Adjustable bending sheath

Abstract

The invention relates to an adjustable bending sheath which comprises a sheath tube and a pull wire, the pull wire comprises a main body and a plurality of branches connected with the main body, the near ends of the branches extend towards the near end, each branch comprises a wire body part slidably embedded in the tube wall of the main body tube, and the wire body parts of the branches extend in the axial direction. The plurality of branches comprise at least one wire group formed by two of the branches, the range of the interval angle of the wire body parts of the two branches of the wire group in the circumferential direction is [60 degrees, 180 degrees], the wire body part of one branch of the wire group is located on one side of the trunk in the circumferential direction, and the wire body part of the other branch of the wire group is located on the other side of the trunk in the circumferential direction. The wire body part of the other branch of the wire group is located on the other side of the trunk in the circumferential direction, or the interval angle between the wire body part of the other branch of the wire group and the trunk in the circumferential direction is 0 degree. According to the adjustable bent sheath, the positioning difficulty of the sheath tube is low.

Description

Technical Field

[0001] The invention relates to the technical field of medical devices, and in particular to an adjustable curved sheath. Background Art

[0002] This section merely provides background information related to the present disclosure and is not necessarily prior art.

[0003] During endovascular treatment, the adjustable curved sheath can be used to establish a delivery channel from inside the body to outside the body, so that doctors can deliver interventional or implantable devices to the target location.

[0004] If the target position is the greater curvature side of the body cavity (e.g., the brachiocephalic artery, the left common carotid artery, or the left subclavian artery on the greater curvature side of the aortic arch), the doctor first pushes the tube opening of the sheath tube of the adjustable bending sheath to the aortic arch, then bends the adjustable bending portion of the sheath tube and keeps the adjustable bending portion in the bent shape. Then, an operating torque is applied to the sheath tube to adjust the circumferential position of the sheath tube so that the tube opening of the sheath tube can be aligned with the target position. However, when adjusting the circumferential position of the tube opening of the sheath tube, it is difficult for the doctor to position the sheath tube so that the tube opening of the sheath tube is aligned with the target position. Summary of the invention

[0005] Based on this, it is necessary to provide an adjustable curved sheath that can reduce the difficulty of positioning the sheath tube.

[0006] An adjustable bending sheath comprises a sheath tube and a pull wire, wherein the sheath tube comprises an adjustable bending tube and a main body tube, the proximal end of the adjustable bending tube is connected to the distal end of the main body tube, and the pull wire comprises: A main trunk, wherein the main trunk is slidably embedded in the wall of the adjustable elbow, the distal end of the main trunk is connected to the distal end of the adjustable elbow, and the proximal end of the main trunk extends axially; A plurality of branches, the distal ends of the plurality of branches are connected to the proximal end of the trunk, the proximal ends of the plurality of branches extend proximally, and the proximal ends of the plurality of branches extend to the outside of the sheath tube, the plurality of branches include a wire body portion slidably embedded in the tube wall of the main tube, and the wire body portions of the plurality of branches extend axially, the plurality of branches include at least one wire group formed by two of the branches, the wire body portions of the two branches of the wire group are spaced at an angle in the circumferential direction in the range of [60°, 180°], and, The wire body of one branch of the wire group is circumferentially located on one side of the trunk, and the wire body of another branch of the wire group is circumferentially located on the other side of the trunk, or the angle between the wire body of another branch of the wire group and the trunk in the circumferential direction is 0°.

[0007] During use of the adjustable bending sheath provided by an embodiment of the present invention, a pulling force is first applied to the proximal ends of the multiple branches to cause the adjustable bending tube to bend and deform. After the bending is completed, the magnitude of the pulling force applied to the proximal ends of the multiple branches is locked to keep the adjustable bending tube in the bent shape, and then the sheath is twisted to adjust the circumferential position of the tube opening of the adjustable bending tube.

[0008] During the twisting of the sheath, when the circumferential angle between the main trunk and the center line of the greater curvature of the aortic arch is within a value within (0°, 30°), the two branches of the wire group are located on both sides of the center line of the greater curvature of the aortic arch, and the directions of the traction wire torques of the two branches of the wire group are opposite. Therefore, the traction wire torques of the two branches of the wire group at least partially offset each other, thereby reducing the magnitude of the combined torque of the traction wire torques of multiple branches. Therefore, the interference of multiple branches to the operator during the twisting of the sheath can be reduced, which is beneficial to reducing the difficulty of sheath positioning. BRIEF DESCRIPTION OF THE DRAWINGS

[0009] In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the following briefly introduces the drawings required for use in the description of the embodiments. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without creative work.

[0010] in: Figure 1 It is a structural schematic diagram of a curved tubular structure in the prior art; Figure 2 for Figure 1 Section along I – I; Figure 3 A cross-sectional view of a sheath tube of an adjustable bending sheath in the prior art; Figure 4 A state diagram of the adjustable curved sheath in the prior art during use; Figure 5 It is a cross-sectional view of the sheath tube and the aortic arch during the use of the adjustable bending sheath in the prior art after the adjustable bending sheath has been adjusted; Figure 6 A cross-sectional view of the sheath and the aortic arch when the traction wire is twisted to a 0° angle in the circumferential direction with the center line of the greater curvature of the aortic arch during use of the adjustable curvature sheath of the prior art; Fig. 7A It is a torque analysis diagram of the traction wire when the traction wire approaches the center line of the greater curvature of the aortic arch along the W direction and does not cross the center line of the greater curvature of the aortic arch during the use of the adjustable bending sheath in the prior art; Figure 7BIt is a torque analysis diagram of the traction wire when the traction wire approaches the center line of the greater curvature of the aortic arch along the W direction and crosses the center line of the greater curvature of the aortic arch during the use of the adjustable bending sheath in the prior art; Figure 8 A three-dimensional diagram of an adjustable bending sheath according to an embodiment; Fig. 9 A three-dimensional view of an embodiment of an adjustable curved sheath with a knob hidden from another viewing angle; Fig.10 A cross-sectional view of a sheath tube of an adjustable bending sheath according to an embodiment; Fig.11 It is a schematic structural diagram of a sheath tube, a pull wire and a sliding member of an adjustable bending sheath according to an embodiment; Fig.12 for Fig.11 Left view of; Fig.13 This is a state diagram of an adjustable bending sheath of an embodiment when the angle between the center line of the main trunk and the lesser curvature side of the aortic arch in the circumferential direction is 0°; Fig.14 This is a state diagram of an adjustable bending sheath of an embodiment when the angle between the center line of the main trunk and the greater curvature side of the aortic arch in the circumferential direction is less than 90°; Fig.15 The adjustable bending sheath of one embodiment is in Fig.14 Torque analysis diagram for the state shown; Fig.16 This is a state diagram of an adjustable bending sheath according to an embodiment when the trunk is rotated to cross the centerline of the greater curvature of the aortic arch and the angle between the trunk and the centerline of the greater curvature of the aortic arch in the circumferential direction is less than 90°; Fig.17 is a schematic structural diagram of a line group according to another embodiment; Fig.18 for Fig.17 A schematic diagram of the structure of the sheath tube, the pull wire and the sliding member of the adjustable bending sheath of the illustrated embodiment; Fig.19A for Fig.17 Left view of; Fig.19B for Fig.19A Enlarged view of O in the middle; Fig. 20A It is a schematic structural diagram of a sheath tube, a pull wire and a sliding member of an adjustable bending sheath in another embodiment; Fig. 20B for Fig. 20A Enlarged view of P in the middle; Fig.21 for Fig. 20A Left view of; Fig.22AIt is a schematic structural diagram of a sheath tube, a pull wire and a sliding member of an adjustable bending sheath in another embodiment; Fig. 22B 22 is a schematic structural diagram of a sliding member, a balancing frame and a branch; Fig.23 for Fig.22A Left view of . DETAILED DESCRIPTION

[0011] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0012] In the description of the embodiments of the present invention, it should be noted that the orientations or positional relationships indicated by the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc. are based on the orientations or positional relationships shown in the drawings, and are only for the convenience of describing the embodiments of the present invention and simplifying the description, rather than indicating or implying that the devices or elements referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as limiting the embodiments of the present invention. In addition, the terms "first", "second", and "third" are used for descriptive purposes only and cannot be understood as indicating or implying relative importance.

[0013] In the description of the embodiments of the present invention, it should be noted that, unless otherwise clearly specified and limited, the terms "installed", "connected", and "connected" should be understood in a broad sense, for example, it can be a fixed connection, a replaceable connection, or an integral connection, it can be a mechanical connection, it can be an electrical connection, it can be a direct connection, it can be indirectly connected through an intermediate medium, and it can be the internal communication of two components. For ordinary technicians in this field, the specific meanings of the above terms in the embodiments of the present invention can be understood according to specific circumstances.

[0014] In the field of interventional medical devices, the end of a medical device implanted in a human or animal body that is closer to the operator is generally called the "proximal end", and the end that is farther from the operator is called the "distal end". The "proximal end" and "distal end" of any component of the medical device are defined based on this principle. "Axial" generally refers to the length direction of the medical device when it is transported, and "radial" generally refers to the direction of the medical device that is not parallel to its "axial direction". The "axial" and "radial" of any component of the medical device are defined based on this principle. "Circumferential" refers to the circumferential direction, that is, the axial direction surrounding the lumen structure or column.

[0015] In order to explain the meaning of the large curved side area, the large curved side centerline, the small curved side area and the small curved side centerline, a curved tubular structure is used as an example in this paragraph. Figure 1 and Figure 2 The tubular structure 100A is a curved tube body, which includes a large curved side area 10A and a small curved side area 20A in the circumferential direction, and both the large curved side area 10A and the small curved side area 20A extend 180° in the circumferential direction. In the circumferential direction, the large curved side area 10A and the small curved side area 20A have two dividing lines L1. The large curved side area 10A has a large curved side centerline 110A, and the area included in the large curved side area 10A is an area that takes the large curved side centerline 110A as the starting position and extends 90° to both sides in the circumferential direction. The small curved side area 20A has a small curved side centerline 210A, and the area included in the small curved side area 20A is an area that takes the small curved side centerline 210A as the starting position and extends 90° to both sides in the circumferential direction. The large curved side centerline 110A and the small curved side centerline 210A are radially opposite to each other and are located in the same plane. It should be noted that in Figure 2 In the cross-sectional view of the tubular structure 10A, four dot structures are used to indicate the circumferential positions of the large-curve side centerline 110A, the small-curve side centerline 210A, and the two dividing lines L1 on the tubular structure 10A.

[0016] See also Figure 3 The existing adjustable bending sheath 100B includes a sheath tube 10B and a traction wire 30B. The traction wire 30B extends axially in the tube wall of the sheath tube 10B. The distal end of the traction wire 30B is connected to the distal end of the sheath tube 10B, and the proximal end extends to the vicinity of the proximal end of the sheath tube 10B and then extends to the outside of the sheath tube 10B. The traction wire 30B is a monofilament. Under the action of tension, the traction wire 30B applies tension to the distal end of the sheath tube 10B on one side of the sheath tube 10B, so that the sheath tube 10B is bent and deformed toward the side where the traction wire 30B is located. After the sheath tube 10B is adjusted to bend, the traction wire 30B is located in the small bend side area of ​​the sheath tube 10B, and the position of the traction wire 30B is the position where the center line of the small bend side of the sheath tube 10B is located.

[0017] See also Figure 4 , taking the target position as the brachiocephalic artery near the center line S2 of the greater curvature of the aortic arch as an example, the use process of the adjustable bending sheath is explained. During use, the operator first pushes the distal end of the sheath 10B to a position close to the brachiocephalic artery of the aortic arch, and then applies a pulling force directed toward the proximal end to the traction wire 30B, so that the sheath 10B is bent and deformed toward one side of the traction wire 30B (i.e., the sheath 10B is adjusted to bend). After the sheath 10B is bent and deformed, the tube opening faces the center S1 of the lesser curvature of the aortic arch. The operator locks the proximal end of the traction wire 30B to keep the sheath 10B at the center of the lesser curvature of the aortic arch. Figure 4 The curved shape shown, and the bending angle remains unchanged.

[0018] Then, a torque is applied to the sheath tube 10B so that the sheath tube 10B moves along Figure 4 The W direction is rotated in order to change the tube opening of the sheath tube 10B from Figure 4 The center line S1 on the lesser curvature of the aortic arch, as shown by the solid line in the middle, twists to Figure 4 The tube opening shown by the middle dotted line is oriented toward the centerline S2 of the greater curvature of the aortic arch (i.e., the tube opening of the sheath tube 10B is aligned with the target position of the brachiocephalic artery of the centerline S2 of the greater curvature of the aortic arch). Figure 4 One side shown by the solid line is twisted to the other side shown by the dotted line which is radially opposite to the solid line. The torque applied by the operator is hereinafter referred to as "operating torque".

[0019] During the twisting process of the sheath tube 10B, it is difficult for the operator to position the tube mouth of the sheath tube 10B in a state aligned with the brachiocephalic artery near the center line S2 of the greater curvature of the aortic arch. During the twisting process, either the tube mouth cannot be rotated toward the center line S2 of the greater curvature of the aortic arch due to the applied operating torque being too small, or the tube mouth is not stopped in time after rotating to the center line S2 of the greater curvature of the aortic arch due to the applied operating torque being too large (i.e., the circumferential position of the sheath tube 10B is locked), and the sheath tube 10B rotates one circle and returns to the initial circumferential position (i.e., the tube mouth returns to the position radially aligned with the center line S1 of the lesser curvature of the aortic arch).

[0020] As to the cause of this defect, the inventor of the present invention has determined through creative work that when the operator applies a pulling force to the sheath tube 10B through the traction wire 30B to bend the sheath tube 10B, when the traction wire 30B is subjected to the pulling force, the traction wire 30B itself will generate tension to counteract the pulling force. The tension of the traction wire 30B is positively correlated with the magnitude of the stretching of the traction wire 30B. When the magnitude of the stretching of the traction wire 30B is greater, the tension of the traction wire 30B is greater, and vice versa, the tension of the traction wire 30B is smaller.

[0021] Since the portion of the sheath tube 10B located at the aortic arch has a curved shape, the sheath tube 10B needs to adapt to the shape of the blood vessel, so the angle between the center line of the lesser curvature of the sheath tube 10B and the center line S1 of the lesser curvature of the aortic arch in the circumferential direction is substantially 0°, and the angle between the center line of the greater curvature of the sheath tube 10B and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is substantially 0°. Figure 4 The side indicated by the solid line is twisted to the other side indicated by the dotted line which is radially opposite to the solid line, and the position of the sheath tube 10B on the traction wire 30B in the circumferential direction is changed from Figure 5 The traction wire 30B shown is spaced 0° from the center line S1 of the lesser curvature of the aortic arch in the circumferential direction. Figure 6The center line S2 of the greater curvature of the aortic arch is shown as being 0° apart in the circumferential direction, that is, the traction wire 30B is rotated 180° in the circumferential direction. In this process, as the circumferential rotation angle of the sheath tube 10B gradually increases, the length of the tube body of the sheath tube 10B at the traction wire 30B gradually increases. Since the positions of the two ends of the traction wire 30B are locked, as the length of the tube body at the traction wire 30 increases, the length of the tube body at this position will increase the tension applied to the two ends of the traction wire 30, so that the stretching amplitude of the traction wire 30B increases, which will cause the tension of the traction wire 30B to increase.

[0022] That is to say, under the same conditions, the smaller the circumferential angle between the traction wire 30B and the center line S2 of the greater curvature of the aortic arch, the longer the traction wire 30B is stretched, and the greater the tension of the traction wire 30B; the closer the traction wire 30B is to the center line S1 of the lesser curvature of the aortic arch in the circumferential direction, the shorter the length of the traction wire 30B, and the smaller the tension of the traction wire 30B. Therefore, when the circumferential angle between the traction wire 30B and the center line S1 of the lesser curvature of the aortic arch is not equal to 0°, the tension of the traction wire 30B will increase to form a tension increment (the magnitude of the tension increment is equal to the magnitude of the tension of the traction wire 30B at this position minus the magnitude of the tension when the circumferential position of the traction wire 30B and the center line S1 of the lesser curvature of the aortic arch are 0° in the circumferential direction). When the circumferential angle between the traction wire 30B and the center line S2 of the greater curvature of the aortic arch is smaller, the tension increment of the traction wire 30B is greater. Furthermore, when the angle between the traction wire 30B and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is 0°, the tension increment of the traction wire 30B is the largest.

[0023] Since a portion of the sheath tube 10B is always curved when the sheath tube 10B rotates relative to the aortic arch in the circumferential direction, the tension increment of the traction wire 30B during the rotation of the sheath tube 10B will generate a circumferential torque, which acts on the sheath tube 10B to rotate the sheath tube 10B in the circumferential direction, thereby making the traction wire 30B and the center line S1 of the lesser curvature of the aortic arch at an angle of 0° in the circumferential direction. In other words, in the absence of external interference, the traction wire 30B is always 0° away from the center line S1 of the lesser curvature of the aortic arch in the circumferential direction. In order to distinguish it from the operating torque, the torque formed by the tension increment of the traction wire 30B is referred to as "traction wire torque" hereinafter.

[0024] Among them, the discussion on the size of the traction wire torque is as follows: As can be known from the content in the previous text, the magnitude of the traction wire torque is related to the extent to which the traction wire 30B is stretched, that is, it is related to the circumferential position of the traction wire 30B. Specifically, the smaller the angle between the traction wire 30B and the centerline S2 of the greater curvature of the aortic arch in the circumferential direction, the greater the value of the traction wire torque. When the angle between the traction wire 30B and the centerline S2 of the greater curvature of the aortic arch in the circumferential direction is 0°, the value of the traction wire torque is the largest. Correspondingly, when the angle between the traction wire 30B and the centerline S1 of the lesser curvature of the aortic arch in the circumferential direction is smaller, the value of the traction wire torque is smaller. When the angle between the traction wire 30B and the centerline S1 of the lesser curvature of the aortic arch in the circumferential direction is 0°, the value of the traction wire torque is zero.

[0025] The discussion on the direction of the torque of the traction wire is as follows: The direction of the traction wire torque is also related to the circumferential position of the traction wire. Specifically, the traction wire torque always drives the sheath tube 10B to rotate so that the traction wire returns to a position where the circumferential angle with respect to the center line S1 of the lesser curvature of the aortic arch is 0°. Fig. 7A As shown, when the traction wire 30B approaches the center line S2 of the large bend side, the direction of the traction wire torque T of the traction wire 30B is Fig. 7A The clockwise direction opposite to the W direction shown in FIG. 1 prevents the operator from twisting the sheath tube 10B in the W direction. Figure 7B As shown in FIG. 1 , after the traction wire 30B rotates in the W direction and crosses the center line S2 of the greater curvature of the aortic arch, the direction of the traction wire torque T of the traction wire 30B changes to Figure 7B The traction wire torque T acts on the sheath 10B in the counterclockwise direction which is the same as the W direction as shown in the figure, and has the effect of driving or accelerating the sheath 10B to rotate along the W direction so that the traction wire 30B returns to a position where the circumferential angle with respect to the center line S1 of the lesser curvature of the aortic arch is 0°.

[0026] During the process of the operator twisting the sheath 10B, the traction wire 30B rotates from the position with an angle of 0° in the circumferential direction with the center line S1 of the lesser curvature of the aortic arch to the center line S2 of the greater curvature of the aortic arch. The traction wire torque formed by the traction wire 30B hinders the sheath 10B from being twisted, so the operator needs to provide a larger operating torque to offset the traction wire torque and drive the sheath 10B to rotate. However, providing a larger operating torque will reduce the accuracy of the operator's manual control, and it is easy for the operator to fail to react in time and fail to lock the circumferential position of the sheath 10B in time after the traction wire 30B rotates in the W direction and crosses the center line S2 of the greater curvature of the aortic arch.

[0027] Furthermore, the traction wire 30B rotates along the W direction until it crosses the center line S2 of the greater curvature of the aortic arch. The direction of the traction wire torque becomes the same as the direction of the operating torque. The driving effects of the two are superimposed on each other. The sheath 10B will accelerate its rotation along the W direction and return to its initial position with a circumferential angle of 0° to the center line S1 of the lesser curvature of the aortic arch.

[0028] The operator needs to repeat the above-mentioned sheath tube 10B for many times, and each time the sheath tube 10B is rotated, the operator needs to concentrate highly, so as to be able to lock the circumferential position of the sheath tube in time at the moment when the angle between the traction wire 30B and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is 0°, so that the tube opening of the sheath tube 10B is aligned with the brachiocephalic artery near the center line S2 of the greater curvature of the aortic arch. Therefore, it is difficult to position the sheath tube in the prior art.

[0029] Based on this, the present disclosure discloses an adjustable bending sheath, in the process of twisting the sheath, when the angle between the main trunk of the pulling wire and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is within a value of (0°, 30°), the two branches of the wire group are respectively located on both sides of the center line S2 of the greater curvature of the aortic arch, and the directions of the pulling wire torques of the two branches of the wire group are opposite, and the pulling wire torques of the two branches of the wire group at least offset each other in part, so that the magnitude of the combined torque of the pulling wire torque formed by multiple branches is reduced, thereby reducing the interference of the pulling wire torque on the operator, and further reducing the difficulty of positioning the sheath. The details are as follows.

[0030] First embodiment See also Figure 8 The adjustable bending sheath 100 according to an embodiment of the present disclosure includes a sheath tube 10 and a handle 30 .

[0031] The sheath tube 10 includes an adjustable elbow tube 110 and a main body tube 130. The proximal end of the adjustable elbow tube 110 is connected to the distal end of the main body tube 130. The proximal end of the main body tube 130 is connected to the handle 30.

[0032] Please also read Figure 8 and Fig. 9 The handle 30 includes a shell 310 and a sliding member 330. The shell 310 is extended in the axial direction and has a receiving cavity 311. The distal end of the shell 310 is provided with a distal opening communicating with the receiving cavity 311, so that the proximal end of the main tube 130 can extend into the receiving cavity 311 from the distal opening. The shell 310 is connected to the proximal end of the main tube 130. The proximal end of the shell 310 is provided with a proximal opening 312 communicating with the proximal tube opening of the main tube 130, so that the implanted instrument or interventional instrument can enter the lumen of the sheath tube 10 from the proximal opening 312.

[0033] See also Fig. 9The housing 310 is provided with a track hole 313 extending in the axial direction. The track hole 313 penetrates the side wall of the housing 310 in the radial direction and communicates with the receiving cavity 311 .

[0034] See also Fig. 9 The sliding member 330 is slidably disposed on the housing 310. The sliding member 330 can slide axially on the housing 310 under the action of an external force.

[0035] The sliding member 330 includes an inner portion 331 and an outer thread 333. In the radial direction, the inner portion 331 is located in the track hole 313 and is slidably matched with the hole wall of the track hole 313. The outer thread 333 is provided on the outer surface of the inner portion 331 and is located outside the track hole 313.

[0036] Please also read Figure 8 and Fig. 9 The handle 30 further includes a knob 350. The knob 350 is rotatably sleeved on the housing 310, and the inner wall of the knob 350 is provided with an inner thread (not shown) that meshes with the outer thread 333 of the sliding member 330. When the knob 350 is subjected to an external force and rotates in the circumferential direction, the sliding member 330 is driven to move axially on the housing 310. During this process, the inner side portion 331 of the sliding member 330 is slidably matched with the track hole 313, so that the sliding member 330 slides axially on the housing 310.

[0037] Please also read Figure 8 and Fig. 9 In one embodiment, in order to limit the axial position of the knob 350, an annular recess 315 is provided on the housing 310. The knob 350 is installed in the recess 315, the distal end of the knob 350 abuts against the distal side wall of the recess 315, and the proximal end of the knob 350 abuts against the proximal side wall of the recess 315, which can prevent the knob 350 from sliding axially relative to the housing 310 under the action of the axial force, so that the knob can lock the axial position of the sliding member 330.

[0038] See also Fig.10 An anchor ring 150 is provided at the distal end of the adjustable elbow 110 , and the anchor ring 150 is fixedly embedded in the tube wall of the distal end of the adjustable elbow 110 .

[0039] The adjustable bending sheath 100 further includes a pull wire 50. In one embodiment, the pull wire 50 includes a trunk 510 and two branches 530 connected to the trunk 510. The two branches 530 of this embodiment form a wire group G.

[0040] The distal end of the trunk 510 is connected to the anchor ring 150, and further connected to the distal end of the adjustable elbow 110 through the anchor ring 150. The proximal end of the trunk 510 extends axially, and the trunk 510 is slidably embedded in the wall of the adjustable elbow 110.

[0041] exist Fig.10 In the embodiment shown, the trunk 510 is formed by folding a cable in half to form a folded line equivalent to a single traction line, and the distal end of the folded line is hooked on the anchor ring 150. In other embodiments, the trunk 510 is a single traction line, and the distal end of the traction line is fixedly connected to the anchor ring 150 by welding. The traction line can be a single-strand line. The traction line can also be a multi-strand line.

[0042] See also Fig.10 The distal ends of the two branches 530 are connected to the proximal end of the trunk 510 , the proximal ends of the two branches 530 extend toward the proximal end of the main organ 130 , and the proximal ends of the two branches 530 extend to the outside of the sheath 10 .

[0043] The two branches 530 each include a wire body portion 531 that is slidably embedded in the wall of the main tube 130 and extends axially. The two wire bodies 531 extend axially in the wall of the main tube 130. The wire bodies 531 of the two branches 530 are spaced apart in the circumferential direction of the sheath tube 10. Fig.10 In the illustrated embodiment, two wire bodies 531 are located on both sides of the trunk 510 in the circumferential direction, the two wire bodies 531 are spaced 180° apart in the circumferential direction, and both wire bodies 531 are spaced 90° apart from the trunk 510 in the circumferential direction of the sheath tube 10. That is, the two branches of the wire group G of this embodiment are spaced 180° apart in the circumferential direction. It should be noted that the angle between the two wire bodies 531 in the circumferential direction of the sheath tube 10 is equal to the central angle of the tube body located between the two wire bodies 531.

[0044] exist Fig.10 In the illustrated embodiment, in order to facilitate the arrangement of the circumferential position of the wire body 531, the two branches 530 each include a connection portion 532 connected to the distal end of the wire body 531, and the ends of the connection portions 532 of the two branches 530 away from the wire body 531 are both connected to the trunk 510. In this embodiment, the two connection portions 532 extend 90° in opposite directions in the circumferential direction from the portion connected to the trunk 510, so that the wire bodies 531 of the two branches 530 are spaced 180° in the circumferential direction of the sheath tube 10, and the wire bodies 531 of the two branches 530 are spaced 90° from the trunk 510 in the circumferential direction, and the wire bodies 531 of the two branches 530 are located on both sides of the trunk 510 in the circumferential direction. In other embodiments, those skilled in the art may, as required, set the circumferential extension angle and the circumferential extension length of the connecting portion 532 to thereby set the circumferential position of the wire body portion 531 connected to the connecting portion 532 and set the relative circumferential position relationship between the wire body portion 531 and the main rod 510.

[0045] See also Fig.10The portion of each branch 530 located outside the sheath tube 10 is an extension portion 533. In each branch 530, the distal end of the extension portion 533 is connected to the proximal end of the wire body portion 531. Fig.11 and Fig.12 , the proximal end of the extension portion 533 is connected to the sliding member 330 .

[0046] When the sliding member 330 is located at the distal end of the track hole 313 , the sliding member 330 applies little or no pulling force to each branch 530 , and the sheath tube 10 is not changed in shape by external force and remains in a straight shape.

[0047] When the sliding member 330 is driven by the knob 350 to slide axially toward the proximal end, a pulling force can be applied to the multiple branches 530, and the pulling force is transmitted to the distal end of the adjustable elbow 110 through the pull wire 50 and the anchor ring 150, so that the adjustable elbow 110 is bent and deformed (i.e., the adjustable elbow 110 is bent).

[0048] After the adjustable bend tube 110 is adjusted, when the adjustable bend tube 110 needs to be maintained at a certain bending angle, the torque applied to the knob 350 is released, so that the knob 350 and the sliding member 330 are locked in the axial position of the housing 310, thereby maintaining the adjustable bend tube 110 at the bending angle.

[0049] When it is necessary to restore the shape of the adjustable elbow 110 to a non-bent shape or reduce the bent angle of the adjustable elbow 110 , this can be achieved by driving the sliding member 330 to slide axially toward the distal end through the knob 350 .

[0050] It should be noted that, in order to facilitate the illustration of the circumferential positions of the trunk 510, the body 531 of the branch 530, the center line S1 of the lesser curvature of the aortic arch, and the center line S2 of the greater curvature of the aortic arch, and their relative positional relationship, Figures 13 to 16 In the figure, the trunk 510, the body 531, the center line S1 of the lesser curvature of the aortic arch, and the center line S2 of the greater curvature of the aortic arch are indicated by dot structures. Based on the same requirements, the trunk 510 and the body 531 located in different cross sections are indicated in the same cross section.

[0051] During the use of the adjustable bending sheath 100, the operator first pushes the sheath tube 10 along the patient's blood vessels so that the distal end of the sheath tube 10 is located near the brachiocephalic artery of the aortic arch.

[0052] Then, the adjustable bend tube 110 is bent according to the above method for bending the sheath tube 10. After the bending of the adjustable bend tube 110 is completed, the operator cancels the torque applied to the knob 350 to keep the adjustable bend tube 110 at the bending angle. Fig.13When the operator completes the bending of the sheath tube 10, the bending shape of the adjustable bend tube 110 is roughly the same as the bending shape of the aortic arch, that is, the tube opening of the sheath tube 10 faces the center line S1 of the lesser curvature of the aortic arch. Fig.13 As shown, in the circumferential direction of the aortic arch, the angle between the trunk 510 and the center line S1 of the lesser curvature of the aortic arch in the circumferential direction is 0°. Accordingly, the two body parts 531 are respectively located on both sides of the center line S2 of the greater curvature of the aortic arch in the circumferential direction, and the angle between the two body parts 531 and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is 90°.

[0053] Then, the operator applies an operating torque to the sheath tube 10 to rotate the sheath tube 10 in the patient's blood vessel in the direction W. The trunk 510 gradually approaches the centerline S2 of the greater curvature of the aortic arch. In this process, since the two wire bodies 531 are located on both sides of the trunk 510 in the circumferential direction, one of the two wire bodies 531 must cross the centerline S2 of the greater curvature of the aortic arch before the trunk 510.

[0054] That is, when the angle r between the trunk 510 and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is Fig.14 When the angle is less than 90°, the two wire bodies 531 are respectively located on both sides of the center line S2 of the greater curvature of the aortic arch along the circumferential direction, and the traction wire torques of the two wire bodies 531 are respectively Fig.15 The traction wire torque T1 and the traction wire torque T2 shown in the figure are in opposite directions, so the magnitude of the combined torque of the traction wire torque T1 and the traction wire torque T2 of the two branches 530 will decrease. The smaller the magnitude of the combined torque is, the more conducive it is to reducing the interference caused by the two branches 530 to the operator's twisting of the sheath 10, and the more conducive it is to reducing the difficulty of the operator's twisting of the sheath 10, thereby improving the accuracy of the circumferential positioning of the sheath 10.

[0055] Furthermore, the two wire bodies 531 are spaced at equal angles from the trunk 510 in the circumferential direction (both are 90°), so the smaller the angle between the trunk 510 and the center line S2 of the greater curvature of the aortic arch in the circumferential direction, the closer the tension of the two branches 530 on both sides of the center line S2 of the greater curvature of the aortic arch is, the smaller the combined torque of the traction wire torques of the two branches 530 will be, and the more conducive to reducing the difficulty of the operator to twist the sheath 10 so that the circumferential position of the trunk 510 is the same as the circumferential position of the aortic arch. When the angle between the trunk 510 and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is equal to 0°, the combined torque of the traction wire torques of the two branches 530 is zero, and the two branches 530 will not interfere with the operator's twisting of the sheath 10.

[0056] In addition, even if the operator's hand shake or other reasons cause Fig.16The trunk 510 shown is rotated to cross the greater curvature centerline S2 of the aortic arch. However, as long as the two wire bodies 531 are located on both sides of the greater curvature centerline S2 of the aortic arch (i.e., the circumferential spacing angle r between the trunk 510 and the greater curvature centerline S2 of the aortic arch is less than 90°, i.e., one wire body 531 has crossed the greater curvature centerline S2 of the aortic arch, and the other wire body 531 has not crossed the greater curvature centerline S2 of the aortic arch), the directions of the traction wire torques of the two wire bodies 531 are opposite. Since after the trunk 510 crosses the greater curvature centerline S2 of the aortic arch, the wire body 531 that has not crossed the greater curvature centerline S2 of the aortic arch is closer to the greater curvature centerline S2 of the aortic arch in the circumferential direction than the wire body 531 that has crossed the greater curvature centerline S2 of the aortic arch. Therefore, the wire body 531 that has not crossed the greater curvature centerline S2 of the aortic arch is closer to the greater curvature centerline S2 of the aortic arch than the wire body 531 that has crossed the greater curvature centerline S2 of the aortic arch. The magnitude of the traction wire torque of the wire body 531 is larger, and the direction of the traction wire torque of the wire body 531 is opposite to the rotation direction W of the sheath tube 10, so that the direction of the combined torque of the traction wire torques of the two branches 530 is opposite to the rotation direction W of the sheath tube 10, which can prevent the sheath tube 10 from continuing to rotate in the W direction or reduce the rotation speed of the sheath tube 10, so that the operator has a time window for operating the sheath tube 10 (i.e., the period from the time when the main trunk 510 rotates across the center line S2 of the greater curvature of the aortic arch to the time before the two wire bodies 531 all cross the center line S2 of the greater curvature of the aortic arch), and the operator can reversely twist the sheath tube 10 (or reversely twist the sheath tube 10 after locking the circumferential position of the sheath tube 10), so that the circumferential position direction of the main trunk 510 rotates to the angle r of 0° with the center line S2 of the greater curvature of the aortic arch in the circumferential direction, so that the distal end of the sheath tube 10 is aligned with the brachiocephalic artery. It is not necessary to require the operator to react at the moment when the angle r is 0°.

[0057] Furthermore, during the rotation of the sheath 10 in the W direction, one of the two branches 530 first crosses the center line S2 of the greater curvature of the aortic arch in the circumferential direction, causing the direction and magnitude of the combined torque of the two branches 530 to change, and the change is fed back to the operator's hand operating the sheath 10 in the form of touch, which is helpful to prompt the operator to reverse twist the sheath 10 in time (or lock the circumferential position of the sheath 10 and then reverse twist the sheath 10).

[0058] Therefore, compared with the prior art, the adjustable bending sheath 100 of this embodiment has lower difficulty in circumferential positioning during the twisting process, and has better fault tolerance in operation. During use, the number of times the operator rotates the operating sheath tube 10 can be reduced, thereby saving operation time.

[0059] In one embodiment, the number of branches 530 is an integer greater than or equal to 3, the number of wire groups G is one, and only one branch 530 of the multiple branches 530 forms a wire group G with another branch 530. The angle between the two branches 530 in the wire group G in the circumferential direction is any value within [60°, 180°] except 180°. The wire body 531 of one branch 530 of the wire group G is located on one side of the trunk 510 in the circumferential direction, and the wire body 531 of another branch 530 of the wire group G is located on the other side of the trunk 510 in the circumferential direction, or the angle between the wire body 531 of another branch 530 of the wire group G and the trunk 510 in the circumferential direction is 0°. Such arrangement enables, when the sheath 10 is twisted by the operator to approach the center line S2 of the greater curvature of the aortic arch, when the angle r between the trunk 510 and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is within a value within (0°, 30°), the two branches 530 in the wire group G are located on both sides of the center line S2 of the greater curvature of the aortic arch along the circumferential direction. Therefore, the traction wire torques generated by the two branches 530 in the wire group G partially offset each other due to their opposite directions, so that the magnitude of the resultant torque of the wire group G is reduced, and then the magnitude of the resultant torque of the traction wire torques of the multiple branches 530 is reduced, which is beneficial to reducing the difficulty of positioning the sheath 10.

[0060] In another embodiment, part or all of the multiple branches 530 form multiple wire groups G, and the branches 530 between different wire groups G are different. The angle between the two branches 530 of each wire group G in the circumferential direction is any value within [60°, 180°].

[0061] Furthermore, in each wire group G, the wire body 531 of one branch 530 is located on one side of the trunk 510 in the circumferential direction, and the wire body 531 of another branch 530 of the wire group G is located on the other side of the trunk 510 in the circumferential direction. Alternatively, the wire body 531 of another branch 530 is spaced from the trunk 510 at an angle of 0° in the circumferential direction.

[0062] Such an arrangement enables, when the sheath 10 is twisted by the operator toward the center line S2 of the greater curvature of the aortic arch, when the angle r between the trunk 510 and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is within a value within (0°, 30°), the traction wire torques generated by the two branches 530 in each wire group G at least partially offset each other, so that the value of the combined torque of the traction wire torques of the multiple branches 530 is further reduced, thereby further reducing the difficulty of positioning the sheath 10 when the operator twists the sheath 10.

[0063] In one embodiment, the wire bodies 531 of the multiple branches 530 are evenly distributed in the circumferential direction in the main tube 130. When the multiple branches 530 are subjected to tension, the wire bodies 531 of each branch 530 will generate a radial force on the main tube 130. The wire bodies 531 of the multiple branches 530 are evenly distributed in the circumferential direction in the main tube 130. The radial forces of the wire bodies 531 of the multiple branches 530 acting on the main tube 130 at least partially offset each other, which is conducive to reducing the bending deformation amplitude of the main section 130 during the bending adjustment process. The smaller the bending amplitude of the main section 130. When the branch 530 rotates at a certain angle in the circumferential direction, the smaller the bending amplitude of the main section 130, the smaller the length change of the branch 530, and therefore the smaller the traction wire torque of the branch 530, the smaller the interference of the wire 50 on the operator, thereby helping to reduce the difficulty of circumferential positioning when the sheath tube 10 is twisted.

[0064] In one embodiment, the handle 30 can be omitted from the adjustable bending sheath 100. After the handle 30 is omitted, when the adjustable bending tube 110 needs to be bent, the operator holds the proximal end of the main tube 130 with one hand, and applies a pulling force directed to the proximal end of the multiple branches 530 with the help of a tool (such as a clamp) or directly (i.e., without the help of a tool) with the other hand, and the adjustable bending tube 110 bends and deforms under the action of the pulling force. After the bending angle of the adjustable bending tube 110 meets the expectation, the magnitude of the pulling force on the multiple branches 530 is kept unchanged to lock the axial position of the proximal ends of the multiple branches 530, so that the bending angle of the adjustable bending tube 110 remains unchanged. When the sheath tube 10 needs to be twisted, the operator applies an operating torque to the main tube 130 with the hand holding the main tube 130, thereby driving the sheath tube 10 to rotate circumferentially. When the sheath tube 10 rotates circumferentially, the traction wire torques generated by the two branches 530 in the wire group G at least partially offset each other, thereby reducing the difficulty of circumferential positioning of the sheath tube 10 .

[0065] Second embodiment In this embodiment, the number of the branches 530 is an even number, and the branches 530 are grouped in pairs to form a line group G.

[0066] The difference between this embodiment and the first embodiment is that the proximal ends of the two branches 530 of each wire group G (i.e., the proximal ends of the extension 533) are movably connected to the sliding member 330 (for example, slidably penetrated, rotatably connected, deflectably connected, etc.).

[0067] When the sliding member 330 slides axially toward the proximal end under the action of an external force, a tensile force is applied to the multiple branches 530. When the multiple branches 530 are subjected to the tensile force and the tensions of the two branches 530 of the wire group G are unequal, the two branches 530 of the wire group G move synchronously relative to the sliding member 330 to make the tensions of the two branches 530 of the wire group G equal. Since the time from the tension of the two branches 530 of the wire group G to the proximal ends of the two branches 530 of the wire group G moving relative to the sliding member 330 to make the tensions of the two branches 530 equal is short, the tensions of the two branches 530 of the wire group G are considered to be always equal during the process of the two branches 530 being subjected to the tensile force.

[0068] When the operator is bending the adjustable bending pipe 110, under the condition of constant pulling force, the tension of the two branches 530 of the wire group G is always equal, which can reduce the risk of the branch 530 with larger tension in the wire group G breaking due to excessive difference in tension between the two branches 530 of the wire group G.

[0069] When the operator twists the sheath 10, the tension of the two branches 530 of the wire group G is always equal, and the traction wire torque of the two branches 530 of the wire group G is always equal. When the two branches 530 of the wire group G are rotated to be located on both sides of the center line S2 of the greater curvature of the aortic arch, the traction wire torques of the two branches 530 are in opposite directions, and the traction wire torques of the two branches 530 of the wire group G offset each other (that is, the total torque is zero), so that the operator can control the sheath 10 more stably, further reducing the difficulty of positioning the twisted sheath 10.

[0070] Third embodiment See also Fig.17 In this embodiment, the number of the line group G is one as an example for description. In other embodiments, the number of the line group G may be multiple.

[0071] Please also read Figures 17 to 19A The proximal ends of the extensions 533 of the two branches 530 of the wire group are connected and form a wire loop G1 at the proximal end of the wire group G, and the wire loop G1 can be slidably passed through the sliding member 330. This arrangement allows the two branches 530 to slide synchronously relative to the sliding member 330 during the stretching process of the two branches 530 and when the tensions of the two branches 530 of the wire group G are not equal, so that the tensions of the two branches 530 of each wire group G are always equal. As long as the angle between the trunk 510 and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is within a value of (0°, 30°), the combined torque of the traction wire torque generated by the two branches 530 of the wire group G is zero, which can further reduce the difficulty of positioning the sheath tube 10 during the twisting process.

[0072] Moreover, when the two branches 530 are stretched and the pulling force is constant, the tension of the two branches 530 of the wire group G is always equal, which can reduce the risk of the branch with greater tension of the two branches 530 of the wire group G breaking due to excessive tension difference.

[0073] Those skilled in the art can understand that when there are multiple groups G, the proximal ends of the extensions 533 of the two branches 530 of each group G are connected and form a wire loop G1 at the proximal end of the wire group G, and each wire loop G1 can be slidably penetrated by a sliding member 330. When the sheath tube 10 is twisted to the angle between the trunk 510 and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is a value within (0°, 30°), the two branches 530 of the wire group G are located on both sides of the center line S2 of the greater curvature of the aortic arch, and the combined torque of the traction wire torque of the two branches 530 of the wire group G is zero, which reduces the size of the combined torque formed by the multiple branches 530, thereby reducing the difficulty of positioning the sheath tube 10 during the twisting process. Moreover, when the multiple branches 330 are stretched, the risk of the two branches 530 of the wire group G causing the branch with greater tension to break due to excessive tension difference can be reduced.

[0074] See also Fig.19A and Fig.19B The sliding member 330 is provided with a through hole 335 , and a portion of the wire loop G1 passes through the through hole 335 , so that the wire loop G1 can slidably pass through the sliding member 330 .

[0075] See also Fig.17 The adjustable bending sheath 100 also includes a drag reducer 60, which can be a polytetrafluoroethylene film with good lubricity or other materials with good lubricity. The drag reducer 60 is wrapped around the outer surface of the wire loop G1. When the wire loop G1 is inserted into the sliding member 330, the drag reducer 60 is separated between the hole wall of the through hole 335 and the wire loop G1. In other embodiments, the drag reducer 60 is cylindrical, sheet-shaped or other shapes, and the drag reducer 60 is pasted on the hole wall of the through hole 335, so that when the wire loop G1 is inserted into the sliding member 330, the drag reducer 60 is separated between the hole wall of the through hole 335 and the wire loop G1.

[0076] During the stretching of the multiple branches 530, when the two branches 530 of the wire group G slide synchronously relative to the sliding member 330 due to unequal tensions with each other, since a drag reducer 60 is provided between the hole wall of the through hole 335 and the wire loop G1, the friction between the wire loop G1 and the hole wall can be reduced, which is beneficial for the operator to always have equal tensions in the two branches 530 of each wire group G during the process of bending the adjustable bend tube 110 and twisting the sheath tube 10.

[0077] When the operator is bending the adjustable elbow 110, under the condition that other conditions are the same, the closer the wire body 531 in the branch 530 and the extension 533 connected to the wire body 531 are to a straight line (that is, the larger the angle formed by the wire body 531 and the extension 533 connected in the branch 530), the smaller the pulling force required for the pull wire 50, and the more favorable it is to reduce the risk of the pull wire 50 breaking when subjected to tension.

[0078] In order to reduce the risk of the pull wire 50 breaking when subjected to tension, the angle formed by the connecting wire body 531 and the extension 533 in each branch 530 can be increased. In one embodiment, the thickness of the portion of the sliding member 330 where the through hole 335 is provided is set so that the ratio of the hole depth of the through hole 335 to the outer diameter of the sheath tube 10 is in the range of 90% to 100%. Under the same other conditions, the closer the ratio of the hole depth of the through hole 335 to the outer diameter of the sheath tube 10 is to 100%, the larger the angle formed by the connecting wire body 531 and the extension 533 in each branch 530 is, and the more conducive it is to reducing the risk of the pull wire 50 breaking when subjected to tension.

[0079] Fourth embodiment See also FIG. 20A to FIG. 21 The difference between this embodiment and the third embodiment is that the adjustable bending sheath 100 further includes a rotating member 71 rotatably disposed on the sliding member 330, and the rotating member 71 may be a rotating shaft. The sliding member 330 is provided with a bearing component 72, and the rotating member 71 is rotatably disposed on the bearing component 72, so as to be rotatably disposed on the sliding member 330 through the bearing component 72. The bearing component 72 may be a bearing fixedly connected to the sliding member 330.

[0080] exist FIG. 20A to FIG. 21 In the illustrated embodiment, there is one wire group G and one rotating member 71. The wire ring G1 is sleeved on the rotating member 71. When multiple branches 530 are subjected to tension and the tension of the two branches 530 of the wire group G is unequal, the rotating member 71 rotates around the rotation center driven by the two branches 530 of the wire group G, so that the tension of the two branches 530 of each wire group G is always equal. When the sheath 10 is twisted to the point where the circumferential angle between the trunk 510 and the center line S2 of the greater curvature of the aortic arch is within a value within (0°, 30°), the two branches 530 of the wire group G are located on both sides of the center line S2 of the greater curvature of the aortic arch, and the combined torque of the traction wire torque of the two branches 530 of the wire group G is zero, which is beneficial to the positioning of the sheath 10.

[0081] In other embodiments, the number of the wire groups G is multiple, the number of the rotating members 71 is the same as the number of the wire groups G, and the multiple rotating members 71 are arranged along the axial direction. In other embodiments, the arrangement of the multiple rotating members 71 can also be that the multiple rotating members 71 are arranged along the circumferential direction. Alternatively, a part of the multiple rotating members 71 is arranged along the circumferential direction, and another part is arranged along the axial direction. The rotating members 71 are arranged one by one with the wire groups G.

[0082] In the corresponding rotating member 71 and wire group G, the wire ring G1 is sleeved on the rotating member 71. When multiple branches 530 are subjected to tension and the tension of the two branches 530 of the wire group G is not equal, the rotating member 71 rotates around the rotation center driven by the two branches 530 of the wire group G corresponding to it, so that the tension of the two branches 530 of each wire group G is always equal. When the sheath 10 is twisted to the angle between the trunk 510 and the center line S2 of the greater curvature of the aortic arch in the circumferential direction is a value within (0°, 30°), the two branches 530 of the wire group G are located on both sides of the center line S2 of the greater curvature of the aortic arch, and the combined torque of the traction wire torque of the two branches 530 of the wire group G is zero, which is beneficial to reduce the risk of branch 530 breakage during the operator's bending of the adjustable bend tube 110, and is beneficial to reduce the difficulty of positioning the sheath 10 during the operator's twisting of the sheath 10.

[0083] In order to reduce the risk of the pull wire 50 breaking when subjected to tension, the angle formed by the connected wire body 531 and the extension 533 in each branch 530 can be increased. In one embodiment, by setting the ratio of the outer diameter of the rotating member 71 to the outer diameter of the sheath tube 10 to be in the range of 90% to 100%, it is beneficial to increase the angle formed by the connected extension 533 and the wire body 531 in the branch 530, thereby reducing the risk of the pull wire 50 breaking when subjected to tension.

[0084] Fifth embodiment See also FIG. 22A to FIG. 23 The difference between this embodiment and the third embodiment is that the adjustable bending sheath 100 further includes a balance frame 80 disposed on the sliding member 330 .

[0085] exist FIG. 22A to FIG. 23 In the illustrated embodiment, the balancing frame 80 is located in the receiving cavity 311 of the housing 310. In other embodiments, the balancing frame 80 may also be located outside the handle 30, and the balancing frame 80 is connected to the sliding member 330 through an intermediate connecting member that slidably passes through the housing 310, and when the sliding member 330 is driven, the balancing frame 80 can be synchronously driven to move along the axial direction. In short, whether the balancing frame 80 is located in the receiving cavity 311 of the handle 30 or outside the handle 30, as long as the sliding member 330 can synchronously drive the balancing frame 80 to move along the axial direction.

[0086] Please also read FIG. 22A to FIG. 23 The balancing frame 80 includes a connecting rod 81 and a balancing rod 82. One end of the connecting rod 81 is fixedly connected to the sliding member 330, and the other end is movably connected to the balancing rod 82. For example, the connecting rod 81 is movably connected to the balancing rod 82 through a ball head, or the connecting rod 81 is rotatably connected to the balancing rod 82 through a pin.

[0087] exist FIG. 22A to FIG. 23 In the embodiment, the number of wire group G is one, and the number of balance frame 80 is also one. The proximal ends of the two extensions 533 in the wire group G are respectively connected to the two ends of the balance bar 82, so that the two branches 530 of the wire group G are movably connected to the sliding member 330. When the two branches 530 are subjected to tension and the tension of the two branches 530 of the wire group G is unequal, the balance bar 82 deflects to make the tension of the two branches 530 of the wire group G equal, so that the two branches 530 of the wire group G are located on both sides of the center line S2 of the greater curvature of the aortic arch, and the combined torque of the traction wire torque of the two branches 530 of the wire group G is zero, which is beneficial to reduce the risk of branch 530 breakage during the operator's bending of the adjustable bend tube 110, and is beneficial to reduce the difficulty of positioning the sheath tube 10 during the operator's twisting of the sheath tube 10.

[0088] In other embodiments, the number of the wire groups G and the number of the balance racks 80 are both multiple, and the number of the wire groups G is the same as the number of the balance racks 80, and the multiple balance racks 80 are arranged along the axial direction. The balance racks 80 and the wire groups G are arranged one by one.

[0089] In the correspondingly arranged balance frame 80 and wire group G, both ends of the balance bar 82 are respectively connected to the proximal ends (i.e., the proximal ends of the extension 533) of the two branches 530 of the wire group G. When the multiple branches 530 are subjected to tension and the tensions of the two branches 530 of the wire group G are unequal, the balance bar 82 deflects to make the tensions of the two branches 530 of the wire group G equal.

[0090] See also FIG. 22A to FIG. 23 The connecting rod 81 extends along the axial direction of the sheath tube 10 , and the connecting rod 81 and the balancing rod 82 are arranged along the axial direction of the sheath tube 10 , which can reduce the radial size of each balancing frame 80 , and further reduce the radial size of the accommodating cavity 311 of the shell 310 .

[0091] In one embodiment, the balance frame 80 of the above embodiment can also be replaced by a universal joint (not shown). In one embodiment, the universal joint is a ball joint. The universal joint includes a first part and a second part that are movably connected by a ball joint, the first part is connected to the sliding member 330, and the second part is connected to the proximal ends of the multiple branches 530. When the multiple branches 530 are subjected to tension and the tension of the multiple branches 530 is unequal, the second part moves relative to the first part to make the tension of the multiple branches 530 equal and offset each other, thereby reducing the difficulty of positioning the sheath 10. In this embodiment, it is not required that the multiple branches 530 form a line group G in pairs, and the number of branches 530 connected to the second part can be an even number or an odd number, as long as each branch 530 is connected to the second part. Therefore, this embodiment is more applicable when it can reduce the difficulty of positioning the sheath 10.

[0092] In other embodiments, the universal joint may also be other types of universal joints, as long as the first part and the second part can be movably connected.

[0093] The technical features of the above-described embodiments may be arbitrarily combined. To make the description concise, not all possible combinations of the technical features in the above-described embodiments are described. However, as long as there is no contradiction in the combination of these technical features, they should be considered to be within the scope of this specification.

[0094] The above disclosure is only the preferred embodiment of the present invention, which certainly cannot be used to limit the scope of the present invention. Therefore, equivalent changes made according to the claims of the present invention are still within the scope of the present invention.

Claims

1. An adjustable bending sheath, characterized in that: The invention comprises a sheath tube and a pull wire, wherein the sheath tube comprises an adjustable curved tube and a main body tube, the proximal end of the adjustable curved tube is connected to the distal end of the main body tube, and the pull wire comprises: A main trunk, wherein the main trunk is slidably embedded in the wall of the adjustable elbow, the distal end of the main trunk is connected to the distal end of the adjustable elbow, and the proximal end of the main trunk extends axially; A plurality of branches, the distal ends of the plurality of branches are connected to the proximal end of the trunk, the proximal ends of the plurality of branches extend proximally, and the proximal ends of the plurality of branches extend to the outside of the sheath tube, the plurality of branches include a wire body portion slidably embedded in the tube wall of the main tube, and the wire body portions of the plurality of branches extend axially, the plurality of branches include at least one wire group formed by two of the branches, the wire body portions of the two branches of the wire group are spaced at an angle in the circumferential direction in the range of [60°, 180°], and, The wire body of one branch of the wire group is circumferentially located on one side of the trunk, and the wire body of another branch of the wire group is circumferentially located on the other side of the trunk, or the angle between the wire body of another branch of the wire group and the trunk in the circumferential direction is 0°.

2. The adjustable bending sheath according to claim 1, characterized in that: The adjustable curved sheath further comprises a handle, wherein the handle comprises: A housing connected to the proximal end of the main body tube; A sliding member, wherein the sliding member is slidably disposed on the shell, the sliding member is movably connected to the proximal ends of the multiple branch lines, and the sliding member can slide axially on the shell under the action of external force, so that a pulling force can be applied to the distal end of the adjustable bend pipe through the pull wire to bend and deform the adjustable bend pipe, or the pulling force applied to the adjustable bend pipe can be cancelled.

3. The adjustable bending sheath according to claim 2, characterized in that: Each of the branches comprises an extension portion located outside the sheath tube, and in each of the branches, the extension portion and the wire body portion are connected to each other; The number of the multiple branches is an even number, and the wire group is formed in groups of two. The proximal ends of the extended parts of the two branches of each wire group are connected to form a wire loop, and each wire loop can be slidably passed through the sliding member. When the multiple branches are subjected to tensile force and the tension of the two branches of the wire group is unequal, the two branches of the wire group slide synchronously relative to the sliding member to make the tension of the two branches of the wire group equal.

4. The adjustable bending sheath according to claim 3, characterized in that: The sliding member is provided with a through hole, and a part of the wire loop passes through the through hole, so that the wire loop can be slidably passed through the sliding member. The adjustable bending sheath also includes a drag reducer, and the drag reducer is arranged between the hole wall of the through hole and the wire loop.

5. The adjustable bending sheath according to claim 3, characterized in that: The ratio of the hole depth of the perforation to the outer diameter of the sheath tube ranges from 90% to 100%.

6. The adjustable bending sheath according to claim 2, characterized in that: Each of the branches comprises an extension portion located outside the sheath tube, and in each of the branches, the extension portion and the wire body portion are connected to each other; The number of the plurality of branches is an even number, and the wire groups are formed in pairs, and the proximal ends of the extensions of the two branches of each wire group are connected to form a wire loop; The adjustable bending sheath further comprises a rotating member rotatably arranged on the sliding member, the number of the rotating members being greater than or equal to one, when the number of the rotating members is greater than one, a plurality of the rotating members are arranged along the axial direction, the rotating members are arranged one by one corresponding to the line groups, and, In the correspondingly arranged rotating member and the wire group, the wire ring is sleeved on the rotating member, and the multiple branches are subjected to tensile force. When the tension of the two branches of the wire group is unequal, the rotating member rotates around the rotation center under the drive of the two branches of the wire group to make the tension of the two branches of the wire group equal.

7. The adjustable bending sheath according to claim 6, characterized in that: The ratio of the outer diameter of the rotating member to the outer diameter of the sheath tube ranges from 90% to 100%.

8. The adjustable bending sheath according to claim 2, characterized in that: The housing is formed with a receiving cavity, the proximal end of the sheath tube is received in the receiving cavity, the adjustable bending sheath is also provided on the sliding member, the number of the balancing frames is greater than or equal to one, when the number of the balancing frames is greater than one, a plurality of the balancing frames are arranged along the axial direction, the balancing frame comprises a connecting rod and a balancing rod, one end of the connecting rod is fixedly connected to the sliding member, and the other end is movably connected to the balancing rod, the balancing frame and the line group are provided one by one, and, In the correspondingly arranged balance frame and the wire group, the two ends of the balance rod are respectively connected to the proximal ends of the two branches of the wire group. When the multiple branches are subjected to tensile force and the tension of the two branches of the wire group is unequal, the balance rod deflects to make the tension of the two branches of the wire group equal.

9. The adjustable bending sheath according to claim 8, characterized in that: The connecting rod extends along the axial direction of the sheath tube, and the connecting rod and the balancing rod are arranged along the axial direction of the sheath tube.

10. The adjustable bending sheath according to claim 2, characterized in that: The adjustable bending sheath also includes a universal joint, which includes a first part and a second part that are movably connected, the first part is connected to the sliding member, and the second part is connected to the proximal ends of the multiple branch lines. When the multiple branches are subjected to tension and the tension of the multiple branches is unequal, the second part moves relative to the first part to make the tension of the multiple branches equal.

11. The adjustable bending sheath according to any one of claims 1 to 10, characterized in that: The plurality of branched wire bodies are evenly distributed along the circumference of the sheath tube.

Images