Mobile catheter

Abstract

assignment Providing a movable catheter capable of simultaneously improving maneuverability and insertability. Solution It is a movable catheter having a flexible tube (2) having a distal end and a proximal end. The tube (2) has a first tube part (sheath body part (20)) in which the flexibility does not substantially change even when subjected to compressive force in the axial direction, and a second tube part (deflection part (21)) which is joined to the distal end of the first tube part and is composed of a porous tube that becomes hard when compressed according to the degree of compressive force acting in the axial direction, and returns to its original soft state when the compressive force is released, and has an operating means (wire (W1, W2)) that can release the compressive force that compresses the second tube part in the axial direction and the deflection force that deflects the second tube part.

Description

Technology Field

[0001] The present invention relates to a catheter, which is a medical treatment device used to perform various treatments or examinations, and in particular, to a steerable catheter capable of freely deflecting its tip. Background Technology

[0002] A movable catheter is known as a medical treatment device (e.g., contrast agent injection catheter, electrode catheter, ablation catheter, catheter sheath) inserted into various organs (e.g., bile duct, heart) through a body cavity, tubular lumen, or blood vessel, etc., to facilitate insertion or access to the target tissue, wherein the direction of the tip (distal end) of the catheter inserted into the body can be deflected by operating a control part installed on the base (proximal end) of the catheter placed outside the body (e.g., see Patent Document 1 and Patent Document 2).

[0003] The catheter described in Patent Document 1 is an endoscopic catheter used for injecting an X-ray contrast agent into the bile duct for examination of the bile duct, etc., and is a catheter in which the tip can be deflected (bent) by manipulating (extruding or pulling) a manipulating wire from the outside of the body so that, after being inserted into the duodenum through the endoscope, the tip can be inserted into the duodenal papilla from the duodenal side and reach into the bile duct. The catheter described in Patent Document 1 has a lumen into which a manipulating wire for deflecting the tip is inserted, separate from the large-diameter lumen used for injecting a contrast agent, etc., and since the manipulating wire is joined to a tip tip installed at the tip of the catheter by means such as plasma welding, the tip of the catheter can be deflected by pulling the manipulating wire from the outside of the body.

[0004] The tip-movable catheter described in Patent Document 2 is a catheter used for guiding an ablation catheter to a site of treatment on the heart to perform catheter ablation treatment on the heart, and is a catheter in which the tip can be deflected (bent) by operating the operating part from the outside so as to easily guide the tip of the ablation catheter to a desired location on the heart. The catheter tube constituting the catheter described in Patent Document 2 has a pair of wire lumens located at positions 180° opposite each other within the tube wall, in addition to the main lumen into which various treatment devices are inserted. In addition, the portion of the catheter tube to be deflected is, for example, set to have a gradually lower rigidity as it approaches the tip, and the respective tips of a pair of wires inserted into each of the wire lumens are connected to a ring (pulling) integrally mounted on the tip by means such as laser welding, and the respective ends of the pair of wires are connected to an operating part. Then, by operating the operating part, one wire is pulled and the other wire is loosened, thereby enabling control of the direction of the tube tip.

[0005] However, in this type of movable catheter, the movable part (deflection part) needs to have enough flexibility to be easily and freely deflected (bent) by manipulating the wire. However, if the configuration is made flexible (soft) for the sake of maneuverability, bending or buckling may occur, such as when penetrating a narrowed part within a lumen like a bile duct, and there is a risk of reduced insertability. Conversely, if the configuration is made rigid (hard) for the sake of insertability, there is a risk of sacrificing maneuverability. Prior art literature

[0006] Japanese Published Patent Application No. 2002-272675 Japanese Published Patent Application No. 2014-188039 The problem to be solved

[0007] The present invention has been made in consideration of these realities, and its purpose is to provide a movable catheter capable of simultaneously improving operability and insertability. means of solving the problem

[0008] To achieve the above objective, the movable catheter according to the present invention is,

[0009] A movable catheter having a flexible tube having a distal end inserted into the body and a proximal end disposed outside the body,

[0010] The above tube comprises a first tube portion in which the flexibility does not substantially change even when subjected to compressive force in the axial direction, and a second tube portion formed of a porous tube that is joined continuously to the distal end of the first tube portion, becomes rigid when compressed according to the degree of compressive force acting in the axial direction, and returns to its original state and becomes soft when the compressive force is released.

[0011] The above second tube portion has an operating means capable of releasing a compressive force that compresses the second tube portion in the axial direction and a deflection force that deflects the second tube portion, respectively.

[0012] According to the movable catheter of the present invention, by appropriately manipulating the operating means, the second tube portion can be deflected by applying a deflection force to the second tube portion while maintaining a soft state without applying a compressive force to the second tube portion as much as possible, and since the second tube portion is in a soft state at this time, good operability can be realized. On the other hand, in cases such as breaking through (penetrating) a stenotic portion within an internal lumen, such as a bile duct, for example, by appropriately manipulating the operating means to apply a compressive force to the second tube portion to make it rigid, bending or buckling can be suppressed, thereby improving insertability. Accordingly, a movable catheter capable of improving both operability and insertability can be provided.

[0013] In a movable catheter according to the present invention, the tube has at least three wire lumens spaced apart from each other and extending from a proximal end to a distal end of the tube within the wall of the tube, and the operating means may have at least two wires, each having approximately half of one end inserted into one of the wire lumens, a middle portion folded back at the distal end of the second tube portion, and approximately half of the other end inserted into another of the wire lumens, with the one end and the other end reaching the proximal end of the first tube portion. The second tube portion can be made rigid by pulling each end (one end and the other end) of all wires (or a suitable portion of wires according to the arrangement of the wire lumens) with the same tensile force between each wire so that a compressive force is applied to the second tube portion. In addition, the second tube section can be deflected according to the difference in tensile force by pulling with a difference in tensile force between each wire (or pulling only some of the wires) so that a deflection force acts on the second tube section.

[0014] In a movable catheter according to the present invention, the tube is provided with at least three wire lumens spaced apart from each other within the wall of the tube, extending from a proximal end to a distal end of the tube, and the operating means may be provided with at least three wires, the distal end of which is connected to the distal end of the second tube portion and is inserted into one of the wire lumens, the proximal end of which reaches the proximal end of the first tube portion. The second tube portion can be made rigid by pulling each proximal end of all wires (or a suitable portion of wires according to the arrangement of the wire lumens) with the same tensile force between each wire so that a compressive force acts on the second tube portion. Additionally, the second tube portion can be deflected according to the difference in tensile force by pulling with a difference in tensile force between each wire (or pulling only some of the wires) so that a deflection force acts on the second tube portion. Brief explanation of the drawing

[0015] FIG. 1 is a drawing showing the external configuration of a movable catheter of an embodiment of the present invention. Figure 2a is a cross-sectional view taken along the line IIa-IIa of Figure 1. FIG. 2b is a perspective view showing an enlarged view of the movable catheter of FIG. 1. FIG. 2c is a cross-sectional view of the distal end of the movable catheter of FIG. 2b, cut at the axis of each of the pair of wire lumens. FIG. 3 is a drawing showing an enlarged view of the distal end of the movable catheter of FIG. 1, and is a drawing for explaining the operation of the deflection part. FIG. 4a is a perspective view showing the case where the number of wires inserted into the lumen for the wire of the movable catheter of FIG. 2b is increased. FIG. 4b is a cross-sectional view of the distal end of the movable catheter of FIG. 4a cut in a plane perpendicular to its axis. FIG. 4c is a cross-sectional view of the distal end of the movable catheter of FIG. 4a, cut at the plane passing through the axis of each of the pair of wire lumens. Figure 5a is a drawing showing a modified example of the movable catheter of Figure 4a. Figure 5b is a drawing showing another variation of the movable catheter of Figure 4a. Figure 5c is a drawing showing another variation of the movable catheter of Figure 4a. Specific details for implementing the invention

[0016] Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. The catheter sheath (movable sheath) as a movable catheter of the present embodiment is a catheter that is inserted in advance of, for example, an electrode catheter for detecting an electrocardiogram or an ablation catheter for cauterizing a lesion when performing catheter ablation, and guides these electrode catheters or ablation catheters. Hereinafter, the catheter sheath is described as an example of a movable catheter to which the present invention is applied, but the present invention can also be applied to electrode catheters, ablation catheters, movable endoscopic catheters used for injecting X-ray contrast agents into the bile duct for examination of the bile duct, and other movable catheters.

[0017] Meanwhile, catheter ablation is a treatment method for treating arrhythmias occurring in the heart. It involves inserting an ablation catheter, which has a high-frequency electrode at its tip, through a blood vessel to the myocardial tissue that is the cause of the arrhythmia within the heart, and cauterizing the myocardial tissue or its vicinity to a temperature of 60 to 70 degrees to cause coagulation and necrosis, thereby blocking the circuit of the arrhythmia.

[0018] First, refer to FIGS. 1 and FIGS. 2a to 2c. A catheter sheath (movable catheter) (1) is configured by roughly comprising a sheath (tube) (2), a control part (3), a grip part (4), and a pair of wires (control means) (W1, W2).

[0019] The sheath (2) is made of a flexible hollow tube having a distal end inserted into the body and a proximal end disposed outside the body, and is composed of a sheath main body (first tube part) (20) disposed on the proximal end side and a deflection part (second tube part) (21) disposed on the distal end side. The sheath main body (20) is configured to have relatively high rigidity so that its flexibility does not substantially change even when subjected to compressive force along the axis (axis direction). As the sheath main body (20), a multilayer tube including a blade layer made of, for example, mesh stainless steel, and a plurality of resin layers is used.

[0020] The deflection section (21) is integrally joined so that its proximal end is continuous with the distal end of the sheath main body (20). The lumen of the deflection section (21) and the lumen of the sheath main body (20) are connected to each other in a continuous manner, and the main lumen (22) is formed by them. The deflection section (21) is composed of a porous tube that becomes hard when compressed according to the degree of compressive force applied in the axial direction, and returns to its original state and becomes soft when the compressive force is released. The flexibility of the porous tube can be controlled by adjusting the compressive force applied in the axial direction.

[0021] The material of the sheath body part (20) is not particularly limited as long as it has flexibility, but it is preferably a thermoplastic resin or a thermoplastic elastomer, and for example, polyamide-based elastomers such as polyether block amide copolymer, polyamide, polyimide, polyamideimide, polyethylene terephthalate, polyethylene, polypropylene, polyurethane, ethylene-vinyl acetate copolymer, polyvinyl chloride, polytetrafluoroethylene, tetrafluoroethylene-hexafluoropropylene copolymer, tetrafluoroethylene-perfluoroalkyl vinyl ether copolymer, etc. are used.

[0022] The material of the porous tube constituting the deflection section (21) is not limited, but it is preferable to use PTFE (polytetrafluoroethylene) due to its excellent heat resistance, chemical resistance, weather resistance, and water repellency. As the porous tube, a tube manufactured by extruding PTFE and then stretching it in the axial direction can be used. By making the PTFE porous, the necessary water resistance can be obtained while maintaining air permeability. In addition, by appropriately adjusting the elongation rate (degree of elongation) during stretching, the porosity can be adjusted, and the change in flexibility when compressed can be appropriately adjusted (controlled). Meanwhile, it is also possible to change the air permeability performance by adjusting the porosity.

[0023] In the operating part (3) and grip part (4) mounted on the proximal end of the sheath (2), an insertion hole is formed through which the proximal end of the sheath (2) is inserted, and a sheath hub (41a) is mounted on the proximal end of the grip part (4).

[0024] The sheath hub (41a) has an inner lumen, and the sheath (2) within the grip portion (4) is mounted on the proximal end of the sheath hub (41a) so that the inner lumen of the sheath hub (41a) and the main lumen (22) of the sheath (2) are in communication. Additionally, a catheter insertion port equipped with a hemostatic valve is formed on the distal end of the sheath hub (41a). When using (treating) the catheter sheath (1), the aforementioned electrode catheter or ablation catheter is inserted through the catheter insertion port of the sheath hub (41a), guided to the main lumen (22) of the sheath (2), and guided to the myocardial tissue to be treated at each distal end. Additionally, a side tube is formed on the side of the sheath hub (41a), and a trigonometric swivel (41c) is mounted on the side tube through a tube (41b). In the three-way swivel (41c), for example, a syringe can be attached to draw blood from the body or send a drug solution into the body.

[0025] At the distal end (the tip of the deflection part (21)) of the sheath (2), a roughly cylindrical tip protection member (29) made of resin and having a hemispherical shape on the distal end side is installed. The tip protection member (29) has an inner cavity with a diameter roughly equal to that of the main lumen (22) of the sheath (2) and is integrally joined (fixed) to the distal end of the sheath (2) (deflection part (21)) by heat fusion or the like. However, the tip protection member (29) may be omitted.

[0026] Within the wall of the sheath (2) (sheath main body part (20) and deflection part (21)), four wire lumens (sub-lumens) (23a to 23d) are formed approximately parallel to the main lumen (22) to surround the outside of the main lumen (22). The wire lumens (23a to 23d) are formed extending from the proximal end of the sheath (2) (proximal end of the sheath main body part (20)) to the distal end (distal end of the deflection part (21)). The wire lumens (23a to 23d) are formed on the outside of the main lumen (22) with an angle pitch (angle interval) of approximately 90° from each other, centered on the axis of the sheath (2).

[0027] A single wire (W1) is inserted into the wire lumen (23a) and the wire lumen (23b), and a single wire (W2) is inserted into the wire lumen (23c) and the wire lumen (23d). In this embodiment, the wires (W1, W2) are formed from a metal such as stainless steel, but the wires (W1, W2) may be formed from other materials such as resin.

[0028] The wire (W1) is arranged such that approximately half (W1a) of its end portion is inserted into the wire lumen (23a), its middle portion (W1c) is folded back at the distal end portion where the tip protection member (29) of the sheath (2) is joined, and approximately half (W1b) of its other end portion is inserted into the wire lumen (23b), and both ends (one end portion and the other end portion) are positioned at the operating portion (3) on the proximal end portion of the sheath (2). Likewise, the wire (W2) is arranged such that approximately half (W2a) of its end portion is inserted into the wire lumen (23c), the middle portion (W2c) is folded back at the distal end portion where the tip protection member (29) of the sheath (2) is joined, and approximately half (W2b) of its other end portion is inserted into the wire lumen (23d), and both ends (one end portion and the other end portion) are positioned at the operating portion (3) on the proximal end portion of the sheath (2).

[0029] Both ends of the wire (W1) and both ends of the wire (W2) are drawn out from a side hole installed in the sheath (2) within the operating part (3) installed on the proximal end side of the sheath (2), and are each connected to the operating part (3) (rotary operating member (31)). The operating part (3) has a pair of protruding gripping parts (32, 32) integrally installed on the rotary operating member (31), and is held in place through a twist-type knob member (5) on a holding part (42) installed on the tip (distal end) side of the grip part (4).

[0030] The rotational operating member (31) is held in the holding member (42) so that it can slide a predetermined amount toward the proximal end, as indicated by the dotted line labeled 31' in the drawing, by pressing both sides of a pair of gripping members (32, 32) toward the proximal end, as indicated by the arrow (A5) in FIG. 1. The rotational operating member (31) is pressed by a pressing means not shown so that it returns to its original position when the pressure in the direction of the arrow (A5) is released.

[0031] In the neutral state shown in FIG. 1, both the wire (W1) and the wire (W2) are in a substantially tension-free state, and the deflection portion (21) at the tip of the sheath (2) is extended in a straight line as shown in FIG. 1 and FIG. 3(a). At this time, since no compressive force is applied to the deflection portion (21) in the axial direction, it is not compressed, and the axial dimension of the deflection portion (21) is L1, and due to the properties of the porous tube constituting the deflection portion (21), the deflection portion (21) is in a relatively soft state.

[0032] From a neutral state, by operating the gripping portion (32, 32) of the rotational operation member (31) to rotate the rotational operation member (31) in the direction of the arrow (A1) in FIG. 1, the wire (W1) is pulled and the wire (W2) is loosened according to this rotation, so that the deflection portion (21) of the tip is deflected as indicated by the arrow (A3) in FIG. 1 and FIG. 3(b).

[0033] Conversely, by operating the gripping portion (32, 32) of the rotational operation member (31) to rotate the rotational operation member (31) in the direction of the arrow (A2) in FIG. 1, the wire (W1) becomes loose and the wire (W2) is pulled, causing the deflection portion (21) of the tip to be deflected as indicated by the arrow (A4) in FIG. 1 and FIG. 3(b).

[0034] When you want to fix the shape of the deflection part (21) while it is in a deflectioned state, rotate the knob member (5) clockwise to tighten it firmly, thereby pressing the rotation operating member (31) against the holding member (42), fixing the rotation operating member (31) in its current position and fixing the shape of the deflection part (21). When you want to release the fixation of the shape of the deflection part (21) (when you want to adjust the deflection state), conversely, rotate the knob member (5) counterclockwise to loosen it, thereby loosely pressing the rotation operating member (31) against the holding member (42), so that the rotation operating member (31) can rotate. As a result, the fixation of the shape of the deflection part (21) is released, and the deflection state of the deflection part (21) can be adjusted by gripping the holding member (32) and rotating the rotation operating member (31).

[0035] Next, from the neutral state shown in FIG. 1, when both ends of the gripping portion (32, 32) are pressed toward the proximal end side in resistance to the pressing force of a pressing means not shown, as indicated by the arrow (A5) in the drawing, the rotational operating member (31) slides toward the proximal end side by a predetermined amount. In this state, both ends of the wires (W1, W2) are pulled and tensioned approximately equally toward the proximal end side (with the same tensile force), and as a result, a force exerted by the tensioned wires (W1, W2) acts on the distal end of the deflection portion (21). That is, since the proximal end of the deflection portion (21) is substantially restrained (does not move toward the proximal end side) by the distal end of the sheath main body portion (20), a compressive force is exerted on the deflection portion (21) in the axial direction by the force pulling toward the proximal end side by the wires (W1, W2). Due to this compressive force, the deflection part (21) is compressed (shortened) along the axis, and as shown in FIG. 3(c), the axial dimension of the deflection part (21) becomes L2, which is smaller than L1, and depending on the properties of the porous tube constituting the deflection part (21), the deflection part (21) becomes relatively rigid.

[0036] When the pressure on the gripping portion (32, 32) is released, the rotational operating member (31) slides to its original position (neutral position) on the distal end side by the pressure of a pressure means not shown, and can be returned to a relatively soft state. If one wishes to maintain the deflection portion (21) in a relatively hard state, the knob member (5) is rotated clockwise to tighten it firmly, thereby pressing the rotational operating member (31) against the holding portion (42) and fixing the rotational operating member (31) in its current position. If one wishes to release this (to make it soft or to adjust the deflection state), conversely, the knob member (5) is rotated counterclockwise to loosen it, thereby loosely pressing the rotational operating member (31) against the holding portion (42) and returning the rotational operating member (31) to its original position (neutral position).

[0037] Meanwhile, if necessary, it is also possible to deflect the deflection part (21) in a compressed state by sliding the rotational operating member (31) toward the proximal end and then rotating the rotational operating member (31) while the deflection part (21) is in a rigid state, as shown in FIG. 3(d). Additionally, it is also possible to deflect the deflection part (21) by rotating the rotational operating member (31) from the neutral position (i.e., the deflection part (21) is in a soft state) and then compress and harden it by sliding the rotational operating member (31) toward the proximal end, as shown in FIG. 3(d). Furthermore, if necessary, the flexibility of the deflection part (21) can be changed and controlled by appropriately adjusting the amount of sliding when sliding the rotational operating member (31) from the neutral position toward the proximal end.

[0038] In the above-described embodiment, the deflection part (21) is composed of a sheath (2) that has no substantial change in flexibility even when subjected to compressive force in the axial direction, and a porous tube that is joined to the distal end of the sheath main body (20) so as to be compressed and hardened according to the degree of compressive force acting in the axial direction, and returns to its original soft state when the compressive force is released. Furthermore, wires (W1, W2) inserted into a plurality of wire lumens (23a~23d) of the sheath (2) are configured to allow the compressive force compressing the deflection part (21) in the axial direction and the deflection force deflecting the deflection part (21) to be released.

[0039] Accordingly, the wires (W1, W2) are in a neutral state, and the deflection part (21) is maintained in a soft state without applying compressive force to it, and the deflection part (21) can be deflected by pulling one end of the wire (W1, W2) toward the proximal end. At this time, since the deflection part (21) is in a soft state, good operability can be realized. On the other hand, for example, in cases such as penetrating a narrowed part within an internal lumen such as a bile duct, if the deflection part (21) is in a soft state, bending or buckling may occur, making insertion difficult. In this case, by pulling both ends of the wire (W1, W2) toward the proximal end with the same tensile force, compressive force can be applied to the deflection part (21) to make it hard. Because of this, bending or buckling of the deflection part (21) can be minimized, and the insertability of the catheter can be improved.

[0040] In addition, in the above-described embodiment, since both a deflection force to deflect the deflection part (21) and a compression force to compress the deflection part (21) are applied by a pair of wires (W1, W2), the configuration can be simplified compared to cases where each is realized by different means, such as installing a wire to apply the deflection force and a wire to apply the compression force. However, it is of course possible to realize each by different means. For example, as a means to apply the compression force, a compression tube having an outer diameter slightly smaller than the inner diameter of the main lumen (22) can be inserted so as to be slidably in the inner lumen (22) of the sheath (2) (sheath main body part (20) and deflection part (21)), and the distal end of the compression tube can be connected to the distal end of the deflection part (21), and the compression tube can be pulled toward the proximal end of the sheath (2) to apply the compression force to the deflection part (21). Meanwhile, in this case, the inner lumen of the compression tube takes on the function of the main lumen.

[0041] In addition, in the above-described embodiment, approximately half (W1a) of one end of the wire (W1) is inserted into the wire lumen (23a), and approximately half (W1b) of the other end is inserted into the wire lumen (23b). Approximately half (W2a) of one end of the wire (W2) is inserted into the wire lumen (23c), and approximately half (W2b) of the other end is inserted into the wire lumen (23d). Since the wires (W1, W2) are each folded back at the distal end of the deflection portion (21), there is no need to install a member for fixing the wire, such as a tip or a puller, which can reduce the number of parts. At the same time, there is no need to perform mounting work on the catheter tube of the member for fixing the wire or connecting work on the wire to the member, which can reduce the number of work processes in manufacturing. In addition, since there is no need to secure an area for installing a member for fixing the wire within the structure of the catheter sheath (1), structural limitations as a catheter sheath (1) can be reduced, and, for example, it is possible to increase the opening area of ​​the distal end (tip) of the sheath (2) (main lumen (22)).

[0042] In addition, both sides of the wire (W1) inserted into the wire lumen (23a) and the wire lumen (23b) inserted into the wire lumen (23b) are pulled to apply a deflection force to deflect the deflection part (21). Because of this, depending on the spacing (angle spacing) between the wire lumen (23a) and the wire lumen (23b), a force can be applied over a relatively wide range in the circumferential direction of the sheath (2). The same applies to the wire (W2). As a result, compared to performing a deflection operation by pulling a single wire that is inserted into a single lumen and is not folded or bent, the force applied to the wire is reduced, so the risk of wire breakage due to the deflection operation is reduced. In addition, the shaking of the distal end when deflecting the deflection part (21) can be reduced, so stable deflection can be realized. For the same reason, it is also possible to stably apply compressive force to the deflection part (21).

[0043] However, it is also possible to have a configuration in which one wire is inserted into each of the wire lumens (23a~23d), that is, four wires are installed, and the distal end of each wire is connected to the distal end of the deflection part (21). In this case, the number of wire lumens and the number of wires may each be three, or five or more.

[0044] In the above-described embodiment, two wires are used: a wire (W1) inserted into the wire lumen (23a) and the wire lumen (23b), and a wire (W2) inserted into the wire lumen (23c) and the wire lumen (23d). However, as shown in FIGS. 4a to 4c, a configuration using four wires may be made by adding a wire (W3) and a wire (W4).

[0045] That is, the wire (W3) has approximately half (W3a) of its end side inserted into the wire lumen (23a), its middle part (W3c) folded back at the distal end where the tip protection member (29) of the sheath (2) is joined, and approximately half (W3b) of its other end side inserted into the wire lumen (23c). The wire (W4) has approximately half (W4a) of its end side inserted into the wire lumen (23b), its middle part (W4c) folded back at the distal end where the tip protection member (29) of the sheath (2) is joined, and approximately half (W4b) of its other end side inserted into the wire lumen (23d). By configuring it in this way, by selecting and pulling one wire appropriately from the wires (W1 to W4), it becomes possible to deflect in four directions. Additionally, by appropriately selecting two adjacent combinations of wires (W1 to W4) and adjusting the balance of the pulling force for each, the deflection part (21) can be deflected 360° in any direction. Furthermore, by pulling all of the wires (W1 to W4), or wires (W1 and W2), or wires (W3 and W4) evenly (with the same tensile force), the deflection part (21) can be made rigid. Meanwhile, in response to the addition of wires (W3 and W4), it is necessary to appropriately change the configuration of the operating part (3), such as adding a rotating operating member identical to the rotating operating member (31) in the operating part (3).

[0046] In addition, in the examples shown in FIGS. 4a to 4c, four wire lumens (23a to 23d) and four wires (W1 to W4) are installed, but as shown in FIGS. 5a to 5c, for example, the number of wire lumens can be increased or decreased, and accordingly, the number of wires can also be increased or decreased.

[0047] That is, in FIG. 5a, six wire lumens (24a) are installed at an angle pitch of 60°, and at the same time, six wires (W5) are installed. By doing so, when pulling one wire (W5) at a time, the deflection part (21) can be deflected in six directions, and also, by appropriately selecting a combination of two adjacent wires (W5) and adjusting the balance of the pulling force for each, the deflection part (21) can be deflected in any direction of 360°. In FIG. 5b, three wire lumens (25a) are installed at an angle pitch of 120°, and at the same time, three wires (W6) are installed. Accordingly, when pulling wires (W6) one by one, the deflection section (21) can be deflected in three directions, and by appropriately selecting a combination of two adjacent wires (W6) and adjusting the balance of the pulling force for each, the deflection section (21) can be deflected in any direction of 360°. In FIG. 5c, 24 wire lumens (26a) are installed at an angle pitch of 15°, and at the same time, 24 wires (W7) are installed. Accordingly, when pulling wires (W7) one by one, the deflection section (21) can be deflected in 24 directions. These are examples, and the number of wire lumens should be 3 or more, and the number of wires should be 2 or more.

[0048] In the examples shown in FIGS. 5a to 5c, the number of wire lumens and the number of wires are equal, but they may differ, and for example, the number of wires may be less than the number of wire lumens. Also, in the examples shown in FIGS. 5a to 5c, both ends of the wire are inserted into an adjacent pair of wire lumens, but for example, a pair of wire lumens may be selected intermittently and both ends of the wire may be inserted into them.

[0049] The embodiments described above are provided to facilitate understanding of the present invention and are not intended to limit the present invention. Accordingly, each element disclosed in the above-described embodiments is intended to include all design modifications or equivalents that fall within the technical scope of the present invention. Explanation of the symbols

[0050] 1… Catheter sheath (mobile catheter) 2… sis(tube) 20… Sheath main body (first tube part) 21… Deflection section (2nd tube section) 22… Main Lumen 23a~23d… Lumens for wire 29… Absence of tip protection 3… Control Unit 31… Absence of rotational operation 32… Pajibu 4… grip section 42… Maintenance Department 5… No knob W1~W7… wire (operation means)

Claims

Claim 1 A movable catheter having a flexible tube having a distal end inserted into the body and a proximal end disposed outside the body, wherein the tube comprises a sheath body portion in which flexibility does not substantially change even when subjected to compressive force in the axial direction, and a deflection portion disposed continuously at the distal end of the sheath body portion and composed only of a single layer porous tube obtained by porousizing polytetrafluoroethylene, and a movable catheter having an operating means for acting to release a deflection force that deflects the deflection portion. Claim 2 A movable catheter according to claim 1, wherein the tube has at least three wire lumens spaced apart from each other within the wall of the tube, extending from a proximal end to a distal end of the tube, and the operating means has at least two wires, each wire having approximately half of one end side inserted into one of the wire lumens, a middle part folded back at the distal end of the deflection part, and approximately half of the other end side inserted into another of the wire lumens, with the one end and the other end reaching the proximal end of the sheath body part. Claim 3 In claim 1, the tube has at least three wire lumens spaced apart from each other within the wall of the tube, extending from a proximal end to a distal end of the tube, and the operating means is a movable catheter having at least three wires, the distal end of which is connected to the distal end of the deflection portion and inserted into one of the wire lumens, the proximal end of which reaches the proximal end of the sheath body portion.

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