HK1211455B

HK1211455B - Catheter for denervation

Info

Publication number: HK1211455B
Application number: HK15112501.0A
Authority: HK
Inventors: 黄仁帝; 张慧原; 宋承佑; 张宇翼
Original assignee: 韩德卡洛斯医药株式会社
Priority date: 2013-02-05
Filing date: 2014-02-05
Publication date: 2019-08-02

Description

Denervation catheter

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application claims priority from korean patent application nos. 10-2013-0013100, 10-2013-0013101 and 10-2013-0013102 filed on 5.2.2013 and korean patent application No. 10-2013-0018085 filed on 20.2.2013, the entire disclosures of which are incorporated herein by reference.

Technical Field

The present invention relates to a catheter, and more particularly, to a denervation catheter that ablates a portion of nerves that do not activate nerve conduction; and a denervation device comprising a catheter.

Background

Denervation is a surgical procedure that blocks some neural pathways, such as sensory nerves and autonomic pathways, from various nerves, rendering stimuli or messages untransmittable. Denervation is increasingly used to treat diseases such as cardiac arrhythmias, pain relief, orthopedic surgery, or the like.

In particular, as recently reported, denervation can be used to treat hypertension, and much effort is being directed to effective treatment of hypertension.

For the case of hypertension, most hypertensive patients have to date been on medication, since blood pressure can mostly be controlled using medication. However, if the blood pressure is lowered by using the medicine, the patient with hypertension should continue to take the medicine, which causes inconvenience and increases costs. In addition, if taken for a long time, various problems occur, such as damage to the internal organs or other side effects. In addition, some hypertensive patients suffer from refractory hypertension and cannot easily control hypertension using drugs. As refractory hypertension cannot be treated with drugs, the likelihood of accidents such as stroke, cardiac arrhythmias, kidney disease, or the like is increased. Therefore, the treatment of intractable hypertension is a very serious and urgent subject.

In this case, denervation attracts attention, as it is an innovative approach to treat hypertension. In particular, denervation for treating hypertension is performed by ablating sympathetic nerves around renal nerves (i.e., renal arteries) that do not activate nerve conduction, so that the renal nerves are blocked. If the renal nerve is stimulated, the kidney increases production of renin hormones, which may lead to an increase in blood pressure. Therefore, if the renal nerve is blocked, nerve conduction is poor, and thus hypertension can be treated, as verified by various recent experiments.

As previously mentioned, renal denervation, which is representative of the treatment of hypertension, currently employs a catheter. In denervation using a catheter, a catheter is inserted into a portion of the body, such as the thigh, with the distal end of the catheter located in the renal artery. In this state, heat is generated at the distal end of the catheter via Radio Frequency (RF) energy or the like to block sympathetic nerves around the renal arteries.

If denervation using a catheter is performed, only a very small area is incised in the body compared to denervation using abdominal surgery. Thus, latent complications or side effects can be significantly reduced and, due to local anesthesia, very short treatment or recovery times. Therefore, denervation using catheters is the focus of next generation hypertension treatment methods due to the above-mentioned benefits.

However, denervation using catheters has not been fully developed, particularly for the treatment of hypertension, and there is room for further improvement.

In particular, some catheters that have been proposed to treat denervation include only one electrode for emitting energy, such as high frequencies, and the electrode is located in a blood vessel, such as in the renal artery, to block nerves surrounding the blood vessel. However, in this configuration, the electrodes may not be placed at the correct locations of the renal nerves, and thus may incorrectly block the renal nerves. Therefore, in the case of such a catheter, the electrodes should be located at various positions of the renal artery, which may increase the time of the operation and cause complicated procedures in order to properly block the renal nerve.

To address this problem, it has recently been proposed to deploy a plurality of electrodes at the distal end of a catheter. However, if a plurality of electrodes are arranged in this manner, the distal end of the catheter with the electrodes (i.e., a catheter tip) has a complicated structure and a large size. If the distal end of the catheter is increased, as previously described, the catheter may not be able to easily move along small diameter vessels, like the renal arteries, and may also damage the inner walls of the vessels. Further, currently, when a catheter is used, in order to protect an organ such as a blood vessel and allow the catheter to be easily moved to a destination, a catheter called a sheath is placed in an organ such as a blood vessel, and then the catheter is moved through the sheath near the destination. In this case, if the catheter has a large distal end, the catheter may not be able to easily move into the sheath, which may make it difficult to reach the sheath during surgery.

In addition, some catheters proposed in the past may cause stenosis, since the blood vessel may be narrow in the ablated region, and also some catheters proposed in the past may not be easily manipulated.

In addition, some catheters proposed in the past may not ensure proper contact between an electrode and a blood vessel. In this case, the heat energy reaching the nerve through the electrodes may not be of sufficient level, which may not be able to block the nerve correctly.

Disclosure of Invention

Technical problem

The present invention is designed to solve the related art problems, and therefore the present invention provides a denervation catheter that can effectively block nerves near blood vessels by including a plurality of electrodes and also improve a tip structure without increasing the size.

Other objects and advantages of the present invention will be apparent from the following description, and become more apparent from the detailed description of the invention. Further, it is to be understood that the objects and advantages of the present invention may be realized and attained by means of the instrumentalities and combinations particularly pointed out in the appended claims.

Technical solution

In a first aspect of the present invention, there is provided a denervation catheter, comprising: a catheter body extending in a direction having a proximal end and a distal end and having a lumen formed longitudinally thereof; a movable member configured to be movable in the lumen of the catheter body along the longitudinal direction of the catheter body; an operating member having a distal end connected to the movable member to move the movable member; a plurality of support members having one end connected to the movable member and configured such that the other end thereof moves toward or away from the catheter main body in accordance with the movement of the movable member; a plurality of electrodes respectively disposed at the other ends of the plurality of support members to generate heat; and a lead electrically connected to the plurality of electrodes, respectively, to provide a power supply path to the plurality of electrodes, the lead having a variable region whose length is variable such that a proximal end of the variable region is fixed to a side portion of the catheter body and a distal end of the variable region is fixed to the movable member.

Preferably, the catheter body has a plurality of side holes formed at a side surface of a distal end thereof, and the plurality of support members are moved into or out of the catheter body through the side holes.

More preferably, the plurality of side holes are closer to the distal end of the catheter body than the movable member, the movable member is connected to a proximal end of the plurality of support members, and the electrodes are respectively disposed at a distal end of the plurality of support members, and the electrodes are moved away from the catheter body when the movable member moves in a direction from the proximal end of the catheter body to the distal end of the catheter body.

Further preferably, the plurality of side holes are closer to the proximal end of the catheter body than the movable member, the movable member is connected to a distal end of the plurality of support members, and the electrodes are respectively disposed at a proximal end of the plurality of support members, and the electrodes move farther from the catheter body when the movable member moves in a direction from the distal end of the catheter body to the proximal end of the catheter body.

Further preferably, the catheter main body has a side insertion groove formed in a region where the side hole is formed, the side insertion groove being recessed toward the inside of the catheter main body so that the electrode is inserted therein.

Further preferably, the catheter has a plurality of front holes formed in a front surface of a distal end thereof, and the plurality of support members are moved into or out of the catheter body through the front holes.

Further preferably, the catheter body has an opening formed in a front surface of a distal end thereof, and the plurality of support members and the plurality of electrodes are moved through the opening to be received in a lumen of the catheter body or pulled out of the catheter body.

Further preferably, the plurality of electrodes are spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body in a state where the other end of the support member is moved away from the catheter body.

Further preferably, the plurality of electrodes are spaced apart from each other by 0.3cm (centimeter) to 0.8cm (centimeter) in the longitudinal direction of the catheter body in a state where the other end of the support member is moved away from the catheter body.

Further preferably, the plurality of electrodes generate heat via radio frequency.

It is also preferred that the support member is pre-shaped so that its other end is movable away from the catheter body upon movement of the movable member.

Further preferably, the catheter body includes at least one stopper disposed in the lumen to limit the distance of movement of the movable member.

Further preferably, the catheter body has a guide hole formed at the distal end so that a guide wire is moved through the guide hole.

Also preferably, the denervation catheter may further include an elastic member connected between the catheter body and the movable member.

In another aspect, there is also provided a denervation apparatus comprising a denervation catheter according to the first aspect of the invention.

In a second aspect of the invention, there is provided a denervation catheter, comprising: a catheter body extending in a direction having a proximal end and a distal end, and having a lumen formed longitudinally thereof; a movable member provided at a distal end of the catheter main body to move in a longitudinal direction of the catheter main body; an operating member having a distal end connected to the movable member to move the movable member; a plurality of support members having one end connected to the one end of the catheter body and the other end connected to the movable member, wherein when the movable member moves to reduce the distance between the distal end of the catheter body and the movable member, at least a portion of the plurality of support members are bent such that the bent portion moves away from the catheter body; a plurality of electrodes respectively disposed at the bent portions of the plurality of support members to generate heat; and a conducting wire electrically connected to the plurality of electrodes respectively to provide a power supply path for the plurality of electrodes.

Preferably, the movable member is disposed outside the catheter body.

More preferably, the catheter according to the second aspect of the present invention may further include a reinforcement member extending in the longitudinal direction of the catheter body and disposed between the catheter body and the movable member, wherein a distal end of the reinforcement member is fixed to the movable member and a proximal end of the reinforcement member is inserted into a through hole of the catheter body so that the proximal end of the reinforcement member moved moves through the through hole of the catheter body in accordance with the movement of the movable member.

Further preferably, the movable member is disposed in the lumen of the catheter body, and the catheter body has an opening through which the curved portion of the support member can be pulled out of the catheter body when the support member is curved.

Further preferably, the plurality of electrodes are spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body in a state where the curved portion of the support member is moved away from the catheter body.

Further preferably, the plurality of electrodes are spaced apart from each other by 0.3cm (centimeter) to 0.8cm (centimeter) in the longitudinal direction of the catheter body in a state where the curved portion of the support member is moved away from the catheter body.

Further preferably, the surface of the catheter main body and the movable member connecting the support member is perpendicular to the longitudinal direction of the catheter main body.

Further preferably, the catheter according to the present invention may further comprise at least one stopper for limiting a moving distance of the movable member.

Preferably, the catheter according to the present invention may further include an elastic member coupled to the movable member to provide a restoring force to the movement of the movable member.

In another aspect, there is also provided a denervation apparatus comprising a denervation catheter according to the second aspect of the invention.

In a third aspect of the invention, there is provided a denervation catheter, the catheter comprising: a catheter body extending in a direction having a proximal end and a distal end and having a lumen formed longitudinally thereof; a movable member provided at the distal end of the catheter main body, movable in the longitudinal direction of the catheter main body; an operating member having a distal end connected to the movable member to move the movable member; a plurality of support members having one end connected to an end of the catheter body and the other end connected to the movable member, wherein when the movable member moves to reduce the distance between the tip of the catheter body and the movable member, at least a portion of the plurality of support members bends such that the bend moves away from the catheter body; a plurality of electrodes respectively disposed at the bent portions of the plurality of support members to generate heat; and a lead wire electrically connected to the plurality of electrodes, respectively, to provide a power supply path to the plurality of electrodes, wherein at least one of the catheter main body and the movable member is connected to at least two support members at points spaced apart from each other by a predetermined distance in a longitudinal direction of the catheter main body.

Preferably, at least one of the catheter body and the movable member has a step formed on a surface thereof to which the support member is coupled.

Further preferably, at least one of the catheter main body and the movable member is inclined on a surface to which the support member is attached.

Further preferably, the movable member is disposed outside the catheter main body.

More preferably, the denervation catheter according to the third aspect of the present invention may further include a reinforcing member extending in the longitudinal direction of the catheter body and disposed between the catheter body and the movable member, wherein a distal end of the reinforcing member is fixed to the movable member and a proximal end of the reinforcing member is inserted into a through hole of the catheter body such that the proximal end of the reinforcing member moves through the through hole of the catheter body in accordance with the movement of the movable member.

Further preferably, a surface of the catheter main body and a surface of the movable member (connection support member) are conformed to each other.

Further preferably, an outer surface length of a part of the support member in the width direction is longer than an inner surface length thereof.

Further preferably, the support member has an arcuate portion formed such that the curved portion has a curved direction to move away from the catheter body.

It is also preferred that the support member is pre-shaped such that the bend has a bend direction to move away from the catheter body.

Further preferably, the plurality of electrodes are spaced apart from each other at a predetermined angle in a longitudinal direction based on a central axis of the catheter body in a state where the curved portion of the support member is moved away from the catheter body.

Further preferably, the denervation catheter according to the present invention may further include at least one stopper for limiting a moving distance of the movable member.

In addition, the denervation catheter according to the present invention may further include an elastic member coupled to the movable member to provide a restoring force to the movement of the movable member.

In another aspect, there is also provided a denervation apparatus comprising a denervation catheter according to the third aspect of the present invention.

In a fourth aspect of the present invention, there is provided a denervation catheter, comprising: a catheter body extending in a direction having a proximal end and a distal end, and having a lumen formed longitudinally thereof; a movable member provided at a distal end of the catheter main body to move in a longitudinal direction of the catheter main body; an operating member having a distal end connected to the movable member to move the movable member; an intermediate member provided between an end portion of the catheter main body and the movable member, and movable in a longitudinal direction of the catheter main body; a first stopper for allowing the intermediate member to be moved by the operating member when the distance between the movable member and the intermediate member is reduced to a predetermined level; a first support member having one end connected to the intermediate member and another end connected to the movable member, wherein when the movable member moves to reduce the distance between the intermediate member and the movable member, at least a portion of the first support member bends such that the bend moves away from the catheter body; a second support member having one end connected to the end of the catheter body and another end connected to the intermediate member, wherein when the intermediate member is moved to reduce the distance between the intermediate member and the end of the catheter body, at least a portion of the second support member bends such that the bend moves away from the catheter body; a plurality of electrodes respectively disposed at the bent portions of the first and second support members to generate heat; and a conducting wire electrically connected to the plurality of electrodes respectively to provide a power supply path for the plurality of electrodes.

Preferably, the movable member and the intermediate member are disposed outside the catheter main body, and the intermediate member has an insertion hole through which the operating member is inserted.

Further preferably, the movable member and the intermediate member are provided in the catheter main body, and the catheter main body has an opening through which the bent portions of the first support member and the second support member are pulled out of the catheter main body when the first support member and the second support member are bent.

Further preferably, the electrodes provided at the first support member and the second support member are spaced apart from each other by 0.3cm (centimeter) to 0.8cm (centimeter) in the longitudinal direction of the catheter body in a state where the bent portions of the first support member and the second support member are moved away from the catheter body.

Preferably, in the width direction, the first support member and the second support member have an outer surface length longer than an inner surface length.

It is also preferred that the first support member and the second support member have an arcuate portion formed so that the curved portion has a curved direction to move away from the catheter body.

It is also preferred that the first support member and the second support member are pre-shaped such that the bend has a bend direction to move away from the catheter body.

Further preferably, the plurality of electrodes are spaced apart from each other at a predetermined angle in a longitudinal direction according to a central axis of the catheter body in a state where the bent portions of the first support member and the second support member are moved away from the catheter body.

Further preferably, the first support member and the second support member include a plurality of unit support members, respectively.

Preferably, the intermediate member includes a plurality of unit intermediate members, and the catheter further includes a third support member having both ends connected to the plurality of unit intermediate members, wherein when a distance between the plurality of unit intermediate members decreases, at least a portion of the third support member is bent such that the bent portion moves away from the catheter main body, wherein an electrode is disposed at the bent portion.

Further preferably, the first stopper is provided on the operating member between the movable member and the intermediate member, and is hooked by an insertion hole of the intermediate member through which the operating member is inserted.

Further preferably, the catheter according to the present invention may further comprise a second stopper provided on the operating member between the intermediate member and the distal end of the catheter main body to be hooked by an operating hole of the catheter main body through which the operating member is insertable.

Preferably, the catheter according to the present invention may further comprise an elastic member connected to the intermediate member to provide a restoring force to the movement of the intermediate member.

In another aspect, there is also provided a denervation apparatus comprising a denervation catheter according to the fourth aspect of the present invention.

Advantageous effects

According to the present invention, since the plurality of electrodes are disposed at a distal end of a catheter main body, nerves around blood vessels can be effectively blocked.

In particular, according to an embodiment of the present invention, the plurality of electrodes are inclined at a predetermined angle according to the central axis of the catheter body, which are widely arranged in a 360 ° direction along the inner circumference of the blood vessel, so that it is possible to maximize ablation of nerves around the blood vessel.

Furthermore, according to an embodiment of the present invention, the plurality of electrodes are not on a single site of the blood vessel, but are spaced apart from each other in a longitudinal direction of the blood vessel, which can prevent stenosis due to ablation.

Moreover, according to the present invention, a distal end of the catheter body (i.e., the catheter tip portion) may not have a complicated structure and a large size. Therefore, the catheter tip portion can easily move a blood vessel having a small diameter, and the vessel wall can be prevented from being damaged by the moving catheter. Furthermore, the present invention can be easily adapted to an operation in which a separate component (such as a sheath) is inserted into a blood vessel and then a catheter is inserted into the sheath, rather than inserting the catheter directly into the blood vessel, but it can be inserted.

Further, according to an embodiment of the present invention, a lead is connected to the electrode to supply electric power to the electrode, the lead being formed in a coil shape at a portion near the distal end. Thus, the length of the wire can be easily adjusted, since the portion has such a coil shape, and it is not necessary to move the entire wire through the catheter body.

Also, according to the present invention, since the electrode is inserted into the catheter body, the electrode can be prevented or reduced from protruding out of the outer surface of the catheter body. Thus, when the distal end of the catheter is moved through the blood vessel, damage to the inner wall of the blood vessel by the electrode can be avoided.

Meanwhile, the present invention can be widely used for treating various diseases or alleviating pains by using a catheter, and in particular, the present invention can be more effectively applied to medical operations for treating hypertension by blocking sympathetic nerves around renal arteries.

Brief description of the drawings

The accompanying drawings illustrate preferred embodiments of the present invention and, together with the foregoing disclosure, provide a further understanding of the technical spirit of the invention. However, the invention is not limited to the following drawings, in which:

FIG. 1 is a perspective view schematically illustrating the distal end of a catheter in accordance with a first aspect of the present invention;

FIG. 2 is a cross-sectional view taken along line A1-A1' of FIG. 1;

FIG. 3 is a cross-sectional view schematically showing the structure of FIG. 2, with one end of a support member attached to a movable member and the other end thereof removed from a catheter body by movement of the movable member;

FIG. 4 is a perspective view of FIG. 3;

FIG. 5 is a front view of FIG. 3;

FIG. 6 is a cross-sectional view showing the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 7 is a schematic view of the catheter shown in the configuration of FIG. 6 with an electrode moved away from the catheter body by movement of the movable member;

FIG. 8 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 9 is a schematic view showing the configuration of FIG. 8 with an electrode moved away from the catheter body by movement of the movable member;

FIG. 10 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 11 is a schematic view of the catheter shown in the configuration of FIG. 10 with an electrode moved away from the catheter body by movement of the movable member;

FIG. 12 is a perspective view schematically illustrating the distal end of a denervation catheter in accordance with another embodiment of the present invention;

FIG. 13 is a perspective view schematically illustrating the distal end of a catheter in accordance with a second aspect of the present invention;

FIG. 14 is a cross-sectional view taken along line A2-A2' of FIG. 13;

FIG. 15 is a cross-sectional view schematically illustrating the structure of FIG. 14 with an electrode removed from the catheter body by movement of the movable member;

FIG. 16 is a perspective view of FIG. 15;

FIG. 17 is a front view of FIG. 16;

FIG. 18 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 19 is a cross-sectional view schematically illustrating the configuration of FIG. 18 with an electrode removed from the catheter body by movement of the movable member;

FIG. 20 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 21 is a cross-sectional view schematically illustrating the configuration of FIG. 20 with an electrode removed from the catheter body by movement of the movable member;

FIG. 22 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 23 is a cross-sectional view showing the catheter of FIG. 22 along a longitudinal direction;

FIG. 24 is a cross-sectional view schematically illustrating the structure of FIG. 23 with an electrode removed from the catheter body by movement of the movable member;

FIG. 25 is a perspective view of FIG. 24;

FIG. 26 is a perspective view schematically illustrating the distal end of a denervation catheter in accordance with another embodiment of the present invention;

FIG. 27 is a perspective view schematically illustrating the distal end of a catheter in accordance with a third aspect of the present invention;

FIG. 28 is a cross-sectional view taken along line A31-A31' of FIG. 27;

FIG. 29 is a cross-sectional view schematically showing the structure of FIG. 28 with the curved portion of a support member moved away from the catheter body by movement of the movable member;

FIG. 30 is a perspective view of FIG. 29;

FIG. 31 is a front view of FIG. 30;

FIG. 32 is a cross-sectional view taken along line A32-A32' of FIG. 27;

FIG. 33 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, in accordance with another embodiment of the present invention;

FIG. 34 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 35 is a cross-sectional view schematically illustrating the configuration of FIG. 34 with an electrode removed from the catheter body by movement of the movable member;

FIG. 36 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 37 is a cross-sectional view schematically illustrating the structure of FIG. 36 with an electrode removed from the catheter body by movement of the movable member;

FIG. 38 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 39 is a cross-sectional view showing the catheter of FIG. 38 along the longitudinal direction;

FIG. 40 is a cross-sectional view schematically illustrating the structure of FIG. 39 with an electrode removed from the catheter body by movement of the movable member;

FIG. 41 is a perspective view of FIG. 40;

FIG. 42 is a perspective view schematically illustrating the distal end of a denervation catheter in accordance with another embodiment of the present invention;

FIG. 43 is a perspective view schematically illustrating the distal end of a catheter in accordance with the fourth aspect of the present invention;

FIG. 44 is a cross-sectional view taken along line A4-A4' of FIG. 43;

FIG. 45 is a cross-sectional view schematically showing the configuration of FIG. 44 with the curved portion of a first support member moved away from the catheter body by movement of the movable member;

FIG. 46 is a cross-sectional view schematically illustrating the configuration of FIG. 45 with the curved portion of a second support member moved away from the catheter body by movement of an intermediate member;

FIG. 47 is a perspective view of FIG. 46;

FIG. 48 is a front view of FIG. 47;

FIG. 49 is a schematic view showing the arrangement and segments in the width direction of the first and second support members according to one embodiment of the present invention;

FIG. 50 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 51 is a cross-sectional view schematically illustrating the configuration of FIG. 50 with an electrode removed from the catheter body by movement of the movable member and the intermediate member;

FIG. 52 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 53 is a cross-sectional view schematically illustrating the configuration of FIG. 52 with an electrode removed from the catheter body by movement of the movable member and the intermediate member;

FIG. 54 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 55 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention;

FIG. 56 is a cross-sectional view showing the catheter of FIG. 55 along the longitudinal direction;

fig. 57 is a sectional view schematically showing the structure of fig. 56 in which the movable member is moved in the right direction;

FIG. 58 is a sectional view schematically showing the structure of FIG. 57 with the intermediate member moved in the right direction;

FIG. 59 is a perspective view of FIG. 58; and

FIG. 60 is a perspective view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention.

Detailed description of the preferred embodiments

Best mode

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings. Before describing, it should be understood that the terms used in the specification and the appended claims should not be construed as limited to general and dictionary meanings, but interpreted based on the meanings and concepts corresponding to technical aspects of the present invention on the basis of the principle that the inventor is allowed to define terms appropriately for the best explanation.

Accordingly, the description proposed herein is just a preferable example for the purpose of illustrations only, not intended to limit the scope of the invention, so it should be understood that other equivalents and modifications could be made thereto without departing from the spirit and scope of the invention.

First, a denervation catheter according to a first aspect of the present invention will be described with reference to fig. 1 to 12.

Fig. 1 is a perspective view schematically showing the distal end of a catheter according to the first aspect of the present invention, and fig. 2 is a sectional view taken along line a1-a1' of fig. 1. FIG. 2 shows a support member and an electrode used in the catheter of FIG. 1.

Herein, the distal end of the catheter means that one end of the catheter, which reaches a part of the human body under a surgical procedure, is interposed between both ends of the catheter extending in the longitudinal direction, and it is also called a catheter tip. In addition, the end of the catheter opposite the distal end is referred to as a proximal end. Hereinafter, with respect to various components extending in the longitudinal direction of the catheter so as to have both ends in the longitudinal direction, one end of the component positioned at the distal end of the catheter will be referred to as a distal end of the corresponding component, and a proximal end of the component positioned at the proximal end of the catheter will be referred to as a proximal end of the corresponding component.

Referring to fig. 1 and 2, the catheter according to the present invention may include a catheter body (1100), a movable member (1200), an operating member (1300), a support member (1400), an electrode (1500), and a lead (1600).

The catheter body (1100) has a tube or tube shape extending in a direction and having a lumen along a longitudinal direction. Here, the catheter body (1100) has two ends along the longitudinal direction, wherein one end of the catheter body (1100) is inserted into the body using the catheter and reaches a destination during a surgical procedure, which is the subject of the surgical procedure, referred to as a distal end (1101), and the end of the catheter body (1100) that is close to and manipulated by the operator is referred to as a proximal end (not shown), as previously described.

The catheter body (1100) has a hollow tubular shape and has a lumen along a longitudinal direction. Thus, various components of a surgical procedure may be disposed in or moved through the lumen, and a substance, such as a drug or lotion, may be injected through the lumen. To this end, the proximal end of the catheter body (1100) may be formed such that the lumen opens outwardly.

The catheter body (1100) may have various shapes depending on its purpose or purpose, and may also have various inner or outer diameters. In addition, the catheter body (1100) may be made using various materials, such as soft materials (such as rubber and plastic) or hard materials (such as metal). The invention is not limited to a particular shape, material, or size of the catheter body (1100), and the catheter body (1100) may have various shapes, materials, sizes, or the like.

Preferably, the distal end (1101) of the catheter body may be made using a soft and resilient material. The distal end (1101) of the catheter body is positioned at a forward end of the catheter. Thus, as the catheter is moved along a blood vessel or the like, the distal end (1101) of the catheter body may contact the inner wall of the blood vessel or the like. However, if the distal end (1101) of the catheter body is made of such a soft and elastic material, damage to the blood vessel or the like caused by the distal end (1101) of the catheter body can be reduced or avoided, and also the direction of movement of the distal end (1101) of the catheter body can be easily changed.

Further, in a similar manner, the distal end (1101) of the catheter body may have a rounded edge. For example, the distal end (1101) of the catheter body may have a rounded convex shape extending toward the forward end of the catheter.

The moveable member (1200) is included in the lumen of the catheter body (1100). Further, the movable member (1200) constitutes an inner cavity of the catheter main body (1100), and moves in the longitudinal direction of the catheter main body (1100). For example, as shown in fig. 2, if the catheter main body (1100) is extended in the lateral direction, the movable member (1200) is configured to move in the lateral direction as indicated by an arrow b 11.

The operating member (1300) may be formed to extend long along the longitudinal direction of the catheter main body (1100), and one end (i.e., the distal end) of the operating member (1300) is connected and fixed to the movable member (1200). The operation member (1300) may be disposed according to the inner lumen of the catheter main body (1100), and the other end, i.e., the proximal end, of the operation member (1300) may expose the catheter main body (1100) through the opening portion of the proximal end of the catheter main body (1100). In this case, the operator may utilize a separate tool to manually or automatically pull or push the operating member (1300). In this case, the operating member (1300) is movable in the lateral direction, as indicated by an arrow b12 in fig. 2, and by so doing, the movable member (1200) connecting one end of the operating member (1300) is movable in the lateral direction, as indicated by an arrow b 11.

The support member (1400) may have a bar or plate shape extending in one direction. Further, the support member (1400) may be configured such that one end is connected and fixed to the movable member (1200) among both ends in the longitudinal direction. In this configuration, if the movable member (1200) moves, the other end of the support member (1400) may move closer to or further away from the central axis of the catheter body (1100). This will be described in more detail with reference to fig. 3 to 5.

Fig. 3 is a sectional view schematically showing the structure of fig. 2 in which one end of the support member (1400) is connected to the movable member (1200), and the other end is moved away from the catheter main body (1100) by the movement of the movable member (1200). Fig. 4 is a perspective view of fig. 3, and fig. 5 is a front view of fig. 3.

Referring to fig. 3 to 5, the catheter body (1100) has a plurality of side holes (1111) formed at one side surface of the distal end (1101). For example, as shown in fig. 3, the side hole (1111) may be formed near the distal end (in the right direction of fig. 3) of the catheter body (1100) compared to the movable member (1200).

Here, the number of the side holes (1111) may correspond to the number of the support members (1400). For example, as shown in fig. 3 and 4, if the catheter has three support members (1400), three side holes (1111) may also be formed in the catheter body (1100).

In this case, the plurality of support members (1400) may move into or out of the catheter body (1100) through the side holes (1111) in a one-to-one relationship. For example, as shown in fig. 3, if three side holes (1111) are formed near the distal end (1101) of the catheter body (1100) as compared to the movable member (1200), the proximal ends (left end in fig. 3) of three support members (1400) may be connected to the movable member (1200). Further, the three support members (1400) may be configured such that the distal ends thereof (e.g., the right end in fig. 3) expose the catheter body (1100) through the three side holes (1111), respectively, according to the movement of the movable member (1200).

In this case, if the movable member (1200) is moved in the right direction, i.e., toward the distal end of the catheter body (1100), as indicated by arrow c11, the three support members (1400) slide through the side holes (1111), respectively, so that the distal ends thereof move away from the catheter body (1100), as indicated by arrows d11, d12, and d13 in fig. 3 and 4. Herein, the distal end of the support member (1400) moving away from the catheter body (1100) means that the distal end of the support member (1400) gradually moves away from a central axis (o1) of the catheter body (1100).

Meanwhile, an electrode (1500) is disposed at the other end of the plurality of support members (1400). For example, in the embodiment depicted in fig. 1-4, an electrode (1500) may be disposed at each distal end of the plurality of support members (1400).

The electrode (1500) may be connected to an energy supply unit (not shown) via a lead (1600) to generate heat. In addition, heat generated by the electrode (1500) can ablate surrounding tissue. For example, the electrode (1500) may ablate nerves around blood vessels by generating heat at about 40 ℃ or more (preferably 40 to 80 ℃), which may block the nerves. However, the temperature of the heat generated by the electrode (1500) may be set in different ways depending on the use or purpose of the catheter.

The electrode (1500) should apply heat to the nerve tissue surrounding the vessel that contacts the vessel wall, so that the electrode (1500) is preferably tightly attached to the vessel wall. Thus, the electrode (1500) may have a curved shape, such as a circle, semi-circle, or oval, to conform to the shape of the inner wall of the vessel. In this embodiment, the electrode (1500) may be more positively attached to the vessel wall, such that heat generated by the electrode (1500) may be efficiently transferred to the nerve tissue surrounding the vessel.

The electrode (1500) may be made of a material such as platinum or stainless steel, but the invention is not limited to this particular material for the electrode (1500). The electrode (1500) may be made of a variety of materials, taking into account a variety of factors, such as a type of energy generated and a surgical target.

Preferably, the electrode (1500) can generate heat via Radio Frequency (RF). For example, the electrode (1500) may be connected to a high frequency generating unit through a lead (1600) and emit high frequency energy to ablate a nerve.

Meanwhile, the electrode (1500) provided at the catheter may be a negative electrode, and a positive electrode (opposite to the negative electrode) may be connected to an energy supply unit, such as a high frequency generating unit, similarly to the negative electrode, and a die or a patch or the like is employed to attach a specific part of the human body.

Since the electrode (1500) is disposed at the other end of the support member (1400), when the other end of the support member (1400) is moved closer to or away from the catheter body (1100), the electrode (1500) is thus also moved closer to or away from the catheter body (1100).

For example, as shown in fig. 2 and 3, if the side hole (1111) is closer to the distal end of the catheter body (1100) (in the right direction of fig. 2 and 3) than the movable member (1200), and the movable member (1200) is connected to the proximal end of the support member (1400), the electrode (1500) may be disposed at the distal end of the support member (1400). In this embodiment, when the movable member (1200) is moved in a direction from the proximal end to the distal end of the catheter body (1100), as indicated by arrow c11 in fig. 3, the electrode (1500) disposed at the distal end of the support member (1400) may be configured to move away from the catheter body (1100). Conversely, if the movable member (1200) moves in a direction opposite to that shown by arrow c11 in fig. 3, the electrode (1500) disposed at the distal end of the support member (1400) may be configured to move toward the catheter body (1100).

In other words, the electrode (1500) is configured to move longitudinally, based on the central axis (o1) of the catheter body (1100), towards or away from a line perpendicular to the central axis (o1) in response to movement of the movable member (1200).

To this end, the support member (1400) supporting the electrode (1500) with the electrode (1500) at the other end may be of a suitable material or shape such that the electrode (1500) may move toward or away from the central axis (o1) of the catheter body (1100) in accordance with the movement of the movable member (1200).

For example, the support member (1400) may be pre-shaped such that when the movable member (1200) is moved along arrow c11, the other end may be moved away from the central axis (o1) of the catheter body (1100), as shown in fig. 3-5. In particular, the support member (1400) may also be made of a shape memory alloy, such as nitinol. In this embodiment, if the support member (1400) is offset from the catheter body (1100), the other end is moved away from the central axis (o1) of the catheter body (1100) depending on the form of the pre-form, and thus the electrode (1500) disposed at the other end of the support member (1400) is also moved away from the central axis (o1) of the catheter body (1100).

However, the present invention is not limited thereto, and various structures may be used such that the other end of the support member (1400) with the electrode (1500) may move closer to or away from the catheter body (1100) according to the movement of the movable member (1200). For example, the support member (1400) may be configured such that an end of the support member (1400) moves closer to or away from the catheter body (1100) by changing an angle among the side hole (1111), an end of the support member (1400), and a horizontal line, according to the movement of the movable member (1200). In other words, in the embodiment of fig. 3, if the movable member (1200) is moved in the direction (c11), the angle between the side hole (1111), one end of the support member (1400) and the horizontal gradually increases, and the other end of the support member (1400) with the electrode (1500) can be configured to gradually move away from the catheter body (1100).

As described above, in the denervation catheter according to the present invention, the electrode (1500) is provided at the other end of the support member (1400) to move closer to or away from the catheter body (1100). Thus, if the catheter according to the invention is used to perform denervation, the distal end of the catheter (i.e. a catheter tip) can be moved through the blood vessel to the surgical target with the other end of the support member (1400) with the electrode (1500) in close proximity to the catheter body (1100). In addition, if the catheter tip reaches the surgical target, the other end of the support member (1400) with the electrode (1500) is moved away from the catheter body (1100) so that the electrode (1500) contacts or approaches the inner wall of the blood vessel. Further, in this state, energy for generating heat (e.g., high-frequency energy) is emitted through the electrode (1500), thereby blocking nerves around the blood vessel. Thereafter, if denervation is completed using energy emitted through the electrode (1500), the other end of the support member (1400) with the electrode (1500) is again moved closer to the catheter body (1100), and the catheter may then be withdrawn from the blood vessel.

Meanwhile, in a state where the electrode (1500) is moved away from the central axis (o1) of the catheter body, a distance between the electrode (1500) and the central axis (o1) of the catheter body, such as an inner diameter of a blood vessel, may be variously selected depending on the size of a surgical target. For example, the distance between each electrode (1500) and the central axis (o1) of the catheter body may be 2mm (centimeters) to 4mm (centimeters) in a state where the electrodes (1500) are moved away from the central axis (o1) of the catheter body.

The conducting wires (1600) are electrically connected to the plurality of electrodes (1500) respectively to provide a power supply path for the plurality of electrodes (1500). In other words, the lead (1600) is connected between the electrode (1500) and an energy supply unit (not shown) such that energy from the energy supply unit is transferred to the electrode (1500). For example, one end of the wire (1600) is connected to the high frequency generating unit, and the other end is connected to the electrode (1500) to transfer energy generated by the high frequency generating unit to the electrode (1500), thereby allowing the electrode (1500) to generate heat using high frequency.

In particular, a lead (1600) according to the present invention may include a variable region (1610) configured to adjust its length, as shown in fig. 3 and 4. Here, the proximal end of the variable region (1610) may be fixed to a side of the catheter body (1100), and the distal end of the variable region (1610) may be fixed to the movable member (1200). To this end, a fixing unit (1140) for fixing one end of the variable region (1610) of the lead (1600) to the lumen may be separately provided at the catheter main body (1100), as shown in fig. 3.

In the configuration of the present invention, even if the electrode (1500) is configured to move closer to or away from the catheter body (1100) in response to movement of the moveable member (1200), the lead (1600) may remain substantially stationary due to the variable region (1610). In other words, even if the movable member (1200) whose distal end (at the right end in fig. 3) of the variable region (1610) is fixed moves in the direction (c11) as shown in fig. 3, only the length of the variable region (1610) increases, and thus the proximal end (at the left in fig. 3) of the variable region (1610) can be fixed. Thus, even if the movable member (1200) moves, only the distal end of the wire (1600) moves according to the variable region (1610), and most of the region of the wire (1600) inserted into the catheter body (1100) does not need to move. For this reason, thanks to this structure of the invention, even if the movable member (1200) moves, the operator does not need to insert or remove the wire (1600), which can avoid complicating the surgical procedure for the operator. In addition, if the vessel is severely curved, the lead (1600) may not be easily moved into the catheter body (1100). At this time, since the wire 1600 does not need to be moved in the catheter main body 1100 except for the catheter tip portion according to the present invention, no problem is caused since the wire 1600 is not easily movable.

Preferably, the variable region (1610) of the wire may have a spring-like helical coil shape, as shown. However, the present invention is not limited to the shape of the variable region. For example, the variable regions (1610) of the conductive lines may be bent or folded in different directions in a meandering pattern. In other words, in the present invention, the variable region (1610) of the conductive wire may be configured in various shapes such that the length between both ends of the variable region (1610) can be adjusted by expanding or folding the arc-shaped portion of the variable region (1610) according to the movement of the movable member (1200).

Meanwhile, even though fig. 3 and 4 show that three wires (1600) are disposed at the distal end of the catheter body (1100) and the variable region (1610) is formed at each wire (1600), the present invention is not limited to this structure. For example, a single wire may be used in the movable member (1200) to form the wire (1600), which splits into three wires on the right side of the movable member (1200). In this case, only one variable region 1610 may be formed on the conductive line 1600.

The lead (1600) may be attached to an upper or lower portion of the support member (1400) or disposed in the support member (1400) between the movable member (1200) and the electrode (1500). Further, the lead wire (1600) may not be fixed to the support member (1400), but connected to the electrode (1500) to be separated from the support member (1400).

Also, the lead 1600 may be configured without separating the support members 1400 and implementing the integrated support members 1400 together. For example, at least a portion of the support member (1400) may be made of an electrically conductive material such that the support member (1400) may be used as a lead (1600) between the movable member (1200) and the electrode (1500).

Meanwhile, even though the embodiment of fig. 2 and 3 has been illustrated, the plurality of side holes (1111) are close to the distal end (in the right direction) of the catheter body (1100) compared to the movable member (1200), but the present invention is not limited thereto.

Fig. 6 is a cross-sectional view showing the distal end of a denervation catheter in accordance with another embodiment of the present invention. In addition, fig. 7 is a schematic view showing that in the structure of fig. 6, the electrode (1500) is moved away from the catheter body (1100) by the movement of the movable member (1200). In this embodiment, components similar to those of fig. 1 to 5 will not be described in detail, and other components different from them will be described in detail.

First, referring to fig. 6, a plurality of side holes (1111) are formed at one side surface of the catheter body (1100), and unlike fig. 2 and 3, the side holes (1111) are close to the proximal end (in the left direction of fig. 6) of the catheter body (1100) compared to the movable member (1200). In addition, a movable member (1200) is connected to each distal end of the plurality of support members (1400), and an electrode (1500) is disposed at the proximal end of the plurality of support members (1400).

At this time, if the movable member (1200) moves from the distal end to the proximal end of the catheter body (1100) in a direction as indicated by an arrow (e11) in fig. 6, the electrode (1500) disposed at the proximal end of the support member (1400) may be deviated and moved away from the catheter body (1100) as indicated by arrows (f11, f12, f13) in fig. 7.

In other words, in the embodiment depicted in fig. 2 and 3, even if the electrode (1500) moves away from the catheter body (1100), if the operator pushes the operating member (1300) towards the distal end of the catheter, in the embodiment depicted in fig. 6 and 7, the electrode (1500) moves away from the catheter body (1100) when the operator pulls the operating member (1300) towards the proximal end of the catheter.

Also, in the embodiment of fig. 6 and 7, the wire 1600 may have a variable region 1610, and because of the variable region 1610, the entire portion of the wire 1600 need not move even if the movable member 1200 moves. In other words, in the embodiment of fig. 6 and 7, a proximal end of the variable region (1610) of the lead (1600) is fixed to one side of the catheter body (1100), i.e., the fixed unit (1140) fixed to the catheter body (1100), and a distal end of the variable region (1610) is fixed to the movable member (1200). Thus, when the movable member (1200) moves, only the length of the variable region (1610) changes and the entire lead (1600) need not move within the catheter body (1100) except for the variable region (1610).

Preferably, the one-side insertion groove (1121) may be formed at the catheter main body (1100). In other words, as shown in fig. 2 and 6, the side insertion groove (1121) may be formed at one side surface of the catheter body (1100) in which the side hole (1111) is formed. In addition, the side insertion groove (1121) may be recessed to the inside of the guide tube body (1100) so that the electrode (1500) may be inserted therein.

In this embodiment, although the distal end of the catheter main body (1100) (i.e., the catheter tip) is moving through the blood vessel, the electrode (1500) can be moved in a state to be inserted into the side insertion slot (1121). Thus, when the catheter tip is moving, vessel damage caused by the electrode (1500) is reduced.

For this, it is more preferable that the electrode (1500) is not protruded to the outside of the side surface of the catheter main body (1100) when the electrode (1500) is inserted into the side insertion groove (1121). For example, in the embodiment of fig. 2 and 6, depending on the side slot (1121) and the electrode (1500) located at the uppermost position, the depth (i.e., a vertical length) of the side slot (1121) is equal to or greater than the vertical length of the electrode (1500). In this case, the electrode (1500) may be fully inserted without protruding outside the catheter body (1100).

Further preferably, in the embodiment, if the electrode (1500) is inserted into the side slot (1121), the side hole (1111) located at the side slot (1121) may be closed. In other words, in a state where the electrode (1500) is inserted into the side slot (1121), the side hole (1111) corresponding to the side slot (1121) may not allow the inflow or outflow of liquid. In this embodiment, in a state where the electrodes (1500) are inserted into the side slots (1121), if the catheter tip is moved through the blood vessel, blood can be prevented from flowing through the side hole (1111), and the operation of each component located in the catheter can also be prevented from being hindered by the coagulated blood. In addition, blood flow through the lumen of the catheter body (1100) to the proximal end of the catheter body (1100) is also avoided.

Meanwhile, even though a through hole allowing the support member (1400) to pass therethrough has been described in the embodiments of fig. 1 and 7, is formed at the side surface of the catheter main body (1100), the present invention is not limited to these embodiments.

Fig. 8 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention. In addition, fig. 9 is a schematic view showing that the electrode (1500) is moved away from the catheter body (1100) by the movement of the movable member (1200) in the structure of fig. 8. Hereinafter, components different from the foregoing embodiments will be described in detail.

First, referring to fig. 8, a plurality of front holes (1112) may be formed in a front surface of the catheter body (1100) at the distal-most tip of the distal end. In addition, the plurality of support members (1400) may be moved into and out of the catheter body (1100) through the anterior aperture (1112), respectively. Here, the movable member (1200) may be connected to proximal ends of the plurality of support members (1400), and the electrode (1500) may be disposed at a distal end thereof.

In this case, as shown in fig. 9, if the moveable member (1200) is moved in a direction from the proximal end to the distal end of the catheter body (1100), the electrode (1500) may be withdrawn from the catheter body (1100).

Preferably, if the electrode (1500) is inserted into a portion of the catheter body (1100) in which the front hole (1112) is formed, a front slot (1122) is recessed into the inside of the catheter body (1100). In this case, when the catheter tip portion is moving in a blood vessel, the electrode (1500) can move in the state of the pre-insertion slot (1122). Therefore, when the catheter tip is moving, the inner side of the blood vessel can be prevented from being damaged by the protruding electrode (1500).

At this time, more preferably, if the electrode (1500) is inserted into the front slot (1122), the front hole (1112) may be closed. In this embodiment, blood or other fluid is prevented from flowing into the catheter through the anterior aperture (1112) due to the catheter tip being closed by the electrode (1500) at the anterior aperture (1112).

Meanwhile, in this embodiment, a plurality of through holes are formed in a side surface or a front surface of the catheter main body (1100), and only the support member (1400) may be partially received in the inner lumen of the catheter main body (1100). However, the present invention is not limited thereto.

Fig. 10 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention. In addition, fig. 11 is a schematic view showing that in the structure of fig. 10, an electrode (1500) is moved away from the catheter body (1100) by the movement of the movable member (1200). In this embodiment, components similar to those of the previous embodiments will not be described in detail, and different components will be described in detail.

Referring to fig. 10 and 11, an opening (1113) is formed in the front surface of the distal end of the catheter body (1100). In other words, the distal end of the catheter body (1100) can open the lumen of the catheter body (1100) through the opening (1113).

In addition, the plurality of support members (1400) and the plurality of electrodes (1500) may be inserted into and received in the lumen of the catheter body (1100) through the opening (1113) or pulled out of the catheter body (1100) through the opening (1113).

In more detail, as shown in fig. 10 and 11, the plurality of support members (1400) may be respectively configured such that the movable member (1200) is connected to a proximal end thereof and the electrode (1500) is disposed at a distal end.

In this case, as shown in fig. 11, if the moveable member (1200) is moved in a direction from the proximal end to the distal end of the catheter body (1100), the electrode (1500) disposed at the distal end of the support member (1400) may be pulled out of the catheter body (1100) through the opening (1113). In addition, the pulled out electrode (1500) moves away from the central axis (o1) of the catheter body (1100) to contact or approach the inner wall of the blood vessel.

In this embodiment, as shown in fig. 10, the plurality of support members (1400) and the plurality of electrodes (1500) may form a lumen adapted in the catheter body (1100) while the catheter tip is moving. Thereafter, if the catheter tip reaches a surgical target, the plurality of support members (1400) and the plurality of electrodes (1500) are pulled out of the catheter body (1100) through the opening (1113), as shown in fig. 11, such that the electrodes (1500) are moved away from the catheter body (1100). Thereafter, if the nerve at the corresponding portion is blocked by the heat emission of the electrode (1500), the support member (1400) and the electrode (1500) are again inserted into and housed in the catheter main body (1100) through the opening (1113), and in this state, the catheter tip portion can be pulled out of the human body along the blood vessel wall or moved to other portions of the human body.

Preferably, in some embodiments of the present invention, the plurality of electrodes (1500) are configured to be spaced apart from each other by a predetermined distance in a longitudinal direction of the catheter main body (1100) in a state where the other end of the support member (1400) is away from the catheter main body (1100).

For example, referring to the embodiment of fig. 3, in a state where the three electrodes (1500) are moved away from the catheter body (1100), as indicated by arrows g11 and g12, the three electrodes (1500) are formed to be spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (1100).

If the plurality of electrodes (1500) emit heat separately, the heated portion of the blood vessel may expand into the interior of the blood vessel, which may result in stenosis. However, if the three electrodes (1500) are spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter main body (1100) as in this embodiment, the heated portions of the blood vessel are spaced apart from each other by a predetermined distance in the longitudinal direction of the blood vessel, thereby preventing the occurrence of such stenosis.

In particular, as indicated by arrows g11 and g12, the distance between the electrodes (1500) in the longitudinal direction of the catheter body (1100) can be set differently depending on the size of the catheter or a surgical object. For example, the catheter is constituted such that, in a state where the plurality of electrodes (1500) are away from the catheter main body (1100), the distance between the electrodes (1500) is 0.3 to 0.8cm (centimeter) in the longitudinal direction of the catheter main body (1100). In this embodiment, stenosis of the vessel is avoided and the passage of nerves around the vessel between the electrodes (1500) is minimized.

Meanwhile, as in this embodiment, in a state where the plurality of electrodes (1500) are distant from the catheter main body (1100), the electrodes (1500) are configured to be spaced apart from each other at a predetermined distance in the longitudinal direction of the catheter main body (1100) in various ways.

For example, in order to separate the electrodes (1500) from each other, the plurality of support members (1400) may be configured such that distances between one end and the other end thereof may be different from each other. In other words, the plurality of support members (1400) may have a rod shape extending in one direction and having lengths different from each other. For example, in the embodiment of fig. 2, the three support members (1400) are formed in a rod shape having different lengths. Thus, when the movable member (1200) is moved in the right direction, an electrode (1500) provided at the support member (1400) having the longest length can be positioned at the forefront position in the longitudinal direction of the catheter main body (1100), and an electrode (1500) provided at the support member (1400) having the shortest length can be positioned at the rearmost position in the longitudinal direction of the catheter main body (1100). In particular, in a state where the electrode (1500) is distant from the catheter main body (1100), in order to space the plurality of support members (1400) from each other by 0.3cm (centimeter) to 0.8cm (centimeter), the plurality of support members (1400) are configured to have different lengths from each other by 0.3cm (centimeter) to 0.8 cm.

As another example, in order to space the electrodes (1500) from each other, the movable member (1200) may have a step formed on a surface connecting the plurality of support members (1400). For example, in the embodiment of fig. 3, the step may be formed on the right surface of the movable member (1200), and the plurality of movable members (1200) may be connected to different steps. In this embodiment, even though the plurality of support members (1400) have the same length, the electrodes (1500) may be spaced apart from each other by the step length size since the steps are formed at the movable member (1200).

In addition, various schemes may be used to space the electrodes (1500) from each other, and for example, the electrodes (1500) may be spaced from each other by tilting the surface of the movable member (1200) to which the support member (1400) is attached, with a predetermined angle with respect to the direction perpendicular to the central axis (o1) of the catheter.

Further preferably, in various embodiments of the present invention, the plurality of electrodes (1500) are formed in a longitudinal direction to be spaced apart from each other at a predetermined angle according to a central axis (o1) of the catheter main body (1100) in a state where the other end of the support member (1400) is distant from the catheter main body (1100).

For example, as shown in fig. 5, in a state where the three electrodes (1500) are moved away from the catheter body (1100) in accordance with the movement of the movable member (1200), it is assumed that the angles among the three electrodes (1500) are h11, h12 and h13, and h11, h12 and h13 have predetermined angles in accordance with the central axis (o1) of the catheter, so that the three electrodes (1500) are spaced apart from each other at the predetermined angles. For example, h11, h12, and h13 may likewise be 120 °.

Additionally, in an embodiment including four or more support members (1400) and four or more electrodes (1500), the plurality of electrodes (1500) may also be spaced apart from each other at a predetermined angle based on the central axis (o1) of the catheter.

In the embodiment where the electrodes (1500) are spaced apart from each other at a predetermined angle according to the central axis (o1) of the catheter body (1100) as previously described, the electrodes (1500) are configured in all directions that are widely dispersed around the catheter body (1100). Thus, even though the nerve is disposed at a local site of the blood vessel, the electrode (1500) may encompass a majority of the nerve.

Also preferably, as shown in the figures of the various embodiments, the catheter body (1100) may include a stopper (1130) located in the lumen. The stopper 1130 restricts the moving distance of the movable member 1200, and the catheter main body 1100 may include at least one stopper.

More preferably, the brake (1130) may include a first brake (1131) and a second brake (1132). Here, the first brake (1131) may be disposed proximate the proximal end as compared to the movable member (1200) such that the movable member (1200) is not restricted from moving further toward the proximal end. Further, the second detent (1132) may be disposed proximate the distal end as compared to the movable member (1200) such that the movable member (1200) is not restricted from moving further toward the distal end.

Embodiments that include a stop (1130) in the catheter body (1100) may facilitate operator manipulation and avoid damage to various components included in the catheter, as previously described. For example, in the embodiment of fig. 2, the first stopper (1131) may limit the movable member (1200) from further movement in the left direction, which may prevent the connection between the electrode (1500) and the support member (1400) or the connection between the electrode (1500) and the wire (1600) from being cut. In another example, in the embodiment of fig. 3, the second stopper (1132) may limit the movable member (1200) from further moving in the right direction, which may prevent the wire (1600) from being cut or prevent the connection between the wire (1600) and the fixed unit (1140) from being cut.

Also preferably, the catheter body (1100) may have a guide hole formed at a distal end thereof such that a guide wire may pass through the guide hole. Here, the guide wire is used to guide the catheter to a surgical target, and can guide the surgical target in front of the catheter. In this embodiment, a guide wire may be inserted into the catheter through the guide hole, and the tip portion of the catheter may be advanced along the guide wire to reach the surgical target.

At least one guide hole may be formed in the catheter body (1100). For example, the catheter body (1100) may have a single guide hole at the distal end such that a guide wire may be inserted into the guide hole. In this case, when the catheter body (1100) is moved, the guide wire inserted through the guide hole may be moved along the lumen of the catheter body (1100). In another example, the catheter body (1100) may include two guide holes at the distal end. In this case, the guide wire may be inserted into the catheter body (1100) through one guide hole and pulled out of the catheter body (1100) through the other guide hole.

As described above, in the embodiment in which a guide hole is formed in the catheter body (1100), since the guide wire inserted into the guide hole guides the movement of the tip portion of the catheter, the catheter can smoothly reach the surgical target and the catheter can be easily manipulated. Further, since the catheter does not need to include a member for adjusting the moving direction of the catheter, the catheter can have a more compact structure, which is advantageous in reducing the size of the catheter.

Also preferably, the denervation catheter according to the present invention may further include an elastic member (not shown).

The resilient member may be connected between the catheter body (1100) and the movable member (1200). For example, in the embodiments of fig. 2, 8 and 10, the resilient member may be connected between the stationary unit (1140) and the movable member (1200) of the catheter body (1100). Further, in the embodiment of fig. 6, the elastic member may be connected between the movable member (1200) and the distal end of the catheter main body (1100) (the right tip portion of the catheter main body (1100) shown in fig. 6).

As described above, in the embodiment including the elastic member, the movable member (1200) may be more easily restored to its original state due to the restoring force of the elastic member.

For example, as shown in fig. 3, in a state where the movable member (1200) moves in the right direction, after the electrode (1500) blocks the nerve, the movable member (1200) should move in the left direction again. However, if an elastic member is included between the fixed unit (1140) and the movable member (1200), the movable member (1200) may be more easily moved in the left direction due to the restoring force of the elastic member. Therefore, after the electrode (1500) blocks the nerve, the operator can insert the electrode (1500) into the side insertion groove (1121) without difficulty.

Furthermore, if the elastic member is provided, the electrode (1500) can be prevented from deviating from the side insertion groove (1121) of the catheter main body (1100) when the catheter tip is moving, so that damage to the blood vessel due to deviation or protrusion of the electrode (1500) can be prevented. Also, even if the stopper (1130) is not provided, the moving distance of the movable member (1200) is limited by the elastic member, which can avoid damage to various components due to excessive movement of the movable member (1200).

Fig. 12 is a perspective view schematically illustrating the distal end of a denervation catheter in accordance with another embodiment of the present invention.

Referring to fig. 12, a denervation catheter according to the present invention may further include an end tip (1700).

A tip (1700) may be disposed on a front surface of the distal end of the catheter body. In other words, the tip portion (1700) may be considered to be distal to the end of the catheter body. In this case, the tip (1700) may be a component used as the tip of a denervation catheter according to the present invention.

The tip portion (1700) may be made of a soft and resilient material. In particular, the tip portion (1700) can be formed using a composition containing Polyether Block Amide (PEBA). Here, the composition of the tip portion (1700) may contain other additives in addition to the composition of the polyether block amide. For example, the tip portion (1700) may be made from a composition containing 70 wt% of polyether block amide and 30 wt% of barium sulfate, based on the total weight of the composition.

In this configuration of the invention, when the distal end (1101) of the catheter body is moved along a blood vessel or the like, the tip portion (1700) made of a soft and elastic material is positioned at the most forward position, which reduces damage to the blood vessel and facilitates easier changing of the direction of movement. In addition, the tip portion (1700) made of the above material can be radiographed, and thus, the position of the distal end of the catheter main body can be easily determined.

Preferably, the tip portion (1700) may have a hollow tubular shape. Further, the cavities of the tip portion (1700) may extend in the same direction longitudinally of the catheter body. If the tip (1700) has a tubular shape as described above, a wire may be passed through the lumen of the tip. For example, the tip portion may be tubular with a length of 6mm (millimeters) and a cavity diameter of 0.7mm (millimeters).

The tip portion may extend in a longitudinal direction of the catheter body. In this case, the tip may have different dimensions along its length. In particular, if the tip portion has a cylindrical shape, a distal end of the tip portion has a minimum diameter compared to other regions. For example, when the thickest region of the tip portion has a diameter of 1.3mm (mm), the distal end of the tip portion may have a minimum diameter of 1.1mm (mm).

The tip portion (1700) may have a suitable length, which cannot be too long and too short. For example, in the configuration of fig. 12, L1 indicates that the length of the tip portion (1700) may be 5mm (centimeters) to 15mm (centimeters). In this configuration, movement is prevented from being disturbed by the tip (1700) as the catheter is moved along the lumen of the vessel or the lumen of the sheath. Further, in this structure, the shape of the blood vessel or the like at the end tip portion (1700) to be disposed can be easily determined from the curved shape or curved direction of the end tip portion (1700).

Also preferably, the denervation catheter according to the present invention may further include a temperature measuring means (not shown).

In particular, the temperature measuring member may be disposed around the electrode (1500) to measure the temperature of the electrode (1500), disposed around the electrode (1500). Further, as previously described, the temperature measured by the temperature measuring means may be used to control the temperature of the electrode (1500). Here, the temperature measuring member may be connected to the lead (1600) through a separate wire, and the separate wire may extend through the lumen of the catheter body (1100) to the proximal end of the catheter body (1100) and out of the catheter body (1100).

Meanwhile, even though some embodiments have been illustrated such that three support members (1400) and three electrodes (1500) are provided, the number of the support members (1400) and the electrodes (1500) is not limited to the above of the present invention, and the number of the support members (1400) and the electrodes (1500) may be differently set.

A denervation apparatus according to the present invention includes a denervation catheter. In addition, the denervation apparatus may further include an energy supply unit and a counter electrode, and a denervation catheter. The energy supply unit can be electrically connected to the electrode (1500) via a line (1600). In addition, the counter electrode can be electrically connected to the power supply unit through a lead (1600) different from the lead (1600). In this case, the energy supply unit can supply energy to the electrode (1500) of the catheter in a high frequency or the like, and the electrode (1500) of the catheter generates heat to ablate the nerve around the blood vessel, thereby blocking the nerve.

Next, a denervation catheter according to a second aspect of the present invention will be described with reference to fig. 13 to 26.

Fig. 13 is an end view schematically showing the distal end of a catheter according to the second aspect of the invention, and fig. 14 is a sectional view taken along line a2-a2' of fig. 13. For convenience, fig. 14 shows a support member, an electrode and a lead included in the catheter of fig. 13.

As used herein, the distal end of the catheter means that one end of the catheter reaches a portion of the body under a surgical procedure, between the two ends of the longitudinally extending catheter, and is also referred to as a catheter tip. In addition, the end of the catheter opposite the distal end is referred to as a proximal end. Hereinafter, with respect to various components extending in the longitudinal direction of the catheter and having both ends in the longitudinal direction, one end of one component positioned at the distal end of the catheter will be referred to as a distal end of the corresponding component; and a proximal end of one assembly positioned at the proximal end of the catheter will be referred to as a proximal end of the corresponding assembly.

Referring to fig. 13 and 14, the catheter according to the present invention may include a catheter body (2100), a movable member (2200), an operation member (2300), a support member (2400), an electrode (2500), and a guide wire (2600).

The catheter body (2100) has a catheter or tube shape extending in a direction and having a lumen along a longitudinal direction. Here, the catheter body (2100) has two ends in the longitudinal direction, wherein during a surgical procedure using the catheter, an end of the catheter body (2100) which is first inserted into the human body and reaches a target (i.e., a target of the surgical procedure) is referred to as a distal end (2101), and an end of the catheter body (2100) which is close to and manipulated by an operator is referred to as a proximal end (not shown), as described above.

The catheter body (2100) has a hollow tubular shape with a longitudinal lumen. Thus, various components used in surgical procedures may be disposed within or moved through the lumen, and substances such as drugs or lotions may be injected through the lumen. To this end, the proximal end of the catheter body (2100) may be formed such that the lumen is open to the outside.

The catheter body (2100) may have various shapes depending on its purpose or purpose, and also various inner or outer diameters. In addition, the catheter body (2100) may be made from a variety of materials, such as soft materials (e.g., rubber and plastic) or hard materials (e.g., metal). The invention is not limited to a particular shape, material, or size of the catheter body (2100), and the catheter body (2100) may have a variety of shapes, materials, sizes, or the like.

A movable member (2200) is disposed at the distal end (2101) of the catheter body and is configurable to move in a longitudinal direction of the catheter body (2100). Further, via movement of the movable member (2200), the distance between the tip (2110) of the catheter body and the movable member (2200) may be increased or decreased.

In particular, as shown in fig. 13 and 14, the movable member (2200) may be disposed outside of the catheter body (2100). In other words, the movable member (2200) may be detached from the catheter body (2100) and positioned outside (on the right side of fig. 14) compared to the tip (2110) of the catheter body. In this case, if the movable member (2200) moves in the left direction, the distance between the movable member (2200) and the catheter main body (2100) may decrease, and if the movable member (2200) moves in the right direction, the distance between the movable member (2200) and the catheter main body (2100) may increase.

Preferably, the distal end (2101) of the catheter body and/or the moveable member (2200) may be made with soft and resilient materials. Since the distal end (2101) of the catheter body and the movable member (2200) are positioned at a leading end of the catheter, the distal end (2101) of the catheter body and the movable member (2200) may contact the inner wall of a blood vessel or the like when the catheter is moved along the blood vessel or the like. However, if the distal end (2101) of the catheter body and the movable member (2200) are made of such soft and elastic materials, damage to blood vessels or the like caused by the distal end (2101) of the catheter body and the movable member (2200) can be reduced or avoided, and also the direction of movement of the distal end (2101) of the catheter body and the movable member (2200) can be easily changed.

Further, in a similar manner, the distal end (2101) of the catheter body and/or the moveable member (2200) may have a rounded edge. In particular, as shown in the drawings, the movable member (2200) may have an outer surface (the right surface in fig. 14) that is rounded convex toward the forward end of the catheter. In addition, the inner surface (left surface in fig. 14) of the movable member (2200) may also have a rounded edge.

The operating member (2300) may be formed to extend along a longitudinal direction of the catheter body (2100), and the movable member (2200) may be moved in the longitudinal direction. To this end, one end of the operating member (2300), which is a distal end thereof, is connected and fixed to the movable member (2200), and the operating member (2300) may be disposed depending on the inner lumen of the catheter body (2100). In addition, the other end of the operating member (2300), which is a proximal end of the operating member, can be exposed to the catheter body (2100) through the opening of the proximal end of the catheter body (2100). In this case, the operator may use a separate tool to manually or automatically pull or automatically push the operating member (2300). In this case, the operating member (2300) may be moved in a lateral direction as shown by an arrow b22 of fig. 14, and thus, the movable member (2200) connecting one end of the operating member (2300) may be moved in a lateral direction as shown by an arrow b 21.

Meanwhile, in the embodiment of fig. 14, since the operating member (2300) is connected to the movable member (2200) outside the catheter body (2100), an operating hole (2120) may be formed in the catheter body (2100) so that the operating member (2300) may move through the operating hole (2120).

The support member (2400) may have a bar or plate shape extending in one direction and may be connected between the catheter main body (2100) and the movable member (2200). In other words, the support member (2400) can be connected at one end to the tip (2110) of the catheter body (i.e., the distal-most end of the distal end (2101) of the catheter body) and at the other end to the movable member (2200). For example, in the structure of fig. 14, the proximal end (left end) of the support member (2400) may be secured to the outer surface of the tip (2110) of the catheter body, and the distal end (right end) of the support member (2400) may be secured to the left surface of the movable member (2200).

Here, when the catheter main body (2100) and the movable member (2200) disposed at both ends of the support member (2400) are in a direction perpendicular to the longitudinal direction of the catheter main body (2100), both may have flat surfaces. In other words, according to fig. 14, the right surface of the tip (2110) of the catheter body (where the proximal end of the support member (2400) is connected), and the left surface of the movable member (2200) where the distal end of the support member (2400) is connected, may be vertically flat to each other and perpendicular to the central axis of the catheter body (2100) in the longitudinal direction.

Meanwhile, as described above, the movable member (2200) may be configured to move toward or away from the tip (2110) of the catheter body (2100) in the longitudinal direction thereof via the operating member (2300).

In particular, in the present invention, if the movable member (2200) is moved to reduce the distance between the end (2110) of the catheter body and the movable member (2200), the support member (2400) may be at least partially bent, and this bend may be configured to move away from the catheter body (2100). This will be described in more detail with reference to fig. 15 to 17.

Fig. 15 is a sectional view schematically showing that in the structure of fig. 14, the curved portion of the support member (2400) is moved away from the catheter body (2100) by the movement of the movable member (2200). Further, fig. 16 is a perspective view of fig. 15, and fig. 17 is a front view of fig. 16.

Referring to fig. 15-17, if movable member (2200) moves toward catheter body (2100), as indicated by arrow (e2), the distance between movable member (2200) and catheter body (2100) may decrease. If so, the spacing between the ends of the plurality of support members (2400) disposed between the movable member (2200) and the catheter body (2100) may be reduced such that the plurality of support members (2400) may at least partially flex. Further, if the movable member (2200) is further moved toward the catheter main body (2100), the curved portion of the support member (2400) may gradually move away from the catheter main body (2100). Here, as shown by an arrow curved part c22 of fig. 15, the curved part may be regarded as meaning one apex of the curved part, that is, one point of the curved part of the support member (2400) at which the degree of curvature is the maximum; alternatively, at a point of the bend of the support member (2400) furthest from the central axis (o2) of the catheter body (2100). Further, herein, the bending portion moved away from the catheter body (2100) means that the bending direction of the bending portion is formed to the outside of the catheter body such that the bending portion is moved away from the central axis (o2) of the catheter body (2100). In addition, if the curved portion of the support member (2400) is progressively moved away from the catheter body (2100), the curved portion may have a progressively decreasing angle of curvature.

Since the supporting member (2400) should form a bent portion according to the movement of the movable member (2200), the supporting member (2400) can be made of a bent material as the distance between both ends thereof is reduced. For example, the support member (2400) may be made using metal or polymer. However, the present invention is not limited to this specific material of the support member (2400), and the support member (2400) may be made using various materials forming a part of the bent portion.

Meanwhile, the electrode (2500) is disposed at the bent portions (c22) of the plurality of support members (2400). For example, as shown in the embodiments of fig. 13 to 16, an electrode (2500) may be disposed at each bent portion (c22) of the plurality of support members (2400).

The electrodes (2500) can be connected to the energy supply unit (not shown) via wires (2600) to generate heat. In addition, heat generated by the electrode (2500) can ablate surrounding tissue. For example, the electrode (2500) can ablate nerves around a blood vessel by generating heat at about 40 ℃ or more (preferably 40 to 80 ℃), thus blocking the nerves. However, the temperature at which the electrode (2500) generates heat may be set in different ways depending on the use or purpose of the catheter.

The electrodes (2500) can apply heat to the nerve tissue surrounding the vessel that contacts the vessel wall, so that the electrodes (2500) preferably adhere tightly to the vessel wall. Thus, the electrode (2500) can have a curved shape, such as a circle, semi-circle, or oval, to conform to the shape of the inner wall of the blood vessel. In this embodiment, the electrodes (2500) can more precisely adhere to the vessel wall, so that the heat generated by the electrodes (2500) can be efficiently transferred to the nerve tissue around the vessel.

Meanwhile, the electrode (2500) may be disposed at a point of the bending portion of the support member (2400) which is farthest from the central axis (o2) of the catheter body (2100). In other words, if the distance between the movable member (2200) and the end (2110) of the catheter body is reduced to form a bend in the support member (2400), the electrode (2500) may be disposed at an apex of the bend that is furthest from the central axis (o2) of the catheter body (2100). In this embodiment, the contact force of the electrode (2500) against the vessel wall is further improved by maximizing the protrusion of the electrode (2500) from the catheter body (2100).

The electrode (2500) can be made using a material such as platinum or stainless steel, but the invention is not limited to this particular material for the electrode (2500). The electrode (2500) can be made of various materials in consideration of various factors such as a heat generation method and a surgical target.

Preferably, the electrode (2500) can generate heat via Radio Frequency (RF). For example, the electrode (2500) can be connected to a high frequency generating unit through a lead (2600), and emit high frequency energy to ablate nerves.

Meanwhile, the electrode (2500) provided at the catheter may be a negative electrode, and a positive electrode opposite to the negative electrode may be connected to an energy supply unit, such as a high frequency generating unit, similar to the negative electrode, and a die or a patch or the like is employed to attach a specific part of the human body.

Because the electrode (2500) is disposed at the curved portion of the support member (2400), when the distance between the catheter body (2100) and the movable member (2200) is reduced, the electrode (2500) can move away from the central axis (o2) of the catheter body (2100) due to the movement of the movable member (2200). Meanwhile, if the movable member (2200) moves to increase the distance between the catheter body (2100) and the movable member (2200), the electrode (2500) disposed at the bent portion can move closer to the central axis (o2) of the catheter body (2100).

For example, as shown in fig. 15, if the movable member (2200) moves along arrow (e2), the bend gradually moves away from the central axis (o2) of the catheter body (2100), and the electrode (2500) disposed at the bend also moves away from the central axis (o2) of the catheter body (2100) in a direction as shown by arrows (f21, f22, f 23). Conversely, if the movable member (2200) moves in a direction opposite to the arrow (e2) shown in fig. 15, the electrode (2500) provided at the curved portion of the support member (2400) can be configured to move closer to the catheter body (2100) again.

In other words, the electrode (2500) is longitudinally movable, according to the movement of the movable member (2200), towards the outside of the catheter body (2100) or into the catheter body (2100), according to the central axis (o2) of the catheter body (2100).

To this end, the support member (2400) supporting the electrode (2500) with the electrode (2500) at the bend may be of a suitable material or shape such that the electrode (2500) may be moved closer to or farther away from the central axis (o2) of the catheter body (2100) in response to movement of the movable member (2200).

For example, as shown by the arrow arc (c21) of fig. 14, the support member (2400) may have an at least partially formed arc. In other words, even in a state where the distance between the movable member (2200) and the catheter body (2100) is the largest, the support member (2400) may not be very flat but slightly curved at the arc portion. In this case, if the movable member (2200) moves to reduce the interval between both ends of the supporting member (2400), the curvature of the arc portion (c21) increases, forming a curved portion (c 22). Accordingly, in this embodiment, the bent portion (c22) may be formed at a region where the arc portion (c21) of the support member (2400) is formed.

Furthermore, the support member (2400) can be pre-shaped such that the pair of bends are not moved toward the central axis of the catheter body (2100), but are moved away from the central axis of the catheter body (2100). For example, the support member (2400) may be preformed so as to have the shape shown in fig. 15 and 16 when the distance between the two ends of the support member (2400) is decreased.

In this case, the support member (2400) may also be made of a shape memory alloy, such as nitinol. In this embodiment, the support member (2400) may be configured such that as the distance between the movable member (2200) and the catheter body (2100) decreases, the curved portion may move away from the catheter body (2100) in accordance with the memorized shape.

In addition, the bent portion of the support member (2400) may be provided by forming a notch at a predetermined portion of the support member (2400). In this case, if the distance between both ends of the supporting member (2400) is decreased, a bent portion may be formed at the portion of the supporting member (2400) where the recess is formed. In this embodiment, with the orientation of the adjustment notch, the bend can move away from the catheter body (2100) as the distance between the ends of the support member (2400) decreases.

As described above, in the denervation catheter according to the present invention, the electrode (2500) is provided at the curved portion of the support member (2400) to move closer to or away from the catheter body (2100). Therefore, if the catheter according to the present invention is used to perform denervation, the distal end of the catheter (i.e., the catheter tip) can be moved to a surgical target through a blood vessel in a state where the curved portion of the support member (2400) with the electrode (2500) is close to the catheter main body (2100). In addition, if the catheter tip reaches the surgical target, the electrode (2500) may contact or approach the inner wall of the blood vessel by moving the curved portion of the support member (2400) with the electrode (2500) away from the catheter body (2100). In addition, in this state, energy generating heat, such as high frequency energy, is emitted through the electrodes (2500), blocking nerves around the blood vessel. Thereafter, if denervation is accomplished using energy emitted through the electrodes (2500), the curved portion of the support member (2400) with the electrodes (2500) is again moved proximal to the catheter body (2100), and the catheter may then be removed from the blood vessel or moved to another location.

Meanwhile, in a state where the electrode (2500) is moved away from the central axis of the catheter body (2100), the distance between the electrode (2200) and the central axis of the catheter body (2100) may be selected in various ways depending on the size of the surgical object, such as the inner diameter of a blood vessel. For example, in a state where the electrodes (2500) are moved away from the central axis of the catheter body (2100), the distance between each electrode (2500) and the central axis of the catheter body (2100) may be 2mm (centimeters) to 4mm (centimeters).

The wires (2600) are electrically connected to the plurality of electrodes (2500), respectively, to provide a power supply path to the plurality of electrodes (2500). In other words, the wire (2600) is connected between the electrode (2500) and the energy supply unit such that energy supplied from the energy supply unit is transferred to the electrode (2500). For example, one end of the wire (2600) is connected to the high frequency generating unit, and the other end is connected to the electrode (2500), so that energy generated by the high frequency generating unit is transferred to the electrode (2500), thereby causing the electrode (2500) to generate heat using high frequency.

The lead wire (2600) may be attached to an upper or lower portion of the support member (2400), or disposed at the support member (2400), between the end (2110) of the catheter body and the electrode (2500). In addition, the conductive wire (2600) may not be fixed to the supporting member (2400), but connect the electrode (2500) separated from the supporting member (2400).

Also, the conductive line 2600 may provide not separate support members 2400 but implement the integrated support members 2400. For example, at least a portion of the support member (2400) can be made using an electrically conductive material such that an area of the support member (2400) between the end (2110) of the catheter body and the electrode (2500) can be used as the lead (2600).

Preferably, in the present invention, the plurality of electrodes (2500) may be configured such that the plurality of electrodes (2500) are spaced apart from each other in a longitudinal direction of the catheter body (2100) in a state where the curved portion of the support member (2400) is away from the catheter body (2100).

For example, referring to the embodiment of fig. 15, in a state where the three electrodes (2500) are moved away from the catheter body (2100), as indicated by arrows (d21, d22), the three electrodes (2500) may be formed to be spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (2100).

If the plurality of electrodes (2500) emit heat separately, the heated portion of the blood vessel may expand into the interior of the blood vessel, which may cause stenosis. However, as in this embodiment, if the three electrodes (2500) are spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (2100), the heated portion of the blood vessel is spaced apart from each other by a predetermined distance in the longitudinal direction of the blood vessel, thereby preventing the occurrence of such stenosis.

In particular, the distance between the electrodes (2500) in the longitudinal direction of the catheter body (2100) may be set differently depending on the size of the catheter or the surgical object, as indicated by arrows (d21, d 22). For example, the catheter may be constructed such that the distance between the electrodes (2500) is 0.3 to 0.8cm (centimeter) in the longitudinal direction of the catheter body (2100) in a state where the plurality of electrodes (2500) are away from the catheter body (2100). In this embodiment, stenosis of the vessel is avoided and the problem that nerves around the vessel pass between the electrodes (2500) and cannot be ablated by the electrodes (2500) is reduced.

Meanwhile, as in this embodiment, in a state where the plurality of electrodes (2500) are distant from the catheter body (2100), the electrodes (2500) may be variously configured to be spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (2100).

For example, as described above, an arc portion may be formed at the plurality of support members (2400) such that a bent portion is formed at the arc portion. In this embodiment, the arc portions of the plurality of support members (2400) may be spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (2100).

In addition, in the embodiment in which the support member (2400) is made of a shape memory alloy, the bent portions of the plurality of support members (2400) may be spaced apart from each other at a predetermined distance in the longitudinal direction of the catheter body (2100) using the plurality of shape memory support members (2400).

Further preferably, in the present invention, the plurality of electrodes (2500) are formed in a longitudinal direction to be spaced apart from each other at a predetermined angle according to a central axis of the catheter body (2100) in a state where the bending portion of the support member (2400) is spaced apart from the catheter body (2100).

For example, as shown in fig. 17, in a state where the three electrodes (2500) are moved away from the catheter body (2100) in accordance with the movement of the movable member (2200), it is assumed that the angles g21, g22 and g23, g21, g22 and g23 among the three electrodes (2500) have a predetermined angle in accordance with the central axis (o2) of the catheter so that the three electrodes (2500) are spaced apart from each other at a predetermined angle. For example, g21, g22, and g23 may likewise be 120 °.

In addition, in embodiments including four or more support members (2400) and four or more electrodes (2500), the plurality of electrodes (2500) may be spaced apart from one another at a predetermined angle with respect to the central axis (o2) of the catheter.

As previously described, in embodiments where the electrodes (2500) are spaced apart from each other at a predetermined angle with respect to the central axis of the catheter body (2100), the electrodes (2500) may be configured in all directions that are widely dispersed about the catheter body (2100). Thus, the electrode (2500) can cover a majority of the nerves even though the nerves are disposed at a local site of the blood vessel.

Fig. 18 is a cross-sectional view schematically illustrating the distal end of a denervation catheter according to another embodiment of the present invention, and fig. 19 is a cross-sectional view schematically illustrating an electrode (2500) being moved away from the catheter body (2100) by the movement of the movable member (2200) in the configuration of fig. 18.

Referring to fig. 18 and 19, a denervation catheter according to the present invention may include a stiffening member (2700).

The reinforcing member (2700) may have a bar or plate shape extending in the longitudinal direction of the catheter body (2100) and disposed between the catheter body (2100) and the movable member (2200). Further, a distal end of the reinforcing member (2700) may be connected and fixed to a movable member (2200) which is movable in accordance with the movement of the movable member (2200).

At this time, a through hole (2130) may be formed in the catheter body (2100), and a proximal end of the movable member (2200) may be inserted into the through hole (2130).

In this embodiment, as shown in fig. 19, if the movable member 2200 moves in the left direction, i.e., toward the catheter body (2100), the stiffening member (2700) may also move in the left direction. At this time, the proximal end of the reinforcing member (2700) is inserted into the through hole (2130) of the catheter body (2100) so that the reinforcing member (2700) can slide through the through hole (2130) according to the movement of the movable member (2200).

In this embodiment, the connection between the catheter body (2100) and the movable member (2200) may be more strongly supported by the stiffening member (2700). In other words, if the movable member (2200) separates the catheter body (2100), in the case of connecting the catheter body (2100) and the movable member (2200) by a single operation member (2300), the connection state and the supporting force between the catheter body (2100) and the movable member (2200) may be weak. However, if the reinforcing member (2700) provides the separation operation member (2300), as in this embodiment, the supporting force to the movable member (2200) separated from the catheter body (2100) is more reinforced, and the coupled state between the catheter body (2100) and the movable member (2200) can be stably maintained. In addition, since the reinforcing member (2700) can guide the movement of the movable member (2200), the moving direction of the movable member (2200) can be maintained without deviating from the central axis of the catheter main body (2100).

Also, although the embodiment of fig. 18 and 19 illustrates only one reinforcing member (2700) being provided, two or more reinforcing members (2700) may be provided.

Furthermore, even though only one operating member (2300) is depicted in some of the figures, two or more operating members (2300) may be provided.

Also preferably, a denervation catheter according to the present invention may include a brake (2800). The stopper (2800) limits the distance of movement of the movable member (2200), and the catheter body may include at least one stopper.

Preferably, the stopper (2800) may be fixed to the operating member (2300), as shown in fig. 18 and 19. At this time, the stopper (2800) may include: a first stopper (2810) fixed to a portion of the operating member (2300) located on the catheter body (2100); and a second stopper (2820) fixed to a portion of the operating member (2300) located outside the catheter body (2100). Here, the first stopper (2810) may limit the movement of the movable member (2200) so that the movable member (2200) does not move further away from the catheter body (2100) in a direction. In addition, the second stopper (2820) may restrict the movement of the movable member (2200) so that the movable member (2200) does not move further in a direction approaching the catheter body (2100).

As previously described, in embodiments that include a brake (2800), operator manipulation may be facilitated and various components included in the catheter may also be prevented from damage. For example, in the embodiment of fig. 18, the first stopper (2810) restricts the movable member (2200) from moving further in the right direction, thereby avoiding excessive movement of the movable member (2200) away from the catheter body (2100), thus cutting off the connection between the support member (2400) and the catheter body (2100), or the connection between the support member (2400) and the movable member (2200). In another example, the second stopper (2820) may restrict the movable member (2200) from moving further in the left direction, thereby preventing the movable member (2200) from moving excessively closer to the catheter body (2100), thus damaging the support member (2400) or cutting the connection between the support member (2400) and the catheter body (2100) or between the support member (2400) and the movable member (2200). Also, since the operating distance is limited by the stopper (2800) when the operating member (2300) is pushed or pulled, the operator may not notice the operating distance of the operating member (2300).

Fig. 20 is a cross-sectional view schematically illustrating the distal end of a denervation catheter according to another embodiment of the present invention, and fig. 21 is a cross-sectional view schematically illustrating an electrode (2500) being moved away from the catheter body (2100) by movement of the movable member (2200) in the configuration of fig. 20.

Referring to fig. 20 and 21, the catheter body (2100) may have a guide hole (2140) formed at the distal end thereof such that a guide wire (W2) may pass through the guide hole. Here, a guide wire (W2) is used to guide the catheter to a surgical target and to reach the surgical target in front of the catheter. In this embodiment, the guide wire (W2) can be inserted into the catheter through the guide hole (2140), and the catheter tip can be guided along the guide wire (W2) to reach the surgical target.

The catheter body (2100) may have one or more guide holes (2140). For example, as shown in fig. 20 and 21, the catheter body (2100) has: a first via (2141) formed at the end; and a second guide hole (2142) formed at a position spaced apart from the end (2110) of the catheter body by a predetermined distance. In this case, the guide wire may be inserted into the lumen of the catheter body (2100) through the first guide hole (2141), and then pulled out of the catheter body (2100) through the second guide hole (2142). However, the second guide hole (2142) may not be provided, and in this case, the guide wire inserted into the lumen of the catheter body (2100) through the first guide hole (2141) may extend along the lumen of the catheter body (2100), and then be pulled out of the catheter body (2100) at the proximal end of the catheter body (2100).

If a second via (2142) is provided, the second via may be located at different positions depending on the circumstances. In particular, the second guide hole (2142) may be formed at a point spaced apart from the end (2110) of the catheter body by 10cm (centimeter) to 15cm (centimeter) in the longitudinal direction of the catheter body. Even though only for illustration, fig. 20 shows the second guide hole (2142) near the end (2110) of the catheter body, and the distance from the end of the catheter body to the second guide hole, denoted by L21, may be 10cm (centimeters) to 15cm (centimeters). In this embodiment, when the catheter body is moving, the problem that the guide wire pulled out of the catheter body through the second guide hole is entangled with the catheter body can be prevented, thereby facilitating smooth movement of the catheter body. However, the present invention is not limited to this position of the second guide hole.

Also, in this embodiment, a via (2210) may also be formed in the movable member (2200) so that a wire may pass through the via.

As described above, in the embodiment in which the guide hole (2140) is formed in the catheter body (2100), since the guide wire inserted into the guide hole guides the movement of the tip portion of the catheter, the catheter can smoothly reach a surgical target and the catheter can be easily manipulated. Also, since the catheter does not need to include a component for adjusting the moving direction of the catheter, the catheter can have a more compact structure, which can advantageously reduce the size of the catheter.

Also preferably, the denervation catheter according to the present invention may further include an elastic member (2900).

One end of the elastic member (2900) may be coupled to the movable member (2200) to provide a restoring force when the movable member (2200) is moving. For example, as shown in fig. 20, an elastic member (2900) may be connected between the tip (2110) of the catheter body and the movable member (2200). In this case, as shown in fig. 21, if the movable member (2200) is moved in the left direction so that the electrode (2500) is moved away from the catheter main body (2100), the restoring force (i.e., elastic restoring force) of the elastic member (2900) is applied in the right direction. Therefore, after the electrode (2500) completely blocks the nerve, the movable member (2200) should be moved again in the right direction and returned to its original state, as shown in fig. 20. Here, the movement of the movable member (2200) in the right direction can be more easily performed via the restoring force of the elastic member (2900). Thus, after the electrode (2500) blocks the nerve, the operator can move the electrode (2500) closer to the central axis of the catheter body (2100) with little effort.

In addition, as described above, in the embodiment where the elastic member (2900) is provided, when the catheter tip is moving, the electrode (2500) can be prevented from deviating from the central axis of the catheter main body (2100), and thus, the damage of the blood vessel due to the protrusion of the electrode (2500) can be prevented, and the easy movement of the catheter tip can be facilitated. Also, even if the stopper (2800) is not provided, the moving distance of the movable member (2200) can be restricted by the elastic member (2900), avoiding various component damages due to excessive movement of the movable member (2200).

In particular, a temperature measuring member may be disposed around the electrode (2500) to measure the temperature of the electrode (2500) or the temperature around the electrode (2500). Furthermore, as previously mentioned, the temperature measured by the temperature measuring means may be used to control the temperature of the electrode (2500). Here, the temperature measuring means may be connected to the wire (2600) through a separate wire, and the separate wire may extend through the lumen of the catheter body (2100) to the proximal end of the catheter body (2100) and out of the catheter body (2100).

Meanwhile, even though various embodiments illustrate that the movable member (2200) is provided outside the catheter body (2100), the present invention is not limited thereto.

Fig. 22 is a cross-sectional view schematically showing the distal end of a denervation catheter according to another embodiment of the present invention, and fig. 23 is a cross-sectional view showing the catheter of fig. 22 along the longitudinal direction. However, features described with respect to the specific embodiment of fig. 13-21 will not be described in detail, but different features will be described in detail.

Referring to fig. 22 and 23, the moveable member (2200) may be disposed within the lumen of the catheter body (2100). Further, the movable member (2200) is movable in a lateral direction of the lumen of the catheter body (2100). Here, unlike the embodiment of fig. 13-21, the proximal end of the support member (2400) can be connected and fixed to the movable member (2200), and the distal end of the support member can be fixed to the tip (2110) of the catheter body.

Compared to the catheter body (2100), since the movable member (2200) is close to the proximal end of the catheter, if the operator pushes the operating member (2300), the movable member (2200) moves in the right direction of fig. 23, so that the distance between the movable member (2200) and the tip (2110) of the catheter body decreases. Meanwhile, if the operator pulls the operating member (2300), the movable member (2200) moves in the left direction of fig. 23, so that the distance between the movable member (2200) and the tip (2110) of the catheter main body increases.

Even more, in this embodiment, if the distance between the movable member (2200) and the tip (2110) of the catheter body is reduced, the electrode (2500) disposed at the curved portion of the support member (2400) can be moved away from the catheter body (2100), which will be described in more detail with reference to fig. 24 and 25.

Fig. 24 is a sectional view schematically showing the electrode (2500) being moved away from the catheter body (2100) by the movement of the movable member (2200) in the structure of fig. 23, and fig. 25 is a perspective view of fig. 24.

Referring to fig. 24 and 25, if the movable member (2200) moves toward the distal end (2110) of the catheter body (in the right direction of fig. 24) such that the distance between the movable member (2200) and the distal end (2110) of the catheter body decreases, the distance between both ends of the support member (2400) may decrease. Thus, the bend of the support member (2400) is movable away from the catheter body (2100), and the electrode (2500) disposed at the bend is movable away from the catheter body (2100).

As previously described, in the embodiment of fig. 22 to 25, the support member (2400) and the electrode (2500) located in the lumen of the catheter body (2100) extend to the outside of the catheter body (2100) in accordance with the movement of the movable member (2200). To this end, the catheter body (2100) may have an opening (2150) through which the support member (2400) and the electrode (2500) may protrude. In other words, if the movable member (2200) moves such that the distance between the movable member (2200) and the tip (2110) of the catheter body decreases, the curved portion of the support member (2400) and the electrode (2500) can be pulled out of the catheter body (2100) through the opening (2150) of the catheter body (2100). Meanwhile, if the movable member (2200) moves such that the distance between the movable member (2200) and the tip (2110) of the catheter body increases, the curved portion of the support member (2400) and the electrode (2500) may be inserted into the lumen of the catheter body (2100) through the opening (2150) of the catheter body (2100).

Also, the features of the embodiment of fig. 13-21 may be applied to the catheter according to the embodiment of fig. 22-25. For example, in the embodiment of fig. 22 to 25, the plurality of electrodes (2500) may be spaced apart from each other by a predetermined length in the longitudinal direction of the catheter body (2100) in a state where the bending portion of the support member (2400) is spaced apart from the catheter body (2100). In addition, the plurality of electrodes (2500) may be formed in the longitudinal direction so as to be spaced apart from each other at a predetermined angle according to the central axis of the catheter body (2100) in a state where the bending portion of the support member (2400) is spaced apart from the catheter body (2100).

In addition, in the embodiment of fig. 22-25, a guide hole may also be formed in the catheter body (2100), and the catheter may also further include a stopper or a resilient member.

In particular, if the catheter includes a stopper, one or more stoppers may be secured to the catheter body (2100). In other words, since the movable member (2200) is movable to the right or left in the inner cavity of the catheter main body (2100) along the longitudinal direction, a stopper is provided in the left space and/or the right space of the inner cavity of the catheter main body (2100) depending on the movable member (2200) to restrict the movement of the movable member (2200) in the lateral direction.

In addition, if the catheter includes a resilient member, the resilient member may be disposed between the moveable member (2200) and the end (2110) of the catheter body. In other words, the proximal end of the resilient member may be connected and secured to the movable member (2200) and the distal end of the resilient member may be secured to the tip (2110) of the catheter body such that when the movable member (2200) is moved in the right direction, the resilient member may provide a return force in the left direction.

Fig. 26 is a perspective view schematically illustrating the distal end of a denervation catheter in accordance with another embodiment of the present invention.

Referring to fig. 26, a denervation catheter according to the present invention may further include an end tip (2950).

The tip (2950) is disposed on a front surface of the catheter body (2100) and the distal end of the movable member (2200). For example, as in the embodiment of fig. 26, if the movable member is near the distal end, the tip (2950) can be disposed on the front surface of the distal end of the movable member as compared to the catheter body. However, as in the embodiment of fig. 22, if the end of the catheter body is near the distal end, as compared to the movable member, the tip (2950) may be disposed on the front surface of the distal end of the catheter body. In other words, the tip (2950) may be considered to be distal to the end of the catheter body and the movable member. In this case, the tip (2950) may be used as a component of the distal end of the denervation catheter according to the present invention.

Also, the tip portion (2950) may constitute a separate movable member or a catheter body. For example, in the configuration of fig. 26, the tip portion (2950) may disengage the movable member. In this case, if the operating member moves the movable member in operation, the end tip (2950) does not move, and the distance between the movable member and the end tip (2950) can be changed. However, the tip (2950) may also be fixed to the movable member or catheter body.

The tip (2950) may be made of a soft and resilient material. In particular, the tip (2950) may be made from a composition containing Polyether Block Amide (PEBA). The composition of the tip (2950) can contain further additives and polyether block amides. For example, the tip portion (2950) may be formed from a composition containing 70 wt% of polyether block amide and 30 wt% of barium sulfate, based on the total weight of the composition.

In this configuration of the invention, when the distal end (2101) of the catheter body is moved along a blood vessel or the like, the tip portion (2950) made of a soft and elastic material is positioned at the most forward position, which can reduce damage to the blood vessel and facilitate easier changing of the direction of movement. In addition, the tip portion (2950) made of the foregoing material can be radiographed, so that the position of the distal end of the catheter main body can be easily determined.

Preferably, the tip portion (2950) may have a hollow tubular shape. Further, the cavities of the tip portions (2950) may extend in the same direction longitudinally of the catheter body. If the tip (2950) has a tubular shape as previously described, a wire may be passed through the lumen of the tip (2950). For example, the tip portion may have a tubular shape with a length of 6mm (millimeters) and a cavity diameter of 0.7mm (millimeters).

The tip portion may extend in a longitudinal direction of the catheter body. In this case, the tip portion may have different dimensions along its length. In particular, if the tip portion has a cylindrical shape, a distal end of the tip portion has a minimum diameter compared to other regions. For example, when the thickest region of the tip portion has a diameter of 1.3mm (mm), the distal end of the tip portion has a minimum diameter of 1.1mm (mm).

The tip portion (2950) has a suitable length that cannot be too long and too short. For example, in the configuration of FIG. 26, the tip (2950) indicated by L22 may have a length of 5mm (mm) to 15mm (mm). In this configuration, the movement is prevented from being disturbed by the tip (2950) as the catheter is moved along the lumen of the blood vessel or the lumen of the sheath. Further, in this structure, a curved shape or a curved direction of the end tip (2950) can easily determine a shape of a blood vessel or the like in which the end tip (2950) is located.

In addition, the denervation catheter according to the present invention may further include a through tube (not shown). The through-tube may have a hollow tubular shape, the through-tube being included in the lumen of the catheter body, and the operation member may be located in the lumen of the through-tube. In other words, the operating member is movable in a state of being inserted into the through-tube lumen. In this case, the tube may be exposed to the lumen and exterior of the catheter body. For example, in the structure of fig. 26, the through-tube may be provided in a space between the catheter main body and the movable member. In addition, the movable member may have a ring shape movable while surrounding the outer circumference of the tube. In this structure, a moving path of the movable member can be fixed, and the coupling force between the catheter body and the movable member can be further strengthened.

Meanwhile, even though it has been illustrated that some embodiments provide three support members (2400) and three electrodes (2500), the number of the support members (2400) and the electrodes (2500) is not limited to the aforementioned number, and the number of the support members (2400) and the electrodes (2500) may be differently set.

Furthermore, even though some embodiments have been illustrated in which a single bent portion is formed at a supporting member (2400), two or more bent portions may be formed at a single supporting member (2400), and thus, two or more electrodes (2500) may be disposed at a single supporting member (2400).

A denervation apparatus according to the present invention includes a denervation catheter. In addition, the denervation apparatus may further include an energy supply unit and a counter electrode, and a denervation catheter. The energy supply unit can be electrically connected to the electrodes (2500) via lines (2600). In addition, the opposite electrode can be electrically connected to the power supply unit through a conductive line (2600), which is different from the conductive line (2600). In this case, the energy supply unit can supply energy to the electrode (2500) of the catheter in a high frequency or the like, and the electrode (2500) of the catheter can generate heat to ablate the nerve around the blood vessel, thereby blocking the nerve.

Next, a denervation catheter according to a third aspect of the present invention will be described with reference to fig. 27 to 42.

Fig. 27 is a perspective view schematically showing the distal end of a catheter according to the third aspect of the present invention, and fig. 28 is a sectional view taken along line a31-a31' of fig. 27. For convenience, fig. 28 shows a support member (3400), an electrode (3500), and a lead (3600) included in the catheter of fig. 27.

As used herein, the distal end of the catheter means that a portion of the catheter reaching the body under surgical procedures is between the two ends of the longitudinally extending catheter and is also referred to as a catheter tip. In addition, the end of the catheter opposite the distal end may be referred to as a proximal end. Hereinafter, with respect to various components extending in the longitudinal direction of the catheter, so that there are both ends in the longitudinal direction, one end of a component positioned at the distal end of the catheter will be referred to as a distal end of the corresponding component, and a proximal end of a component positioned at the proximal end of the catheter will be referred to as a proximal end of the corresponding component.

Referring to fig. 27 and 28, the catheter according to the present invention may include a catheter body (3100), a movable member (3200), an operating member (3300), a support member (3400), n electrodes (3500), and a lead (3600).

The catheter body (3100) has a tube or tube shape extending in a direction and having a lumen along a longitudinal direction. Here, the catheter body (3100) has two ends in the longitudinal direction, wherein during a surgical procedure using the catheter, one end of the catheter body (3100) that is inserted into the body first and reaches the destination (i.e., the subject of the surgical procedure) is referred to as the distal end, and one end of the catheter body (3100) that is near the operator and manipulated by the operator is referred to as the proximal end (not shown), as previously described.

The catheter body (3100) has a hollow tubular shape and a lumen along a longitudinal direction. Thus, various components for a surgical procedure may be disposed within or moved through the lumen, and a substance, such as a drug or lotion, may be injected through the lumen. To this end, the proximal end of the catheter body (3100) may be formed such that the lumen is open to the outside.

The catheter body (3100) can have various shapes depending on its purpose or purpose, and can have various inner or outer diameters. In addition, the catheter body (3100) may be made using various materials, such as soft materials (e.g., rubber and plastic) or hard materials (e.g., metal). The invention is not limited to a particular shape, material, or size of the catheter body (3100), and the catheter body (3100) may have a variety of shapes, materials, sizes, or the like.

A moveable member (3200) is disposed at a distal end (3101) of the catheter body and is configured to move in a longitudinal direction of the catheter body (3100). Further, via the movement of the movable member (3200), the distance between the tip (3110) of the catheter body and the movable member (3200) may be increased or decreased.

In particular, as shown in fig. 27 and 28, the movable member (3200) may be provided outside the catheter body (3100). In other words, the movable member (3200) is separated from the catheter body (3100) and positioned outside (on the right side in fig. 28) compared to the tip (3110) of the catheter body. In this case, if movable member (3200) moves in the left direction, the distance between movable member (3200) and catheter body (3100) can be decreased, and if movable member (3200) moves in the right direction, the distance between movable member (3200) and catheter body (3100) can be increased.

Preferably, the catheter body and/or the distal end (3101) of the moveable member (3200) may be made using soft and elastic materials. Because the distal ends (3101) of the catheter body and the movable member (3200) are located at a forward end of the catheter, the distal ends (3101) of the catheter body and the movable member (3200) may contact the inner wall of a blood vessel or the like as the catheter is moved along the blood vessel or the like. However, if the catheter body and the distal end (3101) of the movable member (3200) are made of a soft and elastic material, damage to blood vessels or the like caused by the distal end (3101) of the catheter body and the movable member (3200) can be reduced or avoided, and the direction of movement of the distal end (3101) of the catheter body and the movable member (3200) can also be easily changed.

In a similar manner, the distal end (3101) of the catheter body and/or the moveable member (3200) may have a rounded edge. In particular, as shown, the movable member (3200) may have an outer surface (right surface in fig. 28) that extends circularly towards the forward end of the conduit. In addition, the inner surface (left surface in fig. 28) of the movable member 3200 may have a rounded edge.

The operating member (3300) may be formed to extend long along the longitudinal direction of the catheter body (3100), and the movable member (3200) may be moved in the longitudinal direction. To this end, one end (i.e., a distal end) of the operating member (3300) may be connected and fixed to the movable member (3200), and the operating member (3300) may be disposed depending on the lumen of the catheter body (3100). In addition, the other end (i.e., a proximal end) of the operating member (3300) can be exposed to the outside of the catheter body (3100) through an opening portion of the proximal end of the catheter body (3100). In this case, the operator can use a separate tool to pull or push the operating member (3300) manually or automatically. In this case, the operating member (3300) may be moved in the lateral direction as shown by an arrow b32 in fig. 28, and thus, the movable member (3200) connecting one ends of the operating member (3300) may be moved in the lateral direction as shown by an arrow b 31.

Meanwhile, in the embodiment of fig. 28, since the operating member (3300) is connected to the movable member (3200) outside the catheter body (3100), an operating hole (3120) may be formed at the catheter body (3100), so that the operating member (3300) can be moved through the operating hole (3120).

The support member (3400) may have a bar or plate shape extending in one direction and may be connected between the catheter body (3100) and the movable member (3200). In other words, the support member (3400) may have one end connected to the tip (3110) of the catheter body (i.e., the most distal end of the distal end (3101) of the catheter body) and the other end connected to the movable member (3200). For example, in the configuration of fig. 28, the proximal end (left end) of the support member (3400) may be secured to the outer surface of the tip (3110) of the catheter body, and the distal end (right end) of the support member (3400) may be secured to the left surface of the movable member (3200).

Meanwhile, as described above, the movable member (3200) may be configured to move closer to or away from the tip (3110) of the catheter body (3100) in the longitudinal direction thereof via the operating member (3300).

In particular, in the present invention, if movable member (3200) is moved to reduce the distance between the end (3110) of the catheter body and movable member (3200), support member (3400) may be at least partially curved, and this curve may constitute a departure from catheter body (3100). This will be described in more detail in fig. 29 to 31.

Fig. 29 is a sectional view schematically showing that in the structure of fig. 28, the curved portion of the support member (3400) is moved away from the catheter body (3100) by the movement of the movable member (3200). Further, fig. 30 is a perspective view of fig. 29, and fig. 31 is a front view of fig. 30.

Referring to fig. 29 to 31, if movable member (3200) moves toward catheter body (3100), as indicated by arrow (g3), the distance between movable member (3200) and catheter body (3100) may be reduced. If so, the distance between both ends of the plurality of support members (3400) provided between the movable member (3200) and the catheter body (3100) can be reduced so that the plurality of support members (3400) can be at least partially bent. In addition, if the movable member (3200) is further moved toward the duct body (3100), the curved portion of the support member (3400) can be gradually moved away from the duct body (3100). Here, as shown by an arrow curved portion p3 in fig. 29, the curved portion may be regarded as meaning one apex of the curved portion, that is, one point of the curved portion of the support member (3400) having the greatest degree of curvature, or one point of the curved portion of the support member (3400) farthest from the central axis of the catheter body (3100). Further, herein, the bend being displaced from the catheter body (3100) means that the bend direction of the bend (p3) is formed to the outside of the catheter body so that the bend (p3) is displaced from the central axis of the catheter body (3100).

Since the support member (3400) should form a bent portion according to the movement of the movable member (3200), the support member (3400) can be made of a bent material as the distance between both ends is reduced. For example, the support member (3400) may be made using metal or polymer. However, the present invention is not limited to this specific material of the support member (3400), and the support member (3400) may be made using various materials that may form a partial bent portion.

Meanwhile, electrodes (3500) are provided at the bent portions (p3) of the plurality of support members (3400). For example, as shown in the embodiments of fig. 27 to 30, an electrode (3500) may be disposed at each bent portion (p3) of the plurality of support members (3400).

The electrode 3500 may be connected to an energy supply unit (not shown) via lead 3600 to generate heat. In addition, the heat generated by the electrodes (3500) can ablate the surrounding tissue. For example, the electrode (3500) may ablate nerves around blood vessels by generating heat at about 40 ℃ or more (preferably 40 to 80 ℃), which may block the nerves. However, the thermal temperature generated by the electrode (3500) may be set in different ways depending on the use or purpose of the catheter.

Electrode (3500) may contact the vessel wall to apply heat to nerves surrounding the vessel, and as such, electrode (3500) preferably adheres closely to the vessel wall. Thus, the electrode (3500) may have an arcuate shape, such as a circle, semi-circle, or oval, to conform to the shape of the inner wall of the vessel. In this embodiment, the electrode (3500) can be attached to the vessel wall more precisely, so that the heat generated by the electrode (3500) can be transferred to the nerve tissue around the vessel efficiently.

At the same time, the electrode (3500) may be disposed at a point of the curvature of the support member (3400) that is furthest from the central axis of the catheter body (3100). In other words, if the distance between the movable member (3200) and the distal end (3110) of the catheter body is reduced to form a bend in the support member (3400), the electrode (3500) may be disposed at an apex of the bend, the apex being located at the central axis furthest from the catheter body (3100). In this embodiment, the contact force of the electrode (3500) against the vessel wall can be further improved by maximizing the protrusion of the electrode (3500) from the catheter body (3100).

Electrode (3500) may be made using a material such as platinum or stainless steel, but the invention is not limited to this particular material for electrode (3500). The electrode (3500) may be made of various materials, taking into consideration various factors such as the method of heat generation and the surgical target.

Preferably, the electrode (3500) may generate heat via Radio Frequency (RF). For example, the electrode (3500) may be connected to a high frequency generating unit through a lead (3600) and emit high frequency energy to ablate nerves.

Meanwhile, the electrode (3500) provided at the catheter may be a negative electrode, and like the negative electrode, the positive electrode opposite to the negative electrode may be connected to an energy supply unit such as a high frequency generating unit, and a die or a patch or the like is employed to attach a specific part of the human body.

Since the electrode (3500) is provided at the curved portion of the support member (3400), the electrode (3500) can be moved away from the central axis of the catheter body (3100) when the distance between the catheter body (3100) and the movable member (3200) is reduced due to the movement of the movable member (3200). Meanwhile, if movable member (3200) is moved to increase the distance between catheter body (3100) and movable member (3200), electrode (3500) provided at the bent portion can be moved closer to the central axis of catheter body (3100).

For example, as shown in fig. 29, when movable member (3200) is moved along arrow (g3), bending portion (p3) is gradually moved away from the central axis of catheter body (3100), and electrode (3500) provided at the bending portion is also moved in a direction away from the central axis of catheter body (3100), as shown by arrows (h31, h32, h 33). Conversely, if movable member (3200) is moved in the direction opposite to arrow (g3) shown in fig. 29, electrode (3500) provided at the curved portion of support member (3400) can be configured to move closer to catheter body (3100) again.

In other words, electrode (3500) may be moved longitudinally, according to the central axis of catheter body (3100), towards the exterior of catheter body (3100) or into catheter body (3100) depending on the movement of moveable member (3200).

For this purpose, the support member (3400) for supporting the electrode (3500) with the electrode (3500) at the bent portion may have a suitable material or shape so that the bending direction of the bent portion may be moved away from the central axis of the catheter body (3100) as the distance between the movable member (3200) and the catheter body (3100) decreases, i.e., the distance between both ends thereof decreases.

For example, the support member (3400) may be configured such that an outer surface length of a part in the width direction is longer than an inner surface length thereof. This structure will be described in more detail with reference to fig. 32.

FIG. 32 is a cross-sectional view taken along line A32-A32' of FIG. 27. However, fig. 32 does not depict the operation member (3300), the electrode (3500), and the lead wire (3600), but shows a single support member (3400) in an enlarged view for convenience.

Referring to fig. 32, in a cross-sectional view in the width direction, the supporting member (3400) may be configured such that the length of an outer surface is greater than the length of an inner surface. Here, the length of the outer surface means that the length of a surface is away from the central axis of the catheter body (3100), as shown in (L31) of fig. 32, and the length of the inner surface means that the length of a surface is close to the central axis of the catheter body (3100), as shown in (L32) of fig. 32.

If the length of the outer surface (L31) of the support member (3400) is longer than the length of the inner surface (L32), as previously described, the support member (3400) may flex from the inner surface to the outer surface when a force is applied to the support member (3400) in the longitudinal direction. In other words, in this embodiment, as movable member (3200) is moved such that the distance between the two ends of support member (3400) is reduced, each support member (3400) may have a bending direction that is displaced from the central axis of catheter body (3100), as shown by arrows (I31, I32, I33) in fig. 32. Therefore, if the distance between the catheter body (3100) and the movable member (3200) is reduced, the electrode (3500) provided at the bent portion of the support member (3400) can be moved away from the catheter body (3100), as shown in fig. 29 and 30.

As another example, the support member (3400) may have an arcuate portion formed at least partially in a direction away from a central axis of the catheter body (3100). In other words, even in a state where the distance between the movable member (3200) and the catheter body (3100) is the largest, the support member (3400) may not be very flat but have an outward curved portion. In this case, if the movable member (3200) is moved to reduce the distance between both ends of the support member (3400), the curvature of the curved portion is increased, which may form a curved portion, and the curved portion may have a curved direction curved toward the outside of the catheter body (3100). In addition, if movable member (3200) is further moved, the curved portion may gradually move away from catheter body (3100).

Furthermore, the support member (3400) may be pre-shaped such that as the distance between the moveable member (3200) and the catheter body (3100) decreases, the bend does not move toward the central axis of the catheter body (3100), but away from the central axis of the catheter body (3100). For example, the support member (3400) may be preformed so as to have a shape as shown in fig. 29 and 30 when the distance between the two ends of the support member (3400) is reduced.

In this case, the support member (3400) may also be made of a shape memory alloy, such as nitinol. In this embodiment, support member (3400) may be configured such that as the distance between moveable member (3200) and catheter body (3100) decreases, the bend moves away from catheter body (3100) according to the memorized shape.

In addition, the bending portion of the support member (3400) may be provided by forming a notch at a predetermined portion of the support member (3400). In this case, if the distance between both ends of the support member (3400) is reduced, a bent portion may be formed at a portion of the support member (3400) formed at the notch. In this embodiment, by adjusting the orientation of the notch, the bend can be moved away from the catheter body (3100) as the distance between the ends of the support member (3400) decreases.

As described above, in the denervation catheter according to the present invention, the electrode (3500) is provided at the curved portion of the support member (3400) to move toward or away from the catheter body (3100). Therefore, if the catheter according to the present invention is used to perform denervation, the distal end of the catheter (i.e., the catheter tip portion) can be moved to the surgical target through the blood vessel in a state where the curved portion of the support member (3400) with the electrode (3500) is close to the catheter main body (3100). In addition, if the catheter tip reaches the surgical target, the electrode (3500) can contact or approach the inner wall of the blood vessel by moving the curved portion of the support member (3400) with the electrode (3500) away from the catheter body (3100). In addition, in this state, by emitting energy for generating heat, such as high-frequency energy, through the electrode (3500), nerves around the blood vessel can be blocked. Thereafter, if denervation is completed using energy emitted through the electrode (3500), the curved portion of the support member (3400) with the electrode (3500) is again moved closer to the catheter body (3100), and the catheter can then be removed from the blood vessel or moved to another location.

Meanwhile, in a state where the electrode (3500) is displaced from the central axis of the catheter body (3100), the distance between the electrode (3500) and the central axis of the catheter body (3100) may be selected in various ways depending on the size of the surgical object, such as the inner diameter of the blood vessel. For example, the distance between each electrode (3500) and the central axis of the catheter body (3100) may be 2mm (millimeters) to 4mm (millimeters) in a state where the electrodes (3500) are moved furthest away from the central axis of the catheter body (3100).

The wires (3600) are electrically connected to the plurality of electrodes (3500) respectively to provide a power supply path for the plurality of electrodes (3500). In other words, the lead (3600) is connected between the electrode (3500) and the energy supply unit such that energy supplied from the energy supply unit can be transferred to the electrode (3500). For example, one end of the wire (3600) is connected to the high frequency generating unit, and the other end thereof is connected to the electrode (3500), so that energy generated by the high frequency generating unit is transferred to the electrode (3500), thereby causing the electrode (3500) to generate heat by high frequency.

The lead (3600) may be attached to the upper or lower portion of the support member (3400), or disposed on the support member (3400) between the distal end (3110) of the catheter body and the electrode (3500). Further, the lead wire (3600) may not be fixed to the support member (3400), but an electrode (3500) separated from the support member (3400) is connected.

Furthermore, the lead (3600) may provide that the support member (3400) is not separated, but an integrated support member (3400) is implemented. For example, at least a portion of the support member (3400) may be made using an electrically conductive material such that the support member (3400) may be used as a guide wire (3600) in a region between the tip (3110) of the catheter body and the electrode (3500).

In particular, in the catheter according to the present invention, at least one of the catheter body (3100) and the movable member (3200) connecting both ends of the support member (3400) may be configured such that the connection points of the support member (3400) are spaced apart by a predetermined distance in the longitudinal direction of the catheter body (3100).

In more detail, referring to fig. 28, the proximal ends (left ends) of a plurality of support members (3400) are connected and fixed to an outer surface (right surface) of the distal end (3110) of the catheter body, and the plurality of support members have connection points (c31, c32, c 33). At this time, connection points (c31, c32, c33) of the support member (3400) of the relevant catheter body (3100) are spaced apart from each other by a predetermined distance as shown by f31 and f 32. In other words, the catheter body (3100) may be configured such that the connection points of the proximal ends of the at least two support members (3400) are spaced apart from each other by a predetermined distance in the longitudinal direction (in the lateral direction of fig. 28) of the catheter body (3100).

In addition, referring to fig. 28, distal ends (right ends) of a plurality of support members (3400) are connected and fixed to an inner surface (left surface) of the movable member (3200), and the plurality of support members have connection points (e31, e32, e 33). At this time, connection points (e31, e32, e33) of the support member (3400) with respect to the movable member (3200) are spaced apart from each other by a predetermined distance as shown by f33 and f 34. In other words, the movable member (3200) may be constituted such that the connection points of the distal ends of at least two support members (3400) are spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (3100).

In order to separate the connection points of the support members (3400) from each other, as shown in fig. 28, at least one of the catheter body (3100) and the movable member (3200) may have a step formed on the surface where the support members (3400) are connected. For example, if three support members (3400) are attached to the outer surface of the end (3110) of the catheter body, the outer surface of the end (3110) of the catheter body may be stepped to form three steps.

As described above, in the catheter of the present invention, since the connection points of the support member (3400) are spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (3100), if the distance between the movable member (3200) and the catheter body (3100) is reduced so that the electrodes (3500) are moved away from the catheter body (3100), the electrodes (3500) can be spaced apart from each other in the longitudinal direction of the catheter body (3100).

In other words, if the distance between the catheter body (3100) and the movable member (3200) is reduced so that the distance between both ends of the support member (3400) is reduced, the support member (3400) can be bent. At this time, as shown in fig. 29, the bent portion may be formed at a central portion of the support member (3400) in the longitudinal direction. Thus, as in this embodiment, if a step is formed with respect to the movable member (3200) and the catheter body (3100), the central portions of the support members (3400) may be spaced apart from each other in the longitudinal direction of the catheter body (3100). Further, if the electrodes (3500) are provided at the central portion of the support member (3400), the electrodes (3500) may be spaced apart from each other in the longitudinal direction of the catheter body (3100). In particular, if the distance between catheter body (3100) and moveable member (3200) is decreased such that electrodes (3500) are moved away from catheter body (3100), the plurality of electrodes (3500) may be spaced apart from each other in the longitudinal direction of catheter body (3100), as shown at d31 and d32 in fig. 29.

As previously described, according to an embodiment of the present invention, the distance between the catheter body (3100) and the moveable member (3200) is reduced such that the electrodes (3500) are moved away from the catheter body (3100), the electrodes (3500) being spaced apart from each other in the longitudinal direction of the catheter body (3100), thereby avoiding stenosis. In other words, if the plurality of electrodes (3500) emit heat, respectively, the heated portion of the blood vessel may expand toward the inside of the blood vessel. At this time, if the distance between the electrodes (3500) is short in the longitudinal direction of the blood vessel, stenosis may occur. However, in the present invention, since the plurality of electrodes (3500) are spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (3100), the heated portion of the blood vessel is spaced apart by a predetermined distance in the longitudinal direction of the blood vessel. Therefore, even if heat is applied to ablate nerves around a blood vessel using the catheter of the present invention, stenosis at the corresponding site can be prevented.

Preferably, in a specific embodiment in which the connection points of the catheter body (3100) and the movable member (3200) of the relevant support member (3400) are spaced apart from each other, the surfaces (facing each other) of the catheter body (3100) and the movable member (3200) may be matched to each other. Herein, the mating of the opposing faces of conduit body (3100) and moveable member (3200) means that the surfaces thereof that face each other are substantially coincident when conduit body (3100) and moveable member (3200) are moved closer to each other.

For example, as shown in fig. 28, if steps are formed on the outer surface of catheter body (3100) and the inner surface of moveable member (3200), the steps formed on catheter body (3100) can match the steps formed on moveable member (3200). In this case, the difference in distances (f31, f32) between the connection points of the catheter body (3100) is substantially equal to the difference in distances (f33, f34) between the connection points of the movable member (3200).

In this embodiment, the plurality of support members (3400) may be constructed to have the same length, and the electrode (3500) may be disposed at a central portion of each support member (3400) in the longitudinal direction. In this case, as shown in fig. 29, if the distance between the catheter body (3100) and the movable member (3200) is decreased so that the electrodes (3500) are moved away from the catheter body (3100), the distance (d31) between the electrodes (3500) is substantially equal to f31 (f 33), and the distance (d32) between the electrodes (3500) is substantially equal to f32 (f 34).

Therefore, when the opposing surfaces of the catheter body (3100) and the movable member (3200) are configured to match each other, the distance between the connection points can be controlled by adjusting the distance when the electrode (3500) is separated from the catheter body (3100). Therefore, in this structure, the distance between the electrodes (3500) can be easily adjusted.

Here, as the distance between moveable member (3200) and catheter body (3100) decreases, i.e. as electrode (3500) moves away from catheter body (3100), the distance (d31, d32) between electrodes (3500) may be selected differently depending on the size of the catheter or surgical target. For example, the catheter may be configured such that, in a state where the plurality of electrodes (3500) are distant from the catheter body (3100), the distance between the electrodes (3500) is 0.3 to 0.8cm (centimeter) in the longitudinal direction of the catheter body (3100). In this embodiment, stenosis of the vessel can be avoided and the problem that nerves around the vessel pass between the electrodes (3500) and the electrodes (3500) cannot be ablated is reduced.

The support member (3400) may have a predetermined curved portion or notch formed at a position where a curved portion is formed, for facilitating easier formation of the curved portion. For example, the support member (3400) may include an electrode (3500) at a central portion in the longitudinal direction, and a predetermined curved portion may be formed at the central portion such that the curved portion is formed at the central portion.

Meanwhile, in the embodiment of fig. 27 to 30, steps are formed at the surfaces of the catheter body (3100) and the movable member (3200) such that connection points with respect to the plurality of support members (3400) are spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (3100). However, the present invention is not limited thereto, and the duct body 3100 and the movable member 3200 may be formed in various shapes so as to separate the connection points of the plurality of support members 3400 from each other.

Figure 33 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention.

Referring to fig. 33, the catheter body (3100) and the movable member (3200) may be inclined at the surface connecting the support members (3400). In other words, the outer surface of the tip (3110) of the catheter body connecting the proximal ends of the support members (3400) and the inner surface of the movable member (3200) connecting the distal ends of the support members (3400) may form a downward slope.

In particular, as shown, the surface with the inclined catheter body (3100) and the surface with the inclined moveable element (3200) may have the same inclination pattern so as to match each other. In this case, the plurality of support members (3400) may have the same length, and the electrodes (3500) may be respectively located at the central portions of the support members (3400).

In this embodiment, if the distance between the catheter body (3100) and the movable member (3200) is reduced, a curved portion may be formed at the central portion of the support member (3400). At this time, since the ends of the support members (3400) are spaced apart from each other, the bent portions of the support members (3400) may also be spaced apart from each other. Therefore, if the distance between the catheter body (3100) and the movable member (3200) is decreased so that the support member (3400) is bent, the plurality of electrodes (3500) can be moved away from the catheter body (3100) in a state where the plurality of electrodes are spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (3100).

Meanwhile, in the embodiment of fig. 28 and 33, it has been illustrated that the connection points of both the catheter body (3100) and the movable member (3200) with respect to at least two support members (3400) are spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (3100), but the present invention is not limited thereto. For example, the surface of either the conduit body (3100) or the moveable member (3200) to which the support member (3400) is attached may also be stepped or sloped.

Preferably, in the present invention, the plurality of electrodes (3500) may be configured to be spaced apart from each other at a predetermined angle in the longitudinal direction according to the central axis of the catheter body (3100) in a state where the bent portion of the support member (3400) is distant from the catheter body (3100).

For example, as shown in fig. 31, in a state where the three electrodes (3500) are moved away from the catheter body (3100) by the movement of the movable member (3200), it is assumed that angles among the three electrodes (3500) are J31, J32 and J31 depending on the central axis (o3) of the catheter, and that J33, J32 and J33 have predetermined angles such that the three electrodes (3500) are spaced apart from each other at the predetermined angles. For example, J31, J32, and J33 may likewise be 120 °.

In addition, in an embodiment including four or more support members (3400) and four or more electrodes (3500), the plurality of electrodes (3500) may also be spaced apart from one another at a predetermined angle with respect to the central axis (o3) of the catheter.

As previously described, in embodiments where the electrodes (350) are spaced apart from each other at a predetermined angle according to the central axis (o3) of the catheter body (3100), the electrodes (3500) can be configured in all directions that are widely dispersed around the catheter body (3100). Thus, even if the nerve is treated at a local site of the blood vessel, the electrode (3500) may cover most of the nerve.

Fig. 34 is a cross-sectional view schematically illustrating the distal end of a denervation catheter according to another embodiment of the present invention, and fig. 35 is a cross-sectional view schematically illustrating the movement of an electrode (3500) away from the catheter body (3100) by the movement of the movable member (3200) in the configuration of fig. 34.

Referring to fig. 34 and 35, a denervation catheter according to the present invention may include a reinforcing member (3700).

The reinforcing member (3700) may have a bar or plate shape extending in the longitudinal direction of the catheter body (3100) and disposed between the catheter body (3100) and the movable member (3200). Further, a distal end of reinforcing member (3700) may be connected and fixed to movable member (3200), which is movable according to the movement of movable member (3200).

At this time, a through hole (3130) may be formed in the catheter body (3100), and a proximal end of the movable member (3200) may be inserted into the through hole (3130).

In this embodiment, as shown in fig. 35, when the movable member (3200) is moved in the left direction, that is, the guide tube body (3100), the reinforcing member (3700) can also be moved in the left direction. At this time, the proximal end of the reinforcing member (3700) is inserted into the through hole (3130) of the catheter body (3100), so that the reinforcing member (3700) can slide through the through hole (3130) according to the movement of the movable member (3200).

In this embodiment, the connection between the catheter body (3100) and the moveable member (3200) may be more strongly supported by the stiffening member (3700). In other words, if movable member (3200) is separated from catheter body (3100), the coupled state and supporting force between catheter body (3100) and movable member (3200) may be weak if catheter body (3100) and movable member (3200) are coupled using a single operation member (3300). However, as in this embodiment, if the reinforcing member (3700) is provided with the separation operation member (3300), the supporting force for the movable member (3200) separated from the catheter body (3100) is further reinforced, and the coupled state between the catheter body (3100) and the movable member (3200) can be stably maintained. In addition, since the reinforcing member (3700) can guide the movement of the movable member (3200), the movement direction of the movable member (3200) can be maintained without being deviated from the central axis of the catheter body (3100).

Meanwhile, even though the embodiment of fig. 34 and 35 illustrates that only one reinforcing member (3700) is provided, two or more reinforcing members (3700) may be provided.

Furthermore, even though some of the figures depict only one operating member (3300) being provided, two or more operating members (3300) may be provided.

Also preferably, the denervation catheter according to the present invention may include a brake (3800). The stopper (3800) limits the moving distance of the movable member (3200), and the catheter body may include at least one stopper.

More preferably, the stopper (3800) may be fixed to the operating member (3300), as shown in fig. 34 and 35. At this time, the stopper (3800) may include: a first stopper (3810) fixed to a part of an operating member (3300) located at the catheter body (3100); and a second stopper (3820) fixed to a part of an operating member (3300) located outside the catheter body (3100). Here, the first stopper (3810) may restrict the movement of the movable member (3200) so that the movable member (3200) does not move further in a direction away from the catheter body (3100). In addition, the second stopper (3820) may restrict the movement of the movable member (3200) so that the movable member (3200) does not move further in a direction approaching the catheter body (3100).

In embodiments including a stop (3800) as described above, operator manipulation may be facilitated and damage to various components contained within the catheter may also be avoided. For example, in the embodiment of fig. 34, first stopper (3810) restricts movable member (3200) from further moving in the right direction, thereby preventing movable member (3200) from excessively moving away from catheter body (3100), thus cutting off the connection between support member (3400) and catheter body (3100), or the connection between support member (3400) and movable member (3200). In another example, the second stopper (3820) may restrict the movable member (3200) from moving further in the left direction, thereby preventing the movable member (3200) from excessively moving closer to the catheter body (3100), which may damage the support member (3400) or cut off the connection between the support member (3400) and the catheter body (3100), or the connection between the support member (3400) and the movable member (3200). Also, when the operating member (3300) is pushed or pulled, the operator may not notice the operating distance of the operating member (3300) since the operating distance is restricted by the stopper (3800).

Fig. 36 schematically shows a cross-sectional view of the distal end of a denervation catheter according to another embodiment of the present invention, and fig. 37 is a cross-sectional view schematically showing the movement of an electrode (3500) away from the catheter body (3100) by the movement of the movable member (3200) in the configuration of fig. 36.

Referring to fig. 36 and 37, catheter body (3100) may have a guide hole (3140) formed at its distal end such that a guide wire (W3) may pass through the guide hole. Here, the guide wire (W3) is used to guide the catheter to the surgical target and to reach the surgical target before the catheter. In this embodiment, the guide wire (W3) can be inserted into the catheter through the guide hole (3140), and the tip of the catheter reaches the surgical target along the guide wire (W3).

The catheter body (3100) may have one or more guide holes (3140). For example, as shown in fig. 36 and 37, the catheter body (3100) has: a first guide hole (3141) formed at an end of the catheter body; and a second guide hole (3142) formed at a position spaced apart from the distal end (3110) of the catheter body by a predetermined distance. In this case, the guide wire may be inserted into the lumen of the catheter body (3100) through the first guide hole (3141), and then pulled out of the catheter body (3100) through the second guide hole (3142). However, the second guide hole (3142) may not be provided, and in this case, a lead wire inserted into the lumen of the catheter body (3100) through the first guide hole (3141) may extend along the lumen of the catheter body (3100), and then the catheter body (3100) is pulled out at the proximal end of the catheter body (3100).

If a second via (3142) is provided, the second via may be located at different locations depending on the circumstances. In particular, the second guide hole (3142) may be formed at a point spaced apart from the distal end (3110) of the catheter body by 10cm (centimeter) to 15cm (centimeter) in the longitudinal direction of the catheter body. Even though fig. 36 shows that the second guide hole (3142) is near the distal end (3110) of the catheter body, it is merely illustrative, and the distance from the end of the catheter body to the second guide hole may be 10cm (centimeter) to 15cm (centimeter), as shown by L33. In this embodiment, although the catheter main body is moving, the problem that the wire pulled out from the catheter main body through the second guide hole is entangled with the catheter main body can be avoided, thereby enabling smooth movement of the catheter main body. However, the present invention is not limited to this position of the second guide hole.

Also, in this embodiment, a guide hole (3210) may be formed in the movable member (3200) so that a wire may pass through the guide hole.

As described above, in the embodiment in which the guide hole (3140) is formed in the catheter body (3100), since the guide wire inserted into the guide hole guides the movement of the tip portion of the catheter, the catheter can smoothly reach the surgical target and the catheter can be easily manipulated. Furthermore, since the catheter does not need to include a member for adjusting the moving direction of the catheter, the catheter can have a more compact structure, which can advantageously reduce the size of the catheter.

Also preferably, the denervation catheter according to the present invention may further comprise an elastic member (3900).

One end of the elastic member (3900) may be coupled to the movable member (3200) to provide a restoring force when the movable member (3200) is moving. For example, as shown in fig. 36, elastic member (3900) may be connected between the tip (3110) of the catheter body and movable member (3200). In this case, as shown in fig. 37, if movable member (3200) is moved in the left direction so that electrode (3500) is moved away from catheter body (3100), the restoring force (i.e., elastic restoring force) of elastic member (3900) is applied in the right direction. Therefore, after the electrode (3500) completely blocks the nerve, the movable member (3200) should be moved again in the right direction and returned to its original state, as shown in fig. 36. Here, the movement of the movable member (3200) in the right direction can be more easily performed via the restoring force of the elastic member (3900). Thus, after electrode (3500) blocks the nerve, the operator need not forcibly move electrode (3500) closer to the central axis of catheter body (3100).

In addition, as described above, in the embodiment in which the elastic member (3900) is provided, when the catheter tip portion is moving, the electrode (3500) can be prevented from deviating from the central axis of the catheter body (3100), and thus damage to the blood vessel due to the protrusion of the electrode (3500) can be prevented, and easy movement of the catheter tip portion can be facilitated. Also, even if stopper (3800) is not provided, the moving distance of movable member (3200) can be restricted by elastic member (3900), and damage to various components due to excessive movement of movable member (3200) can be avoided.

In particular, the temperature measuring member may be disposed around the electrode (3500) to measure the temperature of the electrode (3500), or disposed around the electrode (3500). Further, as described above, the temperature measured by the temperature measuring means may be used to control the temperature of the electrode (3500). Here, the temperature measuring member may be connected to the lead (3600) through a separate wire, and the separate wire may extend through the lumen of the catheter body (3100) to the proximal end of the catheter body (3100) and be pulled out of the catheter body (3100).

Meanwhile, even though the various embodiments illustrate that the movable member (3200) is provided outside the catheter body (3100), the present invention is not limited thereto.

Fig. 38 is a cross-sectional view schematically illustrating the distal end of an innervation catheter in accordance with another embodiment of the present invention, and fig. 39 is a cross-sectional view illustrating the catheter of fig. 38 taken along the longitudinal direction. However, features that apply the description of the specific embodiment shown in fig. 27 to 37 will not be described in detail, but different features will be described in detail.

Referring to fig. 38 and 39, moveable member (3200) may be disposed within the lumen of catheter body (3100). Further, the moveable member (3200) is moveable laterally within the lumen of the catheter body (3100). Here, unlike the embodiment of fig. 27 to 37, the proximal end of the support member (3400) may be connected and fixed to the movable member (3200), and the distal end thereof may be fixed to the tip (3110) of the catheter body.

In addition, in this embodiment, a structure for generating a distance difference between coupling points of the support member (3400), such as a step or an inclination, may be formed on an outer surface (right surface in fig. 39) of the movable member (3200) and/or an inner surface (left surface in fig. 39) of the distal end (3110) of the catheter body.

Since the movable member (3200) is closer to the proximal end of the catheter than the catheter body (3100), if the operator pushes the operating member (3300), the movable member (3200) moves in the right direction of fig. 39, so that the distance between the movable member (3200) and the tip (3110) of the catheter body decreases. Meanwhile, if the operator pulls the operating member (3300), the movable member (3200) moves in the left direction of fig. 39, so that the distance between the movable member (3200) and the tip (3110) of the catheter body increases.

Even in this embodiment, if the distance between the movable member (3200) and the distal end (3110) of the catheter body is decreased, the electrode (3500) provided at the bent portion of the support member (3400) may be moved away from the catheter body (3100), which will be described in more detail with reference to fig. 40 and 41.

Fig. 40 is a sectional view schematically showing that the electrode (3500) is moved away from the catheter body (3100) by the movement of the movable member (3200) in the structure of fig. 39, and fig. 41 is a perspective view of fig. 40.

Referring to fig. 40 and 41, if the movable member 3200 moves toward the distal end 3110 of the catheter body (in the right direction of fig. 40), so that the distance between the movable member 3200 and the distal end 3110 of the catheter body decreases, the distance between both ends of the support member 3400 may decrease. Thus, the bend of the support member (3400) is movable away from the catheter body (3100), and the electrode (3500) disposed at the bend is movable away from the catheter body (3100).

As previously described, in the embodiment of fig. 38-41, the support member (3400) and the electrode (3500) located in the lumen of the catheter body (3100) may extend outside the catheter body (3100) in response to movement of the movable member (3200). To this end, the catheter body (3100) may have an opening (3150) through which the support member (3400) and the electrode (3500) may protrude. In other words, if movable member (3200) is moved such that the distance between movable member (3200) and distal end (3110) of the catheter body is reduced, the curved portion of support member (3400) and electrode (3500) can be pulled out of catheter body (3100) through opening (3150) of catheter body (3100). At the same time, if movable member (3200) is moved so that the distance between movable member (3200) and distal end (3110) of the catheter body is increased, the curved portion of support member (3400) and electrode (3500) can be inserted into the lumen of catheter body (3100) through opening (3150) of catheter body (3100).

Also, features of the embodiment of fig. 27-37 may be employed in a catheter according to the embodiment of fig. 38-41. For example, in the embodiment of fig. 38 to 41, in a state where the bent portion of the support member (3400) is distant from the catheter body (3100), the plurality of electrodes (3500) may be spaced apart from each other at a predetermined angle according to the central axis of the catheter body (3100) in the longitudinal direction.

In addition, in the embodiment of fig. 38-41, a guide hole may also be formed in the catheter body (3100), and the catheter may also further include a stopper or a resilient member.

In particular, if the catheter includes a brake, one or more brakes may be secured to the catheter body (3100). In other words, since the movable member (3200) can be moved right or left in the inner cavity of the catheter body (3100) along the longitudinal direction, the stopper can be provided in the left and/or right cavity in the inner cavity of the catheter body (3100) depending on the movable member (3200) to restrict the movement of the movable member (3200) in the lateral direction.

In addition, if the catheter includes an elastic member, the elastic member may be provided between the movable member (3200) and the distal end (3110) of the catheter body. In other words, the proximal end of the resilient member may be connected and fixed to the movable member (3200), and the distal end of the resilient member may be fixed to the tip (3110) of the catheter body, such that when the movable member (3200) is moved in the right direction, the resilient member may provide a restoring force in the left direction.

FIG. 42 is a perspective view schematically illustrating the distal end of a denervation catheter in accordance with another embodiment of the present invention.

Referring to fig. 42, the denervation catheter according to the present invention may further include an end tip (3950).

A tip (3950) is disposed on a front surface of the catheter body (3100) and a distal end of the moveable member (3200). For example, as in the embodiment of fig. 42, if the movable member is closer to the distal end than the catheter body, a tip (3950) may be disposed on a front surface of the distal end of the movable member. However, as in the embodiment of fig. 38, if the end of the catheter body is closer to the distal end than the movable member, the tip (3950) may be disposed on the front surface of the distal end of the catheter body. In other words, the tip (3950) may be considered to be further from the distal end of the catheter body and the movable member. In this case, the tip (3950) may be a component used as the tip of a denervation catheter according to the present invention.

Also, the tip (3950) may be configured to separate the movable member or catheter body. For example, in the configuration of fig. 42, the tip (3950) may disengage the movable member. In this case, if the operating member moves the movable member in operation, the end tip (3950) does not move, and the distance between the movable member and the end tip (3950) may change. However, the tip (3950) may also be fixed to the movable member or catheter body.

The tip portion (3950) may be made of a soft and resilient material. In particular, the tip (3950) may be formed from a composition comprising polyether block amide (PEBA). The composition of the tip (3950) may contain further additives and also polyether block amide compositions. For example, the tip portion (3950) may be made from a composition containing 70 wt% of polyether block amide and 30 wt% of barium sulfate, based on the total weight of the composition.

In this configuration of the invention, when the distal end (3101) of the catheter body is moved along a blood vessel or the like, the tip portion (3950) made of a soft and elastic material is positioned at a most forward position, which reduces damage to the blood vessel and facilitates easier changing of the direction of movement. In addition, the tip (3950) made of the above material can be radiographically imaged, so that the position of the distal end of the catheter body can be easily determined.

Preferably, the tip portion (3950) may have a hollow tubular shape. Furthermore, the cavities of the tip portions (3950) may extend in the same direction in the longitudinal direction of the catheter body. If the tip (3950) has a tubular shape, as previously described, a wire may pass through the lumen of the tip (3950). For example, the tip portion may have a tubular shape with a length of 6mm (millimeters) and a cavity diameter of 0.7mm (millimeters).

The tip portion may extend in a longitudinal direction of the catheter body. In this case, the tip portion may have different dimensions along its length. In particular, if the tip portion has a cylindrical shape, a distal end of the tip portion may have a minimum diameter compared to other regions. For example, when the thickest region of the tip portion has a diameter of 1.3mm (mm), the distal end of the tip portion may have a minimum diameter of 1.1mm (mm).

The tip portion (3950) may have a suitable length, which is not too long and too short. For example, in the structure of fig. 42, the length of the tip portion (3950) indicated by L34 may be 5mm (mm) to 15mm (mm). In this configuration, as the catheter is moved along the lumen of the vessel or the lumen of the sheath, the movement is prevented from being disturbed by the tip (3950). In addition, in this structure, a vessel or the like in which the end tip portion (3950) is located can be easily determined from a curved shape or a curved direction of the end tip portion (3950).

In addition, the denervation catheter according to the present invention may further include a through tube (not shown). The through tube may have a hollow tubular shape which is included in the lumen of the catheter body, and the operation member may be located in the hollow cavity of the through tube. In other words, the operating member is movable in a state of being inserted into the through-tube lumen. In this case, the tube may be exposed to the lumen and exterior of the catheter body. For example, in the structure of fig. 42, the through-tube may be provided in a space between the catheter main body and the movable member. Furthermore, the movable member may have a ring shape, movable while encircling the outer circumference of the tube. In this structure, the moving path of the movable member can be fixed, and the coupling force between the catheter main body and the movable member can be further strengthened.

Meanwhile, even though some embodiments have illustrated that three support members (3400) and three electrodes (3500) are provided, the number of the support members (3400) and the electrodes (3500) is not limited to the aforementioned number of the present invention, and the number of the support members (3400) and the electrodes (3500) may be differently set.

In addition, even though some embodiments have illustrated a single curved portion formed at a single support member (3400), two or more curved portions may be formed at a single support member (3400), and thus, two or more electrodes (3500) may be disposed at a single support member (3400).

A denervation apparatus according to the present invention includes a denervation catheter. In addition, the denervation device may comprise an energy supply unit and a counter electrode, and a denervation catheter. The energy supply unit can be electrically connected to the electrodes (3500) via wires (3600). In addition, the opposite electrode can be electrically connected with the energy supply unit through a lead wire (3600), and the lead wire is different from the lead wire (3600). In this case, the energy supply unit may supply energy to the electrode (3500) of the catheter in a high frequency or similar form, and the electrode (3500) of the catheter may generate heat to ablate the nerve around the blood vessel, thereby blocking the nerve.

Next, a denervation catheter according to a fourth aspect of the present invention will be described with reference to fig. 43 to 60.

Fig. 43 is a perspective view schematically illustrating the distal end of a catheter in accordance with the fourth aspect of the invention, and fig. 44 is a cross-sectional view taken along line a4-a4' of fig. 43. For convenience, fig. 44 shows the first support member, the second support member, and the electrodes and leads included in the catheter of fig. 43.

As used herein, the distal end of the catheter means that one end of the catheter reaches a portion of the body under the surgical procedure between the two ends of the catheter extending in the longitudinal direction, and may also be referred to as a catheter tip. Further, the end of the catheter opposite the distal end may be referred to as a proximal end. Hereinafter, with respect to various elements extending in the longitudinal direction of the catheter, such that there are two ends in the longitudinal direction, one end of an element at the distal end of the catheter will be referred to as a distal end of the corresponding element, and a proximal end of an element at the proximal end of the catheter will be referred to as a proximal end of the corresponding element.

Referring to fig. 43 and 44, a catheter according to the present invention may include a catheter body (4100), a movable member (4200), an operating member (4300), an intermediate member (4400), a first stopper (4310), a first support member (4510), a second support member (4520), an electrode (4600), and a wire (4700).

The catheter body (4100) has a tube or tube shape extending in a direction and having a lumen along a longitudinal direction. Here, the catheter body (4100) has two ends in the longitudinal direction, wherein during a surgical procedure using the catheter, the end of the catheter body (4100) that is inserted into the human body first and reaches the destination (i.e., the subject of the surgical procedure) is referred to as the distal end, and the end of the catheter body (4100) that is near and manipulated by the operator is referred to as the proximal end (not shown), as previously described.

The catheter body (4100) has a hollow tubular shape and has an inner cavity along the longitudinal direction. Thus, various components used in surgical procedures may be disposed within or moved through the lumen, and substances such as drugs or lotions may be injected through the lumen. To this end, the proximal end of the catheter body (4100) may be formed such that the lumen is open to the outside.

The catheter body (4100) may have various shapes depending on the purpose or purpose, and may also have various inner or outer diameters. In addition, the catheter body (4100) may be made of various materials, such as soft materials (such as rubber and plastic) or hard materials (such as metal). The invention is not limited to a particular shape, material, or size of the catheter body (4100), and the catheter body (4100) may have a variety of shapes, materials, sizes, or the like.

The movable member (4200) is provided at the distal end (4101) of the catheter body and is configured to move in the longitudinal direction of the catheter body (4100). Further, the distance between the intermediate member (4400) and the movable member (4200) can be increased or decreased via the movement of the movable member (4200).

In particular, as shown in fig. 43 and 44, the movable member (4200) may be provided outside the catheter body (4100) together with the intermediate member (4400). In other words, the moveable member (4200) and the intermediate member (4400) may separate the catheter body (4100) and be located outside (on the right side of fig. 44) compared to the end (4110) of the catheter body. In this case, if the movable member (4200) is moved in the left direction, the distance between the movable member (4200) and the intermediate member (4400) may be decreased, and if the movable member (4200) is moved in the right direction, the distance between the movable member (4200) and the intermediate member (4400) may be increased.

The operating member (4300) may be formed to extend long along the longitudinal direction of the catheter body (4100), and may move the movable member (4200) in the longitudinal direction. To this end, one end (i.e., the distal end) of the operating member (4300) is connected and fixed to the movable member (4200), and the operating member (4300) may be disposed depending on the lumen of the catheter body (4100). In addition, the other end (i.e., proximal end) of the operating member (4300) may be exposed outside the catheter body (4100) through an opening portion of the proximal end of the catheter body (4100). In this case, the operator may pull or push the operating member (4300) manually or automatically using a separate tool. In this case, the operating member (4300) is movable in the lateral direction as shown by an arrow b42 in fig. 44, and thus the movable member (4200) connecting one end of the operating member (4300) is movable in the lateral direction as shown by an arrow b 41.

Meanwhile, in the embodiment of fig. 44, since the operating member (4300) is connected to the movable member (4200) outside the catheter body (4100), an operating hole (4120) may be formed in the catheter body (4100) so that the operating member (4300) may move through the operating hole (4120).

The intermediate member (4400) is disposed between the tip (4110) of the catheter body and the movable member (4200). For example, as shown in the embodiment of fig. 44, if the intermediate member (4400) and the moveable member (4200) are disposed outside of the catheter body (4100), the intermediate member (4400) may be located to the right of the end (4110) of the catheter body and to the left of the moveable member (4200).

Like the movable member (4200), the intermediate member (4400) may be configured to move along the longitudinal direction of the catheter body (4100). In addition, the distance between the end (4110) of the catheter body and the intermediate member (4400) may be increased or decreased by the movement of the intermediate member (4400).

Since the intermediate member (4400) is located between the catheter body (4100) and the movable member (4200), in the embodiment in which the intermediate member (4400) is provided outside the catheter body (4100) together with the movable member (4200), a receptacle (4401) may be formed therein through which the operating member (4300) can be inserted. Further, the operating member (4300) may move in a lateral direction when sliding over the receptacle (4401) of the intermediate member (4400).

As described above, since the operating member (4300) moves through the insertion hole (4401) of the intermediate member (4400), the intermediate member (4400) is not moved only by the movement of the operating member (4300). Thus, in order to move the intermediate member (4400) by the movement of the operating member (4300), the catheter according to the present invention comprises a first stopper (4310).

With respect to the first stopper (4310), the operating member (4300) is operable to move the intermediate member (4400) if the distance between the movable member (4200) and the intermediate member (4400) decreases to a predetermined level.

Preferably, the first brake (4310) may be provided at a portion of the operating member (4300) which is located between the movable member (4200) and the intermediate member (4400). For example, as shown in fig. 44, the first stopper (4310) may be fixed to the operating member (4300) at a position spaced apart from the intermediate member (4400) by a predetermined distance in the outer direction.

The first stopper (4310) may be configured to be hooked by the insertion hole (4401) of the intermediate member (4400). For example, the first stopper (4310) may be configured such that at least a portion thereof has a size larger than a diameter of the insertion hole (4401) formed in the intermediate member (4400). In this case, the operating member (4300) is escaped from the insertion hole of the intermediate member (4400) to a distance, and then, if a portion fixing the first stopper (4310) reaches the insertion hole (4401), the first stopper (4310) is caught by the insertion hole (4401). Therefore, the operating member (4300) cannot be moved further away from the receptacle (4401) of the intermediate member (4400), and when the operating member (4300) is moved, the intermediate member (4400) may be moved together.

Similarly, the first stopper (4310) may restrict such that the distance between the movable element (4200) and the intermediate element (4400) is reduced only to a predetermined level, and after the distance between the movable element (4200) and the intermediate element (4400) is reduced to the predetermined level, the movable element (4200) and the intermediate element (4400) may move together while maintaining the predetermined distance.

Also, the distal end (4101), the moveable member (4200), and/or the intermediate member (4400) of the catheter body may be made with soft and resilient materials. Because the distal end (4101), the movable member (4200) and the intermediate member (4400) of the catheter body are located at a forward end of the catheter, the catheter may contact the inner wall of a blood vessel or the like as it moves along the blood vessel or the like. However, if the members are made of such a soft and elastic material, damage to blood vessels or the like can be reduced or avoided, and also the direction of movement can be easily changed.

Further, in a similar manner, the distal end (4101), the moveable member (4200), and/or the intermediate member (4400) of the catheter body may have a rounded edge. In particular, as shown in fig. 43, if the movable member (4200) is in the forward most position, the movable member (4200) may have an outer surface (the right surface in fig. 44) that is rounded to extend toward the forward end of the catheter. In addition, the movable member (4200) may also have an inner surface (left surface in fig. 44) with a rounded edge. In addition, the edges of the inner or outer surface of the intermediate member (4400) and the edges of the distal end (4110) of the catheter body also have a rounded shape.

The first support member (4510) may have a bar or plate shape extending in one direction and may be connected between the intermediate member (4400) and the movable member (4200). In other words, one end of the first support member (4510) may be connected to the intermediate member (4400), and the other end may be connected to the movable member (4200). For example, in the configuration of fig. 44, the proximal end (left end) of the first support member (4510) may be secured to the outer surface of the intermediate member (4400) and the distal end (right end) of the first support member (4510) may be secured to the inner surface of the movable member (4200).

Meanwhile, as described above, the movable member (4200) may be configured to move closer to or away from the intermediate member (4400) in the longitudinal direction of the catheter body (4100) via the operating member (4300).

In particular, in the present invention, if the moveable member (4200) is moved to reduce the distance between the intermediate member (4400) and the moveable member (4200), the first support member (4510) may be at least partially curved, and this curve may constitute a displacement away from the catheter body (4100). This will be described in more detail with reference to fig. 45.

Fig. 45 is a sectional view schematically showing that in the structure of fig. 44, the curved portion of the first support member (4510) is movable away from the catheter body (4100) by the movement of the movable member (4200).

Referring to fig. 45, when the operating member (4300) is pulled in the left direction, the movable member (4200) is moved in the left direction as shown by the arrow (c 41). At this time, since the operating member (4300) moves through the insertion hole of the intermediate member (4400), the intermediate member (4400) does not move momentarily despite the movement of the operating member (4300). Accordingly, since the intermediate member (4400) is fixed and only the movable member (4200) moves toward the intermediate member (4400), the distance between the intermediate member (4400) and the movable member (4200) can be reduced.

If so, the distance between both ends of the first support member (4510) disposed between the movable member (4200) and the intermediate member (4400) may be reduced so that the first support member (4510) may be at least partially bent. Further, if the intermediate member (4400) is further moved toward the movable member (4200), the curved portion of the first support member (4510) may gradually move away from the catheter main body (4100). Here, as shown by an arrow (e4) of fig. 45, the curved portion may be regarded as meaning one apex of the curved portion, that is, one point of the curved portion of the first support member (4510) at which the degree of curvature is the largest, or one point of the curved portion of the first support member (4510) which is the farthest from the central axis of the catheter body (4100). Further, here, the bending portion being displaced from the catheter body (4100) means that the bending direction of the bending portion is formed to the outside of the catheter body (4100) so that the bending portion is displaced from the central axis of the catheter body (4100).

Like the first support member (4510), the second support member (4520) may have a bar or plate shape extending in one direction. However, the second support member (4520) may be connected between the catheter body (4100) and the intermediate member (4400). In other words, one end of the second support member (4520) is connected to the tip (4110) of the catheter body, i.e. the most distal end of the distal end (4101) of the catheter body; and the other end may be connected to an intermediate member (4400). For example, in the configuration of fig. 44, the proximal end of the second support member (4520) may be secured to the tip (4110) of the outer surface of the catheter body, and the distal end of the second support member (4520) may be secured to the inner surface of the intermediate member (4400).

Meanwhile, as described above, in a state where the first stopper (4310) is hooked by the insertion hole (4401) of the intermediate member (4400), if the operating member (4300) is kept moved to the guide tube body (4100) (in the left direction of fig. 44), the intermediate member (4400) can be moved to the guide tube body (4100).

In particular, in the present invention, if the intermediate member (4400) is moved to reduce the distance between the end (4110) of the catheter body and the intermediate member (4400), the second support member (4520) may be at least partially curved, and the curve may be configured to move away from the catheter body (4100). This will be described in more detail with reference to fig. 46 to 48.

Fig. 46 is a cross-sectional view schematically illustrating the movement of the flexure of the second support member (4520) away from the catheter body 4520 by movement of an intermediate member (4400) in the configuration of fig. 45. Further, fig. 47 is a perspective view of fig. 46, and fig. 48 is a front view of fig. 47.

First, as shown in fig. 45, since the operating member (4300) is moved in the left direction, when the movable member (4200) is mainly being moved in the left direction, if the first stopper (4310) is caught by the intermediate member (4400), the intermediate member (4400) is moved dependently due to the movement of the operating member (4300). In other words, if the operating member (4300) remains pulled to move in the left direction after the stopper is hooked by the intermediate member (4400), the movable member (4200) moves in the left direction, and the intermediate member (4400) may also move in the left direction.

If the intermediate member (4400) moves toward the catheter body (4100), as shown by the arrow (c42) in fig. 46, the distance between the intermediate member (4400) and the catheter body (4100) can be reduced. In this way, the distance between both ends of the second support member (4520) provided between the intermediate member (4400) and the catheter body (4100) is reduced, and thus at least a portion of the second support member (4520) can be bent toward the outside of the catheter body (4100). In addition, if the intermediate member (4400) is moved further towards the catheter body (4100), the curved portion of the second support member (4520) may gradually move away from the central axis of the catheter body (4100).

In the catheter of the present invention, since the first support member (4510) and the second support member (4520) should form the bending portions according to the movement of the movable member (4200) and the intermediate member (4400), the first support member (4510) and the second support member (4520) may be made of a bending material so that both support members can be bent when the distance between both ends is reduced. For example, the first support member (4510) and the second support member (4520) may be made of metal or polymer. However, the present invention is not limited to this particular material of the support member.

Meanwhile, the electrode (4600) may be disposed at the bent portion (e4) of the first support member (4510) and the second support member (4520). In particular, since the catheter according to the present invention includes the electrodes (4600) at the first support member (4510) and the second support member (4520), a plurality of electrodes (4600) may be provided.

The electrodes (4600) may be connected to an energy supply unit (not shown) through wires (4700) to generate heat. Further, heat generated by the electrodes (4600) can ablate surrounding tissue. For example, the electrode (4600) can ablate nerves around blood vessels by generating heat at about 40 ℃ or more (preferably 40 to 80 ℃), thus blocking the nerves. However, the temperature at which the electrodes (4600) generate heat may be set differently depending on the use or purpose of the catheter.

The electrodes (4600) may apply heat to the nerve tissue surrounding the blood vessel in contact with the blood vessel wall, so that the electrodes (4600) preferably adhere tightly to the blood vessel wall. Thus, the electrode (4600) may have a curved shape, such as a circular, semi-circular or oval shape, to conform to the shape of the inner wall of the blood vessel. In this embodiment, the electrodes (4600) can more securely adhere to the vessel wall, and thus, the heat generated by the electrodes (4600) can be efficiently transferred to the nerve tissue surrounding the vessel.

Meanwhile, the electrode (4600) may be disposed at a point of the bending portion of the first support member (4510) and the second support member (4520), which is farthest from the central axis of the catheter body (4100). In other words, if the distance between the two ends is decreased to form a bend in the first support member (4510) and the second support member (4520), the electrode (4600) may be disposed at an apex of the bend, the apex being located furthest from the central axis of the catheter body (4100). In this embodiment, by extending the electrode (4600) from the catheter body (4100) to the maximum, the contact force of the electrode (4600) against the vessel wall can be further improved.

The electrodes (4600) may be made of a material such as platinum or stainless steel, but the invention is not limited to this particular material for the electrodes (4600). The electrodes (4600) can be made of various materials, taking into account various factors, such as the heat generation method and the surgical target.

Preferably, the electrode (4600) can generate heat via Radio Frequency (RF). For example, the electrodes (4600) can be connected to a high frequency generating unit through leads (4700) and emit high frequency energy to ablate nerves.

Meanwhile, the electrode (4600) provided at the catheter may be a negative electrode, and like the negative electrode, a positive electrode opposite to the negative electrode may be connected to an energy supply unit, such as a high frequency generating unit, and may be attached to a specific part of the human body with a die or a patch or the like.

Since the electrode (4600) is provided at the bent portions of the first support member (4510) and the second support member (4520), the electrode (4600) can move away from the central axis of the catheter body (4100) as the distance between the two ends decreases.

For example, in the configuration depicted in fig. 45, if the movable member (4200) is moved along arrow (c41), the flexure of the first support member (4510) is gradually moved away from the central axis of the catheter body (4100), and the electrode (4600) disposed at the flexure of the first support member (4510) is also moved away from the central axis of the catheter body (4100) in a direction, as indicated by arrows (f41, f 42). Conversely, if the movable member (4200) is moved in the direction opposite to the arrow (c41) of fig. 45, the electrode (4600) provided at the bent portion of the first support member (4510) may constitute a central axis which is moved closer to the catheter body (4100) again.

Further, in the configuration depicted in fig. 46, if the intermediate member (4400) is moved in the direction of arrow (c42), the flexure of the second support member (4520) is gradually moved away from the central axis of the catheter body (4100), and the electrode (4600) disposed at the flexure of the second support member (4520) is also moved away from the central axis of the catheter body (4100), as indicated by arrows (f43, f 44). Conversely, if the movable member (4200) is moved in a direction opposite to the direction c42 in fig. 46, the electrode (4600) provided at the bent portion of the second support member (4520) may constitute a central axis which is moved closer to the catheter body (4100) again.

Similarly, the electrode (4600) may be moved longitudinally in accordance with the central axis of the catheter body (4100) toward the outside of the catheter body (4100) or into the catheter body (4100) in accordance with the movement of the movable member (4200) or the intermediate member (4400).

To this end, the first support member (4510) and/or the second support member (4520) with the electrodes (4600) at the bending portion to support the electrodes (4600) may be of a suitable material or shape such that the bending direction of the bending portion is movable away from the central axis of the catheter body (4100) as the distance between the two ends decreases.

For example, at least one of the first support member (4510) and the second support member (4520) is configured such that an outer surface length of a portion in the width direction is longer than an inner surface length. This structure will be described in more detail with reference to fig. 49.

Fig. 49 is a schematic diagram showing the arrangement and segments in the width direction of the first support member (4510) and the second support member (4520) according to an embodiment of the present invention. In fig. 49, for convenience, the first supporting member (4510) and the second supporting member (4520) are shown in a plane, and components other than the catheter body (4100), the first supporting member (4510), and the second supporting member (4520) are not shown. In addition, a single support member is enlarged.

Referring to fig. 49, in a cross-sectional view in a width direction, the first supporting member (4510) and the second supporting member (4520) may be configured such that a length of an outer surface is greater than a length of an inner surface. Here, the width direction means a direction orthogonal to the longitudinal direction of the duct.

For illustration, an enlarged view of a section of the second support member (4520) shown in the width direction is shown in the right portion of fig. 49. Referring to the enlarged view, the length of the outer surface of the second support member (4520) means the length of a surface away from the central axis of the catheter body (4100), as shown at L41, and the length of the inner surface of the second support member (4520) means the length of a surface close to the central axis of the catheter body (4100), as shown at L42.

As shown in fig. 49, the second support member (4520) may be configured such that the length L41 of the outer surface is longer than the length L42 of the inner surface, and the first support member (4510) is also configured such that the length of the outer surface is longer than the length of the inner surface.

If the outer surface length of the first support member (4510) and the second support member (4520) is longer than the inner surface length, as previously described, each support member may flex in a direction from the inner surface to the outer surface when a force is applied to each support member in the longitudinal direction. In other words, in this embodiment, when the movable member (4200) is moved such that the distance between the ends of the first support member (4510) is decreased and the intermediate member (4400) is moved to decrease the distance between the ends of the second support member (4520), the first support member (4510) and the second support member (4520) may each have a bending direction that is moved away from the central axis of the catheter body (4100), as shown by arrows (I41, I42, I43, I44) in fig. 49. Therefore, if the distance between the movable member (4200) and the intermediate member (4400) is decreased and the distance between the intermediate member (4400) and the catheter main body (4100) is decreased, the electrodes (4600) provided at the bent portions of the first support member (4510) and the second support member (4520) can be moved away from the catheter main body (4100), as shown in fig. 46 and 47.

As another example, at least one of the first support member (4510) and the second support member (4520) may have an arcuate portion formed at least partially in a direction away from the central axis of the catheter body (4100). In other words, even in a state where the distance between the movable member (4200) and the intermediate member (4400) is the largest, the first support member (4510) may not be very flat, but a portion is bent outward of the central axis of the catheter body (4100). Furthermore, in a state where the distance between the intermediate member (4400) and the end (4110) of the catheter body is at a maximum, the second support member (4520) may not be very flat, but may have a portion that curves outward of the central axis of the catheter body (4100).

In this case, if the movable member (4200) and the intermediate member (4400) are moved to reduce the distance between the ends of the first support member (4510) and the second support member (4520), the curvature of the arcuate portion increases, which forms a curved portion, and the curved portion may have a curved direction that curves toward the outside of the catheter body (4100). In addition, if the movable member (4200) and the intermediate member (4400) are further moved, the bending portion may be gradually moved away from the catheter body (4100).

As another example, at least one of the first support member (4510) and the second support member (4520) may be pre-shaped such that as the distance between the two ends decreases, the bend does not move toward the central axis of the catheter body (4100) but moves away from the central axis of the catheter body (4100). For example, the first support member (4510) and the second support member (4520) may be preformed to have a shape as shown in fig. 46 and 47 as the distance between the ends decreases.

In this case, the first support member (4510) and the second support member (4520) may also be formed from a shape memory alloy, such as nitinol. In this embodiment, the first support member (4510) may be configured such that as the distance between the moveable member (4200) and the intermediate member (4400) decreases, the bend moves away from the catheter body (4100) in accordance with the memorized shape. Furthermore, the second support member (4520) may be configured such that the bend moves away from the catheter body (4100) in accordance with the memorized shape as the distance between the intermediate member (4400) and the catheter body (4100) decreases.

In addition, the bending of the first support member (4510) and the second support member (4520) may be provided by forming a notch at a predetermined portion. In this case, if the distance between both ends of each support member is decreased, a bent portion may be formed at a portion of the support member formed at the notch. In this embodiment, by adjusting the orientation of the notch, the bend can be moved away from the catheter body (4100) as the distance between the two ends of the support member decreases.

As described above, in the denervation catheter according to the present invention, the electrodes (4600) are disposed at the bent portions of the first support member (4510) and the second support member (4520) to move closer to or away from the central axis of the catheter body (4100). Thus, if the catheter according to the present invention is used to perform denervation, the distal end of the catheter (i.e. the catheter tip) can be moved through the blood vessel to the surgical target with the bend of the first support member (4510) with the electrodes (4600) and the second support member (4520) close to the catheter body (4100). Furthermore, if the catheter tip reaches the surgical target, the bend of the first support member (4510) is first removed from the catheter body (4100), and then the bend of the second support member (4520) is removed from the catheter body (4100). Thus, the plurality of electrodes (4600) disposed at the curved portions of the first support member (4510) and the second support member (4520) may contact or approach the inner wall of the blood vessel. In addition, in this state, by emitting energy (e.g., high-frequency energy) generating heat through the electrodes (4600), nerves around the blood vessel can be blocked. Thereafter, if denervation is completed using energy emitted through the electrodes (4600), the bends of the first support member (4510) and the second support member (4520) with the electrodes (4600) are moved closer to the catheter body (4100) again, and the catheter is then removed from the blood vessel or moved to another location.

Here, in a state where the electrode (4600) is moved away from the central axis of the catheter body (4100), the distance between the electrode (4600) and the central axis of the catheter body (4100) may be selected in various ways depending on the size of the surgical object, such as the inner diameter of a blood vessel. For example, in a state where the electrodes (4600) are moved away from the central axis of the catheter body (4100), the distance between each electrode (4600) and the central axis of the catheter body (4100) may be 2mm (centimeters) to 4mm (centimeters).

Preferably, the first support member (4510) and/or the second support member (4520) may include a plurality of unit support members.

For example, as shown in the embodiment of fig. 43, the first support member (4510) and the second support member (4520) may each include two-unit support members. In addition, the first supporting member (4510) and the second supporting member (4520) may also include three or more unit supporting members, respectively.

If the first support member (4510) and the second support member (4520) comprise at least two unit support members, as previously described, an electrode (4600) may be disposed at each unit support member. Therefore, a plurality of electrodes (4600) may be disposed on the first support member (4510) and the second support member (4520), and the electrodes (4600) may be located at different positions. Therefore, in this embodiment, the nerve can be prevented from passing between the electrodes (4600), thereby improving the nerve blocking effect.

The wires (4700) are electrically connected to the plurality of electrodes (4600) respectively to provide a power supply path for the plurality of electrodes (4600). In other words, the wire (4700) is connected between the electrode (4600) and the power supply unit, so that the power supplied from the power supply unit is transferred to the electrode (4600). For example, one end of a wire (4700) is connected to a high-frequency generating unit, and the other end is connected to an electrode (4600), so that energy generated by the high-frequency generating unit is transferred to the electrode (4600), thereby causing the electrode (4600) to generate heat by high frequency.

The wire (4700) may be attached to an upper or lower portion of the first support member (4510) or the second support member (4520), or disposed between the end (4110) of the catheter body and the electrode (4600) at the first support member (4510) or the second support member (4520). Further, the wire (4700) may not be fixed to the first support member (4510) or the second support member (4520), but connected to the electrode (4600) to be separated from the first support member (4510) or the second support member (4520).

Also, the wire (4700) may not be provided as a separate first support member (4510) or second support member (4520), but an integrated support member is implemented. For example, at least a portion of the first support member (4510) may be made using an electrically conductive material such that the region of the first support member (4510) between the intermediate member (4400) and the electrode (4600) may serve as the conductive wire (4700).

In the catheter of the present invention, a first support member (4510) and a second support member (4520) are sequentially arranged along the longitudinal direction of a catheter body (4100). For example, in the catheter according to the embodiment of fig. 43, the catheter body (4100), the second support member (4520) and the first support member (4510) are sequentially arranged in a direction from the proximal end to the distal end.

As described above, since the first support member (4510) and the second support member (4520) are arranged in sequence along the longitudinal direction of the catheter body (4100), the electrode (4600) provided at the first support member (4510) and the electrode (4600) provided at the second support member (4520) can be spaced apart from each other along the longitudinal direction of the catheter body (4100).

In particular, in a state where the bent portions of the first support member (4510) and the second support member (4520) are distant from the catheter body (4100), the electrode (4600) provided at the first support member (4510) and the electrode (4600) provided at the second support member (4520) may be spaced apart from each other by a predetermined distance.

In more detail, in the embodiment of fig. 46, in a state where the first support member (4510) and the second support member (4520) are bent toward the outside of the catheter body (4100), respectively, the electrode (4600) provided at the bent portion of the first support member (4510) and the electrode (4600) provided at the bent portion of the second support member (4520) may be spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (4100), as indicated by d 41.

In the present invention, since the electrode (4600) provided at the first support member (4510) and the electrode (4600) provided at the second support member (4520) are spaced apart from each other by a predetermined distance, as described above, occurrence of stenosis can be avoided. If the plurality of electrodes (4600) emit heat, respectively, the heated portion of the blood vessel may expand toward the inside of the blood vessel. At this time, in the catheter of the present invention, since at least two electrodes (4600) are spaced apart from each other by a predetermined distance in the longitudinal direction of the catheter body (4100), the heated portions of the blood vessels are spaced apart from each other by a predetermined distance in the longitudinal direction of the blood vessels. Therefore, in the present invention, the occurrence of stenosis can be avoided.

Here, in the longitudinal direction of the catheter body (4100), as shown by d41, the distance between the electrode (4600) provided at the first support member (4510) and the electrode (4600) provided at the second support member (4520) may be variously selected depending on the size of the catheter or the surgical object. For example, the catheter may be configured such that, in a state where the electrodes (4600) provided at the first support member (4510) and the electrodes (4600) provided at the second support member (4520) are away from the catheter body (4100), the distance between the electrodes (4600) in the longitudinal direction of the catheter body (4100) is 0.3 to 0.8cm (centimeter). In this embodiment, stenosis of the blood vessel can be avoided and the problem that nerves around the blood vessel pass between the electrodes (4600) and the electrodes (4600) cannot be ablated can be reduced.

Meanwhile, if the plurality of electrodes (4600) are disposed on the first support member (4510) or the second support member (4520), the plurality of electrodes (4600) disposed on the first support member (4510) or the plurality of electrodes (4600) disposed on the second support member (4520) are also spaced apart from each other by a predetermined distance. For example, in the structure described in fig. 46, even if there is no difference in distance between the two electrodes (4600) provided in the first support member (4510) along the longitudinal direction of the catheter body (4100), the two electrodes (4600) may be configured to have different distances.

Preferably, in the present invention, in a state where the bent portions of the first support member (4510) and the second support member (4520) are distant from the central axis of the catheter body (4100) in the longitudinal direction, the plurality of electrodes (4600) may be configured to be spaced apart from each other by a predetermined angle according to the central axis of the catheter body (4100) in the longitudinal direction.

For example, as shown in fig. 48, in a state where the electrodes (4600) provided at the first support member (4510) and the second support member (4520) are moved away from the catheter body (4100), it is assumed that angles among the four electrodes (4600) are g41, g42, g43 and g44, and g41, g42, g43 and g44 have predetermined angles depending on the central axis (o4) of the catheter, so that the four electrodes (4600) are spaced apart from each other by the predetermined angles. For example, g41, g42, g43, and g44 may be the same 90.

As previously mentioned, in embodiments where the electrodes (4600) are spaced apart from each other at a predetermined angle depending on the central axis (o4) of the catheter body (4100), the electrodes (4600) may be constructed in all directions that are widely dispersed around the catheter body (4100). Thus, even if the nerves are distributed at a local site of the blood vessel, the electrode (4600) may cover a large portion of the nerves.

Fig. 50 is a cross-sectional view schematically illustrating the distal end of a denervation catheter according to another embodiment of the present invention, and fig. 51 is a cross-sectional view schematically illustrating the movement of an electrode (4600) away from the catheter body (4100) by the movable member (4200) and the intermediate member (4400) in the configuration of fig. 50.

Referring to fig. 50 and 51, a denervation catheter according to the present invention may include a second actuator (4320).

The second stopper (4320) prevents the distance between the intermediate member (4400) and the catheter body (4100) from decreasing below a predetermined level. To this end, the second detent (4320) may be provided at a portion of the operating member (4300) positioned between the intermediate member (4400) and the tip (4110) of the catheter body. In this case, the second stopper (4320) may be hooked by an operation hole (4120) of the catheter main body (4100) through which the operation member (4300) is insertable.

In more detail, in the catheter according to the embodiment of fig. 50, first, if the operator pulls the operating member (4300) to the left, the intermediate member (4400) is fixed and the movable member (4200) moves in the left direction, wherein the first support member (4510) may be bent due to the decreased distance between both ends. Then, if the first stopper (4310) is caught by the insertion hole (4401) of the intermediate member (4400), the intermediate member (4400) starts to move in the left direction. If so, the distance between the intermediate member (4400) and the end (4110) of the catheter body is reduced, wherein the second support member (4520) may bend as the distance between the two ends is reduced. Thereafter, if the second stopper (4320) is caught by the operation hole (4120) of the catheter body (4100), as shown in fig. 51, the intermediate member (4400) does not move in the left direction, and thus the operator cannot pull the operation member (4300) in the left direction.

In embodiments including a second stop (4320) as described above, operator manipulation may be facilitated and possible damage to various components included in the catheter may be avoided. For example, in the embodiment of fig. 51, the second stopper (4320) may limit the intermediate member (4400) from moving further in the left direction, thereby preventing the intermediate member (4400) from moving too close to the catheter body (4100), thus damaging the second support member (4520) or cutting off the connection between the second support member (4520) and the catheter body (4100), or the connection between the second support member (4520) and the intermediate member (4400). Also, when the operating member (4300) is pushed or pulled, the operator may not be aware of the operating distance of the operating member (4300) since the operating distance is limited by the first stopper (4310) and the second stopper (4320).

In addition, as shown in fig. 50, a denervation catheter according to the present invention may include a reinforcing member (4800).

The reinforcing member (4800) may have a rod or plate shape extending in the longitudinal direction of the catheter body (4100) and disposed between the catheter body (4100) and the movable member (4200). Furthermore, a distal end of the reinforcing member (4800) may be connected and fixed to the movable member (4200) which moves according to the movement of the movable member (4200).

At this time, the first through hole (4130) and the second through hole (4402) may be formed in the tube body (4100) and the intermediate member (4400), respectively, and the reinforcement member (4800) may be inserted through the first through hole (4130) and the second through hole (4402).

In this embodiment, as shown in fig. 51, if the movable member (4200) is moved in the left direction, the reinforcing member (4800) may also be moved in the left direction. At this time, the reinforcement member (4800) is inserted into the first through hole (4130) of the catheter body (4100) and the second through hole (4402) of the intermediate member (4400) so that the reinforcement member (4800) can slide through the first through hole (4130) and the second through hole (4402) according to the movement of the movable member (4200).

In this embodiment, the connections among the catheter body (4100), the intermediate member (4400), and the movable member (4200) can be more strongly supported by the reinforcing member (4800). In other words, if the movable member (4200) is separated from the intermediate member (4400) as in this embodiment, in the case of connecting the catheter body (4100), the intermediate member (4400) and the movable member (4200) by using a single operation member (4300), the connection state and the supporting force among the catheter body (4100), the intermediate member (4400) and the movable member (4200) may be weak. However, as in this embodiment, if the reinforcing member (4800) is provided to separate the operating member (4300), the supporting force of the catheter body (4100) in which the movable member (4200) and the intermediate member (4400) are separated can be further reinforced, and the connected state among the catheter body (4100), the intermediate member (4400), and the movable member (4200) can be more firmly maintained. In addition, since the reinforcing member (4800) guides the movement of the movable member (4200) and the intermediate member (4400), the movement direction of the movable member (4200) and the intermediate member (4400) can be properly maintained without deviating from the central axis of the catheter body (4100).

Meanwhile, in the embodiment including the reinforcement member (4800), the first stopper (4310) and/or the second stopper (4320) may be provided at the reinforcement member (4800). In other words, the first brake (4310) and/or the second brake (4320) may be provided not at the operating member (4300) but at the reinforcement member (4800); alternatively, the first brake (4310) and/or the second brake (4320) may be provided at both the operating member (4300) and the strengthening member (4800).

Furthermore, even though the embodiment of fig. 50 and 51 illustrates the provision of one stiffening member (4800), two or more stiffening members (4800) may be provided.

Moreover, even though some of the figures depict only one operating member (4300) being provided, two or more operating members (4300) may be provided.

Fig. 52 is a cross-sectional view schematically illustrating the distal end of a denervation catheter according to another embodiment of the present invention, and fig. 53 is a cross-sectional view schematically illustrating the movement of an electrode (4600) away from the catheter body (4100) by the movable member (4200) and the intermediate member (4400) in the configuration of fig. 52.

Referring to fig. 52 and 53, the catheter body (4100) may have a guide hole (4140) formed at the distal end thereof such that a guide wire (W4) may pass through the guide hole. Here, the guide wire (W4) guides the catheter to the surgical target, and the surgical target before the catheter can be reached. In this embodiment, the guide wire (W4) can be inserted into the catheter through the guide hole (4140), and the tip of the catheter can reach the surgical target along the guide wire (W4).

The catheter body (4100) may have one or more guide holes (4140). For example, as shown in fig. 52 and 53, the catheter body (4100) has: a first via hole (4141) formed at an end thereof; and a second guide hole (4142) formed at a position of the distal end (4110) of the conduit body spaced apart by a predetermined distance. In this case, the wire (W4) can be inserted into the lumen of the catheter body (4100) through the first guide hole (4141), and then pulled out of the catheter body (4100) through the second guide hole (4142). However, the second guide hole (4142) may not be provided, and in this case, the wire (W4) inserted into the lumen of the catheter body (4100) through the first guide hole (4141) may be extended along the lumen of the catheter body (4100) and then pulled out of the catheter body (4100) at the proximal end of the catheter body (4100).

If a second via (4142) is provided, the second via may be located at a different position depending on the situation. In particular, the second guide hole (4142) may be formed at a point spaced apart from the tip end (4110) of the catheter body by 10cm (centimeter) to 15cm (centimeter) in the longitudinal direction of the catheter body. Even though FIG. 52 shows the second guide hole (4142) near the end (4110) of the catheter body, this is for illustration only, and as shown at L43, the distance from the end of the catheter body to the second guide hole may be 10cm (centimeters) to 15cm (centimeters). In this embodiment, when the catheter body is moving, the problem that the guide wire pulled out of the catheter body through the second guide hole is entangled with the catheter body can be prevented, thereby facilitating smooth movement of the catheter body. However, the present invention is not limited to such a position of the second via hole.

Also, in this embodiment, a via (4210) may be formed in the movable member (4200) such that a wire (W4) may pass through the via, and a via (4403) may also be formed in the intermediate member (4400) such that a wire (W4) may pass through the via.

As described above, in the embodiment in which the guide hole (4140) is formed in the catheter body (4100), since the guide wire (W4) inserted into the guide hole (4140) guides the movement of the tip portion of the catheter, the catheter can smoothly reach the surgical target and the catheter can be easily manipulated. Furthermore, since the catheter does not need to include an adjustment member for adjusting the moving direction of the catheter, the catheter can have a more compact structure, which can advantageously reduce the size of the catheter.

Also preferably, the denervation catheter according to the present invention may further comprise an elastic member (4900).

One end of the resilient member (4900) may be coupled to the intermediate member (4400) to provide a restoring force when the intermediate member (4400) is moving. For example, as shown in fig. 52, a resilient member (4900) may be connected between the tip end (4110) of the catheter body and the intermediate member (4400). In this case, as shown in fig. 53, if the operating member (4300) is continuously pulled in the left direction after the first stopper (4310) is hooked by the insertion hole of the intermediate member (4400), the intermediate member (4400) moves in the left direction. In this case, the restoring force (i.e., elastic restoring force) of the elastic member (4900) is applied in the right direction. Therefore, after the electrode (4600) completely blocks the nerve, the intermediate member (4400) should be moved again in the right direction and return to its original state, as shown in fig. 52. Here, the activity of the middle member (4400) in the right direction can be more easily performed via the restoring force of the elastic member (4900). Thus, after the electrode (4600) blocks a nerve, the operator does not need to apply force to move the electrode (4600) closer to the central axis of the catheter body (4100).

In addition, as described above, in the embodiment in which the elastic member (4900) is provided, when the catheter tip portion is moving, the electrode (4600) can be prevented from deviating from the central axis of the catheter main body (4100), and thus damage to the blood vessel due to protrusion of the electrode (4600) can also be prevented, and easy movement of the catheter tip portion is facilitated. Also, even if the second stopper (4320) is not provided, the movable distance of the intermediate member (4400) can be restricted by the elastic member (4900), so that damage of various components due to excessive movement of the intermediate member (4400) can be prevented.

Furthermore, if the resilient member (4900) is provided between the distal end (4110) of the catheter body and the intermediate member (4400), as in this embodiment, the intermediate member (4400) is prevented from pushing towards the distal end (4110) of the catheter body when the movable member (4200) is moving to bend the first support member (4510). Therefore, the problem of incomplete bending of the first support member (4510) due to movement of the intermediate member (4400) before the first support member (4510) is completely bent can be avoided.

Further, in the structure described in fig. 52 and 53, even if the elastic member (4900) is provided between the intermediate member (4400) and the catheter body (4100), the elastic member (4900) may be provided between the intermediate member (4400) and the movable member (4200). Moreover, at least two resilient members (4900) may also be disposed at different locations on the catheter.

Also, even though various embodiments illustrate only a single intermediate member (4400) disposed between the movable member (4200) and the distal end (4110) of the catheter body, two or more intermediate members (4400) may be disposed therebetween.

Figure 54 schematically illustrates a cross-sectional view of the distal end of a denervation catheter, according to another embodiment of the present invention.

Referring to fig. 54, the intermediate element (4400) may include a plurality of unit intermediate elements. Here, the cell intermediate element represents an individual cell intermediate element in the case where a plurality of intermediate elements (4400) are provided. Fig. 54 shows that the intermediate member (4400) is composed of a two-unit intermediate member. Here, the unit intermediate member at the right portion of fig. 54 is referred to as a first unit intermediate member (4410), and the unit intermediate member at the left portion is referred to as a second unit intermediate member (4420).

In this structure, the first unit intermediate member (4410) may be connected to a proximal end of the first support member (4510), and the second unit intermediate member (4420) may be connected to a distal end of the second support member (4520).

As previously described, in embodiments where the intermediate member (4400) comprises a plurality of unit intermediate members, the catheter may comprise a single support member, as well as a first support member (4510) and a second support member (4520).

For example, the catheter may include a third support member (4530) interposed between the first unit intermediate member (4410) and the second unit intermediate member (4420). The third support member (4530) may be connected and fixed at a distal end thereof to the first unit intermediate member (4410), and may be connected and fixed at a proximal end thereof to the second unit intermediate member (4420).

The third support member (4530) may be configured to have a shape similar to the first support member (4510) and the second support member (4520) even if the position of the third support member is different from the other members. For example, the third supporting member (4530) may be configured such that at least a portion thereof is bent as the distance between both ends thereof decreases. At this time, the bending direction may be formed to the outside of the catheter body (4100) such that the bending part is gradually moved away from the central axis of the catheter body (4100) as the distance between both ends thereof is reduced. In addition, the third support member (4530) may have an electrode (4600) at the bent portion.

Moreover, in an embodiment where the intermediate member (4400) includes a plurality of unit intermediate members, a stopper may be further included in addition to the first stopper (4310).

For example, as shown in fig. 54, the catheter may further include a third actuator (4330) to move the second unit intermediate member (4420). Here, a third stopper (4330) may be provided at a predetermined position of the operation member (4300) between the first unit intermediate member (4410) and the second unit intermediate member (4420).

In this embodiment, if the operator pulls the operating member (4300), first, the movable member (4200) is moved such that the distance between the first unit intermediate member (4410) and the movable member (4200) is decreased, thereby bending the first support member (4510). Thereafter, if the first stopper (4310) is hooked by the insertion hole (4401) of the first unit intermediate member (4410), the first unit intermediate member (4410) starts to move such that the distance between the first unit intermediate member (4410) and the second unit intermediate member (4420) decreases, thereby bending the third support member (4530). Thereafter, if the third stopper (4330) is hooked by the insertion hole (4401) of the second unit intermediate member (4420), the second unit intermediate member (4420) starts to move such that the distance between the second unit intermediate member (4420) and the catheter main body (4100) is reduced, thereby bending the second support member (4520).

In other words, in this embodiment, if the operator pulls the operating member (4300), the first support member (4510) may bend first, the third support member (4530) may bend in the second order, and the second support member may bend in the third order.

As previously mentioned, in embodiments where the plurality of intermediate members (4400) are comprised between the moveable member (4200) and the end (4110) of the catheter body, the plurality of electrodes (4600) may in some stages be arranged at a predetermined distance from each other in the longitudinal direction of the catheter body (4100). In addition, the electrodes (4600) may be arranged at more angles depending on the central axis of the catheter body (4100). For example, in the embodiment of fig. 54, six electrodes (4600) disposed on a first support member (4510), a second support member (4520), and a third support member (4530) may be disposed in a widely dispersed arrangement with adjacent electrodes using an angle of 60 ° depending on the central axis (o4) of the catheter body. In this embodiment, the nerve blocking effect can be further improved by the electrodes (4600).

In particular, the temperature measuring member may be disposed around the electrode (4600) to measure the temperature of the electrode (4600) or around the electrode (4600). Further, as mentioned above, the temperature measured by the temperature measuring means may be used to control the temperature of the electrode (4600). Here, the temperature measurement member may be connected to the lead (4700) through a separate wire that may extend through the lumen of the catheter body (4100) to the proximal end of the catheter body (4100) and out of the catheter body (4100).

Meanwhile, even though various embodiments illustrate that the movable member (4200) is provided outside the catheter body (4100), the present invention is not limited thereto.

Fig. 55 is a cross-sectional view schematically illustrating the distal end of a denervation catheter, according to another embodiment of the present invention, and fig. 56 is a cross-sectional view illustrating the catheter of fig. 55 along the longitudinal direction. However, features described using the embodiments with respect to fig. 43-54 will not be described in detail, but different features will be described in detail.

Referring to fig. 55 and 56, the moveable element (4200) and the intermediate element (4400) may be disposed within the inner lumen of the catheter body (4100). Further, the movable member (4200) and the intermediate member (4400) are movable in a lateral direction of the inner cavity of the catheter body (4100).

Furthermore, the movable member (4200) may be close to the proximal end of the catheter (in the left direction of fig. 56) compared to the intermediate member (4400), and the operating member (4300) may be connected and fixed to the movable member (4200).

Here, the proximal end of the first support member (4510) may be connected and fixed to the movable member (4200), and the distal end thereof may be connected and fixed to the intermediate member (4400). Further, a proximal end of the second support member (4520) may be connected and fixed to the intermediate member (4400) and a distal end thereof may be connected and fixed to a tip (4110) of the catheter body.

Furthermore, the first support member (4510) and the second support member (4520) may be bent to the outside of the catheter body (4100), similar to the previous embodiment, as the distance between their ends is reduced, so that the electrode (4600) disposed at the bend is moved away from the catheter body (4100).

Meanwhile, as shown in fig. 55 and 56, the first stopper (4310) may be provided to protrude toward the movable member (4200) on at least a portion of the intermediate member (4400) to limit a distance between the movable member (4200) and the intermediate member (4400) and also to allow the intermediate member (4400) to move according to the operation of the operating member (4300). In another case, the first stopper (4310) may also be provided with an intermediate member (4400) extending to at least a part of the movable member (4200).

In this embodiment, because movable member (4200) is near the proximal end of the catheter, movable member (4200) may move in the right direction of fig. 56 if the operator pushes on operating member (4300) as compared to intermediate member (4400).

Fig. 57 is a sectional view schematically showing that in the structure of fig. 56, the movable member (4200) is moved in the right direction.

Referring to fig. 57, if the movable member (4200) moves in the right direction, the distance between the movable member (4200) and the intermediate member (4400) decreases since the intermediate member (4400) does not move in the initial stage. Thus, the first support member (4510) can be bent toward the outside of the catheter body (4100), and thus the electrode (4600) provided at the bent portion of the first support member (4510) can be moved away from the central axis of the catheter body (4100).

Thereafter, if the movable member (4200) reaches the first stopper (4310), the distance between the movable member (4200) and the intermediate member (4400) is not reduced at all due to the first stopper (4310). Further, if the operator continues to push the operating member (4300), the intermediate member (4400) may move in the right direction of fig. 57.

Fig. 58 is a sectional view schematically showing that the intermediate member (4400) is moved in the right direction in the structure of fig. 57, and fig. 59 is a perspective view of fig. 58.

Referring to fig. 58 and 59, if the intermediate member (4400) moves in the right direction, the distance between the end (4110) of the catheter body and the intermediate member (4400) decreases. Therefore, the second support member (4520) can be bent to the outside of the catheter body (4100), and thus the electrode (4600) provided at the bent portion of the second support member (4520) can be moved away from the central axis of the catheter body (4100).

In addition, in the embodiment of fig. 55 to 59, the first support member (4510) and the second support member (4520) (including the plurality of electrodes (4600) disposed on the support members) located in the inner cavity of the catheter body (4100) may extend to the outside of the catheter body (4100) according to the movement of the movable member (4200) and the intermediate member (4400). To this end, the catheter body (4100) may have an opening (4150) through which the first and second support members (4510, 4520) and the electrode (4600) may protrude to the outside. In other words, if the movable member (4200) and the intermediate member (4400) are moved such that the distance between the two ends of the first support member (4510) or the second support member (4520) is reduced, the first support member (4510) or the second support member (4520), and the curved portion of the electrode (4600) can be pulled out of the catheter body (4100) through the opening (4150) of the catheter body (4100). At the same time, if the movable member (4200) and the intermediate member (4400) are moved such that the distance between the two ends of the first support member (4510) or the second support member (4520) is increased, the first support member (4510) or the second support member (4520), and the curved portion of the electrode (4600) can be inserted into the inner cavity of the catheter body (4100) through the opening (4150) of the catheter body (4100).

Meanwhile, the features of the embodiment of fig. 43 to 54 may also be applied to the catheter according to the embodiment of fig. 55 to 59.

For example, in the embodiment of fig. 55 to 59, in a state where the bent portions of the first support member (4510) and the second support member (4520) are distant from the catheter body (4100), the plurality of electrodes (4600) may be spaced apart from each other at a predetermined angle in the longitudinal direction according to the central axis of the catheter body (4100).

In addition, in the embodiment of fig. 55 to 59, a plurality of intermediate members (4400) may be provided, and may further include a second stopper (4320) or a resilient member (4900). In particular, a second stop (4320) may be disposed between the intermediate member (4400) and the terminal end (4110) of the catheter body to limit a distance between the intermediate member (4400) and the terminal end (4110) of the catheter body.

Referring to fig. 60, a denervation catheter according to the present invention may further include an end tip (4950).

The tip (4950) is disposed on a front surface of the catheter body (4100) and the distal end of the moveable member (4200). For example, in the embodiment of fig. 60, if the movable member is near the distal end, the tip (4950) may be disposed at a front surface of the distal end of the movable member as compared to the catheter body. However, as in the embodiment of fig. 55, if the tip of the catheter body is near the distal end, as compared to the movable member, the tip (4950) may be disposed on the front surface of the distal end of the catheter body. In other words, the tip (4950) may be considered distal to the distal end of the catheter body and the movable member. In this case, the tip (4950) may be a component used as the tip of a denervation catheter according to the present invention.

Also, the tip (4950) may be configured to separate the movable member or catheter body. For example, in the configuration of fig. 60, the tip (4950) may disengage the movable member. In this case, if the operating member operates to move the movable member, the tip (4950) does not move, and the distance between the movable member and the tip (4950) may change. However, the tip (4950) may also be fixed to the moveable member or catheter body.

The tip (4950) may be made of a soft and resilient material. In particular, the tip (4950) may be made from a composition containing Polyether Block Amide (PEBA). Here, the composition of the tip (4950) may include other additives, as well as polyether block amides. For example, the tip (4950) may be made from a composition containing 70 wt.% polyether block amide and 30 wt.% barium sulfate, based on the total weight of the composition.

In this configuration of the invention, the tip (4950) made of a soft and resilient material is positioned in a forward-most position when the distal end (4101) of the catheter body is moved along a blood vessel or the like, which reduces damage to the blood vessel and facilitates easier changing of the direction of movement. Further, a tip portion (4950) made of the above material can be radiographed, and thus, a position of the distal end of the catheter main body can be easily determined.

Preferably, the tip portion (4950) may have a hollow tubular shape. Further, the lumens of the tip portion (4950) may extend in the same direction longitudinally of the catheter body. If the tip (4950) is tubular as described above, a wire may be passed through the lumen of the tip (4950). For example, the tip portion may have a tubular shape with a length of 6mm (millimeters) and a cavity diameter of 0.7mm (millimeters).

The tip portion may extend in a longitudinal direction of the catheter body. In this case, the tip portion may have different dimensions along its length. In particular, if the tip portion has a cylindrical shape, a distal end of the tip portion may have a minimum diameter compared to other regions. For example, the distal end of the tip may have a minimum diameter of 1.1mm (millimeters) in diameter, while the thickest region of the tip has a diameter of 1.3mm (millimeters).

The tip portion (4950) may have a suitable length that is not too long or too short. For example, in the configuration of fig. 60, the tip (4950), indicated by L44, may be 5mm (millimeters) to 15mm (millimeters) in length. In this configuration, the movement is prevented from being disturbed by the tip (4950) when the catheter is moved along the lumen of the blood vessel or the lumen of the sheath. Further, in this structure, from a curve shape or a curve direction of the tip portion (4950), a shape of a blood vessel or the like in which the tip portion (4950) is located can be easily determined.

In addition, the denervation catheter according to the present invention may further include a through tube (not shown). The through-tube may have a hollow tubular shape, the through-tube being included in the lumen of the catheter body, and the operating member may be located in the lumen of the through-tube. In other words, the operating member is movable in a state of being inserted into the lumen of the through-tube. In this case, the tube may be exposed to the lumen and exterior of the catheter body. For example, in the structure of fig. 60, the through-tube may be provided in a space between the catheter main body and the movable member. In addition, the movable member has a movable ring shape when the movable member surrounds the outer circumference of the through tube. In this structure, a moving path of the movable member can be fixed, and the coupling force between the catheter main body and the movable member is further strengthened.

Meanwhile, even though the drawings illustrating the above embodiments illustrate that two first support members (4510) and two second support members (4520) are used, the present invention is not limited to a specific number of support members. In other words, the number of the first supporting members (4510) and the second supporting members (4520) may be three or more, and may also be different from each other.

For example, two first support members (4510) and four second support members (4520) may be provided. In particular, in the structure depicted in fig. 43, if the number of the second support members (4520) is greater than the number of the first support members (4510), when the operator pulls the operating member (4300), a phenomenon in which the intermediate member (4400) moves to cause the second support members (4520) to bend before the first support members (4510) bend completely can be prevented.

Furthermore, even though various embodiments illustrate that one electrode (4600) is disposed at each unit supporting member included in the first supporting member (4510) and the second supporting member (4520), two or more electrodes (4600) may be disposed at each unit supporting member, and some unit supporting members may not be provided with electrodes.

A denervation apparatus according to the present invention includes a denervation catheter. In addition, the denervation device comprises the denervation catheter, and further comprises an energy supply unit and an opposite electrode. Here, the energy supply unit may electrically connect the electrodes (4600) through wires (4700). In addition, the opposite electrode can be electrically connected to the power supply unit through a lead wire (4700) different from the lead wire (4700). In this case, the energy supply unit may supply energy to the electrode (4600) of the catheter in a high frequency or the like, and the electrode (4600) of the catheter generates heat to ablate the nerve around the blood vessel, thereby blocking the nerve.

The present invention has been described in detail. It should be understood, however, that the detailed description and specific examples, while indicating preferred embodiments of the invention, are given by way of illustration only, since various changes and modifications within the spirit and scope of the invention will become apparent to those skilled in the art from this detailed description.

Furthermore, even though directional terms such as proximal, distal, upper, lower, right, left or the like have been used in this specification, for convenience, the terms are used only to indicate relative positions, and other terms as would be apparent to those skilled in the art may be substituted depending on the viewer's viewpoint or configuration of the component.

Claims

1. A denervation catheter, comprising:

a catheter body extending in a direction having a proximal end and a distal end and having a lumen formed longitudinally;

a movable member disposed at the distal end of the catheter body, movable along the longitudinal direction of the catheter body;

an operating member having a distal end connected to the movable member to move the movable member;

a plurality of support members having one end connected to an end of the catheter body and the other end connected to the movable member, wherein when the movable member moves to reduce the distance between the end of the catheter body and the movable member, at least a portion of the plurality of support members bends such that the bend moves away from the catheter body;

a plurality of electrodes respectively disposed at the bent portions of the plurality of support members to generate heat; and a conducting wire, it connects said multiple electrodes electrically separately, in order to provide a power supply route to said multiple electrodes;

wherein at least one of the catheter body and the movable member is connected with at least two support members at several points spaced apart from each other by a predetermined distance in a longitudinal direction of the catheter body.

2. The denervation catheter according to claim 1, wherein the movable member is disposed outside of the catheter body.

3. The denervation catheter according to claim 2, further comprising a reinforcing member extending in the longitudinal direction of the catheter body and disposed between the catheter body and the movable member, wherein a distal end of the reinforcing member is fixed to the movable member and a proximal end of the reinforcing member is inserted into a through hole of the catheter body such that the proximal end of the reinforcing member can move through the through hole of the catheter body according to the movement of the movable member.

4. The denervation catheter according to claim 1, wherein the movable member is disposed in the lumen of the catheter body; and

wherein the catheter body has an opening through which the curved portion of the support member can be pulled out of the catheter body when the support member is curved.

5. The denervation catheter according to claim 1, wherein the plurality of electrodes are spaced apart from each other by a predetermined distance in a longitudinal direction of the catheter body in a state in which the curved portion of the support member is moved away from the catheter body.

6. The denervation catheter according to claim 5, wherein the plurality of electrodes are spaced apart from each other by 0.3cm to 0.8cm in a longitudinal direction of the catheter body in a state where the curved portion of the support member is moved away from the catheter body.

7. The denervation catheter according to claim 5, wherein at least one of the plurality of support members has an arc-shaped portion to define the curved portion according to the movement of the movable member.

8. The denervation catheter according to claim 5, wherein at least one of the plurality of support members is pre-shaped to define the curve upon movement of the movable member.

9. The denervation catheter according to claim 1, wherein the plurality of electrodes are spaced apart from each other at a predetermined angle in the longitudinal direction according to a central axis of the catheter body in a state where the curved portion of the support member is moved away from the catheter body.

10. The denervation catheter according to claim 1, wherein the plurality of electrodes generate heat via radio frequency.

11. The denervation catheter according to claim 1, wherein the catheter body has a guide hole formed at a distal end thereof such that a guide wire can move through the guide hole.

12. The denervation catheter according to claim 1, further comprising at least one brake for limiting a movement distance of the movable member.

13. The denervation catheter according to claim 12, wherein the at least one brake is fixed to the operating member.

14. The denervation catheter according to claim 12, wherein the at least one brake is fixed to the catheter body.

15. The denervation catheter according to claim 1, further comprising an elastic member coupled to the movable member to provide a return force related to movement of the movable member.

16. The denervation catheter according to claim 1, further comprising an end tip made of a composition containing polyether block amide and positioned at the distal end of the catheter body and a front surface of the movable member.

17. The denervation catheter according to claim 1, wherein at least one of the catheter body and the movable member has a step formed on a surface connecting the support member.

18. The denervation catheter according to claim 1, wherein at least one of the catheter body and the movable member is inclined on a surface connecting the support member.

19. The denervation catheter according to claim 1, wherein a surface of the catheter body connecting support member and a surface of the movable member connecting support member are mated with each other.

20. The denervation catheter according to claim 1, wherein a portion of the support member in the width direction has an outer surface length that is longer than an inner surface length thereof.

21. A denervation device comprising a denervation catheter as defined in claim 1.