According to the invention, an inflatable balloon cuff comprising: a proximal opening and a distal opening in a wall of the balloon cuff； and a tapered section along at least 50% of the length along an axis of the inflated balloon cuff, wherein at least a portion of the tapered section is configured to form a seal against a tracheal wall of a patient, wherein the tapered section comprises a balloon wall with continuously varying thickness along the tapered section, and wherein the tapered section comprises: a sealing portion, wherein the sealing portion is adapted to form a wrinkle-free band at least 1 millimeter in length against a patient's tracheal wall when inflated； a wrinkled portion, wherein a largest diameter of the wrinkled portion is larger than a tracheal diameter such that the wrinkled portion forms a wrinkled band against a patient's tracheal wall when inflated and wherein the wrinkled band is longer than the wrinkle-free band； and wherein the wrinkle-free band has a first balloon wall thickness greater than a second balloon wall thickness in the wrinkled portion.
