JP2011206268A - Catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To improve the torsional stiffness of a catheter with a leaf spring.SOLUTION: The catheter is equipped with: a tubular member 4; the leaf spring 30 that is provided to the inner part of the tubular member 4 such that at least part of the side edges 30e and 30f that run along the axial direction of the tubular member 4 are embedded in the tubular member 4; and multiple tubes 41-46, which each form multiple paths 31-36 that are each provided to a first region 20A on one main surface 30a of the leaf spring 30 and to a second region 20B on the other main surface 30b of the leaf spring 30 in the inner part of the tubular member 4 and which include paths 31 and 32 for operating wires to pass through. In addition, in the first region 20A and in the second region 20B, some tubes 43-46 are provided such that the tubes are in contact with the main surfaces 30a and 30b of the leaf spring 30.

Description

  The present invention relates to a catheter. More specifically, the present invention relates to a catheter capable of easily changing the direction of the vicinity of the distal end inserted into the body cavity by operating the operation portion on the proximal end side arranged outside the body. .

  In a catheter such as an electrode catheter inserted through a blood vessel and into the heart, the orientation of the distal end (tip) of the catheter inserted into the body is the proximal end (proximal end or proximal side) of the catheter placed outside the body. It is deflected by operating the operation unit mounted on the. As a mechanism for deflecting the distal end of the catheter, for example, Patent Document 1 includes a leaf spring and two operation wires arranged on both sides of the leaf spring, and pulls the operation wire. A configuration for deflecting the distal end in two directions is disclosed. When the distal end is deflected using a leaf spring, the flatness of the curved portion of the catheter can be improved.

JP 2008-245766 A

  In a conventional catheter provided with a leaf spring, the leaf spring is inserted in a free state through a lumen extending along the axial direction of the catheter within the tubular member. And the proximal end of the leaf | plate spring was being fixed to the tubular member etc. by adhesion | attachment etc. In such a configuration, there is a possibility that the distal end of the leaf spring is twisted with respect to the tubular member when the wire for operation is pulled and the leaf spring is bent. Therefore, the conventional catheter has room for improving torsional rigidity.

  This invention is made | formed in view of such a subject, The objective is to provide the technique which can improve the torsional rigidity of the catheter provided with the leaf | plate spring more.

  One embodiment of the present invention is a catheter. The catheter includes a tubular member, a leaf spring provided in the tubular member so that at least a part of an end portion along the axial direction of the tubular member is embedded in the tubular member, and an inside of the tubular member. A plurality of passages including an operation wire insertion passage provided in each of the first region on one main surface side of the leaf spring and the second region on the other main surface side of the leaf spring. It is characterized by.

  According to this aspect, the torsional rigidity of the catheter provided with the leaf spring can be further increased.

  In the catheter of the above aspect, the leaf spring may be embedded in the tubular member at the end portion over the entire region in the axial direction. In addition, a plurality of tube portions for forming a plurality of passages are provided, and provided in the first region and the second region so that at least some of the tube portions are in contact with the main surface of the leaf spring. May be.

  Further, in the catheter of the above aspect, the plurality of tube portions include at least two tube portions and one operation wire insertion tube portion, and in the first region and the second region, the two tube portions are leaf springs. The operating wire insertion tube portion may be provided in contact with the main surface and separated from the leaf spring. Further, in the first region and the second region, two tube portions are provided with a center line of a leaf spring along the catheter axial direction, and an operation wire insertion tube portion is provided between the two tube portions. May be.

  Further, in the first region and the second region, the operation wire insertion tube portions are circumscribed with the two tube portions, and the plurality of tube portions are arranged so as to be inscribed in a substantially circle centered on the central axis of the catheter. May be. Further, in the first region and the second region, the two tube portions are provided apart from each other, and in at least one of the first region and the second region, the two tube portions, the operation wire insertion tube portion, A member for adjusting the bendability of the catheter may be inserted into a region surrounded by the leaf spring. A plurality of electrodes may be provided in the distal end region, and a plurality of electrode wires may be inserted into at least a part of the plurality of passages other than the operation wire insertion passage.

  A combination of the above-described elements as appropriate can also be included in the scope of the invention for which protection by patent is sought by this patent application.

  ADVANTAGE OF THE INVENTION According to this invention, the torsional rigidity of the catheter provided with the leaf | plate spring can be improved more.

1 is a schematic side view of a catheter according to Embodiment 1. FIG. 1 is a schematic plan view of a catheter according to Embodiment 1. FIG. It is a schematic sectional drawing on the AA line of FIG. It is a schematic perspective view which faces the cross section on the BB line of FIG. It is sectional drawing on the CC line of FIG. It is a schematic sectional drawing for demonstrating arrangement | positioning of a tube.

  Embodiments of the present invention will be described below with reference to the drawings. In all the drawings, the same constituent elements are denoted by the same reference numerals, and detailed description thereof will be appropriately omitted in the following description.

(Embodiment 1)
The catheter according to Embodiment 1 is an electrode catheter capable of tip deflection operation, and can be used for diagnosis or treatment of arrhythmia in the heart, for example. FIG. 1 is a schematic side view of the catheter according to the first embodiment, and FIG. 2 is a schematic plan view of the catheter according to the first embodiment. FIG. 3 is a schematic cross-sectional view taken along the line AA in FIG. In FIG. 3, the leaf spring 30 and the operation wires 50a and 50b are not shown.

  As shown in FIGS. 1 and 2, the catheter 2 according to the first embodiment includes a tubular member 4, a handle 6, a distal tip electrode 10, and a plurality of ring-shaped electrodes 12a to 12k (hereinafter appropriately referred to as ring-shaped electrodes 12a to 12h). 12k is collectively referred to as “ring-shaped electrode 12”).

  The catheter 2 has a tip electrode 10 and a ring electrode 12 at the distal end of the tubular member 4. The tip electrode 10 is fixed to the tubular member 4 by, for example, an adhesive or melt bonding. The ring-shaped electrodes 12 a to 12 k are fixed to the outer peripheral surface of the tubular member 4 by caulking a metal ring having a diameter larger than the outer diameter of the tubular member 4, for example. The number of ring-shaped electrodes 12 is not particularly limited, and can be appropriately set according to the number of conducting wires that can be inserted into the tubular member 4.

  A handle 6 is attached to the proximal end of the tubular member 4. A handle 7 is attached to the handle 6 for performing a deflection operation (swing operation) of the distal end portion of the tubular member 4. The handle 6 and the knob 7 constitute an operation unit.

  As shown in FIG. 3, the tubular member 4 includes an outer cylinder 4 a having a single lumen structure and an inner cylinder 4 b having an accommodation space 20 provided in the lumen of the outer cylinder 4 a. The inner cylinder 4b extends to a predetermined area from the distal end of the outer cylinder 4a. The inner peripheral surface of the outer cylinder 4a and the outer peripheral surface of the inner cylinder 4b are fixed in close contact with each other. For fixing the outer cylinder 4a and the inner cylinder 4b, methods such as adhesion and welding can be used. As will be described later, the accommodation space 20 is provided with a leaf spring and a plurality of passages (in FIG. 3, only the passages 31 and 32 (tubes 41 and 42) are shown) (FIGS. 4 and 4). 5). The tubular member 4 is preferably configured such that the flexibility near the distal end is relatively high and the flexibility near the proximal end is relatively low. For example, the tubular member 4 is disposed adjacent to the member I having a Shore D hardness of 20 to 63 disposed on the distal end side and the proximal end side of the member I, and the Shore D hardness is 45 to 72. And a member II that is less flexible than the member I, and a member III that is disposed adjacent to the proximal end side of the member II, has a Shore D hardness of 55 to 80, and is less flexible than the member II. It has a joined structure. The tubular member 4 may have a structure in which the outer cylinder 4a and the inner cylinder 4b are integrated. Further, the tubular member 4 may have a multilayer structure of the outer cylinder 4a.

  The main part of the tubular member 4 is made of a synthetic resin such as polyolefin, polyamide, polyether polyamide, or polyurethane. The outer diameter of the tubular member 4 is generally about 0.6 to 3 mm, and the length is about 500 to 1200 mm. In the present embodiment, the tubular member 4 has an outer diameter of about 2.0 mm and a length of about 1170 mm.

  The tip electrode 10 and the ring-shaped electrode 12 are made of a metal having good electrical conductivity, such as aluminum, copper, stainless steel, gold, or platinum. In addition, in order to give favorable contrast properties for X-rays, the tip electrode 10 and the ring electrode 12 are preferably made of platinum or an alloy thereof. The outer diameters of the tip electrode 10 and the ring electrode 12 are not particularly limited, but are preferably about the same as the outer diameter of the tubular member 4 and are generally about 0.5 to 3 mm.

  FIG. 4 is a schematic perspective view of a cross section taken along line BB in FIG. FIG. 5 is a cross-sectional view taken along the line CC of FIG. As shown in FIGS. 4 and 5, the catheter 2 according to this embodiment includes a leaf spring 30 and a plurality of passages 31, 32, 33, 34, 35, 36 inside the tubular member 4.

  In the present embodiment, the leaf spring 30 is accommodated in the accommodation space 20. The leaf spring 30 is a plate-like body extending along the axial direction of the tubular member 4, and has two main surfaces 30 a and 30 b extending in the axial direction of the tubular member 4 and two side surfaces 30 c extending in the axial direction of the tubular member 4. , 30d. The leaf spring 30 has a distal end extending to the vicinity of the distal end of the tubular member 4 and a proximal end extending from the distal end of the tubular member 4 to a predetermined distance. Here, the leaf spring 30 is provided in the accommodation space 20 so that the end 30e and the end 30f on the side along the axial direction of the tubular member 4 are embedded in the tubular member 4 (inner cylinder 4b). . Thereby, the accommodation space 20 is partitioned into two regions. That is, the accommodating space 20 is partitioned into a first region 20A on the one main surface 30a side of the leaf spring 30 and a second region 20B on the other main surface 30b side of the leaf spring 30.

  Here, “the end portion 30e and the end portion 30f are embedded in the tubular member 4 (inner tube 4b)” means that, of the leaf spring 30, the side surfaces 30c and 30d extending in the axial direction of the tubular member 4 and both The area | region which contact | connects the said side surfaces 30c and 30d of the surfaces 30a and 30b is contacting the tubular member 4. FIG. In the present embodiment, the leaf spring 30 has both end portions 30e and 30f in contact with the inner wall of the inner cylinder 4b over the entire axial direction. Thereby, since the leaf spring 30 is locked to the tubular member 4 over the entire length, the twist of the leaf spring 30 with respect to the tubular member 4 that may occur when the operation wire is operated can be restricted. As a result, the torsional rigidity of the catheter 2 is increased, and the flatness at the curved portion of the catheter 2 can be further improved. The existence range of the leaf spring 30 can be appropriately set according to the length of the curved region of the catheter 2 and the like.

  A plurality of passages are provided in each of the first region 20A and the second region 20B partitioned by the leaf spring 30. In the present embodiment, passages 31, 33, and 34 are provided in the first region 20A, and passages 32, 35, and 36 are provided in the second region 20B. The passage 31 provided in the first region 20A and the passage 32 provided in the second region 20B are used as operation wire insertion passages, respectively. Further, the passages 33 and 34 provided in the first region 20A and the passages 35 and 36 provided in the second region 20B extend from the handle 6 and are electrically connected to the tip electrode 10 and the ring electrode 12. It is used as a passage for inserting a plurality of conducting wires.

  The plurality of passages 31 to 36 are respectively formed by a plurality of tubes 41, 42, 43, 44, 45, and 46 (tube portions). That is, in this embodiment, the several tubes 41-46 which have a hollow structure are accommodated in the accommodation space 20, and the hollow part of the several tubes 41-46 becomes the paths 31-36, respectively. Each of the tubes 41 and 42 corresponds to an operation wire insertion tube portion. In this embodiment, the inner diameters of the tubes 41 and 42, that is, the diameters of the passages 31 and 32 are, for example, about 0.34 mm, and the inner diameters of the tubes 43 to 46, that is, the diameters of the passages 33 to 36 are, for example, about 0.45 mm. is there.

  An operation wire 50 a is slidably inserted into the tube 41, and an operation wire 50 b is slidably inserted into the tube 42. At the distal end of the operation wire 50a, a partially spherical anchor 52a having a larger diameter than the operation wire 50a located in the tube 41 is formed. Similarly, a partial spherical anchor 52b having a larger diameter than the operation wire 50b located in the tube 42 is formed at the distal end of the operation wire 50b. A recess 11 is formed inside the tip electrode 10, and the recess 11 is filled with solder 62. The anchors 52 a and 52 b are embedded in the solder 62. Thereby, the operation wires 50 a and 50 b are fixed to the solder 62 and the tip electrode 10 and are connected to the vicinity of the distal end of the tubular member 4.

  The proximal ends of the operation wires 50a and 50b are connected to the knob 7 shown in FIGS. Accordingly, by operating the knob 7 shown in FIGS. 1 and 2, the operation wires 50a and 50b are pulled, and the distal end of the catheter 2 can be swung. In the present embodiment, the distal end of the catheter 2 can be deflected in the direction of the arrow D1 in FIG. 2 by pulling the operation wire 50a, and the distal end of the catheter 2 is pulled in FIG. 2 by pulling the operation wire 50b. Can be deflected in the direction of arrow D2.

  Further, by providing the anchors 52a and 52b at the distal ends of the operation wires 50a and 50b as described above, the operation wires 50a and 50b can be made difficult to come out of the solder 62. Thereby, the operation reliability of the catheter 2 can be improved. In the present embodiment, the operation wires 50a and 50b are fixed to the tip electrode 10. However, the operation wires 50a and 50b are not particularly limited thereto, and the operation wires 50a and 50b are connected to the tubular member 4 or the like at the distal ends. It may be fixed.

  The tube 45 is inserted with a lead tip electrode lead wire 60 electrically connected to the tip tip electrode 10. The distal end of the tip tip electrode lead wire 60 is embedded in the solder 62 (not shown). As a result, the tip tip electrode lead wire 60 and the tip tip electrode 10 are electrically connected via the solder 62. Note that the distal end of the tip tip electrode lead wire 60 may be electrically connected to the tip tip electrode 10 by welding. In addition, a plurality of ring electrode conducting wires (not shown) electrically connected to each of the ring electrodes 12 are inserted into the tubes 43, 44, and 46 while being insulated from each other. The distal end of each ring-shaped electrode lead wire is electrically connected to each ring-shaped electrode 12 through the tubes 43, 44, 46 and the pores provided in the tubular member 4. The distal end of each ring electrode lead is fixed to the ring electrode 12 by soldering (not shown) or welding.

  In the present embodiment, the tube 41 is in contact with the tubes 43 and 44, and the tube 42 is in contact with the tubes 45 and 46. Moreover, each tube 41-46 is closely_contact | adhered and fixed to the internal peripheral surface of the inner cylinder 4b. For fixing the tubes 41 to 46 and the inner cylinder 4b, methods such as adhesion and welding can be used. In the first region 20A and the second region 20B, at least some of the plurality of tubes, here, the two tubes 43 and 44 on the first region 20A side and the two tubes 45 on the second region 20B side. , 46 are provided in contact with the main surfaces 30a, 30b of the leaf spring 30, respectively. Thereby, since the leaf | plate spring 30 will be in the state pinched | interposed by the tubes 43 and 44 and the tubes 45 and 46, the motion of the twist direction with respect to the tubular member 4 of the leaf | plate spring 30 can be controlled. Therefore, the torsional rigidity of the catheter 2 can be further increased.

  In the first region 20A and the second region 20B, the operation wire insertion tubes 41 and 42 are provided apart from the leaf spring 30. Therefore, the leaf spring 30 can be bent with a smaller force than when the tubes 41 and 42 are closer to the leaf spring 30. Therefore, the operability of the catheter 2 is improved. The tubes 41 and 42 are provided, for example, so that the central axis is located outside a circle passing through the central axes of the tubes 43, 44, 45, and 46.

  In the present embodiment, in the first region 20 </ b> A, the two tubes 43 and 44 are provided across the center line of the leaf spring 30 along the axial direction of the catheter 2. Similarly, in the second region 20 </ b> B, two tubes 45 and 46 are provided across the center line of the leaf spring 30 along the axial direction of the catheter 2. An operation wire insertion tube 41 is provided between the two tubes 43 and 44, and an operation wire insertion tube 42 is provided between the two tubes 45 and 46. Thereby, since the tubes 41 and 42 can be brought close to the center line of the leaf spring 30 in a direction parallel to the main surfaces 30a and 30b of the leaf spring 30, the torsional rigidity of the catheter 2 can be further increased. The operation wire insertion tube 41 is provided so as to circumscribe the tubes 43, 44, and the operation wire insertion tube 42 is provided so as to circumscribe the tubes 45, 46. Thereby, compared with the case where the tube 41 is separated from the tubes 43 and 44 and the tube 42 is separated from the tubes 45 and 46, the strength of the catheter 2 can be increased.

  Here, the arrangement of the tubes 41 to 46 in the catheter 2 according to the present embodiment will be described in detail with reference to FIG. FIG. 6 is a schematic cross-sectional view for explaining the arrangement of the tubes 41 to 46. As shown in FIG. 6, in the first region 20 </ b> A and the second region 20 </ b> B, the plurality of tubes 41 to 46 are arranged so as to be inscribed in a virtual substantially circle S centering on the central axis of the catheter 2. . Thereby, the cross-sectional shape of the tubular member 4 can be easily kept substantially circular. When the cross-sectional shape of the tubular member 4 is substantially circular, the catheter 2 can be easily inserted into the sheath or blood vessel. Therefore, according to the catheter 2 which concerns on this embodiment, the favorable operativity of the catheter 2 can be ensured easily. Further, the size (thickness) of the catheter 2 that can be inserted into the patient body cavity is generally determined by the size (diameter) of the maximum diameter portion of the tubular member 4. Therefore, when comparing the size of the maximum diameter portion with the same size, the space utilization rate of the catheter 2 can be increased in the substantially circular cross section than in the flat cross section or polygonal cross section. That is, the number of conducting wires or the like that can be inserted into the tubular member 4 can be increased, and the multifunctional and high performance of the catheter 2 can be achieved.

  Further, by making the cross-sectional shape of the tubular member 4 substantially circular, the strength balance of the tubular member 4 can be improved, and a structure that is stable against external forces from multiple directions can be obtained. For example, as described above, the ring-shaped electrode 12 is fixed to the tubular member 4 by caulking a metal ring having a diameter larger than the outer diameter of the tubular member 4 and fastening it to the tubular member 4. By making the cross-sectional shape of the tubular member 4 substantially circular, it is possible to prevent the tubular member 4 from being deformed by the force applied to the tubular member 4 during caulking. The “substantially circle” means that it includes a perfect circle and a circle having a roundness to the extent that the above effect can be obtained. The leaf spring 30 may also be provided so that the side surfaces 30c and 30d are in contact with the virtual substantially circle S. In this case, the tubular member 4 can have a more stable structure against external force.

  In the present embodiment, two tubes 43 and 44 are provided apart from each other in the first region 20A, and two tubes 45 and 44 are provided apart from each other in the second region 20B. Therefore, in the first region 20A, a space 22A surrounded by the tubes 43, 44, the tube 41, and the leaf spring 30 is formed, and in the second region 20B, the tubes 45, 46, the tube 42, A space 22B surrounded by the leaf spring 30 is formed. A member for adjusting the bendability of the catheter 2 (hereinafter, appropriately referred to as a bending adjusting member) can be inserted into at least one of the spaces 22A and 22B as necessary. This bending adjusting member is, for example, a bar made of a metal such as SUS or NiTi or a resin. By inserting the bending adjusting member, the hardness of the tubular member 4 can be changed, and thereby the bendability of the catheter 2 can be adjusted. Inserting a bending adjustment member into one of the spaces 22A and 22B, or inserting bending adjustment members having different flexibility into both the spaces 22A and 22B, thereby making the bending state of the catheter 2 non-target. Can do.

  For example, the bending adjustment member is inserted into the space 22 </ b> A at a predetermined distance from the distal end of the catheter 2, so that the region on the distal end side of the bending adjustment member is the curved region of the catheter 2. Can do. Thereby, the bending range of the catheter 2 when bent in the direction of arrow D1 in FIG. 2 can be made shorter than the bending range of the catheter 2 when bent in the direction of arrow D2 in FIG.

  The bending adjustment member inserted into the first region 20 </ b> A may be in contact with each of the tube 41, the two tubes 43 and 44, and the leaf spring 30. Further, the bending adjusting member inserted into the second region 20B may be in contact with each of the tube 42, the two tubes 45 and 46, and the leaf spring 30. In this case, the tubular member 4 can have a more stable structure against external force.

  As described above, the leaf spring 30 in the catheter 2 of the present embodiment is configured so that at least a part of the end portions 30e and 30f extending in the axial direction of the tubular member 4 is embedded in the tubular member 4. Is provided. Therefore, when the operation wires 50 a and 50 b are operated and a force is applied to the leaf spring 30, it is possible to prevent the leaf spring 30 from being twisted with respect to the tubular member 4. Thereby, the torsional rigidity of the catheter 2 can be improved, and as a result, the planarity in the curved region of the catheter 2 can be improved. This also makes it possible to further reduce the possibility that the catheter 2 will have a curved shape and the possibility that the tubular member 4 will be damaged by the twist of the leaf spring 30. Further, since the tip tip electrode lead wire 60 and the ring-shaped electrode lead wire are inserted into the passages 34 to 36, the lead wires can be prevented from being entangled with each other as the catheter 2 is bent. Thereby, the situation where the unevenness | corrugation etc. resulting from the entangled conducting wire generate | occur | produce on the surface of the catheter 2 (tubular member 4) can be avoided.

  The present invention is not limited to the above-described embodiments, and various modifications such as design changes can be added based on the knowledge of those skilled in the art, and such combinations or modifications are added. Embodiments are also included in the scope of the present invention. A new embodiment generated by the combination of the above-described embodiment and the following modified example has the effects of the combined embodiment and modified example.

  In the above-described embodiment, the leaf spring 30 has both end portions 30e and 30f embedded in the tubular member 4 over the entire length, but the both end portions 30e and 30f are embedded in the tubular member 4 over a part of the entire length of the plate spring 30. It may be. In other words, the tubular member 4 only needs to be embedded in the tubular member 4 at least part of the end 30e and / or the end 30f extending in the axial direction as long as the effect of improving the torsional rigidity of the catheter 2 is obtained.

  In the catheter 2 according to the above-described embodiment, when the accommodation space 20 formed in the inner cylinder 4b is regarded as one lumen, the inner cylinder 4b has a single lumen structure, and the inner cylinder 4b is disposed in the lumen of the inner cylinder 4b. However, the tubes 41 to 46 may be integrated with the tubular member 4. That is, the inner cylinder 4b may have a multi-lumen-like structure in which a plurality of lumens constituting the passages 31 to 36 and through holes for inserting the leaf springs 30 are formed. In this case, a tube portion is formed by a portion having a predetermined thickness from the inner wall of each lumen constituting the passages 31 to 36, and the tube portion corresponding to the passages 33 to 36 contacts the main surfaces 30 a and 30 b of the leaf spring 30. Thereby, the effect of improving the torsional rigidity of the catheter 2 can be obtained. When the inner cylinder 4b has a multi-lumen-like structure, the main surfaces 30a and 30b and the side surfaces 30c and 30d of the leaf spring 30 are entirely embedded in the tubular member 4, and the effect of improving the torsional rigidity of the catheter 2 is achieved. Can be further increased. When the inner cylinder 4b has a multi-lumen-like structure, the constituent material of the inner cylinder 4b is clogged in the area corresponding to the spaces 22A and 22B, but the bendability adjusting member is inserted into this area. Through-holes may be provided.

  In the above-described embodiment, the conductive wires for electrodes are inserted through all of the passages 34 to 37, but not all of the passages 34 to 37 may be passages for inserting conductive wires. For example, a thermocouple as a temperature sensor that detects the temperature in the vicinity of the distal end of the catheter 2 can be inserted into a part of the passages 34 to 37.

  2 catheter, 4 tubular member, 20A first region, 20B second region, 22A, 22B space, 30 leaf spring, 30a, 30b main surface, 30c, 30d side surface, 30e, 30f end, 31, 32, 33, 34 , 35, 36 passage, 41, 42, 43, 44, 45, 46 tube, 50a, 50b wire for operation.

Claims (7)

A tubular member;
A leaf spring provided inside the tubular member such that at least a part of the end of the tubular member along the axial direction is embedded in the tubular member;
A plurality of operation wire insertion passages provided in each of the first region on one main surface side of the leaf spring and the second region on the other main surface side of the leaf spring inside the tubular member. A plurality of tube portions for forming respective passages,
The catheter is characterized in that in the first region and the second region, at least a part of the plurality of tube portions is provided so as to be in contact with the main surface of the leaf spring.   The catheter according to claim 1, wherein the end portion of the leaf spring is embedded in the tubular member over the entire region in the axial direction. The plurality of tube portions include at least two tube portions and one operation wire insertion tube portion,
The said 1st area | region and the said 2nd area | region WHEREIN: The said 2 tube part is in contact with the main surface of the said leaf | plate spring, and the said operation wire insertion tube part is spaced apart and provided with the said leaf | plate spring. 2. The catheter according to 2.   In the first region and the second region, the two tube portions are provided across a center line of a leaf spring along the axial direction of the catheter, and the operation wire insertion tube portion is formed of the two tube portions. The catheter according to claim 3 provided in between.   In the first region and the second region, the operation wire insertion tube portion circumscribes the two tube portions, and the plurality of tube portions are inscribed in a substantially circle centered on the central axis of the catheter. The catheter according to claim 4, which is arranged with respect to each other. In the first region and the second region, the two tube portions are provided apart from each other,
In order to adjust the bendability of the catheter in a region surrounded by the two tube portions, the operation wire insertion tube portion, and the leaf spring in at least one of the first region and the second region. The catheter according to claim 4 or 5, wherein said member is inserted. Comprising a plurality of electrodes in the distal end region;
The catheter according to any one of claims 1 to 6, wherein the plurality of electrode leads are inserted into at least a part of the plurality of passages other than the operation wire insertion passage.

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