JP6464861B2 - Tip movable catheter - Google Patents

Description

  The present invention relates to a catheter that is a medical treatment instrument used for performing various treatments, examinations, and the like, and in particular, relates to a steerable catheter that can freely deflect a distal end portion.

  For catheters (including electrode catheters, ablation catheters, and catheter sheaths) that are inserted through body cavities, lumens, blood vessels, and the like to target tissues such as various organs (for example, the heart). In order to facilitate access and the like, the direction of the distal end (tip) of the catheter inserted into the body is controlled by operating the operation unit provided on the proximal end (base end) side of the catheter disposed outside the body. A tip movable catheter that can be deflected by this is known (for example, see Patent Document 1 below).

  The portion to be deflected of the distal end portion of the catheter tube is set to have a stepwise lower hardness as it goes to the distal end, for example, at a position 180 ° opposite to a ring (pull ring) that is integrally inserted at the distal end. By connecting each distal end of a pair of wires, pulling one wire (first wire) and loosening the other wire (second wire) at each proximal end of the pair of wires; The direction of the tube tip can be controlled.

  As an operation portion provided on the proximal end side of such a catheter tube, as disclosed in, for example, Patent Document 1 below, the operation portion is rotatable in a state where a substantially disk-shaped rotation operation member is sandwiched between a pair of holding members. In the known example, one of the wires is pulled and the other wire is loosened by rotating the rotating operation member clockwise or counterclockwise.

  The rotation operation member and the pair of holding members are formed with through-holes centering on the rotation center of the rotation operation member so as to correspond to each other. In these through holes, a rotary shaft member having a flange portion at one end of a substantially cylindrical shaft portion and a female screw portion at the other end is inserted, and the male screw of the knob member having a male screw portion and a head portion The portion is screwed into the female screw portion of the rotating shaft member. By firmly screwing the knob member into the rotation shaft member, the rotation operation member is strongly held by the pair of holding members, and the rotation of the rotation shaft member is restricted, and thus the shape of the distal end portion of the catheter tube is fixed. On the contrary, by loosening the screwing of the knob member to the rotating shaft member, the rotation restriction of the rotating operation member is released, and the shape of the distal end portion of the catheter tube can be arbitrarily changed. .

Utility Model Registration No. 3162588

  However, according to the prior art as described above, the knob member is held by being screwed to the rotary shaft member. Therefore, if the knob member is loosened too much for some reason, There is a problem in that the screw member is released and the knob member may fall off.

  The present invention has been made in view of these points, and an object of the present invention is to provide a distal-end movable catheter that can prevent parts constituting the operation unit from falling off.

The tip movable catheter according to the present invention is:
A tip movable catheter provided with a catheter tube and an operation part provided on the proximal end side of the catheter tube,
The operation unit is
A first holding part having a first through hole in its central part;
A second holding portion having a second through hole corresponding to the first through hole at the center thereof;
The first holding portion and the third through hole corresponding to the first through hole and the second through hole are sandwiched between the first holding portion and the second holding portion. A substantially disk-shaped rotation operation member rotatably held by the second holding portion;
A flange portion larger than the second through hole is provided at one end portion of the substantially cylindrical shaft portion, and a first female screw portion is provided at the other end portion, and the first female screw portion is inserted into the first through the second through hole. A rotating shaft member inserted into the three through holes;
A head portion larger than the first through hole is formed at one end portion of the neck portion having a smaller diameter than the first through hole, and an outer diameter larger than the first through hole is formed at the other end portion. A knob member having a male screw portion to be screwed,
A second female screw portion having a thread that allows the male screw portion to pass through the first through hole by screwing the male screw portion into at least a part of the inner periphery of the first through hole. It is characterized by.

In the tip movable catheter according to the present invention,
The second female threaded portion may have a central axis that is inclined with respect to the central axis of the first female threaded portion.

In the tip movable catheter according to the present invention,
The central axis of the second female threaded portion is such that the male threaded portion of the knob member is screwed into the first through hole from the side opposite to the side where the second holding portion is present. The head can be provided so as to be inclined so as to be inclined toward the distal end side of the catheter tube.

In the tip movable catheter according to the present invention,
Setting the outer diameter of the shaft portion to be smaller than the outer diameter of the first female screw portion;
The first female thread portion is provided with a slit portion extending from the end opposite to the shaft portion to the shaft portion,
In the inner periphery of the third through hole, when the first female screw portion is inserted into the third through hole, it passes through the slit portion, and when fully inserted, it is positioned at the shaft portion. , A protrusion directed inward can be provided.

  According to the distal end movable catheter of the present invention, even if the knob member is loosened for some reason and the screwing to the rotating shaft member is released, it is more than the second through hole of the second holding portion. Since the outer diameter of the male screw portion is large, the knob member is prevented from falling off from the operation portion (first holding portion).

It is a top view which shows the external appearance structure of the tip movable catheter of embodiment of this invention. It is sectional drawing along the AA line of FIG. It is a side view which decomposes | disassembles and shows the structure of the grip part and operation part of the tip movable catheter of embodiment of this invention. It is a top view which shows the structure of the grip surface member of the tip movable catheter of embodiment of this invention. It is a top view which shows the structure of the grip back member of the tip movable catheter of embodiment of this invention. It is sectional drawing which shows the structure of the holding part of the grip surface member of the tip movable catheter of embodiment of this invention. It is sectional drawing which shows the structure of the holding | maintenance part of the grip back member of the tip movable catheter of embodiment of this invention. It is a top view which shows the structure of the operation part of the tip movable catheter of embodiment of this invention. It is a side view which shows the structure of the operation part of the tip movable catheter of embodiment of this invention. It is a side view of the operation part when the tip movable catheter of the embodiment of the present invention is rotated by a predetermined angle. It is a front view which shows the structure of the knob member of the tip movable catheter of embodiment of this invention. It is a front view which shows the structure of the rotating shaft member of the tip movable catheter of embodiment of this invention. It is a side view which shows the structure of the rotating shaft member of the tip movable catheter of embodiment of this invention. It is a top view which shows the structure of the rotating shaft member of the tip movable catheter of embodiment of this invention. It is a partial cross section figure which shows the procedure at the time of attachment of the rotating shaft member of the tip movable catheter of embodiment of this invention. It is a partial cross section figure (the 1) which shows the procedure at the time of attachment of the knob member of the tip movable catheter of embodiment of this invention. It is a partial cross section figure (2) which shows the procedure at the time of attachment of the knob member of the tip movable catheter of embodiment of this invention. It is a partial cross section figure (the 3) which shows the procedure at the time of attachment of the knob member of the tip movable catheter of embodiment of this invention. It is a partial cross section figure (the 4) which shows the procedure at the time of attachment of the knob member of the tip movable catheter of embodiment of this invention. It is a partial cross section figure (the 5) which shows the procedure at the time of attachment of the knob member of the tip movable catheter of embodiment of this invention.

  Embodiments of the present invention will be specifically described below with reference to the drawings. The catheter sheath (tip movable sheath) as the tip movable catheter of this embodiment precedes, for example, an electrode catheter for detecting an electrocardiogram or an ablation catheter for cauterizing an affected part when performing catheter ablation. A catheter that is inserted and guides these electrode catheters, ablation catheters, and the like. Hereinafter, a catheter sheath will be described as an example of the distal movable catheter to which the present invention is applied. However, the present invention can also be applied to an electrode catheter, an ablation catheter, and other distal movable catheters.

  Catheter ablation is a treatment method for treating an arrhythmia occurring in the heart. An ablation catheter having a high-frequency electrode at its distal end is passed through a blood vessel to the myocardial tissue causing the arrhythmia in the heart. This is a treatment method in which the cardiac muscle tissue or its vicinity is cauterized at about 60 to 70 ° C. to cause coagulative necrosis, thereby interrupting the arrhythmia circuit.

  First, FIG. 1, FIG. 2 and FIG. 3 will be referred to. The catheter sheath 1 includes a sheath body 2 as a catheter tube, an operation unit 3, a grip unit 4, a pair of wires 5a and 5b, a knob member 6, and a rotary shaft member 7.

  Although the sheath body 2 is formed of a hollow tube and is not shown in the figure, for example, a multilayer tube including a blade layer made of mesh-like stainless steel and a plurality of resin layers is used. A part of the distal end side of the sheath body 2 is a deflecting portion 21 whose direction can be arbitrarily deflected, and the deflecting portion 21 is set to have a lower hardness (flexibly) than the remaining portion, Further, the deflection portion 21 is set so that the hardness decreases gradually or step by step toward the tip. The material of the sheath body 2 is not particularly limited as long as it has flexibility, but is preferably a thermoplastic resin or a thermoplastic elastomer, for example, a polyamide-based elastomer such as a polyether block amide copolymer. Polyamide, polyimide, polyamideimide, polyethylene terephthalate, polyethylene, polypropylene, polyurethane, ethylene / vinyl acetate copolymer, polyvinyl chloride, and the like are used.

  An insertion hole through which a portion on the proximal end side of the sheath body 2 is inserted is formed in the operation portion 3 and the grip portion 4 attached to the proximal end side of the sheath body 2. A sheath hub 49a is attached to the end. The sheath hub 49a has a lumen, and the sheath body 2 in the grip portion 4 is attached to the proximal end side of the sheath hub 49a so that the lumen of the sheath hub 49a and the main lumen 22 of the sheath body 2 communicate with each other. It has been. In addition, a catheter insertion opening having a hemostasis valve is formed on the distal end side of the sheath hub 49a. When the catheter sheath 1 is used (procedure), the above-described electrode catheter or ablation catheter is inserted from the catheter insertion port of the sheath hub 49a and guided to the main lumen 22 of the sheath body 2 so that each distal end portion is treated. Guided to the myocardial tissue. Further, a side injection tube is formed on the side portion of the sheath hub 49a, and a three-way cock 49c is attached to the side injection tube via a tube 49b. For example, a syringe or the like can be attached to the three-way stopcock 49c so that blood in the body can be sucked or a chemical solution can be sent into the body.

  In the thick wall of the sheath body 2, a pair of sub-lumens 23 a and 23 b that are substantially parallel to the main lumen 22 are formed. The sub-lumens 23a and 23b are formed at positions opposed to each other by 180 degrees, and the first wire 5a and the second wire 5b made of metal such as stainless steel are inserted into the sub-lumens 23a and 23b, respectively. Yes.

  An annular pull ring (ring member) 24 is integrally attached to the distal end of the sheath body 2 (near the tip of the deflecting portion 21) so as to be inserted into the main lumen 22. The distal ends of the first wire 5a and the second wire 5b are connected and fixed at the opposite positions.

  Proximal ends of the first wire 5a and the second wire 5b are pulled out from a side hole provided in the sheath body 2 inside the operation portion 3 provided on the proximal end side of the sheath body 2, and the operation portion 3 is pulled out. (The rotation operation member 31 described later) is connected to each. The operation section 3 is held by a holding section 42 (42a, 42b) provided on the tip (distal end) side of the grip section 4.

  As shown in FIGS. 3 to 5, the grip portion 4 includes a grip surface member 4 a and a grip back member 4 b that are substantially symmetrical with each other. In addition, they are integrated with each other in a state of being held rotatably by being sandwiched between grip back members 4b. The sheath body 2 is guided to the inside from the distal end opening of the distal end portion 43 (43a, 43b) of the grip portion 4. The material of the grip part 4 is not particularly limited, but is preferably a thermoplastic resin. For example, polycarbonate, polyacetal, polyamide, or the like is used.

  As shown in FIGS. 4 and 6, the holding portion (first holding portion) 42 a of the grip surface member 4 a has a circular recessed portion 45 a that is recessed in a substantially circular shape at a substantially central portion on the outer side (upper side in FIG. 6). A circular concave portion 48a is formed in a substantially central portion on the inner side (lower side in FIG. 6). A through hole (first through hole) 46a is formed at the center of the circular recessed portion 45a and the circular recessed portion 48a. A knob receiving portion 47a is formed on a part of the circular recessed portion 45a on the tip end portion 43a side.

  The base end side (the side opposite to the tip end portion 43a) of the inner surface of the through hole 46a of the holding portion 42a is inclined by an angle θ1 along the axial direction of the grip portion 4 with respect to the central axis AX1 of the through hole 46a. A partial female thread portion (second female thread portion) 44a having a thread with the axis AX2 as the central axis is formed. (That is, the central axis AX2 of the partial female thread portion (second female thread portion) 44a is penetrated from the side opposite to the side where the later-described holding portion (second holding portion) 42b exists by the male screw portion 65 of the knob member 6 described later. When screwed into the hole (first through hole) 46a, the head of the knob member 6 is inclined so as to incline toward the distal end side of the sheath body 2 (catheter tube).) Screw of the partial female screw portion 44a The peak angle of the mountain is 25 degrees in this embodiment. However, the partial female thread portion 44a may be smaller or larger than this pitch. Moreover, it is good also as an internal thread part which replaces with the partial internal thread part 44a and has the thread of 1 pitch or more in the through-hole 46a of the holding | maintenance part 42a. Here, the ridge line of the thread of the partial female thread portion 44a is naturally an arc shape, but it may be approximately linear. The angle θ1 is set to 25 degrees in this embodiment.

  As shown in FIGS. 5 and 7, the holding portion (second holding portion) 42 b of the grip back member 4 b has a circular recessed portion 45 b that is recessed in a substantially circular shape at a substantially central portion on the outer side (lower side in FIG. 7). Is formed, and a circular recessed portion 48b that is recessed in a substantially circular shape is formed in a substantially central portion on the inner side (upper side in FIG. 7). A through hole (second through hole) 46b is formed at the center of the circular recessed part 45b and the circular recessed part 48b corresponding to the through hole 46a of the grip surface member 4a. The central axis of the through hole 46b of the holding part 42b substantially coincides with the central axis AX1 of the through hole 46a of the holding part 42a.

  As shown in FIGS. 8 to 10, the operation unit 3 is configured to include a fixed operation member 38 and a rotation operation member 31 that is rotatably supported by the fixed operation member 38. The fixing operation member 38 includes a front communication portion 38a through which the sheath body 2 is inserted and a rear communication portion (not shown). The fixing operation member 38 includes a substantially circular penetrating portion (not shown) penetrating vertically (vertical direction in FIGS. 9 and 10).

  The rotation operation member 31 includes a first rotation operation member 31a and a second rotation operation member 31b. The first rotation operation member 31a has a substantially disk-shaped disk part and a pair of split gripping parts 32a and 32a protruding left and right. The divided grip portions 32a and 32a are respectively formed with recesses (not shown) that fit into the convex portions formed on the split grip portions 32b and 32b of the second rotation operation member 31b described later. On one surface (the upper surface in FIGS. 9 and 10) of the first rotation operation member 31 a, a circular recessed portion 33 that is recessed in a circular shape is formed, and the circular recessed portion 33 has a pair of window portions 34 and 34. Is formed.

  A through hole (third through hole) 35 is formed at the center of the first rotation operation member 31a. On one surface (upper surface in FIGS. 9 and 10) of the rotation operation member 31, an annular projecting portion 36 a that protrudes to the one surface side (upper side in FIGS. 9 and 10) around the through hole 35 is formed. ing.

  The second rotation operation member 31b has a substantially disk-shaped disk part and a pair of divided gripping parts 32b and 32b protruding left and right. The split gripping portion 32b is formed with a convex portion (not shown) that fits into the concave portion formed in the split gripping portion 32a, 32a of the first rotation operation member 31a.

  A through hole (third through hole) 35 is formed at the center of the second rotation operation member 31b. On one surface (the lower surface in FIGS. 9 and 10) of the rotation operation member 31 b, an annular projecting portion 36 b that projects downward (downward in FIGS. 9 and 10) around the through hole 35 is formed. Yes.

  On the inner periphery of the through hole 35 of the rotation operation member 31 (second rotation operation member 31b), projections 37 and 37 that protrude toward the center are formed at positions that face each other at 180 degrees. The widths of the protrusions 37 and 37 are set to be slightly smaller than the width of a slit portion 74 formed in the female screw portion 73 described later. Although these protrusion parts 37 and 37 are not specifically limited, in this embodiment, as shown in FIG. 8, with respect to the line L1 which passes along the center of a pair of holding parts 32 and 32 of the rotation operation member 31, it is a protrusion part. The angle θ2 formed by the line L2 passing through the centers of 37 and 37 is 48 degrees. The optimal number of protrusions 37 is two as in the present embodiment, but may be one.

  The first rotation operation member 31a is disposed on one surface (upper surface in FIGS. 9 and 10) of the fixed operation member 38, and the second rotation operation member 31b is disposed on the other surface (lower surface in FIGS. 9 and 10). The fixed operation member 38 is sandwiched between the first rotation operation member 31a and the second rotation operation member 31b, and the concave portion provided in the divided gripping portion 32a of the first rotation operation member 31a and the second rotation operation member 31b are arranged. The rotation operation members 31 a and 31 b are rotatably attached to the fixed operation member 38 by fitting the projections provided on the divided gripping portion 32 b.

  When the operation unit 3 configured as described above is sandwiched and integrated between the holding portion 42a of the grip surface member 4a and the holding portion 42b of the grip back member 4b, the fixed operation member 38 is connected to the grip surface member 4a and the grip surface member 4a. While being fixed to the grip back member 4b, the annular projecting portion 36a is loosely fitted in the circular recessed portion 48a of the holding portion 42a with a slight gap, and the annular protruding portion 36b has a slight gap in the circular recessed portion 48b of the holding portion 42b. By loosely fitting, the rotation operation member 31 is rotatably held with respect to the grip part 4 (holding parts 42a and 42b).

  The material of the rotation operation member 31 (first rotation operation member 31a, second rotation operation member 31b) and fixed operation member 38 is not particularly limited, but is preferably a thermoplastic resin, for example, polycarbonate, polyacetal, Polyamide or the like is used.

  The sheath body 2 introduced from the distal end opening of the distal end portion 43 (43a, 43b) in a state where the operation portion 3 is sandwiched and assembled between the retaining portion 42a of the grip front member 4a and the retaining portion 42b of the grip back member 4b. The proximal end side of the fixed member is guided to the sheath hub 4 a at the proximal end of the grip portion 4 through the front communication portion 38 a and the rear communication portion of the fixed operation member 38.

  As shown in FIG. 11, the knob member 6 includes a head at one end of the neck portion 64 and a male screw portion 65 at the other end. The head is composed of a knob portion 61, a disc portion 62, and a circular protrusion 63. The neck portion 64 is set to have a smaller diameter than the through hole 46a of the holding portion 42a, and is set to have a smaller diameter than an inner diameter of a female screw portion 73 of the rotary shaft member 7 described later. The circular protrusion 63 has a larger outer diameter than the through hole 46a of the holding portion 42a, and can be loosely fitted in the circular recess 45a of the holding portion 42a with a slight gap. The male screw portion 65 has an outer diameter slightly larger than the through hole 46a of the holding portion 42a, and has a thread that is screwed into a female screw portion 74 of the rotary shaft member 7 described later. As the material of the knob member 6, for example, aluminum or stainless steel is used.

  As shown in FIGS. 12 to 14, the rotary shaft member 7 has a flange portion 72 at one end portion of a substantially cylindrical shaft portion 71 and a female screw portion (first female screw portion) 73 at the other end portion. . The shaft portion 71 is formed to have a smaller diameter than the through hole 46 b of the holding portion 42 b and is slightly smaller than the distance between the pair of projecting portions 37, 37 provided in the through hole 35 of the rotation operation member 31. Is set to a small outer diameter.

  The flange portion 72 is formed in a substantially disc shape, and its outer diameter is set to be larger than the through hole 46b of the holding portion 42b, and there is a slight gap in the circular recessed portion 45b of the holding portion 42b. It is formed to fit loosely. The female screw portion 73 is formed in a substantially cylindrical shape, and its outer diameter is larger than that of the shaft portion 71, slightly smaller than the through hole 46 b of the holding portion 42 b, and is formed in the through hole 35 of the rotation operation member 31. It is formed so as to be loosely fitted with a slight gap.

  On the inner periphery of the female screw portion 73, a screw thread to which the male screw portion 64 of the knob member 6 is screwed is formed. The female thread portion 73 is formed with a slit portion 74 through which a portion on the proximal end side of the sheath body 2 passes when assembled. The width of the slit portion 74 is set to such a size that it can pass through in consideration of the outer shape of the sheath body 2. As the material of the rotating shaft member 7, for example, aluminum or stainless steel is used similarly to the knob member 6.

  When assembling the grip part 4 described above, the operation part 3 is sandwiched between the holding part 42a of the grip front member 4a and the holding part 42b of the grip back member 4b from the state shown in FIG. The unit 4 is integrated while being held in the part 4.

  Thereafter, as shown in FIG. 15, the female screw portion 73 side of the rotating shaft member 7 is inserted from the through hole 46 b of the grip portion 4 b. At this time, the rotation operation member 31 is set in the neutral state shown in FIG. 1 (a line connecting the centers of the pair of grip portions 32, 32 of the rotation operation member 31 is substantially orthogonal to the axial direction of the grip portion 4. In a state in which the center of the pair of protrusions 37, 37 is substantially aligned with the extending direction of the sheath body 2, and in this state, A pair of projections 37, 37 formed in the through hole 35 of the rotation operation member 31 passes through the slit portion 74 of the female screw portion 73 of the rotary shaft member 7, and the sheath body 2 passes through the slit portion 74. Then, the rotational position around the central axis of the rotary shaft member 7 is adjusted, the female screw portion 73 is inserted into the through hole 35 of the rotary operation member 31, and the flange portion 72 of the rotary shaft member 7 is inserted into the circular recessed portion of the holding portion 42b. Located at 45b To.

  When the rotating shaft member 7 is inserted to this state, the protrusions 37 and 37 of the rotating operation member 31 pass through the slit portion 74 of the female screw portion 73 and reach one end portion (upper end portion in FIG. 15) of the shaft portion 71. Therefore, when the rotation operation member 31 is rotated counterclockwise in this state, the projecting portions 37 and 37 interfere with the end surface (step surface) of the female screw portion 73 on the shaft portion 71 side, and the rotation shaft member 7 is held by the holding portion. 42b (the rotation operation member 31) cannot be removed.

  Next, the knob member 6 is attached to the holding portion 42. First, as shown in FIG. 16, while the central axis AX3 of the knob member 6 is inclined toward the distal end portion 43a with respect to the central axis AX1 of the holding portion 42a, a part of the circular protrusion 63 on the distal end 43 side is knob-received. Positioned on the portion 47a, a part of the male screw portion 65 on the tip end portion 43a side is inserted obliquely into the through hole 46a. In this state, as shown in FIG. 17, the center axis AX3 of the knob member 6 is substantially in agreement with the center axis AX2 of the partial female thread portion 44a of the holding portion 42a. Further, in this state, as shown in FIG. 17, a part of the base end portion side (the side opposite to the tip portion 43) of the male screw portion 65 interferes with the partial female screw portion 44a of the holding portion 42a. Cannot be inserted.

  From this state, when the knob member 6 is rotated (clockwise here) and the male screw portion 65 is screwed into the partial female screw portion 44a, the male screw portion 65 is screwed into the partial female screw portion 44a as shown in FIG. Then, a part of the base end portion side of the male screw portion 65 enters the through hole 46a according to the rotation, and the inclination angle of the central axis AX3 of the knob member 7 with respect to the central axis AX1 of the holding portion 42a gradually decreases. When the knob member 7 is further rotated, as shown in FIG. 19, a part of the base end portion side of the male screw portion 65 passes through the partial female screw portion 44a, and the entire male screw portion 65 passes through the through hole 46a. The circular concave portion 48a is reached, and the central axis AX3 of the knob member 6 substantially coincides with the central axis AX1 of the holding portion 42a. In this state, since the outer diameter of the male screw portion 65 is larger than the inner diameter of the through hole 46a, the knob member 6 cannot be removed from the holding portion 42a.

  In this state, since the tip of the male screw portion 65 reaches the tip of the female screw portion 73 of the rotating shaft member 7, the knob member 6 is rotated (clockwise here), and the male screw portion 65 is screwed into the female screw portion 73. As shown in FIG. 20, the knob member 6 is screwed until the circular protrusion 63 of the knob member 6 comes into contact with the bottom surface of the circular recess 45a of the holding portion 42a, and the assembly is completed.

  In the neutral state shown in FIG. 1, both the first wire 5a and the second wire 5b are in a tension-free state (or in a state where the wire 2 is loosened almost uniformly), and the deflection portion 21 at the distal end of the sheath 2 is shown in FIG. It will be in the state extended straight.

  When the rotation operation member 31 is rotated in the first direction (the direction of the arrow B1 in FIG. 1) from this neutral state, the first wire 5a is pulled and the second wire 5b is loosened along with this rotation. The leading deflection portion 21 is deflected as shown by an arrow B3 in FIG.

  On the contrary, when the rotation operation member 31 is rotated in the second direction (the direction of the arrow B2 in FIG. 1), the first wire 5a is loosened and the second wire 5b is pulled, so that the deflection unit 21 at the tip is moved. In FIG. 1, it is deflected as indicated by an arrow B4.

  When it is desired to fix the shape of the deflection unit 21 while the deflection unit 21 at the distal end of the sheath 2 is deflected, the knob member 61 is gripped and the knob member 6 is rotated in the clockwise direction, as shown in FIG. As described above, the male threaded portion 65 of the knob member 6 is screwed into the female threaded portion 73 of the rotary shaft member 7, and the holding portion 42 a and the holding portion 42 b are formed by the circular protrusion 63 of the knob member 6 and the flange portion 72 of the rotary shaft member 7. Are pressed in directions approaching each other, and accordingly, the rotation operation member 31 is firmly held between the holding portion 42a and the holding portion 42b. As a result, the rotation operation member 31 is fixed at the current position, and the shape of the deflection portion 21 at the distal end of the sheath 2 is fixed.

  When it is desired to release the fixed shape of the deflection portion 21 at the distal end of the sheath 2 (when the deflection state is to be adjusted), the knob member 61 is gripped and the knob member 6 is rotated counterclockwise, contrary to the above. Accordingly, the screwing of the male screw portion 65 of the knob member 6 into the female screw portion 73 of the rotating shaft member 7 is loosened, the pressing in the direction in which the holding portion 42a and the holding portion 42b approach each other is released, and the rotation operation member 31 is held by the holding portion 42a. And the holding portion 42b. As a result, the rotation operation member 31 can rotate, the shape of the deflection unit 21 at the distal end of the sheath 2 is released from being fixed, the grip unit 32 is gripped, and the rotation operation member 31 is rotated. 21 deflection states can be adjusted.

  According to the present embodiment, since the outer diameter of the male screw portion 65 of the knob member 6 is larger than the through hole 46a of the holding portion 42a, the knob member 6 is loosened too much to rotate the rotary shaft member 7 of the male screw portion 65 of the knob member 6. Even when the threaded engagement with the female thread portion 73 is completely released, the knob member 6 does not fall off the holding portion 42 (grip portion 4). Therefore, even in such a case, it is possible to easily return to the original state by screwing the male screw portion 65 of the knob member 6 into the female screw portion 73 of the rotary shaft member 7 again. In addition, when it becomes necessary to remove the knob member 6 from the holding | maintenance part 42, this can be performed by performing the procedure reverse to the procedure shown in FIGS.

  In the present embodiment, since the central axis AX2 of the partial female screw portion 44a is inclined with respect to the central axis AX1 of the through hole 46a, the knob member 6 is loosened too much, and the male screw portion 65 of the knob member 6 is rotated. Even when the knob member 6 is further rotated without being noticed after the screwing of the shaft member 7 with respect to the female screw portion 73 is completely released, the male screw portion 65 of the knob member 6 becomes the partial female screw portion 44. The knob member 6 is less likely to fall off the holding portion 42 (grip portion 4).

  In the present embodiment, the central axis AX2 of the partial female screw portion 44a is adjusted so that the male screw portion 65 of the knob member 6 is screwed into the through hole 46a from the side opposite to the side where the holding portion 42b exists. Therefore, the possibility that the knob member 6 falls off the holding portion 42 (grip portion 4) is further reduced. This is because the user (physician) of the catheter sheath 1 handles the catheter sheath 1 while taking care not to point the sheath 2 downward in order to prevent contamination of the sheath 2, so that the knob member 6 falls off due to gravity. This is because the possibility of tilting in the direction is reduced.

  Further, even when the knob member 6 is loosened too much and the screwing of the male threaded portion 65 of the knob member 6 to the female threaded portion 73 of the rotating shaft member 7 is completely released, the rotating shaft member 7 remains in the holding portion 42b. The end surface of the female screw portion 73 on the shaft portion 71 side by a pair of protrusions 37 and 37 provided in the through hole 35 of the rotation operation member 31 in a state of being inserted into the through hole 46 b and the through hole 35 of the rotation operation member 31. Since it is locked so that it cannot move in the axial direction on the (step surface), the possibility that the rotating shaft member 7 falls off the holding portion 42 is also reduced.

  When it is necessary to remove the rotary shaft member 7 from the holding portion 42, the rotary shaft member 7 is rotated so that the slit portion 74 of the female screw portion 73 of the rotary shaft member 7 is at a position corresponding to the protrusions 37 and 37. By rotating the operation member 31 or the rotating shaft member 7, the rotating shaft member 7 can be pulled out.

  The embodiment described above is described for facilitating understanding of the present invention, and is not described for limiting the present invention. Therefore, each element disclosed in the embodiment described above is intended to include all design changes and equivalents belonging to the technical scope of the present invention.

  For example, in the above-described embodiment, the central axis AX2 of the partial female screw portion 44a is such that the male screw portion 65 of the knob member 6 has a through hole (first through hole) from the side opposite to the side where the holding portion (second holding portion) 42b exists. The hole) is set so that the head of the knob member 6 is inclined toward the distal end side of the sheath body 2 (catheter tube) when screwed into the hole 46a. However, the present invention is not limited to this. The head of 6 may be set to tilt toward the proximal end side of the sheath body 2 (catheter tube), or may be set to tilt in the other direction.

DESCRIPTION OF SYMBOLS 1 ... Catheter sheath 2 ... Sheath body 21 ... Deflection part 22 ... Main lumen 3 ... Operation part 31 ... Rotation operation member 31a ... 1st rotation operation member 31b ... 2nd rotation operation member 32 ... Gripping part 35 ... Through-hole (3rd Through hole)
36a, 36b ... annular protrusion 37 ... projection 38 ... fixed operation member 4 ... grip part 42 (42a, 42b) ... holding part (first holding part, second holding part)
43 (43a, 43b) ... tip end portion 44a ... partial female screw portion (second female screw portion)
45a, 45b ... circular recess 46a, 46b ... through hole (first through hole, second through hole)
47a ... Knob receiving part 48a, 48b ... Circular recessed part 5a, 5b ... Wire 6 ... Knob member 61 ... Knob part 62 ... Disc part 63 ... Circular protrusion 64 ... Neck part 65 ... Male screw part 7 ... Rotating shaft member 71 ... Shaft Part 72 ... Flange part 73 ... Female thread part (first female thread part)
74 ... Slit part

Claims (3)

A tip movable catheter provided with a catheter tube and an operation part provided on the proximal end side of the catheter tube,
The operation unit is
A first holding part having a first through hole in its central part;
A second holding portion having a second through hole corresponding to the first through hole at the center thereof;
The first holding portion and the third through hole corresponding to the first through hole and the second through hole are sandwiched between the first holding portion and the second holding portion. A substantially disk-shaped rotation operation member rotatably held by the second holding portion;
A flange portion larger than the second through hole is provided at one end portion of the substantially cylindrical shaft portion, and a first female screw portion is provided at the other end portion, and the first female screw portion is inserted into the first through the second through hole. A rotating shaft member inserted into the three through holes;
A head portion larger than the first through hole is formed at one end portion of the neck portion having a smaller diameter than the first through hole, and an outer diameter larger than the first through hole is formed at the other end portion. A knob member having a male screw portion to be screwed,
A second female screw portion having a thread that allows the male screw portion to pass through the first through hole by screwing the male screw portion into at least a part of the inner periphery of the first through hole , The distal movable catheter characterized in that the second female threaded portion has a central axis inclined with respect to the central axis of the first female threaded portion . The central axis of the second female threaded portion is such that the male threaded portion of the knob member is screwed into the first through hole from the side opposite to the side where the second holding portion is present. The tip movable catheter according to claim 1 , wherein the head is inclined so as to incline toward the distal end side of the catheter tube. Setting the outer diameter of the shaft portion to be smaller than the outer diameter of the first female screw portion;
The first female thread portion is provided with a slit portion extending from the end opposite to the shaft portion to the shaft portion,
In the inner periphery of the third through hole, when the first female screw portion is inserted into the third through hole, it passes through the slit portion, and when fully inserted, it is positioned at the shaft portion. The tip movable catheter according to claim 1 or 2 , further comprising a protruding portion directed inward.

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