An extendable guidewire for introducing a dilatation catheter into the cardiovascular system. The guidewire has main and auxiliary sections with a connector which permits the two sections to be joined together and separated simply by pushing the two sections together and pulling them apart. One of the sections can be used for positioning the catheter within the cardiovasuclar system, and the other section can be employed to extend the wire to change catheters.

BACKGROUND OF THE INVENTION 
This invention pertains generally to cardiovascular procedures such as 
angioplsaty, angiography and valvuloplasaty, and more particularly to an 
extendable guidewire and the methods of manufacturing and using the same. 
Guide wires are currently used to facilitate the placement of dilatation 
catheters in the arterial system of a patent for cardiovascular procedures 
such as angioplasty, angiography and valvuloplasty. The guidewire is 
typically on the order of 20-50 cm longer thana the catheter to permit the 
guidewire and the catheter to be advanced relative to each other as they 
are steered into position within the patient's body. Suitable guidewires 
are described in U.S. Pat. No. 4,538,622 (Samson et al.) and U.S. Pat. No. 
4,569,347 (Frisbie) which are hereby incorporated herein in their 
entirety. 
In the usual procedure to change dilatation catheters, the guidewire is 
removed from the patient, and an exchange wire is inserted in its place. 
The exchange wire is substantially longer than the guidewire, and it 
generally extends outside the patient's body for a distance greater than 
the length of the catheter. With a dilation catheter having a length on 
the order of 120-140 cm, for example, a guidewire might have a length on 
the order of 175 cm, and an exchange wire might have a length on the order 
of 300 cm. The use of an exchange wire has the obvious disadvantage that 
it adds extra steps to the angioplasty procedures. In addition, it 
requires the doctor to have an additional wire for this purpose. 
Heretofore, there have been some attempts to eliminate the need for a 
separate exchange wire by attaching an extension wire to a coronary wire 
to extend the length of the wire. The two wires are joined together by a 
crimped connector which requires a special tool. Once the connector has 
been crimped, the connection is permanent, and the extension wire cannot 
be removed except by cutting it loose from the coronary wire. 
What has been needed and heretofore unavailable is an extension which can 
be readily connected and disconnected to the guide wire and when in 
position withiin the patient. The present invention satisfies this need. 
SUMMARY OF THE INVENTION 
It is in general an object of the invention to provide a new and improved 
guidewire and methods of manufacturing and using the same. 
Another object of the invention is to provide a guidewire and methods of 
the above character in which the guidewire can be extended in length and 
readily returned to its original length. 
These and other objects are achieved in accordance with the invention by 
providing a guidewire having main and auxiliary sections which are 
detachably secured together by press fitting. One of the wire sections has 
an expandable tubular portion at the connecting end thereof, and the 
second wire section has a end portion tion to expand the portion and to be 
gripped thereby to detachably securing the two sections together. The two 
sections can be readily separated by pulling them apart. The two sections 
can be reconnected and disconnected as many times as desired. 
In a presently preferred embodiment the expandable portion is cylindrically 
shaped with a longitudinally split which is adapated to receive the 
connecting end at the second wire section. The connecting end of the 
second wire section is preferably tapered slightly to facilitate the 
insertion thereof into the split tubular cylindrically shaped expandable 
portion.

DETAILED DESCRIPTION OF THE INVENTIONS 
As illustrated in the drawings, the guidewire has a main section 11 which 
is adapted to be inserted into the patient's vascular system and an 
auxiliary section 12 which can be connected and disconnected to the 
proximal end of the main section. Section 11 has an elongated shaft 13 
with a flexible tip (not shown) at its distal end and a tapered portion 14 
at its proximal end. Details of of this structure can be found in the 
references cited previously and incorporate herein by reference thereto. 
Section 12 also has an elongated shaft 1 with a connector 17 at its distal 
end for mating engagement with the tapered portion at the proximal end of 
Section 11. The guidewire is intended for use in positioning a dilatation 
catheter (not shown) in the cardiovascular system of a patient, and 
section 11 has a length corresponding to the length of a conventional 
guidewire for this purpose. Details of typical dilatation catheters can be 
found in the references cited previously and incorporated herein. 
Section 12 has a length such that when the two sections are connected 
together the wire has an overall length suitable for exchanging catheters 
without removing section 11 from the patient's body. With a dilatation 
catheter having a length on the order of 120-140 cm, for example, section 
11 might have a length on the order of 140-175 cm, and section 12 might 
have a length on the order of 125-160 cm. 
Shafts 13, 16 can be fabricated from any suitable material such as 
stainless steel, and neach should have a diameter such that a dilatation 
catheter can pass freely over them. Although two shafts 13 and 16 do not 
have to have exactly the same diameter, it is preferably that the two 
shafts be of substantially the same diameter in order to provide a smooth 
transition between them. In one presently preferred embodiment for use in 
coronary angioplasaty, shaft 13 has a diameter on the order of 0.013-0.016 
inch, and shaft 16 has a diameter of 0.014 inch. Either or both of the 
shafts can be provided with a coating of Teflon or another suitable low 
friction material to facilitate movement of the catheter over the wire. 
Connector 17 comprises an inner tubular member 19 and an outer tubular 
ember or sleeve 21. Tubular member 19 is mounted on a short axial 
extensionn 22 of reduced diameter at the distal end of shaft 16. The 
distal end portion of this tubular member fits over the post and is 
affixed thereto by suitable means such as an adhesive or soldering or 
welding, as indicated at 24. Post 22 can be formed by any suitable means 
such as grinding down the proximal end portion of the shaft. 
Sleeve 21 is positioned co-axially of tubular member 19 and affixed to 
shaft 16 near the base of post 22 by suitable means such as soldering or 
welding 26. Tubular member 19 and sleeve 21 are each fabricated of a 
suitable material such as stainless steel. 
Tubular member 19 has a longitudinally extending split or slot 28 which 
permits the tubular member to expand as the tapered end portion 14 of wire 
section is inserted into the tubular member. Sleeve 21 limits the amountn 
the tubular member can expand and adds overall strength and rigidity to 
the connection. In one presently preferred embodiment, tubular member 19 
is fabricated or stainless steel tubing have a longitudinally extending 
welded seam, and slot 28 is formed by pressing a mandrel into the tubing 
to split the seam. Alternatively, the slot can be formed by other means 
such as cutting with a millting cutter or with a laser. 
The distal end of the tapered end portion 14 of wire section 11 should have 
a diameter slightly less than the unexpanded inside diameter of tubular 
member 19 and the distal end or base of the tapered portion should have a 
somewhat greater diameter than the unexpanded tubular member to ensure 
proper connection. In a guidewire having a diameter on the order of 0.014 
inch, for example, tubular member 19 might have an unexpanded inner 
diameter on the order of 0.007 inch and a wall thickness on the ordre of 
0.001 inch, sleeve 21 might have an inner diameter on the order of 0.012 
inich and a wall thickness of 0.0015 inch, and tapered end portion 14 
might have a linear taper on the order of 1.7-1.8 cm in length with a 
diameter on the order of 0.0085 inch midway along this length. In this 
embodiment, sleeve 21 might have a length on the order of 2.4-2.5 cm. 
The guidewire and the expansion can be manufactured by grinding the 
proximal and distal end portions of shafts 13 and 16 to form tapered 
portion 14 and post ground as desired and provided with a spring coil (not 
shown) to form a flexible tip for the wire. Tubular member 19 is placed on 
post 22 and soldered or otherwise bonded in position, and outer tubular 
member or sleeve 21 is positioned over the inner tubular member and 
soldered or otherwise bonded to the shaft. Slot 28 can be formed either 
before or after tubular member 19 is attached to the shaft. In one 
presently preferred embodiment, it is formed by pressing a tapered mandrel 
into the tube to split it longitudinally. Alternatively, the slot can be 
formed by cutting with a milling cutter or with a laser as previously 
discussed. 
In use, section 11 of the guidewire is introduced into the vascular system 
of a patient with a dilatation catheter through a guiding catheter and an 
introducer. When performing a coronary angioplasaaty the guiding catheter 
is positioned in the coronary ostium, and the dilatation catheter is 
advancaed so that it is just proximal to the tip of the guiding cathether. 
The tip of the guidewire is advanced beyond the distal tip of the 
dilatation catheter while holding the dilatation catheter in place. As the 
guidewire is advanced, it is rotated and steered into the selected artery. 
The guidewire tip is preferably advanced through the lesion and beyond it, 
if possible. This permits the balloon portion of the catheter to be 
positioned over a more supportive section of the guidewire within the 
lesion. Once the guidewire is in position, it is held in place and the 
dilatation catheter is advanced alongit until the inflatable balloon 
thereof is within the lesion. Tapered end portion 14 remains outside the 
patient's body and outside any adapter which may be connected to the 
proximal end of the dilatation cathether. 
To exchange catheters, the guidewire is extended by manually pressing 
together the tubular inner member 19 of connection 17 or the distal end of 
16 and the tapered section 11 in the patient's body. As the tapered end 
portion 14 is inserted into the tubular member 19, the tubular member 
expands, and the resiliency of the expanded tubular member causes it to 
grip the tapered portion to firmly hold the two sections together. The 
dilatation catheter can then be withdrawn from the patient's body over the 
extended guidewire. 
A new dilatation catheter can then be introduced over section 12 and 
advanced along the wire setion 11 within the patient's body until the 
balloon crosses the lesion. Once the proximal end portion of the new 
balloon has advanced beyond connector 17 and tapered end portion 14, 
section 12 can be removed by grasping the two sections of the wire on 
opposite sides of the connector 17 and pulling them apart without 
disturbing the position of section 11 in the patient's body. 
The main and auxiliary sections 11 and 12 of the guide can be connected 
together and disconnected as many times as necessary simply by prssing 
them together and pulling them apart. 
The invention has a number of important features and advantages. The two 
sections of the wire can be connected together whenever a longer wire is 
needed, and they can be separated wheneer the additional length is not 
required. The two sections of the wire are connected and disconnected by 
simply pressing them together and pulling them apart. This can be done as 
many times as necessary, and no special tools are required either to make 
the connection or to separate it. 
It is apparent from the foregoing that a new and improved extended 
guidewire and methods of manufacturing and using the same have been 
provided. While only certain presently preferred embodiments have been 
described in detail, as will be apparent to those familiar with the art, 
certain changes and modifications can be made without departing from the 
scope of the invention as defined by the following claims.