Patent Publication Number: US-2022218321-A1

Title: Medical material

Description:
TECHNICAL FIELD 
     The present invention relates to a medical material for treating a hole in biological tissue, and particularly relates to a medical material configured to be set in a catheter, sent to a treatment site through a blood vessel, and placed in a living body. 
     BACKGROUND ART 
     The heart of a human is divided into left and right chambers by tissue called the septum, and each of the left and right chambers has an atrium and a ventricle. That is, the heart is composed of two atria and two ventricles, i.e., right atrium, right ventricle, left atrium, and left ventricle. With regard to the heart having such a structure, atrial septal defect (ASD) is known, which is a defect wherein, due to a disorder of development in the fetal period, there is a congenital hole called a hole in the atrial septum separating the right atrium and the left atrium. 
     Treatment for atrial septal defect can be performed by the following two methods. One is a surgical operation performed by opening the chest, and the other is catheterization using an occluder without opening the chest. 
     A surgical operation (patching operation) involves using cardiopulmonary bypass, opening the chest, and closing the hole with a patch. Catheterization involves setting an occluder in a catheter, inserting the catheter into a blood vessel, sending the catheter to a target position (hole), and then releasing the occluder to place it in the body. The catheterization is to close a hole without opening the chest, by sending a small jig (device) called an occluder, folded in an elongated shape, from a vein (femoral vein) at the groin to the position of the hole in the atrial septum. The catheterization is advantageous in that the treatment can be performed merely by making a tiny skin incision (a few millimeters) in the groin (inguinal region), which is an inconspicuous area, without having to perform open chest surgery requiring general anesthesia. 
     Japanese Unexamined Patent Application Publication (Japanese translation of PCT International Application) No. 2008-512139 (Patent document 1) discloses an assembly (occluder) for use in catheterization for atrial septal defect. This assembly seals a passageway (hole) in the heart. The assembly includes: a closure device for sealing the passageway in the heart including a first anchor adapted to be placed proximate a first end of the passageway, a second anchor adapted to be placed proximate a second end of the passageway, and a flexible elongate member adapted to extend through the passageway and connect the first and second anchors, the second anchor capable of movement relative to the flexible elongate member to vary a length of the flexible elongate member between the first and second anchors; and a delivery system for delivering the closure device to the passageway in the heart, the delivery device being configured to move within a lumen of a guide catheter and including a wire configured to control movement of the second anchor along the flexible elongate material. 
     Patent document 1 also discloses that a patent foramen ovale (PFO) closure device (occluder) includes a left atrial anchor, a right atrial anchor, a tether, and a lock, and that the left atrial anchor, the right atrial anchor connected to the left atrial anchor via the tether, and the lock will remain in the heart to seal the PFO. 
     RELATED ART DOCUMENTS 
     Patent Documents 
     
         
         [Patent document 1] Japanese Unexamined Patent Application Publication (Japanese translation of PCT International Application) No. 2008-512139 
       
    
     DISCLOSURE OF THE INVENTION 
     Problems to be Solved by the Invention 
     A patching operation has an issue in that it involves usage of cardiopulmonary bypass, is highly invasive, and therefore requires long hospitalization. Catheterization is preferable because it does not involve usage of cardiopulmonary bypass, is less invasive, and therefore requires only short hospitalization. 
     As disclosed in Patent document 1, the left atrial anchor and the right atrial anchor remain in the heart. Each of the left and right atrial anchors includes one or more arms, which extend radially outward from a hub. The arms are preferably formed from a rolled sheet of binary nickel titanium alloy. A hole is to be closed by extending the left atrial anchor and the right atrial anchor in a living body; however, once the extension of the anchors has been started, it is difficult to bring the anchors into their original state. The anchors are to be folded by means of a dedicated takeout device which has a complicated structure and which is difficult to operate from outside the living body, as disclosed in Patent document 1. 
     However, for example, in the event that an anchor has accidentally been caught in biological tissue within an atrium and damaged the biological tissue, there may be cases where there is not enough time to fold the anchor using such a dedicated takeout device. In such a case, there is no other choice but to perform open chest surgery immediately. Under such circumstances, the patient will end up with highly invasive open chest surgery, which is an issue. 
     There is another issue in that a hole occluder made of metal will remain in the body for the whole life and that some problem may occur in the late post-treatment period. 
     The present invention was made in view of the above-mentioned issues of the conventional techniques, and its object is to provide a medical material which makes it possible to perform less invasive catheterization capable of releasing and placing the medical material at a treatment site inside a living body with easy and reliable operation without a complicated structure and which is unlikely to cause problems in the late post-treatment period even when remaining in the body. 
     Means of Solving the Problems 
     In order to attain the above object, a medical material according to an aspect of the present invention employs the following technical means. 
     Specifically, a medical material according to the present invention is a medical material comprised of a tubular body that has a mesh structure formed of a bioabsorbable linear material, wherein: the medical material has a shape in which a substantially middle portion of the tubular body is smaller in tube diameter than other portions of the tubular body; the medical material has a first tubular portion with a first end and a second tubular portion with a second end which are arranged with the substantially middle portion therebetween, the first end and the second end being opposite ends in a longitudinal direction of the tubular body; when the medical material is contained in a catheter such that the first end and the second end are away from each other with the substantially middle portion therebetween and that the other portions have a reduced tube diameter, the second end is located on the same side of the catheter as a distal end of the catheter; the medical material includes, at the second end, a connecting part configured to have connected thereto a delivery cable that passes through the medical material from the first end via the substantially middle portion toward the second end; and the medical material is configured to allow the delivery cable to pass out of the medical material through the first end. 
     It is preferable that the medical material can be configured such that the connecting part is a hollow cylindrical object which has an internal thread and to which the delivery cable is connected by screwing an external thread at a distal end of the delivery cable into the internal thread. 
     It is more preferable that the medical material can be configured such that the hollow cylindrical object has: an open end which is on the same side of the hollow cylindrical object as the first tubular portion, which has the internal thread, and which is capable of being screwed onto the external thread; and a closed end which is on the opposite side of the hollow cylindrical object from the first tubular portion. 
     It is more preferable that the medical material can be configured such that, while the medical material connected by the connecting part to the delivery cable is entirely contained in the catheter, the delivery cable is manipulated such that the medical material advances in a direction toward an opening of the catheter, and the second tubular portion is allowed to move out of the catheter through the distal end of the catheter and then the first tubular portion is allowed to move out of the catheter through the distal end of the catheter, so that the first end and the second end come close to each other with the substantially middle portion therebetween and the other portions increase in tube diameter to a size corresponding to a hole to be closed with the medical material. 
     It is more preferable that the medical material can be configured such that the medical material further includes a loop which has one end connected to the first end and which has the opposite end connected to an anti-falling member having a size larger than an inner diameter of the catheter, wherein an overall length of the loop is greater than an overall length of the catheter. 
     In order to attain the above object, a medical material according to another aspect of the present invention employs the following technical means. 
     Specifically, a medical material according to the present invention is a medical material comprised of a tubular body that has a mesh structure formed of a bioabsorbable linear material, wherein: the medical material has a shape in which a substantially middle portion of the tubular body is smaller in tube diameter than other portions of the tubular body; the medical material has a first tubular portion with a first end and a second tubular portion with a second end which are arranged with the substantially middle portion therebetween, the first end and the second end being opposite ends in a longitudinal direction of the tubular body; when the medical material is contained in a catheter such that the first end and the second end are away from each other with the substantially middle portion therebetween and that the other portions have a reduced tube diameter, the second end is located on the same side of the catheter as a distal end of the catheter; the medical material includes: a proximal connecting part connected to the mesh structure at the first end; and a distal connecting part connected to the mesh structure at the second end; the proximal connecting part and the distal connecting part each have a hollow tubular shape, and are capable of selectively achieving: “locked” in which the proximal connecting part and the distal connecting part remain united; and “unlocked” in which the proximal connecting part and the distal connecting part do not remain united; an inner diameter of the proximal connecting part is larger than an outer diameter of a delivery cable inserted in the catheter; the distal connecting part is capable of selectively achieving a connected state in which the distal connecting part is connected to a distal end of the delivery cable and a disconnected state in which the distal connecting part is not connected to the distal end of the delivery cable; and the medical material is configured to allow the delivery cable, which has the distal end thereof connected to the distal connecting part, to pass through the substantially middle portion, be inserted into a hollow tube of the proximal connecting part, and pass out of the medical material in a direction from the second end to the first end. 
     It is preferable that the medical material can be configured such that: the distal connecting part is a hollow tubular object having an internal thread; the delivery cable has, at the distal end thereof, an external thread configured to be screwed into the internal thread; the connected state is achieved by screwing the external thread into the internal thread, and the disconnected state is achieved by unscrewing the external thread from the internal thread; and the medical material is configured such that the external thread and the internal thread are capable of being unscrewed from each other while the proximal connecting part and the distal connecting part remain united and locked. 
     It is more preferable that the medical material can be configured such that: the proximal connecting part and the distal connecting part each have a hollow cylindrical shape; an outer diameter of the distal connecting part is smaller than the inner diameter of the proximal connecting part; the distal connecting part has a recess in an outer peripheral surface thereof; the proximal connecting part has, on an inner peripheral surface thereof, a protrusion configured to engage with the recess; and engagement between the recess and the protrusion causes the proximal connecting part and the distal connecting part to be united and locked. 
     It is more preferable that the medical material can be configured such that: a shape of the recess in the outer peripheral surface of the distal connecting part has a groove shape provided along a circumferential direction, and a length of the groove shape along the circumferential direction is less than an outer circumference of the distal connecting part; a shape of the protrusion on the inner peripheral surface of the proximal connecting part is a short shaft shape that extends from the inner peripheral surface toward a cylinder central axis; a groove width of the groove shape and a shaft diameter of the short shaft shape are substantially equal to each other; and engagement of a shaft portion of the short shaft shape with a groove portion of the groove shape causes the proximal connecting part and the distal connecting part to be united and locked. 
     It is more preferable that the medical material can be configured such that the medical material is configured such that the external thread and the internal thread are capable of being unscrewed from each other while the proximal connecting part and the distal connecting part remain united and locked because: the groove shape along the circumferential direction has an area which allows the shaft to be more tightly engaged with decreasing distance to an innermost end of the groove along the circumferential direction; the groove shape along the circumferential direction has an area which has a narrow groove width to allow the shaft to be tightly engaged and which is provided near the innermost end of the groove along the circumferential direction; or the groove shape along the circumferential direction has, near the innermost end of the groove along the circumferential direction, at least one bend at which the groove shape bends from the circumferential direction to another direction other than the circumferential direction. 
     It is more preferable that the medical material can be configured to achieve the following: while the medical material in which the distal end of the delivery cable is connected to the second end by the distal connecting part is entirely contained in the catheter, the delivery cable is manipulated, and the second tubular portion is allowed to move out of the catheter through the distal end of the catheter and then the first tubular portion is allowed to move out of the catheter through the distal end of the catheter such that the medical material advances in a direction toward an opening of the catheter, so that the first end and the second end come close to each other with the substantially middle portion therebetween; the delivery cable is manipulated and the proximal connecting part and the distal connecting part are united and locked so that the proximal connecting part and the distal connecting part remain united, thereby maintaining a state in which the other portions have a tube diameter increased to a size corresponding to a hole to be closed with the medical material; and the delivery cable is manipulated, the distal connecting part and the distal end of the delivery cable are disconnected, and the catheter, together with the delivery cable inserted in the catheter, is separated from a site where there is the hole. 
     Effects of the Invention 
     A medical material according to the present invention makes it possible to perform less invasive catheterization capable of releasing and placing the medical material at a treatment site in a living body with easy and reliable operation without a complicated structure. Furthermore, the medical material according to the present invention is unlikely to cause problems in the late post-treatment period even when remaining in the body. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1A  is an overall view of a hole closing material  100  which is an example of a medical material according to the present invention (state in which a first end and a second end are close to each other). 
         FIG. 1B  is an overall view of a hole closing material  100  which is another example of a medical material according to the present invention (state in which the first end and the second end are close to each other). 
         FIG. 2A  is an overall view of the hole closing material  100  illustrated in  FIG. 1A  (the distance between the first end and the second end is in an intermediate state). 
         FIG. 2B  is an overall view of the hole closing material  100  illustrated in  FIG. 1B  (the distance between the first end and the second end is in an intermediate state). 
         FIG. 3A  is an overall view of the hole closing material  100  illustrated in  FIG. 1A  (the hole closing material is entirely contained in a catheter  300  and the first end and the second end are away from each other). 
         FIG. 3B  is an overall view of the hole closing material  100  illustrated in  FIG. 1B  (the hole closing material is entirely contained in the catheter  300  and the first end and the second end are away from each other). 
         FIG. 4A  is an overall view of the hole closing material  100  illustrated in  FIG. 1A  (state in which a second tubular portion has been moved out of the catheter  300  and a first tubular portion is contained in the catheter  300 ). 
         FIG. 4B  is an overall view of the hole closing material  100  illustrated in  FIG. 1B  (state in which the second tubular portion has been moved out of the catheter  300  and the first tubular portion is contained in the catheter  300 ). 
         FIG. 5A  is a partial side view of the hole closing material  100  in the state shown in  FIG. 2A . 
         FIG. 5B  is a cross-sectional view taken along A-A in  FIG. 5A . 
         FIG. 5C  is a partial side view of the hole closing material  100  in the state shown in  FIG. 2B . 
         FIG. 5D  is a cross-sectional view taken along A-A in  FIG. 5C . 
         FIG. 6  is a conceptual view in which the hole closing material  100  is used in catheterization for atrial septal defect. 
         FIG. 7A  is an enlarged view (1) of part B in  FIG. 6  illustrating a procedure of catheterization using the hole closing material  100  illustrated in  FIG. 1A . 
         FIG. 7B  is an enlarged view (1) of part B in  FIG. 6  illustrating a procedure of catheterization using the hole closing material  100  illustrated in  FIG. 1B . 
         FIG. 8A  is an enlarged view (2) of part B in  FIG. 6  illustrating the procedure of catheterization using the hole closing material  100  illustrated in  FIG. 1A . 
         FIG. 8B  is an enlarged view (2) of part B in  FIG. 6  illustrating the procedure of catheterization using the hole closing material  100  illustrated in  FIG. 1B . 
         FIG. 9A  is an enlarged view (3) of part B in  FIG. 6  illustrating the procedure of catheterization using the hole closing material  100  illustrated in  FIG. 1A . 
         FIG. 9B  is an enlarged view (3) of part B in  FIG. 6  illustrating the procedure of catheterization using the hole closing material  100  illustrated in  FIG. 1B . 
         FIG. 10  is an enlarged view of a distal connecting part  422  provided at the distal end of the hole closing material  100  and a delivery cable  500  screwed to the distal connecting part  422 . 
         FIG. 11A  is an enlarged view of the catheter  300  which includes the distal end (second end  122 ) of the hole closing material  100  and the delivery cable  500  illustrated in  FIG. 1A . 
         FIG. 11B  is a perspective view of  FIG. 11A . 
         FIG. 12A  illustrates a hole closing material  600  which is an example of a medical material according to a variation of the present invention and which has been allowed to move out of the catheter  300  such that the hole closing material  600  is pulled. 
         FIG. 12B  illustrates the hole closing material  600  which is an example of a medical material according to the variation of the present invention. 
         FIG. 13A  is an enlarged view including a distal connecting part  422  provided at the distal end (second end  122 ) and a proximal connecting part  412  provided at the proximal end (first end  112 ) of the hole closing material  100  illustrated in  FIG. 1B , and a delivery cable  500  which is screwed to the distal connecting part  422 . 
         FIG. 13B  shows partial views (1) of  FIG. 13A . 
         FIG. 13C  is a partial view (2) of  FIG. 13A . 
         FIG. 13D  is a partial view (3) of  FIG. 13A . 
         FIG. 13E  is a partial view (4) of  FIG. 13A . 
         FIG. 13F  is a partial view (5) of  FIG. 13A . 
         FIG. 13G  is a partial view (6) of  FIG. 13A . 
         FIG. 13H  is a partial view (7) of  FIG. 13A . 
         FIG. 13I  is a partial view (8) of  FIG. 13A . 
         FIG. 13J  is a partial view (9) of  FIG. 13A . 
         FIG. 14A  is a perspective view of  FIG. 13A . 
         FIG. 14B  is a partial view (1) of  FIG. 14A . 
         FIG. 14C  is a partial view (2) of  FIG. 14A . 
     
    
    
     BEST MODE FOR CARRYING OUT THE INVENTION 
     The following description discusses a medical material according to the present invention in detail with reference to the drawings. Although the following description discusses a hole closing material for use in catheterization as an example of the medical material according to the present invention, the medical material is suitably applicable also to closure of other openings or passageways including, for example, other openings in the heart such as ventricular septal defect and patent ductus arteriosus and openings or passageways in other parts of a living body (for example, stomach) such as arteriovenous fistula. As such, the hole closing material according to an embodiment of the present invention is not limited to be used for the closure of a hole of atrial septal defect. 
     Moreover, although the description in the following embodiment is based on the assumption that a mesh structure of a hole closing material (occluder)  100  which is an example of a medical material according to the present invention is knitted or woven from bioabsorbable fiber (an example of a linear material), the present invention is not limited thereto. It is only necessary that the hole closing material enable catheterization to close a hole in a living body, and its mesh structure and material are not limited, provided that the mesh structure and material have first to third features described later and achieve first to fourth effects described later. With regard to the material, for example, the hole closing material may be knitted or woven from a linear material other than the bioabsorbable fiber. Such a linear material is preferably a linear material having a certain degree of hardness to achieve form retaining property (shape retaining property) of the hole closing material. Note that “FIG. N (N is an integer of 1 to 14 excluding 6 and 10)” (i.e.,  FIGS. 1 to 14  referenced in the following description, except for  FIGS. 6 and 10 ) have a suffix A, B, or the like indicating a corresponding drawing, which is in the form of FIG. NA, FIG. NB, or the like; however, in the following description, if a passage includes “FIG. N” alone, that passage is commonly applicable to FIGS. NA, NB, and the like. 
     [Basic Configuration] 
       FIG. 1  shows an overall view of the hole closing material  100  according to the present embodiment (state in which a first end  112  and a second end  122  are close to each other),  FIG. 2  shows another overall view of the hole closing material  100  (the distance between the first end  112  and the second end  122  is in an intermediate state),  FIG. 3  shows a further overall view of the hole closing material  100  (the hole closing material  100  is entirely contained in a catheter  300 , and the first end  112  and the second end  122  are away from each other), and  FIG. 4  shows still a further overall view of the hole closing material  100  (state in which a second tubular portion  120  has been moved out of the catheter  300  and the first tubular portion  110  is contained in the catheter  300 ). Note that, with regard to the relationship between the hole closing material  100  and the catheter  300  in which the hole closing material  100  is contained,  FIG. 3  illustrates the hole closing material  100  which is entirely contained in the catheter  300 , and  FIG. 4  illustrates the hole closing material  100  which is half (first tubular portion  110 ) contained in the catheter  300 . 
     In terms of temporal transition, when the second tubular portion  120  of the hole closing material  100  which is entirely contained in the catheter  300  (in the space defined by an inner wall  310 ) illustrated in  FIG. 3  is allowed to move out through an opening  320  of the catheter  300  in the direction indicated by an arrow Y, the state of  FIG. 4  results, and, when the first tubular portion  110  is also allowed to move out in the direction indicated by the arrow Y, the state of  FIG. 1  results. It is noted here that the state of the hole closing material  100  illustrated in  FIG. 2  is an imaginary state where the distance between the first end  112  and the second end  122  is in an intermediate state.  FIG. 13  is an enlarged view including a distal connecting part  422  provided at the distal end (second end  122 ) and a proximal connecting part  412  provided at the proximal end (first end  112 ) of the hole closing material  100  and a delivery cable  500  which is screwed to the distal connecting part  422 .  FIG. 14  is a perspective view of them. Note that the terms “proximal” and “base” are synonymous. 
     As illustrated in these drawings, an overview of the hole closing material  100  is as follows: the hole closing material  100  is comprised of a tubular body that has a mesh structure formed of a linear material, the hole closing material  100  has a shape in which a substantially middle portion  130  of the tubular body is smaller in tube diameter than other portions of the tubular body, the hole closing material  100  has a first tubular portion  110  with a first end  112  and a second tubular portion  120  with an opposite end (second end  122 ) which are arranged with the substantially middle portion  130  therebetween, the first end  112  and the opposite end being opposite ends of the hole closing material  100  in a longitudinal direction of the tubular body. 
     The hole closing material  100  is characterized in that, as illustrated in  FIGS. 1A, 2A, 3A, 4A, 5A, and 5B , when the hole closing material  100  is contained in the catheter  300  such that the first end  112  and the second end  122  are away from each other with the substantially middle portion  130  therebetween and that the other portions have a reduced tube diameter (the state as illustrated in  FIG. 3 ), the second end  122  is located on the same side of the catheter  300  as the distal end of the catheter  300 . In such a case, the hole closing material  100  includes, at the second end  122 , the distal connecting part  422  configured to have connected thereto a manipulation wire  500  (which may be hereinafter referred to as “delivery cable  500 ”) that passes through the hole closing material  100  from the first end  112  via the substantially middle portion  130  toward the second end  122 . Furthermore, the hole closing material  100  is configured to allow the delivery cable  500  to pass out of the hole closing material  100  through the first end  112  (for example, the first end  112  has a hole that allows passage of a cable body  510  of the delivery cable  500 ). 
     It is noted here that, as illustrated in  FIGS. 10 and 11 , the distal connecting part  422  is a hollow cylindrical object (made of, for example, metal) having an internal thread  424 , to which the cable body  510  of the delivery cable  500  is connected by screwing an external thread  514  at the distal end of the cable body  510  into the internal thread  424 . Note that, in the living body, by turning the cable body  510  (rotating the cable body  510  on its axis) in the direction opposite to the direction in which the external thread  514  is screwed into the internal thread  424 , it is possible to undo the screwed connection and separate the hole closing material  100  and the delivery cable  500 . 
     It is noted here that, as illustrated in  FIGS. 10 and 11 , the hollow cylindrical object forming the distal connecting part  422  has: an open end which is on the same side of the hollow cylindrical object as the first tubular portion  110 , which has the internal thread  424 , and which is capable of being screwed onto the external thread  514  provided at the distal end of the cable body  510  of the delivery cable  500 ; and a closed end which is on the opposite side of the hollow cylindrical object from the first tubular portion  110 . 
     The end which is on the opposite side of the hollow cylindrical object from the first tubular portion  100  is preferably closed as such, because the delivery cable can be easily manipulated and the hole closing material can be prevented from twisting when the hole closing material is forced to advance within a sheath. 
     Note that the hole closing material  100  is configured as follows, details of which will be described later in [Usage Embodiments]: while the hole closing material  100  connected by the distal connecting part  422  to the delivery cable  500  is entirely contained in the catheter  300 , the delivery cable  500  is manipulated (such that the hole closing material  100  advances in the direction toward the opening  320  of the catheter  300 ) and the second tubular portion  120  is allowed to move out of the catheter  300  through the distal end of the catheter and then the first tubular portion  110  is allowed to move out of the catheter  300  through the distal end of the catheter, so that the first end  112  and the second end  122  come close to each other with the substantially middle portion  130  therebetween and the other portions increase in tube diameter to a size corresponding to the hole to be closed with the hole closing material  100 . 
     In so doing, since the distal connecting part  422  is located at the second end  122  and the distal end of the delivery cable  500  is connected to the distal connecting part  422 , the second tubular portion  120  and the first tubular portion  110  are not pushed out of the catheter  300  (such as cases where the distal connecting part  422  connected to the distal end of the delivery cable  500  is located at the first end  122 ) but moved out of the catheter  300  in a manner such that the second tubular portion  120  and the first tubular portion  110  are pulled. If the second tubular portion  120  and the first tubular portion  110  are pushed out of the catheter  300 , there may be cases where the hole closing material  100  is twisted, the first end  112  and the second end  122  cannot appropriately come close to each other with the substantially middle portion  130  therebetween, and the other portions do not appropriately increase in tube diameter to a size corresponding to the hole to be closed with the hole closing material  100 . However, when the second tubular portion  120  and the first tubular portion  110  are pulled, the twisting of the hole closing material  100  is prevented or reduced, the first end  112  and the second end  122  appropriately come close to each other with the substantially middle portion  130  therebetween, and the other portions can appropriately increase in tube diameter to a size corresponding to the hole to be closed with the hole closing material  100 . 
     Furthermore,  FIG. 5A  is a partial side view of the hole closing material  100  illustrated in  FIGS. 1A, 2A, 3A, and 4A , and  FIG. 5B  is a cross-sectional view taken along A-A in  FIGS. 2A and 5A . Note that although  FIG. 5B  is a cross-sectional view of the hole closing material  100  (more specifically, the second tubular portion  120 ),  FIG. 5B  illustrates a cross-section of the cable body  510  of the delivery cable  500  and does not illustrate the mesh of a bioabsorbable fiber  150  that is visible from a direction indicated by an arrow A. Furthermore, in  FIGS. 1A, 2A, 3A, 4A, 5A, and 5B , the bioabsorbable fiber  150  disposed on the far side of each drawing is not illustrated in order to facilitate the understanding of the presence of the cable body  510  of the delivery cable  500  located inside the hole closing material  100  and the mesh of the bioabsorbable fiber  150 , and there are some areas in which the external shape of the hole closing material  100  is represented by a dashed line in order to facilitate the understanding of the external shape of the hole closing material  100 . 
     Furthermore, the hole closing material  100  is characterized in that, as illustrated in  FIGS. 1B, 2B, 3B, 4B, 5C, and 5D , when the hole closing material  100  is contained in the catheter  300  such that the first end  112  and the second end  122  are away from each other with the substantially middle portion  130  therebetween and the other portions have a reduced tube diameter (the state illustrated in  FIG. 3 ), the second end  122  is located on the same side of the catheter  300  as the distal end of the catheter  300 . In such a case, the hole closing material  100  includes: the proximal connecting part  412  connected to the mesh structure at the first end  112 ; and the distal connecting part  422  connected to the mesh structure at the second end  122 . Note that a non-limiting configuration is as follows: for example, a part of the bioabsorbable fiber  150  forming the first tubular portion  110  is passed through a hole  412 H in the proximal connecting part  412  and the part of the bioabsorbable fiber  150  thus passed through the hole  412 H is tied together with another part of the bioabsorbable fiber  150  that is not passed through the hole  412 H, thereby connecting the proximal connecting part  412  to the mesh structure at the first end  112 ; and, for example, a part of the bioabsorbable fiber  150  forming the second tubular portion  120  is passed through a hole  422 H in the distal connecting part  422  and the part of the bioabsorbable fiber  150  thus passed through the hole  422 H is tied together with another part of the bioabsorbable fiber  150  that is not passed through the hole  422 H 1 , thereby connecting the distal connecting part  422  to the mesh structure at the second end  122 . 
     The proximal connecting part  412  and the distal connecting part  422  each have a hollow tubular shape, and are configured to be capable of selectively achieving: “locked” in which the proximal connecting part  412  and the distal connecting part  422  remain united; and “unlocked” in which the proximal connecting part  412  and the distal connecting part  422  do not remain united. An inner diameter d( 3 ) of the proximal connecting part  412  is larger than an outer diameter D( 2 ) of the manipulation wire  500  (hereinafter may be referred to as “delivery cable  500 ”) inserted in the catheter  300 , and the distal connecting part  422  is configured to be capable of selectively achieving a connected state in which the distal connecting part  422  is connected to the distal end of the delivery cable  500  and a disconnected state in which the distal connecting part  422  is not connected to the delivery cable  500 . The hole closing material  100  is configured to allow the delivery cable  500 , which has the distal end thereof connected to the distal connecting part  422 , to pass through the substantially middle portion  130 , be inserted into a hollow tube of the proximal connecting part  412 , and pass out of the hole closing material  100  in a direction from the second end  122  to the first end  112  (for example, the first end  112  has a hole that allows passage of the cable body  510  of the delivery cable  500 ). 
     More specifically, the distal connecting part  422  may be a hollow tubular object (made of, for example, metal) having the internal thread  424 . The hollow tubular shape of the distal connecting part  422  means that the internal thread  424  is provided to form a hollow space. In such a case, the delivery cable  500  has, at the distal end thereof, the external thread  514  configured to be screwed into the internal thread  424 . Note that the distal end of the delivery cable  500  is synonymous with the distal end of the cable body  510 . The foregoing connected state is achieved by screwing the external thread  514  into the internal thread  424 , and the foregoing disconnected state is achieved by unscrewing the external thread  514  from the internal thread  424 . Thus, the hole closing material  100  is configured such that the external thread  514  and the internal thread  424  can be unscrewed from each other while the proximal connecting part  412  and the distal connecting part  422  are united and locked as described earlier. 
     More specifically, the proximal connecting part  412  and the distal connecting part  422  may each have a hollow cylindrical shape. The hollow cylindrical shape of the distal connecting part  422  means that the internal thread  424  is provided in a distal connecting part&#39;s main body  422 B having a cylindrical shape to form a hollow space. In such a case, the outer diameter of the distal connecting part  422  (more specifically, outer diameter D( 5 ) of a lock groove cover  422 C of the distal connecting part  422 ) is (slightly) smaller than the inner diameter d( 3 ) of the proximal connecting part  412 . The distal connecting part  422  has a recess (more specifically, lock groove  426 ) in the outer peripheral surface thereof (more specifically, the peripheral surface of the lock groove cover  422 C of the distal connecting part  422 ), and the proximal connecting part  412  has, on the inner peripheral surface thereof, a protrusion (more specifically, a lock pin  416  in the form of a short shaft) configured to engage with the recess (lock groove  426 ). The hole closing material  100  is configured such that the engagement between the recess (lock groove  426 ) and the protrusion (lock pin  416 ) causes the proximal connecting part  412  and the distal connecting part  422  to be united and locked. 
     More specifically, the shape of the recess (lock groove  426 ) in the outer peripheral surface of the distal connecting part  422  has a groove shape provided along the circumferential direction, and the length of the groove shape along the circumferential direction is less than the outer circumference of the distal connecting part. The shape of the protrusion (lock pin  416 ) on the inner peripheral surface of the proximal connecting part  412  may be a short shaft shape that extends from the inner peripheral surface toward the cylinder central axis. In such a case, the hole closing material  100  is configured such that: a groove width M of the groove shape and a shaft diameter N of the short shaft shape are substantially equal to each other; and engagement of a shaft portion (lock pin  416 ) of the short shaft shape with a groove portion (lock groove  426 ) of the groove shape causes the proximal connecting part  412  and the distal connecting part  422  to be united and locked. 
     More specifically, the groove shape (lock groove  426 ) along the circumferential direction may have an area which allows the shaft (lock pin  416 ) to be more tightly engaged with decreasing distance to the innermost end of the groove along the circumferential direction as illustrated in  FIG. 13I , may have an area which has a narrow groove width to allow the shaft (lock pin  416 ) to be tightly engaged and which is provided near the innermost end of the groove along the circumferential direction as illustrated in  FIG. 13J , and may have, near the innermost end of the groove along the circumferential direction, at least one bend at which the groove shape bends from the circumferential direction to another direction other than the circumferential direction as illustrated in  FIG. 13G or 13H . The hole closing material  100  is configured such that, since the groove shape (lock groove  426 ) along the circumferential direction is formed as described above, the external thread  514  and the internal thread  424  can be unscrewed from each other while the proximal connecting part  412  and the distal connecting part  422  remain united and locked. 
     Moreover, the hole closing material  100  is configured to achieve the following, details of which will be described later in [Usage Embodiments]. While the hole closing material  100  in which the distal end of the delivery cable  500  is connected to the second end  122  by the distal connecting part  422  is entirely contained in the catheter  300 , the delivery cable  500  is manipulated, and the second tubular portion  120  is allowed to move out of the catheter  300  through the distal end of the catheter  300  and then the first tubular portion  110  is allowed to move out of the catheter  300  through the distal end of the catheter  300  such that the hole closing material  100  advances in the direction toward the opening of the catheter  300 , so that the first end  112  and the second end  122  come close to each other with the substantially middle portion  130  therebetween. The delivery cable  500  is further manipulated and the proximal connecting part  412  and the distal connecting part  422  are united as described earlier and locked so that the proximal connecting part  412  and the distal connecting part  422  remain united, thereby maintaining a state in which the other portions have a tube diameter increased to a size corresponding to the hole to be closed with the hole closing material  100 . The delivery cable  500  is further manipulated, the distal connecting part  422  and the distal end of the delivery cable  500  are brought from the connected state into the disconnected state, and the catheter  300 , together with the delivery cable  500  inserted in the catheter  300 , is separated from the site where there is the hole. 
       FIG. 5C  is a partial side view of the hole closing material  100  illustrated in  FIGS. 1B, 2B, 3B, and 4B , and  FIG. 5D  is a cross-sectional view taken along A-A in  FIGS. 2B and 5C . Note that although  FIG. 5D  is a cross-sectional view of the hole closing material  100  (more specifically, the second tubular portion  120 ),  FIG. 5D  illustrates a cross-section of the cable body  510  of the delivery cable  500  and does not illustrate the mesh of the bioabsorbable fiber  150  that is visible from a direction indicated by an arrow A. It is noted here that  FIG. 5D  illustrates not only the cable body  510  of the delivery cable  500  which is visible from the direction indicated by the arrow A but also the distal connecting part&#39;s main body  422 B and the lock groove cover  422 C of the distal connecting part  422 . Note that the distal connecting part  422  is substantially in the shape of a cylindrical column, and is formed of: the distal connecting part&#39;s main body  422 B having the internal thread  424  which is formed in the side facing the external thread  514  of the delivery cable  500 , which is screwed onto the external thread  514 , and which forms a hollow space; and the lock groove cover  422 C which has the lock groove  426  and which covers the distal connecting part&#39;s main body  422 B. However, a configuration in which the distal connecting part&#39;s main body  422 B has the lock groove  426  in the outer peripheral surface thereof may be employed, instead of the configuration in which the distal connecting part&#39;s main body  422 B and the lock groove cover  422 C are provided independently of each other (provided as members separate from each other). Furthermore, in  FIGS. 1B, 2B, 3B, 4B, 5C, and 5D , the bioabsorbable fiber  150  disposed on the far side of each drawing is not illustrated in order to facilitate the understanding of the presence of the proximal connecting part  412  and the distal connecting part  422  present inside the hole closing material  100 , the presence of the cable body  510  of the delivery cable  500 , and the mesh of the bioabsorbable fiber  150 , and there are some areas in which the external shape of the hole closing material  100  is represented by a dashed line in order to facilitate the understanding of the external shape of the hole closing material  100 . Furthermore, there are some areas in which the proximal connecting part  412 , the distal connecting part  422 , and the cable body  510  of the delivery cable  500  present on the far side of the bioabsorbable fiber  150  in each drawing are represented by solid lines and a part of them overlapping the bioabsorbable fiber  150  is not depicted by dashed lines. 
     As illustrated in such  FIGS. 1 to 5  (particularly  FIG. 2 ), the hole closing material  100  is comprised of two tubular bodies (the first tubular portion  110  and the second tubular portion  120 ) having a mesh structure formed of a bioabsorbable material, and has a shape which is composed of such two tubular bodies and which is called, for example, a sandglass shape, a figure-of-eight shape, a double spindle shape (shape composed of two continuous long rod-like spindle-shaped objects each of which is thick in the middle and thin at both ends), or a peanut shape (outer shape of a peanut shell containing two nuts). The hole closing material  100  having such a shape has a shape in which the substantially middle portion  130  of the tubular body is narrowed such that the substantially middle portion  130  is smaller in tube diameter than other portions. That is, the first tubular portion  110  with the first end  112  and the second tubular portion  120  with the second end  122  are arranged with the substantially middle portion  130  therebetween. 
     In the hole closing material  100 , the first tubular portion  110  and the second tubular portion  120  are integrally knitted or woven such that the substantially middle portion  130  is smaller in tube diameter than other portions and the hole closing material  100  as a whole has a sandglass shape, figure-of-eight shape, double spindle shape, or peanut shape composed of two tubular bodies, although this does not imply limitation. 
     In such a case, the shape of the whole hole closing material  100  is formed by, with use of a frame (a three-dimensional paper mold) having such a sandglass shape, figure-of-eight shape, double spindle shape, or peanut shape, knitting or weaving the tubular portions from a strand of the bioabsorbable fiber  150  in conformity with the mold. Further, such a hole closing material  100  having a sandglass shape, figure-of-eight shape, double spindle shape, or peanut shape composed of two tubular bodies as a whole may be formed in the following manner: the first tubular portion  110  and the second tubular portion  120  are integrally knitted or woven to make a tubular body having a substantially uniform diameter and then the tubular body is, for example, thermally set to obtain the substantially middle portion  130  which is smaller in tube diameter than other portions and which has a larger tube diameter than the diameter of the cable body  510  of the delivery cable  500 , although this does not imply limitation. 
     Such a shape, which is achieved by knitting, achieves the following changes in shape (temporal changes in shape), details of which will be described later: with regard to the hole closing material  100  which is entirely contained in the catheter  300  (in the space defined by the inner wall  310 ) illustrated in  FIG. 3 , the delivery cable  500  having its distal end connected to the distal connecting part  422  at the second end  122  is manipulated (such that the hole closing material  100  advances in the direction toward the opening  320  of the catheter  300 ) and the second tubular portion  120  is allowed to move out of the catheter  300  through the opening  320  at the distal end of the catheter  300  in the direction indicated by the arrow Y such that the second tubular portion  120  is pulled out of the catheter  300 , so that the second tubular portion  120  is released from the space defined by the inner wall  310  of the catheter  300  and the second tubular portion  120  is brought into the state shown in  FIG. 4 ; and the delivery cable  500  is further manipulated (such that the hole closing material  100  (further) advances in the direction toward the opening  320  of the catheter  300 ) and the first tubular portion  110  is allowed to move out of the catheter  300  through the opening  320  at the distal end of the catheter  300  in the direction indicated by the arrow Y such that the first tubular portion  110  is pulled out of the catheter  300 , so that the first tubular portion  110  is also released from the space defined by the inner wall  310  of the catheter  300  after the tubular portion  120  and the first tubular portion  110  (and the second tubular portion  120 ) is brought into the state shown in  FIG. 1 . 
     As illustrated in  FIG. 1 , when the hole closing material  100  is not contained in the catheter  300  and is isolated in a space, the first end  112  and the second end  122  are close to each other with the substantially middle portion  130  therebetween, and the first tubular portion  110  and the second tubular portion  120 , as the other portions other than the substantially middle portion  130 , have an increased tube diameter. With regard to the increased tube diameter, it is particularly preferable that the first tubular portion  110  and the second tubular portion  120  (as the other portions other than the substantially middle portion  130 ) increase in tube diameter to a size corresponding to a hole to be closed with the hole closing material  100 . 
     As illustrated in  FIG. 3 , when the hole closing material  100  is not isolated in a space but restricted from freely deforming in radial directions because, for example, the hole closing material  100  is contained in the catheter  300 , the first end  112  and the second end  122  are away from each other with the substantially middle portion  130  therebetween, and the first tubular portion  110  and the second tubular portion  120 , as the other portions, have a reduced tube diameter. With regard to the reduced tube diameter, it is particularly preferable that the first tubular portion  110  and the second tubular portion  120  (the other portions other than the substantially middle portion  300 ) decrease in tube diameter to a size corresponding to the catheter  300  in which the hole closing material  100  is contained. 
     Note that the diameter of the cable body  510  of the delivery cable  500  is smaller than the tube diameter of the substantially middle portion  130 . 
     As described above, by housing the hole closing material  100  in, for example, the catheter  300  to restrict the hole closing material  100  from freely deforming in radial directions or by allowing the hole closing material  100  to move out of the catheter  300  such that the hole closing material  100  is pulled out to release the restriction of free deformation of the hole closing material  100  in radial directions, the first end  112  and the second end  122 , which are opposite ends of the hole closing material  100  in the longitudinal direction of the tubular body, can be brought away from each other (contained in the catheter  300 ) or close to each other (pulled out of the catheter  300 ). When the hole closing material  100  is allowed to move out of the catheter  300  such that the hole closing material  100  is pulled out of the catheter  300  and free deformation in radial directions is not restricted, as illustrated in  FIG. 1 , the first end  112  and the second end  122  come close to each other and the other portions other than the substantially middle portion  130  (body portion of the first tubular portion  110  and the body portion of the second tubular portion  120 ) increase in tube diameter. When the hole closing material  100  is contained in the catheter  300  and free deformation in radial directions is restricted, as illustrated in  FIG. 3 , the first end  112  and the second end  122  move away from each other and the other portions other than the substantially middle portion  130  (body portion of the first tubular portion  110  and the body portion of the second tubular portion  120 ) decrease in tube diameter. 
     Further, as illustrated in  FIG. 4 , when the second tubular portion  120  is pulled out of the catheter  300  in the direction indicated by the arrow Y, the second tubular portion  120 , which has had its shape restricted by the inner wall  310  of the catheter  300  (restricted from freely deforming in radial directions), becomes freely changeable in shape, and only the body portion of the second tubular portion  120  increases in tube diameter. Furthermore, when the first tubular portion  110  is pulled out of the catheter  300  in the direction indicated by the arrow Y, the first tubular portion  110 , which has had its shape restricted by the inner wall  310  of the catheter  300  (restricted from freely deforming in radial directions), also becomes freely changeable in shape, and the body portion of the first tubular portion  110  also increases in tube diameter. 
     The first tubular portion  110  and the second tubular portion  120  of the hole closing material  100  are formed of woven fabric (coarse-woven fabric), knitted fabric, braided fabric, or tubular knitted fabric of the bioabsorbable fiber  150 , and are entirely composed of a mesh structure. It should be noted here that the mesh structure is not limited to knitted fabric formed by knitting, but includes a network structure composed of a coarse-woven structure like a window net, as described above. That is, the first tubular portion  110  and the second tubular portion  120  may have a structure called “mesh structure” or a structure called “network structure”. 
     As described above, basically the first tubular portion  110  and the second tubular portion  120  are all made of a bioabsorbable material except for the proximal connecting part  412  and the distal connecting part  422  (these may be simply referred to as “connecting parts”, in cases where no distinction is necessary) each composed of a metal piece made of metal (e.g., stainless steel or magnesium), and therefore the entire hole closing material  100  except for the connecting parts is bioabsorbable (the delivery cable  500  is not a constituent element of a medical material according to the present invention and does not remain in a living body, and therefore a material therefor is not particularly limited). Furthermore, treatment to close a hole using the hole closing material  100  changing in shape is performed; in this regard, the hole closing material  100  including the connecting parts employs a material, mesh shape, fiber structure, and fiber cross section that do not damage tissue in a living body even when the shape of the hole closing material  100  is thus changed in the living body. 
     Note that, usually, the connecting parts are made of, for example, a stainless steel or the like and is not bioabsorbable, but the connecting parts may be made of, for example, an alloy based on magnesium (described later) to be bioabsorbable. The use of an alloy not transmitting X rays (electromagnetic waves having a wavelength of about 1 μm to 10 nm) for the connecting parts is advantageous in that the connecting parts are observable in X-ray imaging, and the use of a bioabsorbable alloy is advantageous in that a metallic member does not remain in the body throughout the whole life and therefore an issue of possible problems in the late post-treatment period does not arise. 
     The bioabsorbable fiber  150  forming the first tubular portion  110  and the second tubular portion  120  is, for example, at least one type selected from polyglycolic acid, polylactides (poly-D-lactide, poly-L-lactide, and poly-DL-lactide), polycaprolactone, glycolic acid-lactide (D-lactide, L-lactide, or DL-lactide) copolymers, glycolic acid-ε-caprolactone copolymers, lactide (D-lactide, L-lactide, or DL-lactide)-ε-caprolactone copolymers, poly(p-dioxanone), glycolic acid-lactide (D-lactide, L-lactide, or DL-lactide)-ε-caprolactone copolymers, and the like. The at least one type of material is used after being processed into any one of the following forms: monofilament yarn, multifilament yarn, twisted yarn, braid, and the like, and is preferably used in the form of a monofilament yarn. 
     The material for the bioabsorbable fiber  150  may be a bioabsorbable alloy. Examples of such a bioabsorbable alloy include alloys based on magnesium as a raw material. 
     The bioabsorbable fiber  150  has a diameter of about 0.001 mm to 1.5 mm, and fiber diameter and type that are suitable for catheterization in which the hole closing material  110  is used are selected. Furthermore, the bioabsorbable fiber  150  may have any of the following cross sections: a circle, an ellipse, and other different shapes (such as a star shape), provided that the in vivo tissue is not damaged. Further, the surface of the bioabsorbable fiber  150  may be treated to have hydrophilicity by plasma discharge, electron beam treatment, corona discharge, ultraviolet irradiation, ozone treatment, or the like. The bioabsorbable fiber  150  may have applied thereon or may be impregnated with a radiopaque material (such as barium sulfate, gold chip, or platinum chip), may be treated to have attached thereon an agent (for example, an agent suitable for catheterization for atrial septal defect), and may be coated with a natural polymer such as collagen and/or gelatin or with a synthetic polymer such as polyvinyl alcohol and/or polyethylene glycol. 
     The first tubular portion  110  and the second tubular portion  120  are formed in the following manner: the bioabsorbable fiber  150  is, for example, braided to form braided fabric using a braiding machine with multiple (for example, 8 or 12) yarn feeders around a silicone rubber tube (not illustrated) having an outer diameter desired as a monofilament yarn or knitted or woven into a tubular mesh structure having a substantially uniform diameter using a circular knitting machine (not illustrated). After the knitting or weaving, as described earlier, the braided fabric or the tubular mesh structure is formed into a sandglass shape, figure-of-eight shape, double spindle shape, or peanut shape composed of two tubular bodies (first tubular portion  110  and second tubular portion  120 ). The tube diameters of the first tubular portion  110  and the second tubular portion  120  in a small diameter state are smaller than the inner diameter of the catheter  300 , and the first tubular portion  110  and the second tubular portion  120  in a large diameter state have a size preferable for catheterization for atrial septal defect. For example, the tube diameters of the first tubular portion  110  and the second tubular portion  120  in the large diameter state are about 5 mm to 80 mm, preferably about 15 mm to 25 mm. Furthermore, the lengths of the first tubular portion  110  and the second tubular portion  120  and the density of the mesh structure of the hole closing material  100  also have a density preferable for catheterization for atrial septal defect. Note that the first tubular portion  110  and the second tubular portion  120  do not need to have equal tube diameters and do not need to have equal lengths, and the tube diameters and lengths may be changed to suit for catheterization for atrial septal defect. 
     As has been described, the hole closing material  100  according to the present embodiment illustrated in  FIGS. 1A, 2A, 3A, 4A, 5A, and 5B  and the hole closing material  100  according to the present embodiment illustrated in  FIGS. 1B, 2B, 3B, 4B, 5C, and 5D  include the following features. 
     (First feature) The hole closing material  100  has a sandglass shape, figure-of-eight shape, double spindle shape, or peanut shape that is thin in the substantially middle portion  130  and that is comprised of the first tubular portion  110  and the second tubular portion  120 .
 
(Second feature) The hole closing material  100  includes, at the second end  122  (on the same side of the catheter  300  as the distal end of the catheter  300 ), the distal connecting part  422  configured to have connected thereto the manipulation wire  500  that passes through the hole closing material  100  from the first end  112  via the substantially middle portion  130  toward the second end  122 , and is configured to allow the delivery cable  500  to pass out of the hole closing material  100  through the first end  112 .
 
     With the first feature and the second feature, with regard to the hole closing material  100  contained in the catheter  300 , when the second tubular portion  120  is allowed to move out of the catheter  300 , the second tubular portion  120 , which has had its shape restricted by the inner wall  310  of the catheter  300 , becomes freely changeable in shape, and only the body portion of the second tubular portion  120  increases in tube diameter, and, furthermore, when the first tubular portion  110  is allowed to move out of the catheter  300 , the first tubular portion  110 , which has had its shape restricted by the inner wall  310  of the catheter  300 , also becomes freely changeable in shape, and the body portion of the first tubular portion  110  also increases in tube diameter. It follows that the body portions increase in tube diameter to a size corresponding to a hole to be closed with the hole closing material  100 . 
     The hole closing material  100  illustrated in  FIGS. 1B, 2B, 3B, 4B, 5C, and 5D  further includes the following features. 
     (Third feature) The proximal connecting part  412  and the distal connecting part  422  each have a hollow tubular shape, and are configured to be capable of selectively achieving: “locked” in which the proximal connecting part  412  and the distal connecting part  422  remain united; and “unlocked” in which the proximal connecting part  412  and the distal connecting part  422  do not remain united. The inner diameter d( 3 ) of the proximal connecting part  412  is larger than the outer diameter D( 2 ) of the manipulation wire  500  inserted in the catheter  300 , and the distal connecting part  422  is configured to be capable of selectively achieving a connected state in which the distal connecting part  422  is connected to the distal end of the delivery cable  500  and a disconnected state in which the distal connecting part  422  is not connected to the distal end of the delivery cable  500 . The hole closing material  100  is configured to allow the delivery cable  500 , which has the distal end thereof connected to the distal connecting part  422 , to pass through the substantially middle portion  130 , be inserted into a hollow tube of the proximal connecting part  412 , and pass out of the hole closing material  100  in a direction from the second end  122  to the first end  112  (for example, the first end  112  has a hole which allows passage of the cable body  510  of the delivery cable  500 ). The hole closing material  100  is configured such that, for example, the internal thread  424  is provided in the distal connecting part  422 , the delivery cable  500  has, at the distal end thereof, the external thread  514  configured to be screwed into the internal thread  424 , the above-described connected state is achieved by screwing these threads, the above-described disconnected state is achieved by unscrewing these threads, and the disconnected state can be achieved by unscrewing the external thread  514  and the internal thread  424  while the proximal connecting part  412  and the distal connecting part  422  remain united and locked as described above. 
     In particular, the hole closing material  100  according to the present embodiment illustrated in  FIGS. 1A, 2A, 3A, 4A, 5A, and 5B  and the hole closing material  100  according to the present embodiment illustrated in  FIGS. 1B, 2B, 3B, 4B, 5C, and 5D  are suitable for catheterization for atrial septal defect in that the hole closing material  100  brings about the following effects. 
     (First effect) The hole closing material  100  can be set in the catheter  300  by making the tube diameter of the hole closing material  100  smaller than the inner diameter of the catheter  300  by reducing the tube diameters of the first tubular portion  110  and the second tubular portion  120  which are other portions, by allowing the first end  112  and the second end  122  to move away from each other with the substantially middle portion  130  therebetween (by pulling the first end  112  and the second end  122  in opposite directions such that the first end  112  and the second end  122  move away from each other).
 
(Second effect) Since the distal connecting part  422  is provided at the second end  122  and the distal end of the delivery cable  500  is connected to the distal connecting part  422 , the second tubular portion  120  and the first tubular portion  110  are not allowed to move out of the catheter  300  such that they are pushed out of the catheter  300  but are allowed to move out of the catheter  300  such that they are pulled. This eliminates or reduces the likelihood that, if the second tubular portion  120  and the first tubular portion  110  were pushed out of the catheter  300 , the hole closing material  100  would be twisted, and the first end  112  and the second end  122  would not appropriately come close to each other with the substantially middle portion  130  therebetween and the other portions would not appropriately increase in tube diameter to a size corresponding to the hole to be closed with the hole closing material  100 . Pulling the second tubular portion  120  and the first tubular portion  110  prevents or reduces such twisting of the hole closing material  100 , making it possible to allow the first end  112  and the second end  122  to appropriately come close to each other with the substantially middle portion  130  therebetween and to allow the other portions to appropriately increase in tube diameter to a size corresponding to the hole to be closed with the hole closing material  100 . With this, the first tubular portion  110  located in the right atrium and the second tubular portion  120  located in the left atrium come close to each other with the substantially middle portion  130  therebetween, thereby making it possible to close the hole in the atrial septum.
 
(Third effect) The materials (excluding the connecting parts in some cases) for the hole closing material  100  are all bioabsorbable, and therefore are eventually absorbed by the living body. This substantially eliminates the likelihood that problems will occur in the late post-treatment period.
 
     Furthermore, the hole closing material  100  illustrated in  FIGS. 1B, 2B, 3B, 4B, 5C, and 5D  is suitable for catheterization for atrial septal defect in that the hole closing material  100  brings about the following effect. 
     (Fourth effect) After the second effect is brought about, that is, after the first end  112  and the second end  122  have come close to each other with the substantially middle portion  130  therebetween, the delivery cable  500  is further manipulated, the proximal connecting part  412  and the distal connecting part  422  are united as described earlier and locked so that the proximal connecting part  412  and the distal connecting part  422  remain united, thereby maintaining a state in which the other portions have a tube diameter increased to a size corresponding to the hole to be closed with the hole closing material  100 . Then, while the proximal connecting part  412  and the distal connecting part  422  remain united and locked as described above, the delivery cable  500  is manipulated, the distal connecting part  422  and the distal end of the delivery cable  500  are disconnected, and the catheter  300 , together with the delivery cable  500  inserted in the catheter  300 , can be separated from the site where there is the hole. This makes it possible to reliably maintain the state (the shape of the hole closing material  100 ) in which the first tubular portion  110  located in the right atrium and the second tubular portion  120  located in the left atrium are close to each other with the substantially middle portion  130  therebetween, thereby making it possible to reliably close the hole in the atrial septum. 
     The following description discusses, with reference to  FIGS. 6 to 9 , Usage Embodiments in which the hole closing material  100  according to the present embodiment illustrated in  FIGS. 1A, 2A, 3A, 4A, 5A, and 5B  and the hole closing material  100  according to the present embodiment illustrated in  FIGS. 1B, 2B, 3B, 4B, 5C and 5D  are used in catheterization for atrial septal defect. 
     Usage Embodiments 
       FIG. 6  is a conceptual view in which the hole closing material  100  is used in catheterization for atrial septal defect, and  FIG. 7  to  FIG. 9  are enlarged views of a part B in  FIG. 6  and illustrate the procedure of the catheterization. Note that the following description only discusses matters specific to the usage embodiments of the hole closing material  100  according to the present embodiment, and does not specifically discuss general matters because these are the same as those of known catheterization for atrial septal defect. 
     As illustrated in  FIG. 6 , a heart  200  of a human has two atria and two ventricles: a right atrium  210  connected to the superior vena cava and the inferior vena cava to receive venous blood from the whole body; a right ventricle  220  connected to the right atrium  210  via a pulmonary artery and a tricuspid valve  260  to send venous blood to the lungs; a left atrium  230  connected to a pulmonary vein to receive arterial blood from the lungs; and a left ventricle  240  connected to the left atrium  230  via the aorta and a mitral valve  270  to send arterial blood to the whole body. Atrial septal defect is a defect in which there is a hole  252  in an atrial septum  250  separating the right atrium  210  and the left atrium  230 . Note that, in  FIG. 6 , an end portion of the catheter  300  (portion on the distal side of the break line) is represented by an imaginary line and thereby the hole closing material  100  contained in the catheter  300  is represented by a solid line for easy understanding. 
     First, outside the living body, the hole closing material  100 , which expands to a size appropriate for the hole  252 , is pulled such that the first end  112  and the second end  122  are directed away from each other, thereby causing the hole closing material  100  to have a smaller tube diameter than the inner diameter of the catheter  300 , and the hole closing material  100  is set in the catheter  300 . The catheter  300  containing the hole closing material  100  is inserted through a femoral vein (see  FIG. 3 ) and the catheter  300  (containing the hole closing material  100 ) is moved (together with the contained hole closing material  100 ) in the direction indicated by an arrow X( 1 ) to pass through the hole  252  from the right atrium  210 , and the catheter  300  containing the hole closing material  100  is brought close to the left atrium  230  side. 
     As illustrated in  FIG. 6  and  FIG. 7 , the catheter  300  containing the hole closing material  100  is stopped at a position where the substantially middle portion  130  of the hole closing material  100  substantially corresponds to the hole  252 . The delivery cable  500  is manipulated (such that the hole closing material  100  advances in the direction toward the opening  320  of the catheter  300 ), and, in the living body, because the distal end of the delivery cable  500  is connected to the distal connecting part  422  at the distal end, the second tubular portion  120  is not allowed to move out of the catheter  300  such that the second tubular portion  120  is pushed out of the catheter  300  but is allowed to move out of the catheter  300  in the direction indicated by the arrow Y (in the direction outward of the catheter  300 ) such that the second tubular portion  120  is pulled. It follows that the second tubular portion  120 , which has had its shape (in radial directions) restricted by the inner wall  310  of the catheter  300 , becomes freely changeable in shape, and only the body portion of the second tubular portion  120  increases in tube diameter as illustrated in  FIG. 8 . 
     Furthermore, the delivery cable  500  is further manipulated (such that the hole closing material  100  (further) advances in the direction toward the opening  320  of the catheter  300 ) and, in the living body, because the distal end of the delivery cable  500  is connected to the distal connecting part  422  at the distal end, the first tubular portion  110  is not allowed to move out of the catheter  300  such that the tubular portion  110  is pushed out of the catheter  300  but is allowed to move out of the catheter  300  in the direction indicated by the arrow Y (in the direction outward of the catheter  300 ) such that the tubular portion  110  is pulled after the second tubular portion  120 . It follows that the first tubular portion  110 , which has had its shape (in radial directions) restricted by the inner wall  310  of the catheter  300 , also becomes freely changeable in shape, and only the body portion of the first tubular portion  110  increases in tube diameter as illustrated in  FIG. 9 . 
     That is, when the delivery cable  500  is manipulated (such that the hole closing material  100  advances in the direction toward the opening  320  of the catheter  300 ) at the position where the substantially middle portion  130  of the hole closing material  100  substantially corresponds to the hole  252 , the second tubular portion  120  located in the left atrium expands first, and then the first tubular portion  110  located in the right atrium expands. It follows that the first tubular portion  110  located in the right atrium  210  and the second tubular portion  120  located in the left atrium  230  come close to each other with the substantially middle portion  130  (hole  252 ) therebetween, and that the first tubular portion  110  and the second tubular portion  120  expand. Eventually, as illustrated in  FIG. 9 , the first tubular portion  110  and the second tubular portion  120  sandwich the atrial septum  250  from both sides, thereby making it possible to close the hole  252  in the atrial septum  250  with the hole closing material  100 . 
     Then, in the body, the cable body  510  is turned (rotated on its axis) so that the external thread  514  turns (rotates on its axis) in the direction opposite to the direction in which the external thread  514  is screwed into the internal thread  424 , thereby undoing the screwed connection between the hole closing material  100  and the delivery cable  500 . In so doing, the hole closing material  100 , which has been placed so as to close the hole  252 , does not turn (does not rotate on its axis). 
     After that, the catheter  300  (which contains the delivery cable  500 ) is moved in the direction indicated by an arrow X( 2 ) to take the catheter  300  (and the delivery cable  500 ) out of the living body, thereby completing the treatment. With this, in the living body (technically, in the vicinity of the hole  252 ), the hole closing material  100  entirely made of a bioabsorbable material (the distal connecting part  422  is excluded in some cases) is placed. As such, since all the materials for the hole closing material  100  placed in the living body are bioabsorbable (the distal connecting part  422  is excluded in some cases), the hole closing material  100  is eventually absorbed by the living body. This substantially eliminates the likelihood that problems will occur in the late post-treatment period. 
     If the first tubular portion  110  is pushed out of the catheter  300  and then the second tubular portion  120  is pushed out of the catheter  300  in the direction indicated by the arrow Y with the manipulation wire  500  in such a usage embodiment, there may be cases where the hole closing material  100  is twisted, the first end  112  and the second end  122  cannot appropriately come close to each other with the substantially middle portion  130  therebetween, and the other portions do not appropriately increase in tube diameter to a size corresponding to the hole to be closed with the hole closing material  100 . However, when the second tubular portion  120  and the first tubular portion  110  are pulled, the twisting of the hole closing material  100  is prevented or reduced, the first end  112  and the second end  122  appropriately come close to each other with the substantially middle portion  130  therebetween, and the other portions can appropriately increase in tube diameter to a size corresponding to the hole to be closed with the hole closing material  100 . 
     As has been described, since the defect hole closing material  100  according to the present embodiment illustrated in  FIGS. 1A, 2A, 3A, 4A, 5A, and 5B  is entirely made of a bioabsorbable material (connecting part is excluded in some cases) and is eventually absorbed by the living body, there is no or little likelihood that problems will occur in the late posts-treatment period. Furthermore, if the hole closing material  100  is pushed out of the catheter  300 , there may be cases where the hole closing material  100  is twisted, the first end  112  and the second end  122  cannot appropriately come close to each other with the substantially middle portion  130  therebetween, and the other portions (first tubular portion  110  and second tubular portion  120 ) do not appropriately increase in tube diameter to a size corresponding to the hole to be closed with the hole closing material  100 ; however, when the distal connecting part  422  is provided at the second end  122  and the distal end of the delivery cable  500  is connected to the distal connecting part  422  and the hole closing material  100  is allowed to move out of the catheter  300  such that the hole closing material  100  is pulled, such twisting of the hole closing material  100  is prevented or reduced, the first end  112  and the second end  122  appropriately come close to each other with the substantially middle portion  130  therebetween, and the other portions (first tubular portion  110  and second tubular portion  120 ) can appropriately increase in tube diameter to a size corresponding to the hole to be closed with the hole closing material  100 . It follows that, by merely manipulating the delivery cable  500  such that the hole closing material  100  advances in the direction toward the opening  320  of the catheter  300  at the position of the hole, it is possible to easily change the tube diameter of the hole closing material  100  so that the two tubular bodies (first tubular portion  110  and second tubular portion  120 ) come close to each other and possible to easily fix that form, making it possible to close the hole  252  in the atrial septum  250 . 
     With regard to the hole closing material  100  illustrated in  FIGS. 1B, 2B, 3B, 4B, 5C, and 5D , the state shown in  FIG. 9B  is the state shown in  FIG. 14B  (still in unlocked state). A transition from the unlocked state to the state shown in  FIG. 14C  (locked state) is caused by manipulating the cable body  510  of the delivery cable  500 . Note that  FIG. 14A  serves to facilitate the understanding of the transition from the state shown in  FIG. 14B  to the state shown in  FIG. 14C , and the external thread  514  at the distal end of the delivery cable  500  and the internal thread  424  of the distal connecting part  422  are not screwed together. Furthermore,  FIG. 14  corresponds to  FIGS. 13A to 13D .  FIG. 13A  is a side view corresponding to  FIG. 14A .  FIG. 13B  shows a side view, top view, and the opposite side view (from the right leftward in  FIG. 13B ) of the lock groove cover  422 C of the distal connecting part  422  in  FIG. 13A .  FIG. 13C  is an elevational view of the distal connecting part  422  in  FIG. 13A  as seen in the direction from the proximal end toward the distal end.  FIG. 13D  is an elevational view of the proximal connecting part  412  in  FIG. 13A  as seen in the direction from the distal end toward the proximal end. Note that  FIGS. 13E to 13J  are each a side view of a lock groove cover that is different in groove shape from the lock groove cover  422 C,  FIG. 13I  is an enlarged view of  FIG. 13E , and  FIG. 13J  is an enlarged view of  FIG. 13F . 
     In the unlocked state shown in  FIG. 14B , the cable body  510  of the delivery cable  500  is manipulated to move in the direction indicated by an arrow S, thereby inserting the distal connecting part  422 , screwed to the cable body  510 , into the proximal connecting part 
       412 . In such a case, on the assumption that 
     the catheter  300  has an inner diameter d( 1 ), 
     the cable body  510  of the delivery cable  500  has an outer diameter D( 2 ), 
     the proximal connecting part  412  has an inner diameter d( 3 ) and an outer diameter D( 3 ), 
     the distal connecting part&#39;s main body  422 B of the distal connecting part  422  has an outer diameter D( 4 ), and 
     the lock groove cover  422 C of the distal connecting part  422  has an inner diameter d( 5 ) and an outer diameter D( 5 ), 
     the following relations hold. 
         d (1)&gt; D (2), D (3), D (4), D (5) 
         D (2)&lt; d (3), 
     D( 2 ) is substantially equal to D( 4 ), 
     D( 4 ) is slightly smaller than or substantially equal to d( 5 ), and 
     D( 5 ) is slightly smaller than d( 3 ). 
     As such, since D( 4 ) is slightly smaller than or substantially equal to d( 5 ) and the lock groove cover  422 C is a thin sheet metal having a small thickness (which is easy to deform), when the lock groove cover  422 C is put on the distal connecting part&#39;s main body  422 B of the distal connecting part  422 , the lock groove cover  422 C makes close contact with and is united with the distal connecting part&#39;s main body  422 B. With this, the lock groove cover  422 C does not slide along the longitudinal direction of the cable body  510  of the delivery cable  500  (lateral direction in  FIG. 13 ). 
     Furthermore, since D( 5 ) is slightly smaller than d( 3 ), the distal connecting part  422  can be inserted into the proximal connecting part  412 . In such a case, the lock pin  416  (shaft diameter N) in the shape of a short shaft protrudes inward relative to d( 3 ). The lock pin  416  (shaft diameter N) protrudes inward relative to d( 3 ) so that the lock pin  416  slides on an area defined by the outer diameter D( 5 ) except for the groove portion (lock groove  426 ) in the lock groove cover  422 C until the lock pin  416  is fitted in (engaged with) the lock groove  426  (groove width M) in the shape of a groove. Specifically, in the unlocked state shown in  FIG. 14B , when the distal connecting part  422  screwed to the cable body  510  is inserted into the proximal connecting part  412 , although the lock pin  416  (shaft diameter N) in the shape of a short shaft protrudes inward relative to d( 3 ), the lock pin  416  slides on an area defined by the outer diameter D( 5 ) except for the groove portion (lock groove  426 ) in the lock groove cover  422 C until the lock pin  416  is fitted in (engaged with) the lock groove  426  (groove width M) in the shape of a groove and, once the lock pin  416  has slid to the lock groove  426  in the shape of a groove, the lock pin  416  is fitted in (engaged with) the lock groove  426  in the shape of a groove. 
     Under such circumstances, in the unlocked state shown in  FIG. 14B , when the cable body  510  of the delivery cable  500  is manipulated such that the cable body  510  is turned (rotated on its axis) in the direction indicated by an arrow R, the lock groove  426  of the lock groove cover  422 C rotates and the lock pin  416  engaged with the lock groove  426  advances toward the innermost end of the groove along the circumferential direction. This state means the locked state in which the proximal connecting part  412  and the distal connecting part  422  remain united, which is achieved by setting the shaft diameter N to be slightly smaller than the groove width M. This makes it possible, also when the external thread  514  of the cable body  510  of the delivery cable  500  and the internal thread  424  of the distal connecting part  422  are unscrewed from each other (described later), to unscrew the external thread  514  and the internal thread  424  from each other while keeping the proximal connecting part  41  and the distal connecting part  422  united because of the locked state. 
     Instead of achieving the locked state by setting the shaft diameter N to be slightly smaller than the groove width M as such, the locked state may be achieved more reliably in the following manner. Note that it is also preferable that the following is employed additionally. 
     As illustrated in  FIG. 13E  and  FIG. 13I  which is an enlarged view thereof, the groove shape (lock groove  426 C 1 ) along the circumferential direction may have an area which allows the shaft (lock pin  416 ) to be more tightly engaged with decreasing distance to the innermost end of the groove along the circumferential direction. Specifically, as illustrated in  FIG. 13I , the lock groove  426 C 1  of a lock groove cover  422 C 1  is such that the groove width M decreases with decreasing distance to the innermost end of the groove along the circumferential direction. The lock groove cover  422 C, which is a thin sheet metal having a small thickness, is less rigid than the lock pin  416  which is made of metal and which is in the shape of a solid shaft; therefore, as the lock pin  416  advances toward the innermost end of the groove along the circumferential direction, the groove width is slightly enlarged by the lock pin  416 , making it possible to reliably maintain a state in which the lock pin  416  and the lock groove  426 C 1  are engaged tightly with each other. 
     As illustrated in  FIG. 13F  and  FIG. 13J  which is an enlarged view thereof, the groove shape (lock groove  426 C 2 ) along the circumferential direction may have an area which has a narrow groove width to allow the shaft (lock pin  416 ) to be tightly engaged and which is provided near the innermost end of the groove along the circumferential direction. Specifically, as illustrated in  FIG. 13J , the lock groove  426 C 2  of a lock groove cover  422 C 2  has an area in which the groove width M is small, near the innermost end of the groove along the circumferential direction. The lock groove cover  422 C, which is a thin sheet metal having a small thickness, is less rigid than the lock pin  416  which is made of metal and which is in the shape of a solid shaft; therefore, only when the lock pin  416  passes through the area where the groove width M is small, the groove width M is slightly enlarged and the lock pin  416  passes through the area where the groove width M is small to reach the innermost end of the lock groove  426 C 2  along the circumferential direction, making it possible to reliably maintain a state in which the lock pin  416  and the lock groove  426 C 2  are engaged tightly with each other. 
     As illustrated in  FIG. 13G or 13H , the groove shape (lock groove  426 C 3  or lock groove  426 C 4 ) along the circumferential direction may have, near the innermost end of the groove along the circumferential direction, at least one bend at which the groove shape bends from the circumferential direction to another direction other than the circumferential direction. Specifically, as illustrated in  FIG. 13G , the lock groove  426 C 3  of a lock groove cover  422 C 3  has, near the innermost end of the groove along the circumferential direction, one bend at which the groove shape bends from the circumferential direction to another direction other than the circumferential direction. As illustrated in  FIG. 13H , the lock groove  426 C 4  of a lock groove cover  422 C 4  has, near the innermost end of the groove along the circumferential direction, one bend at which the groove shape bends from the circumferential direction to another direction other than the circumferential direction and another bend at which the groove shape bends to the circumferential direction (there are two bends at each of which the groove shape bends from the circumferential direction to another direction other than the circumferential direction and, at the second bend, the groove shape bends to the circumferential direction). 
     In such a case, it is preferable that the direction to which the groove shape bends at the first bend is opposite to the direction of rotation in which the external thread  514  and the internal thread  424  are unscrewed from each other while the proximal connecting part  412  and the distal connecting part  422  remain united and locked. 
     Such a configuration, in which the groove shape (lock groove  426 C 3  or lock groove  426 C 4 ) along the circumferential direction has at least one bend at which the groove shape bends from the circumferential direction to another direction other than the circumferential direction, makes it possible to reliably maintain a state in which the lock pin  416  and the lock groove  426 C 3  or  426 C 4  are engaged tightly with each other. 
     As such, by forming a groove shape (lock groove  426 , lock groove  426 C 1 , lock groove  426 C 2 , lock groove  426 C 3 , lock groove  426 C 4 , or a combination of any of these) along the circumferential direction, it is possible to unscrew the external thread  514  and the internal thread  424  from each other while the proximal connecting part  412  and the distal connecting part  422  remain united and locked. 
     Then, in the body, the cable body  510  is turned (rotated on its axis) so that the external thread  514  turns (rotates on its axis) in the direction opposite to the direction in which the external thread  514  is screwed into the internal thread  424 , thereby undoing the screwed connection between the hole closing material  100  and the delivery cable  500 . In so doing, the hole closing material  100 , which has been placed so as to close the hole  252 , does not turn (does not rotate on its axis), and the proximal connecting part  412  and the distal connecting part  422  remain united and locked; therefore, as illustrated in  FIG. 9B , the first tubular portion  110  and the second tubular portion  120  sandwich the atrial septum  250  from both sides, thereby making it possible to stably and reliably maintain a state in which the hole  252  in the atrial septum  250  is closed with the hole closing material  100 . 
     After that, the catheter  300  (which contains the delivery cable  500 ) is moved in the direction indicated by the arrow X( 2 ) to take the catheter  300  (and the delivery cable  500 ) out of the living body, thereby completing the treatment. With this, in the living body (technically, in the vicinity of the hole  252 ), the hole closing material  100  entirely made of a bioabsorbable material (the connecting parts are excluded in some cases) is placed. As such, since all the materials for the hole closing material  100  placed in the living body are bioabsorbable (the connecting parts are excluded in some cases), the hole closing material  100  is eventually absorbed by the living body. This substantially eliminates the likelihood that problems will occur in the late post-treatment period. 
     If the first tubular portion  110  is pushed out of the catheter  300  and then the second tubular portion  120  is pushed out of the catheter  300  in the direction indicated by the arrow Y with the manipulation wire  500  in such a usage embodiment, there may be cases where the hole closing material  100  is twisted, the first end  112  and the second end  122  cannot appropriately come close to each other with the substantially middle portion  130  therebetween, and the other portions do not appropriately increase in tube diameter to a size corresponding to the hole to be closed with the hole closing material  100 . However, when the second tubular portion  120  and the first tubular portion  110  are pulled, the twisting of the hole closing material  100  is prevented or reduced, the first end  112  and the second end  122  appropriately come close to each other with the substantially middle portion  130  therebetween, and the other portions can appropriately increase in tube diameter to a size corresponding to the hole to be closed with the hole closing material  100 . 
     Furthermore, it is possible to achieve a transition from the unlocked state, in which the proximal connecting part  412  and the distal connecting part  422  are not united, to the locked state, in which the proximal connecting part  412  and the distal connecting part  422  are united; therefore, after the transition to the locked state has been done, the first tubular portion  110  and the second tubular portion  120  sandwich the atrial septum  250  from both sides, thereby making it possible to stably and reliably maintain a state in which the hole  252  in the atrial septum  250  is closed with the hole closing material  100 . 
     As has been described, with the hole closing material  100  according to the present embodiment illustrated in  FIGS. 1B, 2B, 3B, 4B, 5C, and 5D , in addition to the hole closing material  100  illustrated in  FIGS. 1A, 2A, 3A, 4A, 5A, and 5B , it is possible to achieve a transition from the unlocked state, in which the proximal connecting part  412  and the distal connecting part  422  are not united, to the locked state, in which the proximal connecting part  412  and the distal connecting part  422  are united; therefore, after the transition to the locked state has been done, the first tubular portion  110  and the second tubular portion  120  sandwich the atrial septum  250  from both sides, thereby making it possible to stably and reliably maintain a state in which the hole  252  in the atrial septum  250  is closed with the hole closing material  100 . It follows that, by merely manipulating the delivery cable  500  such that the hole closing material  100  advances in the direction toward the opening  320  of the catheter  300  at the position of the hole, it is possible to easily change the tube diameter of the hole closing material  100  so that the two tubular bodies (first tubular portion  110  and second tubular portion  120 ) come close to each other and possible to easily fix that form, making it possible to stably and reliably maintain a state in which the hole  252  in the atrial septum  250  is closed with the hole closing material  100 . 
     &lt;Variations&gt; 
     The following description discusses, with reference to  FIG. 12 , a hole closing material  600  according to a variation of the present embodiment, which applies both to the hole closing material  100  illustrated in  FIGS. 1A, 2A, 3A, 4A, 5A, and 5B  and the hole closing material  100  illustrated in  FIGS. 1B, 2B, 3B, 4B, 5C, and 5D .  FIG. 12A  illustrates the hole closing material  600  according to this variation which has been allowed to move out of the catheter  300  such that the hole closing material  600  is pulled, and  FIG. 12B  illustrates the hole closing material  600  according to this variation. 
     The hole closing material  600  has the same configuration as the foregoing hole closing material  100 , except that a loop (elongated loop)  610 , which is made of the same material as the bioabsorbable fiber  150 , is passed through a mesh of the bioabsorbable fiber  150  at the first end  112  (base end) of the first tubular portion  110  and thereby has a loop end thereof connected to the first end of the first tubular portion  110 . Therefore, the same configurations are not described here. 
     The opposite loop end of the loop  610  from the loop end which is passed through a mesh at the first end  112  and is thereby connected to the first end  112 , as illustrated in  FIG. 12A , passes through the catheter  300  to extend out of the living body and is connected to an anti-falling member  620 . Specifically, an overall length L of the loop  610  is greater than the distance from the entrance of the catheter  300  to the exit of the catheter  300 . Furthermore, the size of the anti-falling member  620  is larger than the inner diameter of the catheter  300 , and the loop  610  is prevented from being drawn into the catheter  300 . It is also preferable that the anti-falling member  620  is used as a management tag. 
     With the hole closing material  600  according to this variation, the loop  610  can be retrieved out of the living body in the following manner: after the hole closing material  600  is placed in the living body as illustrated in  FIG. 12A , the loop  610  is cut at any position outside the living body, and one of the cut ends (the end with the anti-falling member  620 ) is pulled to allow the loop  610  to come out of the mesh. Furthermore, for example, if the hole closing material  600  fell into the heart from the position at which the hole closing material  600  is provided to close the hole  252 , it is possible to pull the anti-falling member  620  from the catheter  300  without cutting the loop  610  of the hole closing material  600  and retrieve the hole closing material  600  out of the living body through the catheter  300 . As such, since the hole closing material  600  in the living body is connected to the outside of the living body by the loop  610  passed through the catheter  300 , it is not necessary to retrieve the hole closing material  600  by performing open chest surgery. 
     Note that the embodiments disclosed herein should be considered as examples in all aspects and should not be construed as limitations. The scope of the present invention is defined not by the foregoing description but by the claims, and is intended to include all modifications within the scope of the claims and their equivalents. 
     For example, in the hole closing material  100  illustrated in  FIGS. 1B, 2B, 3B, 4B, 5C, and 5D , with regard to the recess (lock groove  426 ) in the outer peripheral surface of the distal connecting part  422  (more specifically, in the peripheral surface of the lock groove cover  422 C of the distal connecting part  422 ), it is also preferable that a plurality of the recesses are provided at different positions along the longitudinal direction of the delivery cable  500  so that the distance between the first end  112  and the second end  122  of the medical material  100  can be changed. This makes it possible, in the state shown in  FIGS. 1B and 9B , to change the length of the substantially middle portion  130  (or the distance between the first end  112  and the second end  122 ) according to the thickness of the atrial septum which varies among individuals. More specifically, when the thickness of the atrial septum is small, the distal connecting part  422  and the proximal connecting part  412  are locked together on the far side (the distal connecting part  422  is inserted more into the proximal connecting part  412 ), whereas when the thickness of the atrial septum is large, the distal connecting part  422  and the proximal connecting part  412  are locked together on the near side (the distal connecting part  422  is inserted less into the proximal connecting part  412 ). 
     INDUSTRIAL APPLICABILITY 
     The present invention is suitable for use as a medical material which is set in a catheter to treat a hole in a biological tissue, and is particularly preferable in that the medical material is capable of being released and placed at a treatment site, enables less invasive treatment, is unlikely to cause a problem in the late post-treatment period even when the medical material remains in the body, and is favorably operable. 
     DESCRIPTION OF THE REFERENCE NUMERAL 
     
         
         
           
               100  Medical material (occluder) 
               110  First tubular portion 
               112  First end 
               120  Second tubular portion 
               122  Second end 
               130  Substantially middle portion 
               150  Bioabsorbable fiber 
               200  Heart 
               250  Atrial septum 
               252  Hole 
               300  Catheter 
               412  Proximal connecting part 
               422  Distal connecting part 
               500  Delivery cable (manipulation wire)