Active catheter

Abstract

Provided is a flexible catheter that can improve both operability and insertability. A flexible catheter has a flexible tube (2) having a distal end that is inserted into a body and a proximal end that is disposed outside the body, the tube having a sheath main body portion (20) whose flexibility does not substantially change even when a compression force is applied in the axial direction, and a deflection portion (21) that is configured in a continuous manner with the distal end of the sheath main body portion and is composed of a porous tube obtained by making polytetrafluoroethylene porous, the flexible catheter having an operation unit that applies a deflection force that deflects the deflection portion in a releasable manner.

Description

[0001] This application is a divisional application of the invention patent application with application number 202080016125.7, the original application being filed on March 2, 2020, and the invention being entitled "Active Catheter". Technical Field

[0002] This invention relates to catheters as medical therapeutic devices for performing various treatments, examinations, etc., and particularly to a steerable catheter capable of freely deflecting its tip. Background Technology

[0003] As a medical treatment device (including contrast agent injection catheters, electrode catheters, ablation catheters, and catheter sheaths) that is inserted into target tissues such as various organs (e.g., bile ducts, hearts) through body cavities, tubes, or blood vessels, there is a known movable catheter that, in order to facilitate its insertion or approach to the target tissue, allows the orientation of the tip (distal end) of the catheter inserted into the body to be deflected by operating a manipulator provided at the base (proximal end) of the catheter disposed outside the body (e.g., see Patent Document 1 and Patent Document 2).

[0004] Patent Document 1 describes an endoscopic catheter used for injecting X-ray contrast agents or the like into the bile duct for examination. After being inserted into the duodenum via an endoscope, the catheter's tip is easily inserted from the duodenal side towards the duodenal papilla and into the bile duct by manipulating (pushing out or tightening) a control line from the outside of the body. This allows for deflection (bending) of the tip. The catheter described in Patent Document 1 has a lumen, different from the large-diameter lumen used for injecting contrast agents, into which a control line for deflecting the tip is inserted. Since the control line is joined to a tip portion at the catheter's tip by methods such as plasma welding, the tip of the catheter can be deflected by tightening the control line from the outside of the body.

[0005] Patent Document 2 describes a tip-movable catheter used for guiding an ablation catheter to the treatment site on the heart for catheter ablation therapy. To easily guide the tip of the ablation catheter to the desired location on the heart, the tip can be deflected (bent) by operating the manipulation part from the outside of the body. The catheter tube described in Patent Document 2, in addition to having a main lumen for inserting various therapeutic instruments, also has a pair of wire lumen located at 180° angles to each other within its tube wall. Furthermore, the deflectable portion of the tip of the catheter is designed such that its rigidity gradually decreases as it approaches the tip. The tips of the pair of wires inserted into each wire lumen are connected to a ring (pull ring) integrally mounted on the tip using methods such as laser welding. The base of each pair of wires is connected to the manipulation part. Moreover, by operating the manipulation part to tighten one wire and loosen the other, the orientation of the catheter tip can be controlled.

[0006] However, in such movable catheters, the movable part (deflection part) needs to be flexible enough to be easily and freely deflected (bent) by manipulating the suture. However, when a soft (flexible) structure is used for maneuverability, bending or buckling may occur when it punctures (penetrates) narrow sections within the lumen, such as the bile duct, potentially reducing insertability. Conversely, when a rigid (hard) structure is used for maneuverability, it may sacrifice maneuverability.

[0007] Existing technical documents

[0008] Patent documents

[0009] Patent Document 1: Japanese Patent Application Publication No. 2002-272675;

[0010] Patent Document 2: Japanese Patent Application Publication No. 2014-188039. Summary of the Invention

[0011] The problem the invention aims to solve

[0012] The present invention was made in view of this situation, and its object is to provide a movable catheter that can simultaneously improve operability and insertability.

[0013] Solution for solving the problem

[0014] To achieve the above objectives, the movable catheter of the present invention has a flexible tube having a distal end inserted into the body and a proximal end disposed outside the body.

[0015] The hose comprises: a first hose portion whose flexibility remains substantially unchanged even when subjected to compressive force in the axial direction; and a second hose portion composed of a porous hose, which is continuously joined to the distal end of the first hose portion, wherein the porous hose is compressed into a rigid form corresponding to the degree of compressive force acting in the axial direction, and returns to a soft form by releasing the compressive force.

[0016] The movable catheter has an operating unit that can be disengaged to apply a compressive force to compress the second flexible section in the axial direction and a deflective force to deflect the second flexible section.

[0017] According to the movable catheter of the present invention, by appropriately manipulating the operating unit, a deflection force is applied to the second flexible tube while maintaining it in a soft state, with minimal compressive force applied. This allows the second flexible tube to be deflected. Since the second flexible tube is in a soft state at this time, good operability can be achieved. On the other hand, when it ruptures (penetrates) a narrow portion within the lumen of a duct such as a bile duct, by appropriately manipulating the operating unit, a compressive force is applied to the second flexible tube to make it rigid, thereby suppressing bending and buckling and improving insertionability. Therefore, a movable catheter that simultaneously improves operability and insertionability can be provided.

[0018] In the movable catheter of the present invention, the flexible tube has at least three lumens for threading arranged separately from each other from the proximal end to the distal end of the flexible tube. The operating unit has at least two threads, approximately half of one end of each thread is inserted into one of the lumens for threading, the middle portion of the thread is folded back at the distal end of the second flexible tube, and approximately half of the other end of the thread is inserted into another lumen for threading. One end and the other end of each thread reach the proximal end of the first flexible tube. By tightening both ends (one end and the other end) of all the threads (or a suitable portion of the threads corresponding to the arrangement of the lumens for threading) with the same tension between each thread, a compressive force is applied to the second flexible tube, thereby making the second flexible tube rigid. Furthermore, by tightening with a difference in tension between the threads (or only tightening a portion of the threads), a deflection force is applied to the second flexible tube, thereby enabling the second flexible tube to deflect in accordance with the difference in tension.

[0019] In the movable catheter of the present invention, the flexible tube has at least three lumens for threading arranged separately from each other from the proximal end to the distal end of the flexible tube within its tube wall. The operating unit has at least three threads, the distal ends of which are connected to the distal end of the second flexible tube portion. The threads are inserted into one of the lumens for threading, and the proximal ends of the threads reach the proximal end of the first flexible tube portion. By tightening the proximal ends of all the threads (or a suitable portion of the threads corresponding to the arrangement of the lumens for threading) with the same tension between each thread, a compressive force is applied to the second flexible tube portion, thereby making the second flexible tube portion rigid. Furthermore, by tightening with a difference in tension between the threads (or only tightening a portion of the threads), a deflection force is applied to the second flexible tube portion, thereby enabling the second flexible tube portion to deflect in accordance with the difference in tension. Attached Figure Description

[0020] Figure 1 This is a diagram showing the external structure of the movable catheter according to an embodiment of the present invention.

[0021] Figure 2A It is along Figure 1 A sectional view of the IIa-IIa line cut.

[0022] Figure 2B It is shown in magnification Figure 1 A three-dimensional view of the main parts of a movable catheter.

[0023] Figure 2C It is Figure 2B A cross-sectional view of the distal end of the movable catheter, cut with a plane passing through the respective axes of the lumen of a pair of filaments.

[0024] Figure 3 It is shown in magnification Figure 1 The diagram of the distal end of the movable catheter is used to illustrate the operation of the deflection section.

[0025] Figure 4A This indicates an increase in the amount directed to Figure 2B A three-dimensional diagram showing the number of threads inserted into the lumen of a movable catheter.

[0026] Figure 4B It is Figure 4A A cross-sectional view of the distal end of a movable catheter cut with a plane orthogonal to its axis.

[0027] Figure 4C It is Figure 4A A cross-sectional view of the distal end of the movable catheter, cut with a plane passing through the respective axes of the lumen of a pair of filaments.

[0028] Figure 5A It means Figure 4A A diagram showing a variation of a movable catheter.

[0029] Figure 5B It means Figure 4A A diagram of another variation of the movable catheter.

[0030] Figure 5C It means Figure 4A The figure shows another variation of the movable catheter. Detailed Implementation

[0031] Hereinafter, embodiments of the present invention will be specifically described with reference to the accompanying drawings. The catheter sheath (movable sheath) of this embodiment is a catheter that is inserted and guides, for example, an electrode catheter used for monitoring electrocardiograms or an ablation catheter used for cauterizing the affected area during catheter ablation procedures. Hereinafter, a catheter sheath will be described as an example of a movable catheter to which the present invention is applied; however, the present invention can also be applied to electrode catheters or ablation catheters, movable endoscopic catheters for injecting X-ray contrast agents into the bile duct for examination, and other movable catheters.

[0032] In addition, catheter ablation is a treatment method used to treat arrhythmias caused by heart disease. It involves inserting an ablation catheter with a high-frequency electrode at its tip through a blood vessel into the myocardial tissue that is causing the arrhythmia in the heart, and burning the myocardial tissue or its vicinity at about 60-70°C to coagulate and die, thereby blocking the arrhythmia circuit.

[0033] First, refer to Figure 1 as well as Figures 2A to 2C The catheter sheath (movable catheter) 1 is generally composed of a sheath (soft tube) 2, an operating part 3, a handle part 4, and a pair of wires (operating units) W1, W2.

[0034] The sheath 2 is composed of a flexible hollow tube having a distal end inserted into the body and a proximal end disposed outside the body, comprising a sheath body portion (first tube portion) 20 disposed on the proximal side and a deflection portion (second tube portion) 21 disposed on the distal side. The sheath body portion 20 is configured to have high rigidity so that its flexibility does not substantially change even when subjected to compressive force in the axial direction. As the sheath body portion 20, a multi-layer tube comprising, for example, a braided layer made of stainless steel in a mesh pattern and multiple resin layers is used.

[0035] The proximal end of the deflection section 21 is integrally joined to the distal end of the sheath body 20 in a continuous manner. The inner cavity of the deflection section 21 is continuously connected to the inner cavity of the sheath body 20, thereby forming the main tube cavity 22. The deflection section 21 is made of a porous flexible tube, which is compressed into a rigid state corresponding to the degree of compressive force acting in the axial direction, and returns to its original state as a soft state by releasing the compressive force. The flexibility of the porous flexible tube can be controlled by adjusting the compressive force acting in the axial direction.

[0036] The material of the sheath body 20 is not particularly limited as long as it is flexible. It is preferred to use thermoplastic resin or thermoplastic elastomer, such as polyamide elastomers like polyether block amide copolymers, polyamides, polyimides, polyamide-imides, polyethylene terephthalate, polyethylene, polypropylene, polyurethane, ethylene-vinyl acetate copolymers, polyvinyl chloride, polytetrafluoroethylene, tetrafluoroethylene-hexafluoropropylene copolymers, tetrafluoroethylene-perfluoroalkyl vinyl ether copolymers, etc.

[0037] The material used for the porous hose constituting the deflection section 21 is not limited, but PTFE (polytetrafluoroethylene) is preferred due to its excellent heat resistance, chemical resistance, weather resistance, and hydrophobicity. The porous hose can be manufactured by stretching a hose obtained from PTFE extrusion molding in the axial direction. By making the PTFE porous, air permeability can be maintained, and the required waterproofness can be obtained. Furthermore, by appropriately adjusting the elongation rate (degree of stretching) during the stretching process, the porosity can be adjusted, and the change in flexibility during compression can be appropriately adjusted (controlled). Additionally, by adjusting the porosity, the air permeability can also be changed.

[0038] The operating part 3 and the handle part 4 are installed on the proximal side of the sheath 2, and an insertion hole is formed through which the proximal side of the sheath 2 is inserted. A sheath hub 41a is installed on the proximal end of the handle part 4.

[0039] The sheath liner 41a has an inner cavity. On the proximal side of the sheath liner 41a, the sheath 2 within the handle portion 4 is installed such that the inner cavity of the sheath liner 41a communicates with the main lumen 22 of the sheath 2. Furthermore, a catheter insertion port with a hemostatic valve is formed on the distal side of the sheath liner 41a. When using the catheter sheath 1 (during treatment), the aforementioned electrode catheter and ablation catheter are inserted through the catheter insertion port of the sheath liner 41a and guided to the main lumen 22 of the sheath 2, with their respective distal ends guided to the myocardial tissue to be treated. Additionally, a side injection tube is formed on the side of the sheath liner 41a, and a three-way valve 41c is installed on this side injection tube via a flexible tube 41b. A syringe or similar device is installed on the three-way valve 41c, allowing for the aspiration of blood or the delivery of medication.

[0040] At the distal end of the sheath 2 (the tip of the deflection portion 21), a generally cylindrical tip protection member 29 made of resin and shaped as a hemisphere on the distal side is provided. The tip protection member 29 has an inner cavity with a diameter approximately the same as that of the main tube cavity 22 of the sheath 2, and is integrally joined (fixed) to the distal end of the sheath 2 by means of heat fusion or the like. However, the tip protection member 29 may be omitted.

[0041] Within the wall of the sheath 2 (sheath body 20 and deflection section 21), four thread-carrying lumens (secondary lumens) 23a to 23d are formed, generally parallel to the main thread lumen 22, surrounding it on the outside. The thread-carrying lumens 23a to 23d extend from the proximal end of the sheath 2 (proximal end of the sheath body 20) to the distal end (distal end of the deflection section 21). The thread-carrying lumens 23a to 23d are formed such that they are separated from each other at approximately 90° angular intervals on the outside of the main thread lumen 22, centered on the central axis of the sheath 2.

[0042] A single thread W1 is inserted into the thread tube 23a and the thread tube 23b, and a single thread W2 is inserted into the thread tube 23c and the thread tube 23d. In this embodiment, the threads W1 and W2 are formed of a metal such as stainless steel, but the threads W1 and W2 may also be formed of other materials such as resin.

[0043] The thread W1 is configured such that approximately half of its end side, W1a, is inserted into the thread lumen 23a, with its middle portion, W1c, folded back at the distal end face of the engagement tip protection member 29 of the sheath 2, and approximately half of its other end side, W1b, is inserted into the thread lumen 23b, with both ends (one end and the other end) located at the operating portion 3 on the proximal side of the sheath 2. Similarly, the thread W2 is configured such that approximately half of its end side, W2a, is inserted into the thread lumen 23c, with its middle portion, W2c, folded back at the distal end face of the engagement tip protection member 29 of the sheath 2, and approximately half of its other end side, W2b, is inserted into the thread lumen 23d, with both ends (one end and the other end) located at the operating portion 3 on the proximal side of the sheath 2.

[0044] Both ends of the thread W1 and both ends of the thread W2 are led out from the side holes of the sheath 2 inside the operating part 3 located on the proximal side of the sheath 2, and are respectively connected to the operating part 3 (rotation operating member 31). The operating part 3 has a pair of protruding grips 32, 32 integrally provided with the rotation operating member 31, and is held in the holding part 42 located on the top (distal) side of the handle part 4 by a screw-in knob member 5.

[0045] The rotating operating member 31 is held by the holding part 42 in the following manner, by means of... Figure 1As shown by arrow A5, both of the gripping parts 32, 32 are pushed towards the proximal end, thereby allowing them to slide a predetermined amount towards the proximal end, as indicated by the symbol 31' and the dotted line in the figure. When the push in the direction of arrow A5 is released, the rotating operating member 31 is force-applied by a force-applying unit (not shown) to return it to its original position.

[0046] exist Figure 1 In the neutral state shown, both threads W1 and W2 are essentially tension-free, and the deflection portion 21 at the tip of the sheath 2 is as follows: Figure 1 and Figure 3 As shown in (a), it extends in a straight line. At this time, no compressive force acts on the bias portion 21 in the axial direction, so it is not compressed. The dimension of the bias portion 21 in the axial direction is L1. According to the nature of the porous hose constituting the bias portion 21, the bias portion 21 becomes a relatively soft state.

[0047] When the gripping parts 32, 32 of the rotating operating member 31 are operated from the neutral state, the rotating operating member 31 is moved towards... Figure 1 When the direction of the middle arrow A1 is rotated, along with this rotation, the wire W1 is tightened and the wire W2 is loosened, thereby causing the deflection part 21 at the tip to... Figure 1 and Figure 3 Deflect as shown by arrow A3 in (b).

[0048] Conversely, when the gripping portions 32, 32 of the rotating operating member 31 are operated, the rotating operating member 31 is moved towards... Figure 1 When rotating in the direction of the middle arrow A2, by loosening the thread W1 and tightening the thread W2, the deflection part 21 at the tip is as follows. Figure 1 and Figure 3 Deflect as shown by arrow A4 in (b).

[0049] When you want to fix the shape of the deflection part 21 while it is deflected, you lock it by rotating the knob member 5 clockwise. This pushes the rotating operation member 31 against the holding part 42, fixing it in its current position, and thus fixing the shape of the deflection part 21. Conversely, when you want to release the fixation of the shape of the deflection part 21 (to adjust the deflection state), you loosen it by rotating the knob member 5 counterclockwise. This loosens the rotating operation member 31, allowing it to rotate freely. As a result, the shape of the deflection part 21 is released, and by rotating the rotating operation member 31 with the holding part 32, you can adjust the deflection state of the deflection part 21.

[0050] Next, when from Figure 1In the neutral state shown, when the holding parts 32, 32, resist the applied force of the force-applying unit (not shown) and are pushed proximally as indicated by arrow A5 in the figure, the rotating operating member 31 slides proximally by a predetermined amount. In this state, the threads W1 and W2 are stretched proximally (with the same tension) and become taut, resulting in a force generated by the taut threads W1 and W2 acting on the distal end of the deflection part 21. That is, since the proximity of the deflection part 21 is substantially restricted by the distal end of the sheath body 20 (does not move proximally), the compressive force is applied to the deflection part 21 along the axial direction by the force of tension generated proximally by the threads W1 and W2. Due to this compressive force, the deflection part 21 is compressed (shortened) in the axial direction, as... Figure 3 As shown in (c), the dimension of the deflection section 21 in the axial direction becomes L2, which is smaller than L1. Based on the properties of the porous hose constituting the deflection section 21, the deflection section 21 becomes a relatively rigid state.

[0051] If the pushing force on the gripping parts 32 is released, the rotary operating member 31 can slide back to its original position (neutral position) by the force applied by the force-applying unit (not shown), returning to a relatively soft state. If it is desired to maintain the state where the deflection part 21 is relatively hard, the knob member 5 is rotated clockwise to lock it, thereby pressing the rotary operating member 31 against the holding part 42 and fixing the rotary operating member 31 in its current position. If it is desired to release this state (to achieve a soft state or to adjust the deflection state), the opposite is true; the knob member 5 is rotated counterclockwise to loosen it, thereby changing the state where the rotary operating member 31 is loosely pressed against the holding part 42, allowing the rotary operating member 31 to return to its original position (neutral position).

[0052] Additionally, if necessary, while the deflection portion 21 is rigid due to the sliding of the rotating operating member 31 towards the proximal end, the rotating operating member 31 can be rotated to achieve the desired effect. Figure 3 As shown in (d), it can be deflected even when compressed. Furthermore, after rotating the rotating operating member 31 to appropriately deflect the deflection part 21 in the neutral position (i.e., when the deflection part 21 is in a soft state), the rotating operating member 31 is slid towards the proximal end, thereby achieving the desired effect. Figure 3 As shown in (d), it can also be compressed to become rigid. Furthermore, if necessary, the flexibility of the deflection section 21 can be controlled by appropriately adjusting the sliding amount when the rotating operating member 31 slides from the neutral position toward the proximal side.

[0053] In the above embodiment, the deflection section 21 comprises a sheath 2 consisting of a sheath body 20 whose softness remains substantially unchanged even when subjected to compressive force in the axial direction, and a deflection section 21 continuously connected to the distal end of the sheath body 20. The deflection section 21 is made of a porous flexible tube, which is compressed into a hard state corresponding to the degree of compressive force acting in the axial direction, and becomes soft again by releasing the compressive force. Furthermore, by using the threads W1 and W2 inserted in the plurality of thread cavities 23a to 23d of the sheath 2, the compressive force that compresses the deflection section 21 in the axial direction and the deflection force that deflects the deflection section 21 can be applied in a way that can be released.

[0054] Therefore, by keeping the threads W1 and W2 in a neutral state, maintaining a soft state so that no compressive force acts on the deflection portion 21, the deflection portion 21 can be deflected by pulling one of the threads W1 and W2 towards the proximal end. Since the deflection portion 21 is in a soft state at this time, good operability can be achieved. On the other hand, when it is to pierce (penetrate) a narrow part in the lumen of a tube such as a bile duct, bending or compression may sometimes occur in the soft state of the deflection portion 21, making it difficult to insert. In this case, by pulling both threads W1 and W2 towards the proximal end with the same tension, the compressive force can be applied to the deflection portion 21, making it hard. Therefore, bending or compression of the deflection portion 21 can be reduced, and the insertion of the catheter can be improved.

[0055] Furthermore, in the above-described embodiment, since a pair of threads W1 and W2 are used to apply both the deflection force for deflecting the deflector 21 and the compression force for compressing the deflector 21, the structure can be simplified compared to using different units, such as separately providing threads for the deflection force and threads for the compression force. However, it is of course possible to use different units to implement the arrangement of each thread. For example, as a unit for applying the compression force, a compression hose having an outer diameter slightly smaller than the inner diameter of the main tube cavity 22 can be slidably inserted into the inner cavity (main tube cavity 22) of the sheath 2 (sheath body 20 and deflector 21), and the distal end of the compression hose is connected to the distal end of the deflector 21. By pulling the compression hose towards the proximal end relative to the sheath 2, the compression force is applied to the deflector 21. In this case, the inner cavity of the compression hose also functions as the main tube cavity.

[0056] Furthermore, in the above-described embodiment, approximately half of one end of the thread W1, W1a, is inserted into the thread lumen 23a, and approximately half of the other end, W1b, is inserted into the thread lumen 23b. Similarly, approximately half of one end of the thread W2, W2a, is inserted into the thread lumen 23c, and approximately half of the other end, W2b, is inserted into the thread lumen 23d. Since the threads W1 and W2 are folded back at the distal end of the deflection portion 21, there is no need to provide components for fixing the threads, such as a tip head or a pull ring. This reduces the number of parts and eliminates the need for installation operations to attach the components for fixing the threads to the guide tube or for connecting the threads to the components, thus reducing manufacturing time. Additionally, there is no need to ensure an area for fixing the threads within the structure of the catheter sheath 1, thus reducing structural limitations on the catheter sheath 1. For example, the opening area at the distal end (tip) of the sheath 2 (main lumen 22) can be increased.

[0057] Furthermore, by tightening approximately half of the thread W1 inserted into the thread tube 23a (W1a) and approximately half of the thread tube 23b (W1b), a deflecting force can be applied to deflect the deflecting part 21. Therefore, the force can be applied over a wider range in the circumferential direction of the sheath 2, corresponding to the interval (angular interval) between the thread tubes 23a and 23b. The same applies to the thread W2. As a result, compared to the case where deflection is performed by tightening a single thread inserted into a single tube without folding back, the force applied to the thread is smaller, thus reducing the possibility of thread breakage during deflection. Furthermore, the swaying of the distal end during deflection of the deflecting part 21 can be reduced, enabling stable deflection. For the same reason, the compressive force can also be applied stably to the deflecting part 21.

[0058] However, the following structure can also be adopted: insert one thread into each of the thread-using lumens 23a to 23d, i.e., set four threads, and connect the distal end of each thread to the distal end of the deflection part 21. In this case, the number of thread-using lumens and the number of threads can be set to three or more.

[0059] In the above embodiment, two threads are used: thread W1, which is inserted into thread tube 23a and thread tube 23b, and thread W2, which is inserted into thread tube 23c and thread tube 23d. However, it is also possible to use... Figures 4A to 4C As shown, a structure using four threads is constructed by adding threads W3 and W4.

[0060] Specifically, in thread W3, approximately half of its end side W3a is inserted into thread tube 23a, its middle portion W3c is folded back at the distal end face of the joint tip protection member 29 of sheath 2, and approximately half of its other end side W3b is inserted into thread tube 23c. In thread W4, approximately half of its end side W4a is inserted into thread tube 23b, its middle portion W4c is folded back at the distal end face of the joint tip protection member 29 of sheath 2, and approximately half of its other end side W4b is inserted into thread tube 23d. With this configuration, by appropriately selecting one thread from threads W1 to W4 to tighten it, it can deflect in four directions. Furthermore, by appropriately selecting a combination of two adjacent threads from threads W1 to W4 to adjust the balance of the tightening force on each thread, the deflection section 21 can be deflected in any direction of 360°. Furthermore, by equally (with the same tension) tightening all of the threads W1 to W4, or threads W1 and W2, or threads W3 and W4, the deflection part 21 can be made rigid. In addition, it is necessary to modify the structure of the operating part 3 accordingly to increase the number of threads W3 and W4, for example, by adding a rotating operating member identical to the rotating operating member 31 to the operating part 3.

[0061] In addition, Figures 4A to 4C The example shown illustrates the case where four wires are installed in tubular cavities 23a to 23d, and four wires W1 to W4 are installed. However, for example... Figures 5A to 5C As shown, the number of lumens for the thread can be increased or decreased, and correspondingly, the number of threads can also be increased or decreased.

[0062] That is, in Figure 5A In this design, six wire-carrying cavities 24a are arranged at 60° intervals, and six wires W5 are installed therein. Therefore, by tightening each wire W5 individually, the deflector 21 can be deflected in six directions. Furthermore, by appropriately selecting the combination of two adjacent wires W5 to adjust the balance of the tightening force on each wire, the deflector 21 can be deflected in any direction up to 360°. Figure 5B In this design, three wire-carrying cavities 25a are arranged at 120° angular intervals, and three wires W6 are installed therein. Therefore, by tightening each wire W6 individually, the deflection section 21 can be deflected in three directions. Furthermore, by appropriately selecting the combination of two adjacent wires W6 to adjust the balance of the tightening force on each wire, the deflection section 21 can be deflected in any direction up to 360°. Figure 5C In this example, 24 lumens 26a for threading are arranged at 15° intervals, and 24 threads W7 are provided. Thus, when each thread W7 is tightened individually, the deflector 21 can be deflected in 24 directions. These are examples; it is sufficient to have three or more lumens for threading and two or more threads.

[0063] exist Figures 5A-5C In the example shown, the number of tubular lumens for the thread is the same as the number of threads, but they can also be different; for example, the number of threads can be less than the number of tubular lumens. Furthermore, in Figures 5A-5C In the example shown, the two ends of the thread are inserted into a pair of adjacent thread tubes, but for example, a pair of thread tubes can be selected intermittently, and the two ends of the thread can be inserted into them.

[0064] The embodiments described above are provided for ease of understanding of the present invention and are not intended to limit the present invention. Therefore, the elements disclosed in the above embodiments are intended to include all design changes or equivalents that fall within the technical scope of the present invention.

[0065] Explanation of reference numerals in the attached figures

[0066] 1: Catheter sheath (movable catheter)

[0067] 2: Sheath (Hose)

[0068] 20: Sheath body (first flexible tube section)

[0069] 21: Deflection section (second flexible hose section)

[0070] 22: The official's tone

[0071] 23a~23d: Tubes for thread

[0072] 29: Top Protective Component

[0073] 3: Operations Department

[0074] 31: Rotary operating component

[0075] 32: Control Department

[0076] 4: Handle section

[0077] 42: Maintaining section

[0078] 5: Knob component

[0079] W1~W7: Silk thread (operating unit)

Claims

1. A movable catheter, characterized in that, A flexible hose having a distal end inserted into the body and a proximal end disposed externally. The hose has: a sheath body portion whose flexibility remains substantially unchanged even when subjected to compressive force in the axial direction; and a deflection portion, which is composed of a porous hose obtained by porousening polytetrafluoroethylene, and is arranged continuously to the distal end of the sheath body portion. The movable catheter includes an operating unit that can deflect a deflecting force in a releasable manner, the deflecting force causing the deflecting portion to deflect. The deflection section is composed of a porous flexible tube that is compressed into a rigid state in accordance with the degree of compressive force acting in the axial direction, and returns to its original state as a soft one by releasing the compressive force. The operating unit has at least two threads, which are respectively connected to the deflection part and can be pulled towards the proximal end to apply tension to the deflection part.

2. The movable catheter according to claim 1, wherein, The hose has at least three lumens for threading arranged separately from each other from the proximal end to the distal end within the hose wall. The operating unit has at least two threads, with approximately half of one end of each thread inserted into a thread lumen, the middle portion of which is folded back at the distal end of the deflection portion, and approximately half of the other end of each thread inserted into another thread lumen. One end and the other end of each thread reach the proximal end of the sheath body.

3. The movable catheter according to claim 1, wherein, The hose has at least three lumens for threading arranged separately from each other from the proximal end to the distal end within the hose wall. The operating unit has at least three threads, the distal ends of which are connected to the distal end of the deflection part, the threads are inserted into a thread lumen, and the proximal ends of the threads reach the proximal end of the sheath body.

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