Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a medical guidewire including a core wire. The core wire may include a distal constant diameter, a first tapered section, an intermediate constant diameter section, a second tapered section, and a proximal constant diameter section. The distal end of the first tapered section may be attached to the proximal end of the distal constant diameter section such that a first inflection point is defined where the distal end of the first tapered section and the proximal end of the distal constant diameter section meet. The core wire may be configured such that when a first predetermined longitudinal force is applied to the distal end of the distal constant diameter section along the longitudinal axis, the distal constant diameter section prolapses such that a first loop is defined about the first inflection point.

Abstract: A therapeutic or diagnostic instrument includes first and second shaped wire members and that can be simultaneously inserted into a catheter tube and has predetermined bending elasticity, in which the first and second shaped wire members and are adapted to respectively have first and second curving parts that curve in a natural state, and when inserted into the catheter tube, curve the catheter tube at two desired positions correspondingly with the first and second curving parts.

Abstract: An intravascular ultrasound “(IVUS”) device having an intrinsic or attachable needle guide is disclosed. In some embodiments, a sheath having a needle guide is used in connection with an IVUS device. The devices may be used in performing minimally invasive image-guided surgical procedures. The devices may be configured to maintain a needle placed through guide in the plane of the IVUS-array to improve visualization of the needle. In some embodiments, the device is used to facilitate the creation of a tract through the liver from the inferior vena cava to the portal vein using IVUS-guidance in a direct intrahepatic portocaval shunt procedure. The devices, systems, and methods can improve patient safety by decreasing the risk of off-target punctures, decrease procedure times, and allow procedures to be performed from a single access site.

Abstract: A distal embolic protection device for dedicated use in cerebral arterial blood vessels is described. The distal embolic protection device comprises a variable-thickness micro-guidewire and a collapsible filtering device mounted on the microguidewire over two mobile attachment points so that in its collapsed configuration, the thickness of the microguidewire and the filtering device at this region is less than or equal to 0.017 inch (0.432 mm) in thickness to be able to pass through existing conventional microcatheters. The mobile attachment points allow for rotatory and longitudinal mobility of the microguidewire while the filtering device is stable thereby decreasing the risk of trauma to the fragile cerebral arterial blood vessels. Preferably, the filtering device comprises an expansion assembly, e.g., a plurality of struts attached to a filter membrane that are in a folded position which self expand to the desired dimensions within the cerebral blood vessels.

Abstract: The present invention relates to a system and method for positioning a sheath and guiderail catheter into the Coronary Sinus (CS) to introduce pacing therapy within a heart of a subject. The guiderail catheter can be customized into a shape compatible with the subject's anatomy and also provide for shapeability of the guiderail catheter. The method includes introducing the sheath into the heart of the subject, with the sheath positioned in the right atrium. The guiderail catheter is introduced into the heart of the subject through the distal end of the sheath and advanced past the distal end of the sheath into the right atrium of the heart to a position near the septum and further guiding the distal end of the guiderail catheter into the coronary sinus.

Abstract: A guide wire includes a wire body having a first wire disposed at a distal end and a second wire joined to a proximal end of the first wire at a joint by welding. The joint is curved. In the joint, at least one component (e.g., Ti) of the material of the first wire decreases toward the proximal end and at least one component (e.g., Fe) of the material of the second wire decreases toward the distal end. When a tensile test is conducted on a region of the wire body including the joint, the region of the wire body has, in a tensile load and elongation diagram, an elastic section extending substantially straight upwardly to the right, a yield section extending substantially horizontally or upwardly to the right from the elastic section, and a substantially straight section extending upwardly to the right from the yield section.

Abstract: A guidewire includes a core shaft, an outer coiled body covering at least a portion of the core shaft, and an inner coiled body positioned between the outer coiled body and the core shaft. The inner coiled body covers the at least a portion of the core shaft and a resin material is filled between the inner coiled body and one of the outer coiled body and the core shaft to form a resin layer. Preferably, a space between the inner coiled body and the other of the outer coiled body and the core shaft is not filled with the resin material.

Abstract: A guide wire includes an elongate wire body, and a marker at least at a distal-side portion of the wire body over the whole circumference to indicate the intracorporeal position of the wire body. The marker has a first line-forming portion and a second line-forming portion which intersect each other at a plurality of locations so that the marker has a grid-like shape as a whole. According to another aspect, a guide wire includes a member with a core wire, a marker-forming layer partly encircling the outer surface of the member and differing in color from the member, and a coating layer covering the marker-forming layer and the member at least in the marker-forming layer region and having transparency making the marker-forming layer visible. The marker-forming and coating layers can be formed from mutually miscible resins, while the marker-forming layer functions as a visible marker.

Abstract: A novel approach to diagnostic and therapeutic interventions in the peritoneal cavity is described. More specifically, a technique for accessing the peritoneal cavity via the wall of the digestive tract is provided so that examination of and/or a surgical procedure in the peritoneal cavity can be conducted via the wall of the digestive tract with the use of a flexible endoscope. As presently proposed, the technique is particularly adapted to transgastric peritoneoscopy. However, access in addition or in the alternative through the intestinal wall is contemplated and described as well. Transgastric and/or transintestinal peritoneoscopy will have an excellent cosmetic result as there are no incisions in the abdominal wall and no potential for visible post-surgical scars or hernias.

Abstract: A catheter having an elongated shaft and a balloon on a distal shaft section, the elongated shaft comprising an outer tubular member, and an inner tubular member which has a bonded portion along which an outer surface of the inner tubular member is bonded to an inner surface of the outer tubular member. The inner tubular member has a proximal portion proximal to the bonded portion, and a distal portion distal to the bonded portion with higher axial compression stiffness and column strength than the proximal portion thereof. The catheter has improved trackability, axial collapse resistance, pushability, and crossability, for improved ability to position the balloon at a desired location in a patient's body lumen.

Abstract: A coil body has high flexibility, satisfactorily tracks a complicated shape, and remarkably transmits fine vibrations occurring on a part of the coil body. A guide wire uses the coil body. The coil body is formed by helically winding a stranded wire including a plurality of stranded element wires. The stranded wire has a first gap as a hollow at the center of the stranded wire.

Abstract: Provided is a guidewire including a core shaft, an outer flexible tube, a stranded wire that extends parallel to the core shaft, and a hollow stranded-wire coil disposed in the outer flexible tube. The hollow stranded-wire coil is formed of multiple strands and surrounds the distal end portion of the core shaft and the stranded wire. Distal ends of the hollow stranded-wire coil, the core shaft, and the stranded wire are joined to a distal end of the outer flexible tube.

Abstract: [Issue] To provide a guidewire insertion aid which is very easy to operate because a lubricated guidewire can be easily fed out. [Means of Resolution] A guidewire insertion aid 11 according to the present invention is used for feeding out a guidewire 1 inserted in a housing 2 in order to insert said guidewire into the lumen of a piece of medical equipment. The insertion aid 11 comprises: a main body 21, a housing support part 22 and a guidewire support part 26. A sliding contact part 28 is disposed between the housing support part 22 and the guidewire support part 26. The sliding contact part 28 extends in the lengthwise direction of the main body and has a sliding contact surface 28 for the guidewire 1. A feed-out member 51 is provided on the main body 21 and has a water-retentive water-retention member 52. The feed-out member 51 is disposed with the water-retention member 52 side thereof facing towards the sliding contact surface 29.

Abstract: Catheter ultrasound systems including a sheath, a handle, a sheath lumen, and an ultrasound catheter disposed within the lumen of the sheath with ultrasound elements capable of visualizing anatomical regions. The handle allowing the ultrasound catheter to rotate with respect to the sheath using a rotation adjustment knob within the handle or alternatively an separate manipulation handle attached to the proximal end of the ultrasound catheter. The sheath, ultrasound catheter, or both may also include one or more electrodes or other location sensor for both orienting the ultrasound element as well as for diagnostic purposes.

Abstract: A coupling wire guide for intracorporeal procedures that may be coupled to a previously introduced wire guide, thereby permitting introduction of the coupling wire guide separately and identically in a manner that is both reliable as well as traceable. One embodiment of the wire guide includes a main body having a distal end and a tip portion connected to the distal end of the main body. The tip portion defines an axial passageway having a distal opening and a proximal opening, the passageway being sized to receive a second wire guide therein. The tip portion includes a linking member connected to the distal end of the main body to provide a secure connection between the distal end of the main body and the tip portion.

Abstract: A steering tool includes an internal tube disposed inside an external tube. The internal and external tubes are arranged for longitudinal axial movement relative to one another. A distal end of the internal tube is fixedly joined to a distal end of the external tube. At least one of the internal and external tubes is slotted near the distal end thereof, and the longitudinal axial movement causes bending of the distal ends of the tubes.

Abstract: The endoscope treatment system includes an endoscope treatment tool that has an operating section including a distal end and a proximal end, and a sheath that is connected to the distal end of the operating section and is formed with a lumen into which the guide wire is capable of being inserted; a guide wire holder that has a tube member, in which the guide wire is accommodated, and that is circumferentially wound; and a fixing member that couples the operating section to the guide wire holder so that the distal end and the proximal end of the operating section are located outside the circumference of the guide wire holder.

Abstract: Guide wires including a guide wire tip portion including a distal tip portion and a proximal tip portion, where the tip portion includes a circular cross-section and substantially constant diameter along both a linear elastic distal tip portion and a superelastic proximal tip portion. Methods for manufacture include providing a superelastic wire (e.g., nitinol) including a length so as to define both a distal tip portion and a proximal tip portion. The distal tip portion is cold worked, without imparting significant cold work to the proximal tip portion, to provide linear elastic properties within the distal tip portion, while the proximal tip portion maintains superelastic properties. The tip portion is ground or otherwise reduced in cross-sectional thickness after cold working of the distal tip portion, so as to provide a circular cross-section having a desired substantially constant diameter along both the distal tip portion and the proximal tip portion.

Abstract: Disclosed herein is a removable cap for connection to an input port of a catheter, comprising a proximal end having a lumen configured to house a guidewire therethrough; a distal end configured to reversibly mate with a luer lock of the input port of a catheter, the distal end having a lumen configured to house the guidewire therethrough; and a tubular body between the proximal end and the distal end, wherein the tubular body comprises an anti-migration feature transformable between a first configuration to allow slidable movement of the guidewire within the cap in a first direction toward the patient, and a second configuration to prevent slidable movement of the guidewire within the cap in the first direction toward the patient. Systems and methods are also disclosed.

Abstract: A guide wire includes a core shaft, a coil body which covers the core shaft, and a coating film which covers the coil body. Portions of the coating film are disposed between adjacent coils of coil body, and gaps are formed between the coils and the portions of the coating film disposed between the adjacent coils. Due to this configuration, the coating the film can be easily bent, and thus the coil body may easily bend. As a result, it is possible to ensure lubricity of guide wire within the blood vessel while also enabling the guide wire to follow the shape of the blood vessel in which it is inserted.

Abstract: In a coil-type guidewire, a coating portion of the coil portion is formed by stacking a plurality of films. An innermost film of the coating portion is arranged to come between adjacent coils of the coil body, and voids are formed between the innermost film and a film disposed outside of the innermost film. By forming such voids, it is possible to easily bend the coating portion and to improve flexibility of the coating portion. As a result, the guidewire in which the coil body is covered with the coating portion and the coil body (the guidewire) can be easily curved.

Abstract: A guidewire for use in a medical procedure includes an elongate guide member dimensioned for insertion within a body vessel of a subject. The guide member includes an elongate body segment and a leading tip segment. The elongate body segment defines a longitudinal opening, and the leading tip segment is adapted and dimensioned to articulate relative to the elongate body segment about a single axis. A control element extends through the longitudinal opening of the elongate body segment and is longitudinally movable through manual manipulation of a clinician to cause corresponding articulating movement of the leading tip segment.

Abstract: Devices and methods for guidewire assisted placement of catheters into blood vessels are described. Some of the devices and methods relate to automated or partially automated or assisted insertion and placement of an intravenous catheter into a vein or artery of a patient. Other of the devices are blood draw devices and methods for insertion and placement of an intravenous device into a vein or artery of a patient or to withdraw a blood sample from the patient. The devices also provide for guide wire tip inspection after use.

Abstract: A medical operation device is attachable to an insertion portion of a medical instrument for observation.

Abstract: A medical device formed of a coil with repeating loops, each loop forming a polygon and each successive loop being slightly rotated with respect to its adjacent loops to form a spiral configuration. The polygon in a preferred embodiment is a triangle, and the repeating triangular loop coil can be used as a guidewire in a stent delivering catheter. The guidewire can further include a stiff core wire that is disposed within the triangular loop coil, where the stiff core wire includes tapered sections that reduce the stiffness in the distal direction. The coil can include multiple sections of different loop shapes, including circular, to alter the stiffness of the guidewire to meet the needs of the application.

Abstract: A guidewire positioning tool includes a sheath having a body bore extending axially through a length of the sheath with a radially extending body slot configured to receive a guidewire. A collet portion extends laterally from the sheath and has collet arms and interstitial spaces with a collet bore extending therethrough. The collet bore has a collet slot extending radially from the collet bore configured to receive a guidewire. The collet arms have threads located on the exterior of the collet arms. A clamp nut is positioned over the collet portion and configured to threadably engage the threads. A retainer is rotatably attached to an end of the sheath opposite from the collet portion. The retainer has a retainer bore extending axially therethrough. The retainer has a retainer slot extending radially from the retainer bore configured to receive a guidewire.

Abstract: A medical device system is provided.

Abstract: Devices and systems for navigation and positioning a central venous catheter within a patient. In an exemplary embodiment of a system of the present disclosure, the system comprises a first pole and a second pole, the first pole and the second pole configured to generate an electric field within a mammalian body sufficient to obtain a plurality of field measurements therein, and an elongated body configured for at least partial insertion into a blood vessel of the mammalian body and advancement through a vasculature, said advancement dependent upon the plurality of field measurements indicative of one or more locations of a portion of the elongated body within the vasculature. In at least one embodiment, the elongated body is configured as a stylet.

Abstract: A catheter device for deploying a local magnetic resonance imaging (MRI) coil is provided. The catheter device includes an outer catheter shaft having a lumen extending from a proximal end to a distal end and an inner catheter shaft having a lumen extending from a proximal end to a distal end. The outer and inner catheter shafts are movably engaged such that one can move relative to the other. A plurality of non-metallic filaments are coupled on one end to the outer catheter shaft and coupled on another end to the inner catheter shaft. The plurality of non-metallic filaments are intertwined to form a braid, to which a local MRI coil is coupled. The local MRI coil is configured to have a circular shape when the braid is in a deployed position. Additionally, motion tracking coils can be coupled to the braid to provide motion tracking information for motion compensation.

Abstract: The invention relates to a retaining clip for retaining at least one medical line in a shortened lateral position and/or to a supportive surface. In one embodiment, the device includes an elongated, tapered helical wire structure defining a hook shaped leading edge, a loading channel, an inner lumen and a handle on the trailing end. The hooked shaped leading edge, inner lumen and channel are configured to accept the largest diameter of medical wires the device is destined to be used with. Sections of the medical wire may be captured in the hook portion, and multiple rotations of the structure by the handle, moves the medical wire(s) into the channel and the inner lumen to be retained.

Abstract: A transmitter unit with an attachable energy source is provided for a sensor guidewire. The transmitter unit is adapted to be connected to a proximal end of a sensor guidewire provided, at its distal end, with a sensor to measure a physiological parameter inside a patient. In some embodiments, the transmitter unit is adapted to wirelessly communicate by a communication signal with a communication unit, arranged in connection with an external device, in order to transfer measured physiological data to the external device. The attachable energy source can be a battery pack or battery holder provided with connecting electrical connecting surfaces. Preferably, the connection is protected from penetrating fluids by a protective seal.

Abstract: A protector which is used to cover a distal portion of a guide wire protruding from a distal opening of a tube body includes a first half body and a second half body which are movable between an open state and a closed state. Each of the first half body and the second half body includes a guide wire sandwiching and holding portion which mutually sandwich and hold the distal portion of the guide wire cooperatively in the closed state of the protector. Each of the first half body and the second half body also includes a tube body sandwiching and holding portion which mutually sandwich and hold the tube body cooperatively in the closed state of the protector.

Abstract: An outer coil and an inner coil are joined in parallel with a distal end portion of a core of a guide wire. A winding direction of a strand of the outer coil is the same as that of a strand of the inner coil. Diameters of the outer and inner coils increase or decrease when rotation of the core is transmitted and thereby rotation transmission capability is improved. An outer space wound portion and an inner space wound portion are formed in corresponding positions in the outer coil and the inner coil, respectively, in a core direction. Even if the guide wire has a double-coil structure, the outer and inner space wound portions improve flexibility of the guide wire. A coil pitch of the outer space wound portion differs from a coil pitch of the inner space wound portion. Thereby, engagement of the strands is prevented.

Abstract: A guide wire includes a first wire disposed on the distal side of the guide wire and a second wire disposed on the proximal side. The second wire has an elastic modulus larger than the first wire. The first wire is joined to the second wire at a welded portion by welding. A coil is disposed on the distal side of the first wire. A cover layer is formed on the outer peripheral surface of the wire member in such a manner as to cover at least the welded portion. The cover layer is made from a material capable of reducing the friction of the cover layer, for example, a fluorocarbon resin or a hydrophilic material, to thereby improve the sliding performance of the guide wire. Such a guide wire is excellent in operationality and kink resistance.

Abstract: A coaxial guidewire for use in accessing smaller vessels within a patient's body, consists of an inner core wire and an outer hollow wire. The distal end of the inner core wire tapers and supports a spring coil. The core wire, including the spring coil, fits within a 25-gauge needle that is used to locate an artery of the patient. When the needle is removed over the inner core wire, the outer hollow wire, having a distal end that tapers to the outer diameter of the spring coil, fits over the inner wire and is advanced until the distal end of the outer wire meets the spring coil of the core wire. A dilator and introducer sheath combination may then be fed over the assembled coaxial guidewire. When the distal end of the sheath is in the desired position, the dilator and the coaxial guidewire are removed.

Abstract: A medical guidewire having distal tip coil that includes a twisted ribbon wire construction. The distal tip coil is mounted to the distal end of the distal core section of the guidewire. The coil is made from a flat ribbon wire with a polygonal, preferably rectangular, cross-section that is twisted along the length of the wire. The twisted, flat ribbon wire creates a tip coil that has a roughened, undulating surface at the outer circumference that, whether coated or bare, is perceptible to the physician or cardiologist when pushing or torquing the guidewire in an interventional procedure.

Abstract: The present invention describes a system for controlling a thin flexible thermoplastic catheter. The system includes a plurality of shape memory alloy filaments attached to the distal end of the catheter, each filament having a phase and a temperature; a means for receiving a strain value for at least one of the filaments; a means for determining the phase change that will results in the strain value, whereby the phase change is dependent on the temperature and the temperature is dependent on a voltage; and a means for setting the voltage in each filament thereby resulting in movement of the catheter. In addition, a three-degrees of freedom force sensor measures the magnitude and direction of the force exerted on the tip of the catheter. The catheter can be autonomously guided or it can be interfaced to a haptic device. The catheter can also be fitted with microtools.

Abstract: Provided is a guidewire including a core shaft, an outer flexible tube, a stranded wire that extends parallel to the core shaft, and a hollow stranded-wire coil disposed in the outer flexible tube. The hollow stranded-wire coil is formed of multiple strands and surrounds the distal end portion of the core shaft and the stranded wire. Distal ends of the hollow stranded-wire coil, the core shaft, and the stranded wire are joined to a distal end of the outer flexible tube.

Abstract: A method of controlling intravascular sheaths including the steps of: a) obtaining a guide assembly having a body with a tubular wall bounding a passageway, the body having a length between axially spaced ends and an outer surface that tapers towards each of the spaced ends, the body flexible at each of the spaced ends to allow the spaced ends to bend transversely to the length of the body; b) directing the guide assembly into an operative state within a human body vessel; c) obtaining a first sheath having a tubular body extending around a passageway; and d) relatively moving the guide assembly body and first sheath to thereby direct the guide assembly body into the passageway on the first sheath and thereafter guidingly sliding the first sheath lengthwise against the outer surface of the guide assembly body to: a) advance the first sheath into the human body vessel; or b) withdraw the first sheath.

Abstract: Provided is a guidewire including a core shaft, an outer flexible tube, a stranded wire that extends parallel to the core shaft, and a hollow stranded-wire coil disposed in the outer flexible tube. The hollow stranded-wire coil is formed of multiple strands and surrounds the distal end portion of the core shaft and the stranded wire. Distal ends of the hollow stranded-wire coil, the core shaft, and the stranded wire are joined to a distal end of the outer flexible tube.

Abstract: Intraluminal guide wires including at least a portion thereof fabricated from a non-super-elastic cobalt-chromium alloy that exhibits improved elasticity, while maintaining a relatively high yield strength, as compared to conventionally employed non-super-elastic cobalt-chromium alloys. The guide wire may include an elongate core wire having a distal end and a proximal end, wherein at least a portion of the elongate core wire is fabricated from a cobalt-chromium alloy having a Young's modulus that is 150 GPa or less while having a yield strength that is at least 280 ksi.

Abstract: A steerable dilator includes a dilator body for holding and guiding a sheath, the dilator body having a deflectable distal end portion, and at least one lateral passage configured to accommodate at least one steering cable and a steering handle operatively associated with a proximal end portion of the dilator and having an actuation mechanism operatively connected to the at least one steering cable accommodated within the at least one lateral passages of the dilator for steering the deflectable distal end portion of the dilator in at least one direction.

Abstract: Provided is a guidewire including a core shaft, an outer flexible tube, and an inner flexible tube that surrounds a distal end portion of the core shaft. The inner flexible tube is disposed in the outer flexible tube so that a distal end thereof is positioned between the distal end of the core shaft and a proximal end of the core shaft so as to be separated from the core shaft. A first joint is formed so as to join the distal end of the inner flexible tube to the core shaft. At least one second joint is formed so as to join the outer flexible tube to the inner flexible tube. The at least one second joint is positioned between the first joint and the proximal end of the core shaft.

Abstract: Disclosed herein is a medical wire with an intracorporeally indwelling member connected to the leading end part of a conductive wire through a thermally-fusible connecting member, wherein the contact of the leading end part of the conductive wire with the intracorporeally indwelling member can be surely prevented even when the connecting member is deformed. The medical wire comprises a conductive wire and an intracorporeally indwelling member connected to the leading end part of the conductive wire through a thermally-fusible connecting member, in which the connecting member is heated and fused by a high-frequency current supplied through the conductive wire, thereby releasing the intracorporeally indwelling member, wherein a non-conductive spacer for preventing the contact of the intracorporeally indwelling member with the conductive wire is provided between them.

Abstract: A medical device is provided comprising a shaft comprising a first segment and a second segment. The first segment is configured to buckle upon application of a first critical force. The second segment includes an outer surface and an inner surface and is configured to buckle upon application of a second critical force. The second critical force is lower than the first critical force. The medical device further comprises a coil disposed radially inwardly of the inner surface of the second segment.

Abstract: A stiffenable structure is made of longitudinal beams that are positioned around a longitudinal axis. In one state, the longitudinal beams are bendable so that the structure is bendable. As the structure bends, the longitudinal beams slide longitudinally with reference to one another. In a second state, the beams are clamped in a fixed position relative to one another so that the structure is stiffened. In some aspects the longitudinal beams are made of two or more longitudinal laminar elements. As each beam bends, the laminar elements slide longitudinally with reference to one another. Each beam, and accordingly the structure, is stiffened by preventing the laminar elements from sliding longitudinally relative to one another.

Abstract: This invention relates to medical guidewire having multiple electrically conductive pathways extending from substantially their distal ends to substantially their proximal ends.

Abstract: Methods and systems for treating an airway disorder and delivering an implant to airway tissue are provided. A method includes partially inserting at least a first and second wire into airway forming tissue, wherein the first and second wires' axes define implant positions for a first and second implant, respectively. A wire guide can be used to maintain an orientation of the first and second axis relative to each other.

Abstract: Medical devices for navigation through anatomy, including guidewires, which may have a core wire, a slotted tubular member, or both. Embodiments may have coils, including non-circular cross-section edge-wound marker coils, extended coil tips, and soldered or glued mesial joint coils. Core wires may have a step, ridge, or taper at the joints to the tubular member, and may be flattened at the distal tip. Radiopaque material may be located inside the tubular member, and the distal tip may be heat treated to make it shapeable. Additional tubular members or coils may be used concentrically or in line and may enhance flexibility, provide radiopacity, reduce friction, or reduce material or manufacturing cost. Tubular members may be chamfered or tapered continuously or incrementally. Slots may be arranged in groups, such as groups of three, and may be equal in depth or unequal in depth to provide a steerable or compressible tip.

Abstract: Provided is a guidewire including a core shaft, an outer flexible tube, and an inner flexible tube that surrounds a distal end portion of the core shaft. The inner flexible tube is disposed in the outer flexible tube so that a distal end thereof is positioned between the distal end of the core shaft and a proximal end of the core shaft so as to be separated from the core shaft. A first joint is formed so as to join the distal end of the inner flexible tube to the core shaft. At least one second joint is formed so as to join the outer flexible tube to the inner flexible tube. The at least one second joint is positioned between the first joint and the proximal end of the core shaft.