow shaft extending from the engagement member along a longitudinal axis; (c) a compression element supported by the hollow shaft, wherein the compression element is radially movable relative to the hollow shaft; (d) a resilient gripping member disposed within the hollow shaft, wherein the resilient gripping member is configured to slidably receive the elongate member therethrough along the longitudinal axis, wherein the compression element is positioned to confront a radially outer surface of the resilient gripping member; and (e) a compression member slidably disposed over the hollow shaft, includes an inner surface configured to engage the compression element as the compression member advances from the unlocked position toward the locked position, wherein the inner surface has a plurality of detent features configured to engage the compression element in the locked position with different sized elongate members, wherein the compression member is operable to selectively translate longitudinally along the hollow shaft between a locked position and an unlocked position, wherein in the locked position the compression member is configured to urge the compression element radially against the resilient gripping member such that the resilient gripping member deforms radially inwardly to grip the elongate member and thereby prohibit translation of the elongate member through the apparatus, wherein in the unlocked position the compression member is configured to permit the compression element and the resilient gripping member to move radially away from the elongate member and thereby permit translation of the elongate member through the apparatus.

The apparatus of Example <NUM>, wherein the resilient gripping member is configured to secure the elongate member axially and rotationally relative to the apparatus when the compression member is in the locked position, wherein the resilient gripping member is configured to permit the elongate member to freely translate and rotate therethrough when the compression member is in the unlocked position.

The apparatus of Example <NUM>, wherein the engagement member, the hollow shaft, the compression element, the resilient gripping member, and the compression member are configured to rotate together about the longitudinal axis.

The apparatus of any one or more of Examples <NUM> through <NUM>, wherein the compression element is configured to overlie the resilient gripping member in the locked position.

The apparatus of Example <NUM>, wherein the compression element comprises a ball, wherein a sidewall of the hollow shaft includes an aperture that movably receives the ball therein.

The apparatus of Example <NUM>, wherein the compression element comprises a flexible arm, wherein a base end of the flexible arm is fixed relative to the hollow shaft.

The apparatus of any one or more of Examples <NUM> through <NUM>, wherein the compression member comprises a plurality of compression members arranged circumferentially about the hollow shaft.

The apparatus of Example <NUM>, wherein the hollow shaft includes the flexible arm.

The apparatus of Example <NUM>, wherein the flexible arm includes an arcuate projection configured to engage one of the detent features.

The apparatus of any one or more of the Examples <NUM> through <NUM>, further comprising a support structure having a first end portion and a second end portion, wherein the first end portion supports a first end of a first coupling member, wherein the second end portion supports the second end of the second coupling member.

An instrument comprising: (a) a handle assembly; and (b) the apparatus of Example <NUM>, wherein the support structure is slidably coupled to the handle assembly.

The instrument of Example <NUM>, further comprising a guide catheter extending distally from the handle assembly.

The instrument of Example <NUM>, further comprising a dilation catheter slidably disposed relative to the guide catheter.

The instrument of Example <NUM>, further comprising an elongate member slidably disposed within one or both of the guide catheter or the dilation catheter.

The instrument of Example <NUM>, wherein the elongate member comprises a guidewire.

The instrument of Example <NUM>, wherein the elongate member is sized to pass through a paranasal sinus ostium of a patient.

An apparatus for use with an elongate member, the apparatus comprising: (a) an engagement member; (b) a hollow shaft extending from the engagement member along a longitudinal axis; (c) a compression element supported by the hollow shaft, wherein the compression element is movable radially relative to the hollow shaft; (d) a resilient gripping member disposed within the hollow shaft, wherein the resilient gripping member is configured to slidably receive the elongate member therethrough along the longitudinal axis, wherein the compression element is positioned to confront a radially outer surface of the resilient gripping member; and (e) a collar slidably disposed over the hollow shaft, wherein the collar is operable to selectively translate longitudinally along the hollow shaft between a locked position and an unlocked position, wherein the collar includes a conical inner surface configured to engage the compression element as the collar advances from the unlocked position toward the locked position wherein the conical inner surface has a set of detent features configured to engage the compression element in the locked position with different sized elongate members, wherein in the locked position the collar is configured to urge the compression element radially against the resilient gripping member such that the resilient gripping member deforms radially inwardly to grip the elongate member and thereby prohibit translation of the elongate member through the apparatus, wherein in the unlocked position the collar is configured to permit the compression element and the resilient gripping member to move radially away from the elongate member and thereby permit translation of the elongate member through the apparatus.

The apparatus of Example <NUM>, wherein the compression element is spherical, wherein a sidewall of the hollow shaft includes an aperture that movably receives the compression element therein.

An apparatus for use with an elongate member, the apparatus comprising: (a) an engagement member; (b) a hollow shaft extending from the engagement member along a longitudinal axis, wherein the hollow shaft includes a cantilever arm, wherein the cantilever arm has a base end fixed relative to the hollow shaft; (c) a cantilever arm supported by the hollow shaft, wherein the cantilever arm is movable radially relative to the hollow shaft; (d) a resilient gripping member disposed within the hollow shaft, wherein the resilient gripping member is configured to slidably receive the elongate member therethrough along the longitudinal axis, wherein the compression element is positioned to confront a radially outer surface of the resilient gripping member; and (e) a collar slidably disposed over the hollow shaft, wherein the collar is operable to selectively translate longitudinally along the hollow shaft between a locked position and an unlocked position, wherein the collar includes a conical inner surface configured to engage the compression element as the collar advances from the unlocked position toward the locked position wherein the conical inner surface has a detent feature configured to engage the compression element in the locked position with different sized guidewires, wherein in the locked position the collar urges the compression element radially against the resilient gripping member such that the resilient gripping member deforms radially inwardly to grip the elongate member and thereby prohibit translation of the elongate member through the apparatus, wherein in the unlocked position the collar permits the compression element and the resilient gripping member to move radially away from the elongate member and thereby permit translation of the elongate member through the apparatus.

The apparatus of Example <NUM>, wherein the cantilever arm has an arcuate projection configured to engage the detent feature.

An apparatus for use with a dilation instrument having a flexible instrument, the apparatus comprising: (a) a first coupling member, wherein the first coupling member includes: (i) a first end, (ii) a second end, and (iii) a first through bore extending between the first end and the second end of the first coupling member; (b) a second coupling member configured to releasably couple with the first coupling member, wherein the second coupling member includes: (i) a first end, (ii) a second end, and (iii) a second through bore extending between the first end and the second end of the second coupling member, wherein the first through bore and the second through bore are sized to receive a flexible instrument axially therethrough; and (c) a compressible body disposed in the first coupling member, wherein the compressible body defines a bore configured to align coaxially with the first through bore and the second through bore to receive the flexible instrument axially therethrough, wherein the compressible body is resiliently biased toward an expanded state in which the flexible instrument is freely translatable through the first and second coupling members and the compressible body, wherein the compressible body is configured to compress radially inwardly in response to relative rotation between the first and second coupling members to frictionally engage the flexible instrument and thereby fix the flexible instrument relative to the first and second coupling members.

The apparatus of Example <NUM>, wherein the first coupling member includes a first threaded portion, wherein the second coupling member includes a second threaded portion configured to threadedly engage the first threaded portion when the first coupling member rotates relative to the second coupling member.

The apparatus of Example <NUM>, wherein the first threaded portion includes external threads and the second threaded portion includes internal threads.

The apparatus of any one or more of Examples <NUM> through <NUM>, wherein the second coupling member further comprises a projection, wherein the projection is configured to compress the compressible body in response to relative rotation between the first coupling member and the second coupling member.

The apparatus of Example <NUM>, wherein the first coupling member includes a conical shaped surface, wherein in response to relative rotation between the first and second coupling members the projection is configured to compress the compressible body axially against the conical shaped surface such that the compressible body deforms radially inwardly against the flexible instrument.

The apparatus of any one or more of Examples <NUM> through <NUM>, wherein the second coupling member includes a counterbore, wherein the projection is disposed within the counterbore.

The apparatus of any one or more of Examples <NUM> through <NUM>, wherein the first and second coupling members are tubular in shape.

The apparatus of any one or more of Examples <NUM> through <NUM>, wherein the second end of the first coupling member is configured to threadedly engage the first end of the second coupling member, wherein the compressible body is disposed at the second end of the first coupling member.

The apparatus of any one or more of Examples <NUM> through <NUM>, further comprising a support structure having a first end portion and a second end portion, wherein the first end portion supports the first end of the first coupling member, wherein the second end portion supports the second end of the second coupling member.

The apparatus of Example <NUM>, wherein the first end portion is configured to allow rotation of the first coupling member relative to the support structure, wherein the second end portion is configured to allow rotation of the second coupling member relative to the support structure.

The apparatus of any one or more of Examples <NUM> through <NUM>, wherein either: (i) the first end portion is configured to allow axial movement of the first coupling member relative to the support structure, or (ii) the second end portion is configured to allow axial movement of the second coupling member relative to the support structure.

An instrument comprising: (a) a handle assembly; and (b) the apparatus of any one or more of Examples <NUM> through <NUM>, wherein the support structure is slidably coupled to the handle assembly.

The instrument of Example <NUM>, further comprising a dilation catheter slidably disposed within the guide catheter.

The instrument of Example <NUM>, further comprising a flexible instrument slidably disposed within the dilation catheter, wherein the flexible instrument comprises a guidewire.

The instrument of Example <NUM>, wherein the flexible instrument comprises a guidewire.

The instrument of Example <NUM>, wherein the flexible instrument is sized to pass through a paranasal sinus ostium of a patient.

An apparatus comprising: (a) a body; (b) a shaft assembly extending distally from the body; (c) a flexible instrument slidably disposed within the shaft assembly; and (d) a flexible instrument actuation assembly configured to actuate the flexible instrument through the shaft assembly, wherein the flexible instrument actuation assembly comprises: (i) a support structure, and (ii) an actuator mounted to the support structure, wherein the actuator comprises: (A) a first coupling member having a first through bore, (B) a second coupling member configured to releasably couple with the first coupling member, wherein the second coupling member includes a second through bore, wherein the flexible instrument is configured to extend axially through the first through bore and the second through bore, and (C) a gripping member, wherein the gripping member is configured to transition between a first state and a second state in response to relative rotation between the first and second coupling members, wherein in the first state the gripping member permits the flexible instrument to freely translate through the actuator, wherein in the second state the gripping member frictionally engages the flexible instrument and fixes the flexible instrument relative to the actuator.

The apparatus of Example <NUM>, wherein the first coupling member includes a first threaded portion, wherein the second coupling member includes a second threaded portion configured to threadedly engage the first threaded portion in response to relative rotation between the first and second coupling members.

The apparatus of any one or more of Examples <NUM> through <NUM>, wherein the first coupling member includes a conical shaped surface, wherein the second coupling member includes a projection, wherein in response to relative rotation between the first and second coupling members the projection is configured to compress the compressible body axially against the conical shaped surface such that the compressible body deforms radially inwardly against the flexible instrument.

An apparatus for use with a dilation instrument having a flexible instrument, the apparatus comprising: (a) a first coupling member, wherein the first coupling member comprises: (i) a first end, (ii) a threaded second end, and (iii) a first through bore extending between the first end and the second end of the first coupling member; (b) a second coupling member configured to releasably couple with the first coupling member, wherein the second coupling member comprises: (i) a threaded first end, (ii) a second end, and (iii) a second through bore extending between the first end and the second end of the second coupling member, wherein the first through bore and the second through bore are sized to receive a flexible instrument axially therethrough, wherein the flexible instrument is sized to pass through a paranasal sinus ostium of a patient; and (c) a compressible body disposed in the first coupling member, wherein the compressible body defines a bore configured to align coaxially with the first through bore and the second through bore to receive the flexible instrument axially therethrough, wherein the compressible body is resiliently biased toward an expanded state in which the flexible instrument is freely translatable through the first and second coupling members and the compressible body, wherein the compressible body is configured to compress radially inwardly in response to threaded engagement of the threaded second end of the first coupling member with the threaded first end of the second coupling member, wherein when compressed the compressible body is configured to frictionally engage the flexible instrument and thereby fix the flexible instrument relative to the first and second coupling members.

The apparatus of Example <NUM>, wherein the first coupling member includes a conical shaped surface, wherein the second coupling member includes a projection, wherein in response to relative rotation between the first and second coupling members the projection is configured to compress the compressible body axially against the conical shaped surface such that the compressible body deforms radially inwardly against the flexible instrument.

A method of operating a flexible instrument actuation assembly of a dilation instrument, wherein the flexible instrument actuation assembly includes a first elongate member, a second elongate member, and a gripping member arranged therebetween, the method comprising: (a) providing the first elongate member in a first rotational state relative to the second elongate member; (b) translating a flexible instrument through the first elongate member and the second elongate member while the first elongate member is in the first rotational state; and (c) rotating the first elongate member relative to the second elongate member toward a second rotational state in which the gripping member frictionally engages the flexible instrument and prevents further translation of the flexible instrument relative to the first and second elongate members.

The method of Example <NUM>, wherein the gripping member comprises a compressible body, wherein rotating the first elongate member relative to the second elongate member comprises compressing the compressible body so that the compressible body frictionally engages the flexible instrument.

An apparatus, comprising: (a) a first elongate member defining a first bore, wherein the first bore of the first elongate member is sized to receive a guidewire; (b) a second elongate member defining a second bore, wherein the second bore of the second elongate member is coaxially aligned with the first bore of the first elongate member and is sized to receive a guidewire, the second elongate member further includes a projection positioned in the first bore of the first elongate member; and (c) a compressible body disposed in the first bore of the first elongate member, wherein the compressible body defines a third bore, wherein the compressible body is resiliently biased to define a first inner diameter in the third bore of the compressible body, wherein the projection of the second elongate member is configured to deform the compressible body in response to relative translation between the first and second elongate members, wherein the compressible body is configured to define a second inner diameter in the third bore of the compressible body in response to deformation by the projection of the second elongate member, wherein the second inner diameter is larger than the first inner diameter, wherein the compressible body is configured to grip the guidewire in the third bore of the compressible body when the third bore has the first inner diameter, wherein the compressible body is configured to release the guidewire in the third bore of the compressible body when the third bore of the compressible body has the second inner diameter.

The apparatus of Example <NUM>, further comprising a frame having a first end portion and a second end portion, wherein the first end portion supports an end of the first elongate member, wherein the second end portion supports an end of the second elongate member.

The apparatus of Example <NUM>, wherein the first end portion is configured to allow rotation of the first elongate member relative to the frame, wherein the second end portion is configured to allow rotation of the second elongate member relative to the frame.

The apparatus of any one or more of Examples <NUM> through <NUM>, wherein either: (i) the first end portion is configured to allow translation of the first elongate member relative to the frame, or (ii) the second end portion is configured to allow translation of the second elongate member relative to the frame.

The apparatus of any one or more of Examples <NUM> through <NUM>, further comprising a handle assembly, wherein the frame is slidably secured to the handle assembly such that the frame is configured to provide translation of the first and second elongate members relative to the handle assembly.

The apparatus of Example <NUM>, further comprising a guide catheter extending distally from the handle assembly.

The apparatus of Example <NUM>, further comprising a dilation catheter slidably disposed in the guide catheter.

The apparatus of Example <NUM>, further comprising a guidewire slidably disposed in the dilation catheter, wherein the guidewire is secured to the first and second elongate members via the compressible body.

The apparatus of any one or more of Examples <NUM> through <NUM>, further comprising a guidewire secured to the first and second elongate members via the compressible body.

The apparatus of Example <NUM>, wherein the guidewire is configured to pass through an ostium of a paranasal sinus of a human.

The apparatus of any one or more of Examples <NUM> through <NUM>, further comprising a resilient member configured to urge the first and second elongate members away from each other.

The apparatus of Example <NUM>, further comprising a boss structure configured to restrict displacement of the first and second elongate members away from each other.

The apparatus of any one or more of Examples <NUM> through <NUM>, wherein the compressible body is cylindraceous.

The apparatus of Example <NUM>, wherein the first bore of the first member includes gripping features configured to engage the compressible body and thereby prevent rotation of the compressible body relative to the first member.

The apparatus of any one or more of Examples <NUM> through <NUM>, wherein the compressible body is elastomeric.

An apparatus, comprising: (a) a guidewire, wherein a distal portion of the guidewire is sized to fit through an anatomical passageway within a head of a human; and (b) an actuator assembly, wherein the actuator assembly comprises: (i) a first tubular member, (ii) a second tubular member, wherein a free end of the second tubular member is positioned within the first tubular member, wherein the first and second tubular members are configured to transition between a locking state and an unlocking state, and (iii) an elastomeric body positioned within the first tubular member, wherein the guidewire is positioned in a bore of the elastomeric body, wherein the elastomeric body is configured to transition between a gripping state and a releasing state, wherein the elastomeric body is configured to firmly grip the guidewire in the gripping state, wherein the elastomeric body is configured to allow the guidewire to translate along the bore in the releasing state, wherein the compressible body is configured to maintain the gripping state when the first and second tubular members are in the locking state, wherein the free end of the second tubular member is configured to drive the compressible body from the gripping state to the releasing state when the first and second tubular members are transitioned from the locking state to the unlocking state.

The apparatus of Example <NUM>, wherein the first and second tubular members together define a first length in the locking state, wherein the first and second tubular members together define a second length in the unlocking state.

The apparatus of Example <NUM>, wherein the second length is less than the first length.

A method, comprising: (a) engaging an actuator assembly while the actuator assembly is in a first state, wherein the actuator assembly includes: (i) a first elongate member, (ii) a second elongate member, and (iii) an elastomeric cylindraceous body, wherein the elastomeric cylindraceous body firmly grips a guidewire while the actuator assembly is in the first state; (b) translating the first elongate member relative to the second elongate member to transition the actuator assembly to a second state, wherein translation of the first elongate member relative to the second elongate member causes deformation of the elastomeric cylindraceous body, wherein the deformed elastomeric cylindraceous body at least partially releases the guidewire; and (c) translating the guidewire relative to the actuator assembly while the actuator assembly is in the second state.

The method of Example <NUM>, further comprising inserting a distal end of the guidewire into a Eustachian tube of a human or into an ostium of a paranasal sinus of a human.

It should be understood that any of the examples described herein may include various other features in addition to or in lieu of those described above. By way of example only, any of the examples described herein may also include one or more of the various features disclosed in any of the various references.

Versions of the devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In particular, versions of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, versions of the device may be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure.

By way of example only, versions described herein may be processed before surgery. First, a new or used instrument may be obtained and if necessary cleaned. The instrument may then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the instrument and in the container. The sterilized instrument may then be stored in the sterile container. The sealed container may keep the instrument sterile until it is opened in a surgical facility.

Claim 1:
An apparatus for use with an elongate member (<NUM>, <NUM>), the apparatus comprising:
(a) an engagement member (<NUM>, <NUM>);
(b) a hollow shaft (<NUM>, <NUM>) extending from the engagement member along a longitudinal axis (A1);
(c) a compression element (<NUM>, <NUM>) supported by the hollow shaft, wherein the compression element is radially movable relative to the hollow shaft;
(d) a resilient gripping member (<NUM>, <NUM>) disposed within the hollow shaft, wherein the resilient gripping member is configured to slidably receive the elongate member therethrough along the longitudinal axis, wherein the compression element is positioned to confront a radially outer surface of the resilient gripping member; and
(e) a compression member (<NUM>, <NUM>) slidably disposed over the hollow shaft, includes an inner surface configured to engage the compression element as the compression member advances from the unlocked position toward the locked position, wherein the inner surface has a plurality of detent features (<NUM>, <NUM>) configured to engage the compression element in the locked position with different diameter elongate members, wherein the compression member is operable to selectively translate longitudinally along the hollow shaft between a locked position and an unlocked position,
wherein in the locked position the compression member is configured to urge the compression element radially against the resilient gripping member such that the resilient gripping member deforms radially inwardly to grip the elongate member and thereby prohibit translation of the elongate member through the apparatus,
wherein in the unlocked position the compression member is configured to permit the compression element and the resilient gripping member to move radially away from the elongate member and thereby permit translation of the elongate member through the apparatus.