Abstract:
A catheter includes an elastically radially expandable body encompassed by an elastically radially expandable slitted sleeve. Before the body is expanded, the slit is closed but is opened when the body and the sleeve are expanded. When the catheter is used to dilate a constricted portion of a blood vessel, the opened slit defines a recess into which the constricted portion projects, in order to resist slippage of the body off the constricted portion. When the body and the sleeve are allowed to contract, the sleeve forces the body into a generally cylindrical shape to facilitate subsequent re-dilation of the constricted portion.

Description:
[0001]     This application claims priority under 35 U.S.C. §119 to Patent Application Serial No. 2004-93145 filed in Japan on Mar. 26, 2004.  
       BACKGROUND OF THE INVENTION  
       [0002]     The present invention relates to a catheter with an expandable body for use in a treatment including an operation of dilating a constricted portion generated in a body lumen, and a method for such treatment.  
         [0003]     In a catheter with an expandable body for dilating a constricted portion (stenosed portion) generated in a blood vessel to thereby improve the bloodstream in the cases of PTCA (percutaneous transluminal coronary angioplasty), PTA (percutaneous transluminal angioplasty) and the like, an expandable body (balloon) is preliminarily folded onto a catheter shaft for permitting insertion into the blood vessel.  
         [0004]     In recent years, there have been an increasing number of cases in which, after dilating a constricted portion by a catheter with an expandable body and evulsing the catheter with the expandable body from the constricted portion, the dilated state of the constricted portion is observed by use of an ultrasonic catheter or the like, and, when constriction remains, the catheter with the expandable body once evulsed is again inserted into the constricted portion to perform re-dilation.  
         [0005]     However, when the expandable body is once expanded at a high pressure so as to dilate the constricted portion, the expandable body would not return to the original folded shape and would easily assume a relatively flat shape such as that of a wing or a foldable Japanese war fans after the expanding fluid is discharged from the expandable body to contract the expandable body. When the expandable body assumes such a war fan-like shape, it is difficult to reinsert the once evulsed catheter with the expandable body into the blood vessel.  
         [0006]     In addition, with a conventional catheter with an expandable body, there have been cases in which the expandable body would slip off from the constricted portion at the time of expanding the expandable body for dilating the constricted portion. In such a case, the operations of once contracting the expandable body, then positioning the balloon to an appropriate position (the position of the constricted portion) and thereafter expanding the expandable body again, and, further, an operation of replacing the catheter with the expandable body by another catheter with an expandable body differing from the former in expandable body size, must be carried out; the operations take much labor and time, thereby impeding a smooth treatment and increasing the burden on the patient. It may be contemplated to lower the expanding pressure for the expandable body for the purpose of preventing the expandable body from coming off from the constricted portion. In this case, however, it is impossible to sufficiently dilate the constricted portion, and it may be impossible to expect the desired treatment effect.  
         [0007]     Japanese Patent Laid-open No. Hei 5-337189 (EP553960A1) discloses a balloon catheter in which a tubular elastic membrane disposed around a balloon (expandable body) is provided between the balloon and a stent, and, upon contraction of the balloon, the elastic membrane squashes the balloon evenly in the circumferential direction, thereby preventing the balloon from assuming a flat war fan-like shape (refer, particularly, to paragraphs 0008 and 0022). However, since the elastic membrane is a simple tube, it is limited in expandability in the radial direction, and, when its outside diameter upon contraction of the balloon is set small for ensuring easy insertion into a blood vessel, it may obstruct the expansion of the balloon. Besides, Japanese Patent Laid-open No. Hei 5-337189 (EP553960A1) does not describe any consideration about the prevention of slipping-off of the expandable body from the constricted portion, in connection with the balloon catheter.  
       SUMMARY OF THE INVENTION  
       [0008]     The present invention provides a catheter with an expandable body which is excellent in the property for re-insertion into a constricted portion in a body lumen. The present invention also provides a catheter with an expandable body which can assuredly prevent the expandable body from slipping off from a constricted portion at the time of dilating the constricted portion. Furthermore, the present invention provides a catheter with an expandable body which is excellent in both the property for re-insertion into a constricted portion and the prevention of slipping-off of the expandable body from the constricted portion.  
         [0009]     According to the present invention, there is provided: a catheter with an expandable body, including a shaft having a passage for permitting a working fluid to pass therethrough, and the expandable body which is capable of expansion and contraction and is provided at a distal end portion of the shaft so as to be communicated with the inside of the passage. The catheter includes a tubular outer sleeve disposed on the outside of the expandable body, the tubular outer sleeve having such a degree of extension-contraction property as to permit expansion of the expandable body when the working fluid is made to flow through the passage into the expandable body. The outer sleeve is provided with at least one slit which is closed when the expandable body is contracted and which is opened when the expandable body is expanded.  
         [0010]     According to the present invention, since the catheter with an expandable body includes the outer sleeve, upon contraction of the expandable body by sucking the working fluid out of the once expanded expandable body, a compressive force is exerted on the expandable body due to the elastic force of the outer sleeve, so that the expandable body can be contracted into a compact form.  
         [0011]     Therefore, upon contraction of the expandable body from the expanded state, it is possible to securely prevent the expandable body from being squashed into a flat war fan-like (wing-like) shape; accordingly, when the catheter with the expandable body once evulsed from a constricted portion of a body lumen is again inserted into the constricted portion (stenosed portion), the re-insertion can be achieved smoothly and easily.  
         [0012]     In addition, since the outer sleeve is provided with the slit(s) opened at the time of expansion of the expandable body, the outer sleeve can be easily bulged in the radial direction, so that the expandable body can be expanded sufficiently, without being obstructed by the outer sleeve.  
         [0013]     Furthermore, when the expandable body is expanded to dilate a constricted portion (stenosed portion) of a body lumen, the contact surface, for contact with the constricted portion, formed by the outside surface of the expandable body exposed via the opened slit(s) and the outer sleeve is rugged (is including projections and recesses), so that friction between the contact surface and the constricted portion is enhanced, to display an anti-slipping effect. Therefore, even where the expandable body is expanded with a high pressure, the expandable body can be securely prevented from slipping off from the constricted portion.  
         [0014]     The invention further involves a method of dilating a constricted portion of a blood vessel comprising the steps of: 
        A) inserting into the constricted portion an expandable body of a catheter, an outer surface of the catheter being encompassed by an elastically expandable sleeve having at least one slit formed therein;     B) imparting an expansion force to the expandable body causing the expandable body and the sleeve to expand radially and dilate the constricted portion of the blood vessel; and     C) relieving the expansion force to allow the expandable body and the expandable sleeve to contract, wherein the sleeve forms the body into a generally rounded shape.        
 
         [0018]     The invention also involves a method of dilating a constricted portion of a blood vessel comprising the steps of: 
        A) inserting into the constricted portion an expandable body of a catheter, an outer surface of the catheter being encompassed by an elastically expandable sleeve having at least one slit formed therein;     B) imparting an expansion force to the expandable body causing the expandable body and the sleeve to expand radially and dilate the constricted portion of the blood vessel, wherein the at least one slit becomes enlarged to define at least one recess into which the constricted portion projects to resist slipping of the expandable body off the constricted portion; and     C) relieving the expansion force to allow the expandable body and the expandable sleeve to contract.       
 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0022]     The above and other features and advantages of the present invention will become apparent from the following description and appended claims, taken in conjunction with the accompanying drawings, in which:  
         [0023]      FIG. 1  is a side view showing the surroundings of an expandable body in its contracted state in a first embodiment of the catheter with the expandable body according to the present invention;  
         [0024]      FIG. 2  is a side view showing the surroundings of the expandable body in its expanded state in the catheter with the expandable body shown in  FIG. 1 ;  
         [0025]      FIG. 3  is a vertical sectional view showing the surroundings of the expandable body in its expanded state in the catheter with the expandable body shown in  FIG. 1 ;  
         [0026]      FIG. 4  is a cross-sectional view showing the expandable body in its contracted state and an inner tube, in the catheter with the expandable body shown in  FIG. 1 ;  
         [0027]      FIG. 5  is a cross-sectional view of the surroundings of the expandable body in its expanded state in the catheter with the expandable body shown in  FIG. 1 ;  
         [0028]      FIG. 6  is a side view for illustrating another configuration example of a slit(s) in an outer sleeve;  
         [0029]      FIG. 7  is a side view showing the surroundings of an expandable body in its contracted state in a second embodiment of the catheter with the expandable body according to the present invention;  
         [0030]      FIG. 8  is a side view showing the surroundings of an expandable body in its contracted state in a third embodiment of the catheter with the expandable body according to the present invention;  
         [0031]      FIG. 9  is a side view showing the surroundings of an expandable body in its contracted state in a fourth embodiment of the catheter with the expandable body according to the present invention;  
         [0032]      FIG. 10  is a vertical sectional view showing the surroundings of an expandable body in its expanded state in a fifth embodiment of the catheter with the expandable body according to the present invention;  
         [0033]      FIG. 11  is a vertical sectional view showing the surroundings of an expandable body in its expanded state in a sixth embodiment of the catheter with the expandable body according to the present invention; and  
         [0034]      FIG. 12  is a vertical sectional view showing the surroundings of an expandable body in its expanded state in a seventh embodiment of the catheter with the expandable body according to the present invention. 
     
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS  
       [0035]     Now, the catheter with an expandable body according to the present invention will be described in detail below, based on some preferred embodiments shown in the accompanying drawings.  
       First Embodiment  
       [0036]      FIG. 1  is a side view showing the exterior of an expandable body in its contracted state in a first embodiment of the catheter with the expandable body according to the present invention;  FIGS. 2 and 3  are respectively a side view and a vertical sectional view, showing the surroundings of the expandable body in its expanded state in the catheter with the expandable body shown in  FIG. 1 ;  FIG. 4  is a cross-sectional view of the expandable body in its contacted state and an inner tube, in the catheter with the expandable body shown in  FIG. 1 ;  FIG. 5  is a cross-sectional view of the surroundings of the expandable body in its expanded state in the catheter with the expandable body shown in  FIG. 1 ; and  FIG. 6  is a side view for illustrating another configuration example of a slit(s) in an outer sleeve. Incidentally, for convenience in description, the right side in FIGS.  1  to  3  will hereinafter be referred to as “the proximal end”, and the left side will be referred to as “the distal end”.  
         [0037]     The catheter with the expandable body,  1 , shown in these figures is for use in a treatment including the step of dilating a constricted (stenosed) portion (lesion portion)  100  generated in a body lumen such as a blood vessel, and includes an elongate (slender) shaft (catheter main body)  2 , an expandable body (balloon)  3  being capable of expansion and contraction and disposed at a distal end portion of the shaft  2 , and a tubular outer sleeve  4  put on the outside of the expandable body  3 . The whole length of the catheter with the expandable body,  1 , is not particularly limited; in the case of a catheter with an expandable body for use in PTCA, ordinarily, the whole length is preferably in the range of 1200 to 1600 mm, more preferably 1300 to 1500 mm.  
         [0038]     As shown in  FIG. 3 , the shaft  2  includes a tubular outer tube  21  having flexibility (elasticity), and a tubular inner tube  22  having flexibility (elasticity) and inserted in a hollow portion (lumen) of the outer tube  21 .  
         [0039]     The material constituting the outer tube  21  is not particularly limited, and examples of the material include flexible high polymeric materials such as polyamide-based resins such as nylon 11, nylon 12, nylon 610, etc., polyamide elastomers, polyolefins such as polypropylene, polyethylene, etc., olefin-based elastomers such as polyethylene elastomer, polypropylene elastomer, etc., polyesters such as polyethylene terephthalate, etc., polyester elastomers, soft polyvinyl chloride, polyurethane and polyurethane elastomers, fluoro-resins and fluoro-resin-based elastomers such as polytetrafluoroethylene, etc., polyimides, ethylene-vinyl acetate copolymer, and silicone rubbers, and metallic materials such as stainless steels, titanium, titanium alloys, superelastic alloys such as TiNi alloy, etc., which may be used either singly or in combination of two or more of them.  
         [0040]     The outside diameter of the outer tube  21  is not particularly limited. In the case of a catheter with an expandable body for use in PTCA, ordinarily, the outside diameter is preferably in the range of 0.70 to 1.1 mm, more preferably 0.80 to 0.90 mm.  
         [0041]     The hollow portion of the inner tube  22  functions as a guide wire lumen  221  for permitting a guide wire (not shown) to pass therethrough. The material constituting the inner tube  22  is not particularly limited, and preferred examples of the material include metallic materials such as stainless steels, titanium, titanium alloys, superelastic alloys such as TiNi alloy, etc., and high molecular materials such as polyamides such as nylon 12, etc., polyamide elastomers, fluoro-resins such as PTFE (polytetrafluoroethylene), ETFE, FEP, PFA, etc., polyethylene, and polyester-based resins.  
         [0042]     The outside diameter of the inner tube  22  is not particularly limited. In the case of a catheter with an expandable body for use in PTCA, ordinarily, the outside diameter is preferably in the range of 0.40 to 0.80 mm, more preferably 0.50 to 0.60 mm.  
         [0043]     A distal end portion  222  of the inner tube  22  protrudes in the distal end direction beyond a distal end portion  211  of the outer tube  21 .  
         [0044]     Between the outer tube  21  and the inner tube  22 , a passage (inflation lumen)  23  is formed through which a working fluid (expanding fluid) for expansion and contraction of the expandable body  3  can flow. Namely, the outside diameter of the inner tube  22  is smaller than the inside diameter of the outer tube  21 .  
         [0045]     At a proximal end portion of the shaft  2  as above, a hub (not shown) is disposed. The hub is provided with a port communicated with the guide wire lumen  221 , and a port communicated with the passage  23 . A balloon inflator (not shown), for example, a syringe, can be connected to the port communicated with the passage  23 . The expandable body  3  can be expanded and contracted by feeding the working fluid, which is supplied from the balloon inflator, into the expandable body  3  through the passage  23  or draining the working fluid out. The working fluid is preferably a liquid. Among usable liquids, more preferred is a liquid having an X-ray contrast property, for example, a liquid obtained by diluting an X-ray contrast agent, such as a contrast agent for artery, with physiological saline in a factor of several folds.  
         [0046]     The expandable body  3  is composed of a tubular film member having flexibility. A proximal end portion  33  of the expandable body  3  is attached liquid-tight to the vicinity of the distal end portion  211  of the outer tube  21  over the entire circumference, and a distal end portion  32  of the expandable body  3  is attached liquid-tight to the vicinity of the distal end portion  222  of the inner tube  22  over the entire circumference. Incidentally, the method for the attachment is not particularly limited, and examples of the method include fusing, adhesion by use of an adhesive, etc.  
         [0047]     The material constituting the expandable body  3  is preferably biaxially stretchable plastics. Examples of the material constituting the expandable body  3  include polyamide-based resins such as nylon 11, nylon 12, nylon 610, etc., polyamide elasomers, polyesters such as polyethylene terephthalate (PET), etc., polyester elastomers, natural rubber, polyethylene, polypropylene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, soft polyvinyl chloride, polyurethane, polyisoprene, polyimides, polytetrafluoroethylene, silicones, polyether-ether ketone (PEEK), and polymer blends and polymer alloys containing at least one of these polymers.  
         [0048]     The wall strength of the expandable body  3  is preferably in excess of 15000 psi.  
         [0049]     As shown in  FIG. 4 , the expandable body  3 , in its contracted state (before expanded), is in the state of being folded on (being wound around) the periphery of the inner tube  22 . Incidentally, in  FIG. 4 , the outer sleeve  4  is omitted.  
         [0050]     With a working fluid fed into the expandable body  3  starting from this condition, the expandable body  3  is brought into the expanded state, as shown in  FIGS. 3 and 5 .  
         [0051]     The size of the expandable body  3  is not particularly limited. In the case of a catheter with an expandable body for use in PTCA, ordinarily, the diameter upon expansion is preferably in the range of φ1.0 to φ5.0 mm, more preferably φ1.25 to φ4.0 mm. The axial length of the expandable body  3  is preferably in the range of 5 to 100 mm, more preferably 10 to 50 mm.  
         [0052]     As shown in  FIG. 3 , at an outer peripheral portion of the inner tube  22  located inside the expandable body  3 , radiopaque markers  11 ,  12  having a contrast property (particularly in X-ray imaging) are disposed. The radiopaque markers  11 ,  12  are provided at positions indicating the boundaries between a hollow cylindrical portion and conical portions of the expandable body  3  in its expanded state. The radiopaque markers  11 ,  12  may each be composed, for example, of a thin wire, coil, or ring of gold, silver, platinum, or tungsten. With such radiopaque markers  11 ,  12  provided, the catheter can be inserted into a living body while confirming the position of the expandable body  3  under fluororoentgenography. The markers  11 ,  12  may be those which display a contrast property in other imaging methods than fluororoentgenography, for example, CT scan, MRI or the like, thereby permitting the confirmation of their positions.  
         [0053]     On the outside of the expandable body  3 , the outer sleeve  4  composed of a tubular film member is disposed so as to cover the expandable body  3 .  
         [0054]     As shown in  FIG. 1 , the outer sleeve  4  is provided with a plurality of slits  41 . In this embodiment, the slits  41  are formed substantially in parallel to the longitudinal direction (axial direction) of the outer sleeve  4 .  
         [0055]     The plurality of slits  41  are formed (arranged) intermittently (at intervals) along the circumferential direction of the outer sleeve  4 , as indicated by symbols  41   a ,  41   b  and  41   c  in  FIG. 1 .  
         [0056]     Besides, the plurality of slits  41  are formed (arranged) intermittently (at intervals) along the longitudinal direction of the outer sleeve  4 , as indicated by symbols  41   d ,  41   e  and  41   f  in  FIG. 1 .  
         [0057]     The outer sleeve  4  as above has such a degree of extension/contraction (stretch) property as to permit expansion of the expandable body  3 , and is expanded and contracted attendant on the expansion and contraction of the expandable body  3 .  
         [0058]     As shown in  FIG. 2 , the slits  41  are opened when the expandable body  3  is expanded. As a result, the outside surface  31  of the expandable body  3  is exposed via the openings of the opened slits  41 .  
         [0059]     Then, when the expandable body  3  is contracted, the slits  41  are again closed as shown in  FIG. 1  due to the elasticity of the outer sleeve  4 .  
         [0060]     In the catheter with the expandable body,  1 , according to the present invention, the provision of the outer sleeve  4  ensures that when the expandable body  3  once expanded is contracted by drawing the working fluid from the inside thereof, a compressive force is exerted on the expandable body  3  over the entire circumference thereof by the elasticity of the outer sleeve  4  and, therefore, the expandable body  3  can be contracted into a compact form. In the case of this embodiment, the expandable body  3  can be contracted so as to return assuredly to the folded state shown in  FIG. 4 .  
         [0061]     Therefore, when the expandable body  3  is contracted from the expanded state, the expandable body  3  can be securely prevented from being squashed flat into a war fan-like (wing-like) shape without being folded. Accordingly, excellent operability (called re-insertability or recross property) can be obtained at the time when the catheter with the expandable body,  1 , once evulsed from the constricted portion  100  is again inserted into the constricted portion  100 , so that the re-insertion can be performed smoothly and easily.  
         [0062]     Besides, in the present invention, the outer sleeve  4  is provided with the slits  41  which are opened upon expansion of the expandable body  3 , so that the outer sleeve  4  can be easily bulged in the radial direction and, therefore, the expandable body  3  can be sufficiently expanded without being obstructed by the outer sleeve  4 .  
         [0063]     In addition, as shown in  FIG. 5 , at the time of expanding the expandable body  3  to thereby dilate the constricted portion  100  of a blood vessel, the contact surface, for contact with the constricted portion  100 , formed by the outside surface  31  of the expandable body  3  exposed via the opened slits  41  and the outer sleeve  4  is rugged (i.e., it defines recesses that receive tissue of the constricted portion, and projections that protrude into the tissue). Thus, friction between the contact surface and the constricted portion  100  is enhanced, and an anti-slipping effect is established. Therefore, the expandable body  3  can be securely prevented from slipping off from the constricted portion  100 , even where the expandable body  3  is expanded with a high pressure.  
         [0064]     The inside surface of the outer sleeve  4  is preferably in close contact with the outside surface  31  of the expandable body  3  even when the expandable body  3  is in its folded state (contracted state). In this case, the expandable body  3  can be contracted into the folded form more assuredly.  
         [0065]     Further, the outer sleeve  4  is preferably frictionally fastened to the outside surface  31  of the expandable body  3  even when the expandable body  3  is in its folded state (contracted state). In this case, by a restoring force of the outer sleeve  4  applied against the body  3 , the expandable body  3  can be contracted into a generally rounded folded form more assuredly. The rounded form, preferably generally cylindrical, can be more easily reinserted into the blood vessel as compared to the flat wing-like shape that has been characteristic of the prior art.  
         [0066]     Particularly, where the inside diameter of the outer sleeve  4  in the natural or relaxed state (in the condition where no external force is exerted on the outer sleeve  4  standing alone) is not more than the maximum outside diameter (the size denoted by L 4  in  FIG. 4 ) of the expandable body  3  in its folded (relaxed) state, the fastening force of the outer sleeve  4  acts on the expandable body  3  assuredly, so that the expandable body  3  can be forcibly contracted into the generally cylindrical folded shape particularly assuredly, which is desirable. Incidentally, the maximum outside diameter means the maximum one of the distances between arbitrary two portions of the expandable body  3  which are located on the opposite sides with the center axis of the shaft  2  (the inner tube  22 ) therebetween, in the cross section of the catheter with the expandable body,  1 . Incidentally, in the case where the expandable body  3  has the same outside diameter over the entire circumference thereof in its folded (contracted) state, it is preferable that the inside diameter of the outer sleeve  4  in the natural state is not more than the outside diameter of the expandable body  3 .  
         [0067]     The fixation locations of the outer sleeve  4  are not particularly limited. In this embodiment, as shown in  FIG. 3 , a distal end portion  42  of the outer sleeve  4  is attached to a distal end portion  32  of the expandable body  3 , and a proximal end portion  43  of the outer sleeve  4  is attached to a proximal end portion  33  of the expandable body  3 . This makes it possible to prevent assuredly the outer sleeve  4  from slipping off from the expandable body  3 , at the time of insertion into a body lumen such as a blood vessel. Incidentally, the method for fixation at the attached portions is not particularly limited, and may be, for example, fusing, adhesion by use of an adhesive, or the like.  
         [0068]     In addition, the slits  41  are each preferably formed in parallel to the longitudinal direction of the outer sleeve  4  or at an inclination relative to the longitudinal direction. More preferably, as in this embodiment, the slits  41  are substantially in parallel to the longitudinal direction of the outer sleeve  4 . This configuration makes it possible for the slits  41  to be opened more easily upon expansion of the expandable body  3 .  
         [0069]     Besides, in the present invention, the number of the slit(s)  41  may be one. In this embodiment, a plurality of the slits  41  are formed, and the slits  41  are arranged dispersedly along the circumferential direction of the outer sleeve  4 , whereby the expansion and contraction of the outer sleeve  4  are made smoother.  
         [0070]     The material constituting the expandable/contractable outer sleeve  4  is not particularly limited, and may be a material having a certain degree of elasticity. Preferable examples of the material include silicone rubbers, nylons (polyamides), nylon elastomers (polyamide elastomers), latex rubbers, and polyester elastomers. Besides, a material having a contrast property, such as barium sulfate, may be kneaded into the material constituting the outer sleeve  4 .  
         [0071]     At the time of producing the catheter with the expandable body,  1 , the inside diameter of the outer sleeve  4  is enlarged by opening the slits  41  and, in this condition, the outer sleeve  4  can be easily put on the outside of the expandable body  3 . Therefore, the catheter with the expandable body,  1 , can be produced easily.  
         [0072]     The method for forming the slits  41  is not particularly limited. The formation can be carried out, for example, by laser processing (e.g., excimer laser, YAG laser), discharge processing, chemical etching, cutting, or the like. Among these forming methods, preferred is the laser processing, from the viewpoints of easiness of formation of the slits  41  or small holes, excellent shape accuracy, and excellent dimensional accuracy. Among laser processings, particularly preferred is the processing by a laser of which the oscillation wavelength is in the UV region. Particularly, excimer laser is preferable. However, where the base material of the outer sleeve  4  is an elastic member and thermal deformation thereof by laser is expected, cutting by use of a sharp cutting tool is also preferred.  
         [0073]     The dimensions of the outer sleeve  4  can be appropriately set according to the dimensions of the expandable body  3 . For example, the length of the outer sleeve  4  is preferably at such a value as to cover at least the folded portion (the conical portions (balloon taper portions) in  FIG. 3  and the hollow cylindrical portion (straight portion)) of the expandable body  3 . Specifically, in the case of a catheter with an expandable body,  1 , for use in PTCA for dilating a constricted portion of the coronary artery, the length of the outer sleeve  4  is preferably in the range of about 1 to 100 mm, more preferably about 10 to 50 mm. In addition, the material thickness of the outer sleeve  4  in the natural state is typically in the range of about 1 to 1000 μm, preferably about 5 to 100 μm, more preferably about 5 to 20 μm. The upper limit of the thickness of the sleeve  4  is set from the standpoint of ensuring contact of both the outer sleeve  4  and the outside surface  31  of the expandable body  3  with the constricted portion  100  so as to dilate the constricted portion steadily. On the contrary, the lower limit of the thickness of the sleeve  4  is set from the standpoint of improving the anti-slipping effect with sufficient vertical interval between the outside surface of the sleeve  4  and the outside surface  31  of the expandable body  3  exposed via the opened slits  41  so as to enhance the friction between the contact surface formed by the outer sleeve  4  and the outside surface  31  of the expandable body  3  and the constricted portion  100  sufficiently. Besides, the inside diameter of the outer sleeve  4  in the natural state is preferably in the range of about 0.4 to 2.0 mm, more preferably about 0.5 to 1.0 mm.  
         [0074]     In this embodiment, the length L 1  (see  FIG. 1 ) of each slit  41  is preferably in the range of about 0.5 to 5 mm, more preferably about 1 to 4 mm.  
         [0075]     In addition, the pitch L 2  (see  FIG. 1 ) of the slits  41  along the circumferential direction of the outer sleeve  4  is preferably in the range of about 0.1 to 5 mm, more preferably about 0.5 to 2 mm.  
         [0076]     Besides, the pitch L 3  (see  FIG. 1 ) of the slits  41  along the longitudinal direction of the outer sleeve  4  is preferably in the range of about 0.6 to 9.9 mm, more preferably about 1.5 to 6 mm.  
         [0077]     The slits  41  may be composed of crevices which close substantially completely upon contraction of the expandable body  3 , as shown in  FIG. 1 , or may not close completely but have a width L 5  upon contraction of the expandable body  3 , like slits  41  in a catheter with an expandable body,  1 ′, shown in  FIG. 6 . In the case as shown in  FIG. 6 , the width L 5  of the slits  41  upon contraction of the expandable body  3  is preferably not more than 2 mm, more preferably not more than 1 mm.  
         [0078]     As in the configuration shown in  FIG. 1 , the slits  41  are preferably so arranged that the slits  41  adjacent to each other in the circumferential direction of the expandable body  3  are offset from each other in the longitudinal direction of the outer sleeve  4 . This ensures that, at the time of expansion of the expandable body  3 , the outer sleeve  4  is more easily expanded at any portion over the entire part in the longitudinal direction thereof, so that the outer sleeve  4  can be expanded uniformly, as shown in  FIG. 2 . Further, the slits  41  are preferably in longitudinally overlapping relationship so that at least one slit  41  is present at any portion in the longitudinal direction of the outer sleeve  4 . This ensures that, at the time of expansion of the expandable body  3 , the outer sleeve  4  can be expanded more assuredly over the entire part thereof.  
         [0079]     In the catheter with the expandable body,  1 , it is preferable that the outside surface of the outer sleeve  4  and/or the outside surface  31  of the expandable body  3  is subjected to a high lubricity treatment for displaying a comparatively high lubricity, and the other is subjected to a low lubricity treatment for displaying a comparatively lower lubricity or is not subjected to any lubricity treatment.  
         [0080]     This ensures that, when the expandable body  3  is expanded, a poor lubricity surface forms the contact surface, for contact with the constricted portion  100 , formed by the expandable body  3  and the outer sleeve  4 , with the result that the friction between the contact surface and the constricted portion  100  can be enhanced. Therefore, even where the expandable body  3  is expanded with a high pressure, it is possible to prevent more securely the expandable body  3  from slipping off from the constricted portion  100 .  
         [0081]     In this case, it is preferable that the outside surface of the outer sleeve  4  is subjected to the high lubricity treatment, and the outside surface  31  of the expandable body  3  is subjected to the low lubricity treatment. It is more preferable that the outside surface of the outer sleeve  4  is subjected to the high lubricity treatment, and the outside surface  31  of the expandable body  3  is not subjected to any lubricity treatment. This results in that, when the expandable body  3  is contracted for insertion into a body lumen such as a blood vessel or for evulsion from the body lumen, the outside surface  31  of the expandable body  3  which is poor in lubricity is covered with the outer sleeve  4 , and only the outside surface of the outer sleeve  4  which is high in lubricity is exposed to the outside of the catheter with the expandable body,  1 , and makes contact with the inside wall of the body lumen. Thus, it is possible to provide a catheter with an expandable body,  1 , which is excellent in the property for insertion into a body lumen and in the property for evulsion from the body lumen.  
         [0082]     On the other hand, where the outside surface  31  of the expandable body  3  is subjected to the low lubricity treatment, the friction between the mutually contacting portions of the outside surface  31  of the folded expandable body  3  and the friction between the outside surface  31  of the inside surface of the sleeve  4  can be reduced. This ensures that, even if the sleeve  4  is making close contact with the expandable body  3  or is fastening the expandable body  3  at the time of expansion of the expandable body  3 , the mutually contacting portions of the outside surface  31  of the expandable body  3  or the inside surface of the sleeve  4  and the outside surface  31  or the expandable body  3  will easily slip on each other, so that the expandable body  3  can be expanded more smoothly.  
         [0083]     In addition, where the inside surface of the sleeve  4  is subjected to a lubricity treatment, the friction between the outside surface  31  of the expandable body  3  and the inside surface of the sleeve  4  can be reduced. This ensures that, even if the sleeve  4  is making close contact with the expandable body  3  or is fastening the expandable body  3 , the outside surface  31  of the expandable body  3  will easily slip relative to the sleeve  4  at the time of expansion, so that the expandable body  3  can be expanded more smoothly. In this case, the outside surface  31  of the expandable body  3  may be subjected to a lubricity treatment, but it is preferable not to subject the outside surface  31  to any lubricity treatment, since the friction between the outside surface  31  and the constricted portion  100  is enhanced and slipping therebetween is prevented, at the time of expansion.  
         [0084]     Examples of the high lubricity treatment include application (formation of a coating layer) of a hydrophilic high polymeric material showing lubricity upon wetting (absorption of water). Examples of the hydrophilic high polymeric material include cellulose-based high polymeric materials, polyethylene oxide-based high polymeric materials, maleic anhydride-based high polymeric materials (e.g., maleic anhydride copolymer such as methyl vinyl ether-maleic anhydride copolymer), acrylamide-based high polymeric materials (e.g., polyacrylamide, polyglycidyl methacrylate-dimethylacrylamide (PGMA-DMAA) block copolymer), water-soluble nylons, polyvinyl alcohol, and polyvinyl pyrrolidone.  
         [0085]     Besides, examples of the low lubricity treatment include silicone coating, PTFE coating, and the like methods.  
         [0086]     Incidentally, such a lubricity-imparting treatment as above may be applied also to the outer peripheral surface of the outer tube  21 . This ensures that, at the time of inserting the catheter with the expandable body,  1 , into a blood vessel  100 , the friction is lowered, the insertion can be performed more smoothly, and operability and safety are enhanced.  
       Second Embodiment  
       [0087]      FIG. 7  is a side view showing the exterior of an expandable body in its contracted state in a second embodiment of the catheter with the expandable body according to the present invention.  
         [0088]     Now, the second embodiment of the catheter with the expandable body according to the present invention will be described below referring to this figure. The following description will be centered on differences from the first embodiment above, and description of the same points as in the first embodiment will be omitted.  
         [0089]     The catheter with the expandable body,  1 B, according to this embodiment is the same as the first embodiment, except that slits  41  are formed at an inclination relative to the longitudinal direction of the outer sleeve  4 .  
         [0090]     A plurality of the slits  41  are formed (arranged) intermittently (at intervals) along the circumferential direction of the outer sleeve  4  as indicated by symbols  41   a ,  41   b  and  41   c  in  FIG. 7 , and are formed (arranged) intermittently (at intervals) also along the longitudinal direction of the outer sleeve  4  as indicated by symbols  41   d ,  41   e  and  41   f  in  FIG. 7 .  
         [0091]     In this embodiment, the same effects as in the first embodiment above can be obtained.  
       Third Embodiment  
       [0092]      FIG. 8  is a side view showing the exterior of an expandable body in its contracted state in a third embodiment of the catheter with the expandable body according to the present invention.  
         [0093]     Now, the third embodiment of the catheter with the expandable body according to the present invention will be described below referring to this figure. The following description will be centered on differences from the first embodiment above, and description of the same points as in the first embodiment will be omitted.  
         [0094]     In the catheter with the expandable body,  1 C, according to this embodiment, one slit  41  is formed in a spiral shape with the center axis of the outer sleeve  4  as a center. This ensures that, in this embodiment, stress concentration would not occur in the vicinity of end portions of the slit  41  in the outer sleeve  4  upon expansion of the expandable body  3 . Therefore, even where the outer sleeve  4  is formed of a material having a comparatively low strength or where the expandable body  3  is expanded with a high pressure, it is possible to securely prevent cracks from being generated in the vicinity of the end portions of the slit  41  at the time of expansion of the expandable body  3 .  
         [0095]     In addition, the slit  41  is absent in the vicinity of the distal end of the outer sleeve  4  and in the vicinity of the proximal end of the outer sleeve  4 . In other words, the tipmost end  411  of the slit  41  is spaced to the proximal end side from the distal end of the outer sleeve  4 , and the basemost end  412  of the slit  41  is spaced to the distal end side from the proximal end of the outer sleeve  4 . This ensures that the fixation to the outer tube  21  and the inner tube  22  can be performed more uniformly.  
         [0096]     Incidentally, in this embodiment, a plurality of axially spaced spiral slits  41  may be formed in the shape of a multiple spiral.  
       Fourth Embodiment  
       [0097]      FIG. 9  is a side view showing the exterior of an expandable body in its contracted state in a fourth embodiment of the catheter with the expandable body according to the present invention.  
         [0098]     Now, the fourth embodiment of the catheter with the expandable body according to the present invention will be described below referring to this figure. The following description will be centered on differences from the first embodiment above, and description of the same points as in the first embodiment will be omitted.  
         [0099]     The catheter with the expandable body,  1 D, according to this embodiment is the same as the first embodiment, except that the shape of slits  41  is different.  
         [0100]     In this embodiment, each of the slits  41  has a shape in which a parallel portion  413  parallel to the longitudinal direction of the outer sleeve  4  and an inclined portion  414  inclined relative to the longitudinal direction intersect each other. This makes it possible for the slits  41  to be opened more largely and easily at the time of expansion of the expandable body  3 .  
       Fifth Embodiment  
       [0101]      FIG. 10  is a vertical sectional view showing an expandable body in its expanded state in a fifth embodiment of the catheter with the expandable body according to the present invention.  
         [0102]     Now, the fifth embodiment of the catheter with the expandable body according to the present invention will be described below referring to this figure. The following description will be centered on differences from the first embodiment above, and description of the same points as in the first embodiment will be omitted.  
         [0103]     A shaft  2  of the catheter with the expandable body,  1 E, according to this embodiment has a tubular distal end tip  24  joined to a distal end portion  222  of an inner tube  22 . The distal end tip  24  is higher in flexibility than the inner tube  22 , and its inside and outside diameters are nearly equal to those of the inner tube  22 , respectively.  
         [0104]     A distal end portion  32  of the expandable body  3  is attached liquid-tight to the distal end portion  222  of the inner tube  22  and the distal end tip  24  over the entire circumference.  
         [0105]     In this embodiment, the provision of the flexible distal end tip  24  makes it possible to further alleviate the stimulus to the inside wall of a body lumen at the time of inserting the catheter with the expandable body,  1 E, into the body lumen, so that a higher safety can be obtained.  
       Sixth Embodiment  
       [0106]      FIG. 11  is a vertical sectional view showing an expandable body in its expanded state in a sixth embodiment of the catheter with the expandable body according to the present invention.  
         [0107]     Now, the sixth embodiment of the catheter with the expandable body according to the present invention will be described below referring to this figure. The following description will be centered on differences from the first embodiment above, and description of the same points as in the first embodiment will be omitted.  
         [0108]     In the catheter with the expandable body,  1 F, according to the present invention, a distal end portion  42  of the outer sleeve  4  is extended to the distal end side beyond a distal end portion  32  of the expandable body  3 . The distal end portion  42  of the outer sleeve  4  is attached to both the distal end portion  32  of the expandable body  3  and the vicinity of a distal end portion  222  of the inner tube  22 . In addition, a proximal end portion  43  of the outer sleeve  4  is extended to the proximal end side beyond a proximal end portion  33  of the expandable body  3 . The proximal end portion  43  of the outer sleeve is attached to both the proximal end portion  33  of the expandable body  3  and a distal end portion  211  of the outer tube  21 .  
         [0109]     This configuration ensures that, in the catheter with the expandable body,  1 F, the outer sleeve  4  can be fixed more firmly, and exfoliation of fixed portions and the like troubles can be prevented more securely.  
       Seventh Embodiment  
       [0110]      FIG. 12  is a vertical sectional view showing an expandable body in its expanded state in a seventh embodiment of the catheter with the expandable body according to the present invention.  
         [0111]     Now, the seventh embodiment of the catheter with the expandable body according to the present invention will be described below referring to this figure. The following description will be centered on differences from the first embodiment above, and description of the same points as in the first embodiment will be omitted.  
         [0112]     A shaft  2  in the catheter with the expandable body,  1 G, according to this embodiment has a tubular distal end tip  24  joined to a distal end portion  222  of the inner tube  22 . The distal end tip  24  is higher in flexibility than the inner tube  22 , and its inside and outside diameters are nearly equal to those of the inner tube  22 , respectively.  
         [0113]     A distal end portion  32  of the expandable body  3  is attached liquid-tight to a distal end portion  222  of the inner tube  22  and the distal end tip  24  over the entire circumference.  
         [0114]     In this embodiment, the provision of the flexible distal end tip  24  makes it possible to further alleviate the stimulus to the inside wall of a body lumen at the time of inserting the catheter with the expandable body,  1 G, into the body lumen, so that a higher safety can be obtained.  
         [0115]     In addition, in the catheter with the expandable body,  1 G, according to this embodiment, a distal end portion  42  of the outer sleeve  4  is extended to the distal end side beyond the distal end portion of the expandable body  3 . The distal end portion  42  of the outer sleeve  4  is attached to both the distal end portion  32  of the expandable body  3  and the distal end tip  24 . Besides, a proximal end portion  43  of the outer sleeve  4  is extended to the proximal end side beyond a proximal end portion  33  of the expandable body  3 . The proximal end portion  43  of the outer sleeve  4  is attached to both the proximal end portion  33  of the expandable body  3  and a distal end portion  211  of the outer tube  21 .  
         [0116]     This configuration ensures that, in the catheter with the expandable body,  1 G, the outer sleeve  4  can be fixed more firmly, and exfoliation of fixed portions or the like troubles can be prevented more assuredly.  
         [0117]     While the embodiments of the catheter with the expandable body according to the present invention have been described above, arbitrary two or more configurations (characteristics) of these embodiments may be combined with each other in the present invention.  
         [0118]     In addition, a difference or differences in the manner of formation of the slit(s)  41  may be provided between a distal end side portion and a proximal end side portion of the outer sleeve  4 . Here, the difference or differences in the manner of formation of the slit(s)  41  mean a difference or differences in the length (L 1 ) of the slit(s)  41 , the width (L 5 ) of the slit(s)  41 , the direction (inclination angle) of the slit(s)  41 , the shape of the slit(s)  41 , the formation density of the slit(s)  41 , and the like.  
         [0119]     For example, in the case of the configuration as in  FIG. 1 , when the formation density of the slits  41  is set higher (the pitch L 2  set smaller) in a distal end side portion (in the longitudinal direction) of the outer sleeve  4  and the formation density of the slits  41  is set lower (the pitch L 2  set larger) in a proximal end side portion (in the longitudinal direction) of the outer sleeve  4 , the flexibility of the distal end side portion of the sleeve  4  is enhanced, so that the sleeve  4  (and the expandable body  3 ) will be easily expanded at the distal end side portion, and the property for passing to a constricted portion  100  is enhanced.  
         [0120]     Other than the above example, a difference or differences in the manner of formation of the slit(s)  41  may be provided between the vicinity of both ends and a central portion in the longitudinal direction of the outer sleeve  4 , whereby a diversity of functions can be added in accordance with the individual cases.  
         [0121]     While the catheter with the expandable body according to the present invention has been described above by way of the embodiments shown in the figures, the invention is not limited to the above embodiments, and each of the portions constituting the catheter with the expandable body can be replaced by one having an arbitrary configuration which can display the same function as the above-described. Besides, an arbitrary component or components may be added.