Coronary artery or vascular wire

Abstract

Disclosed herein is an intraluminal medical guide wire having tip portions usable at each end of the guide wire. The guide wire includes an elongate member defining a longitudinal axis and having a first end and a second end. The first end includes a first tip portion. The second end includes a second tip portion different from the first tip portion.

Description

Technical Field

[0001] Cross-reference This disclosure is related to and claims priority from U.S. Provisional Application No. 63 / 390,579, filed on July 19, 2022, entitled "Coronary / Vascular Wire", the entire content of which is incorporated herein by reference.

[0002] This disclosure relates to a double-sided guidewire that includes a first tip at a first end of the guidewire and a second tip at a second end of the guidewire, and a method of using the same.

Background Art

[0003] A guidewire is a thin, flexible medical wire that is inserted into a patient during various medical procedures. Conventionally, the distal end of a guidewire is a tip that is available in a plurality of configurations. The tip design affects the tracking and torqueability of the guidewire. After a physician performing a procedure inserts the distal end of the guidewire into the patient and advances the tip to a desired location, the guidewire is used to guide the placement of a larger device such as a catheter. Typically, a proceduralist uses a J-tip (J-type tip) guidewire to deliver a device into a blood vessel within a patient. However, during the placement of the guidewire, the proceduralist generally encounters vascular stenosis and / or tortuosity that requires a guidewire with a different tip. Thus, the proceduralist will remove a first guidewire that includes a J-tip and then insert and advance a second guidewire that includes a more flexible tip.

[0004] Accordingly, there is a need for a double-sided guide wire having a tip available at each end of the guide wire in order to simplify the procedure by reducing the number of guide wires used. For example, the first end of the double-sided guide wire can have a stiffer tip such as a J-tip. The second end of the double-sided guide wire can have a floppy (highly flexible), more flexible tip such as a floppy straight tip, a J-tip with low hydrophilicity, or an angled tip. If the operator cannot use the first tip at the first end of the guide wire to cross a blood vessel, the operator can use the second tip at the second end of the guide wire. SUMMARY OF THE INVENTION

[0005] The present disclosure provides a double-sided guide wire and a method of using the same. One aspect of the present disclosure includes an intravascular medical guide wire. The medical guide wire includes an elongated member having a first end and a second end. The first end has a first tip, and the second end has a second tip. The second tip can be different from the first tip.

[0006] The first tip can be a straight tip, an angled tip, or a J-tip and can be stiff. The second tip can be a straight tip, an angled tip, or a J-tip and can be floppy (highly flexible). The diameter of the guide wire can be from 0.018 inches (0.046 cm) to 0.038 inches (0.097 cm), and the length of the guide wire can be from 80 cm to 260 cm. The guide wire can be made of stainless steel, nitinol, or any memory metal, and the guide wire can be coated wholly or in part.

[0007] Also disclosed is a method of using a double-sided guide wire. The method includes inserting a first end of a guide wire having a first tip into a patient's blood vessel and advancing the guide wire toward a desired position. The operator may encounter an obstacle that prevents the guide wire from crossing the obstacle. The method includes removing the guide wire from the patient's blood vessel. Further, the method includes inserting a second end of a guide wire having a second tip into the patient's blood vessel and advancing the guide wire toward a desired position. The guide wire can be removed from the patient's blood vessel.

[0008] The method may include using the guide wire as a guide for delivering a device into the blood vessel. The first tip may be a straight tip, an angled tip, or a J-tip and may be rigid. The second tip portion may be a straight tip portion, an angled tip portion, or a J-tip portion and may be floppy (highly flexible).

[0009] This description is presented as various embodiments of the present disclosure and should not be construed as an exhaustive listing of the scope of the present disclosure. It will be more fully understood by reference to the following drawings and data graphs. Note that for clarity, certain elements in the various drawings may not be drawn to scale. Understanding that these drawings depict only exemplary embodiments of the present disclosure and should not be considered as limiting its scope, the principles of the present specification are explained and additional specificity and detail are provided by using the accompanying drawings.

Brief Description of the Drawings

[0010]

Figure 1A

Figure 1B

Figure 2A

Figure 2B

Figure 3A

Figure 3B

[0011] Various embodiments of the present disclosure will be described in detail below. It should be understood that the description of specific implementations is for illustrative purposes only. Those skilled in the art will recognize that other components and configurations may be used without departing from the spirit and scope of the present disclosure. Accordingly, the following description and drawings are exemplary and should not be construed as limiting. A number of specific details are set forth in order to provide a thorough understanding of the present disclosure. However, in some instances, well-known or conventional details are not described in order to avoid obscuring the description. References to one or an embodiment in the present disclosure can refer to the same embodiment or any embodiment, and such references mean at least one of the embodiments.

[0012] References to "one embodiment", "an embodiment", or "aspect" mean that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment of the invention. The appearances of the phrases "in one embodiment" or "in one aspect" in various places in this specification are not necessarily all referring to the same embodiment, nor do separate or alternative examples exclude other embodiments from each other. Further, various features are described that are shown by some embodiments and not by others.

[0013] The terms used in this specification generally have their ordinary meanings in the context of the present disclosure and in the particular context in which each term is used.

[0014] Alternative languages and synonyms may be used for any one or more of the terms discussed herein, and no special meaning should be placed on whether or not a term is detailed or discussed herein. In some cases, synonyms for particular terms are provided. The listing of one or more synonyms does not exclude the use of other synonyms. The use of examples anywhere in this specification, including examples of any of the terms discussed herein, is for illustration only and is not intended to further limit the scope or meaning of the present disclosure or of any example terms. Similarly, the present disclosure is not limited to the various embodiments given herein.

[0015] Further features and advantages of the present disclosure are described in the following description, some of which will be apparent from the description or can be learned by practicing the principles disclosed herein. The features and advantages of the invention can be realized and obtained by means of the instrumentalities and combinations particularly pointed out in the appended claims. These and other features of the present disclosure will become more fully apparent from the following description and appended claims or can be learned by practicing the principles described herein.

[0016] Provided herein are a double-sided guidewire including tip portions usable at each end of the guidewire and a method of using the same to improve the ability of the guidewire to traverse a vascular lumen (i.e., intraluminal) within a patient. As shown in FIGS. 1A - B, the first end and / or the second end of the guidewire may be a straight tip portion. In other embodiments, the first end and / or the second end of the guidewire may be a J tip as shown in FIGS. 2A - 2B. In other embodiments, as illustrated in FIGS. 3A - B, the first end and / or the second end of the guidewire may be an angled tip portion. In one embodiment, the second end of the guidewire can include a second tip portion different from the first tip portion at the first end of the guidewire.

[0017] A double-sided guide wire can have significant advantages over conventional guide wires. Currently, a guide wire includes only one tip at the distal end of the guide wire. The treating physician selects a guide wire with a specific tip, inserts the guide wire into the blood vessel, and advances the guide wire. However, if the tip of the guide wire cannot cross an obstacle in the blood vessel, the operator can remove the first guide wire. Subsequently, in an attempt to cross the obstacle, the operator can insert and advance a second guide wire having a tip that is more flexible than the first guide wire.

[0018] The double-sided guide wire enhances functionality, thereby simplifying the procedure and increasing the success of the procedure. The double-sided guide wire includes tip portions that can be used at each end of the guide wire, and these tip portions can allow only one guide wire to be used during the procedure. If the tip portion at the first end of the double-sided guide wire cannot cross an obstacle, an attempt can be made to cross the obstacle using the tip portion at the second end (i.e., the alternative end or the opposite end) of the guide wire, which is typically a more flexible wire.

[0019] The double-sided guide wire can reduce the costs associated with the procedure. Currently, the operator selects and opens a guide wire at the start of the procedure. However, if the operator encounters a problem that impedes access or delivery into the blood vessel using that guide wire, the operator is required to open one or more additional guide wires in an attempt to cross the obstacle and improve device delivery. The double-sided guide wire can substantially reduce, if not eliminate, the need to open two or more guide wires per procedure, reducing the costs to the healthcare facility and / or the patient.

[0020] Figures 1A - B show a guide wire 100 having a straight tip. The guide wire 100 includes a long member 102 (i.e., an elongated body) that can be made of a flexible material or from a flexible material. The long member 102 defines a longitudinal axis that points along an axis along the center line of the long member 102 between a first end 104 and a second end 106. In other words, the longitudinal axis follows the path of the long member 102, which can be bent, curved, or otherwise manipulated. Thus, when the long member 102 is being manipulated during use, the longitudinal axis changes along with the center line of the long member 102. The outer diameter of the guide wire 100 may range from 0.010 inches (0.025 cm) to 0.038 inches (0.097 cm). The length of the guide wire 100 may range from 40 cm to 450 cm. For example, the guide wire 100 may be about 180 cm or 260 cm in length in various embodiments.

[0021] The long member 102 defines a first end 104 and a second end 106. Since the double - sided guide wire 100 has two usable ends, it does not have a designated proximal end and distal end. When the first end 104 of the long member 102 is inserted into a patient, the first end 104 is the distal end and the second end 106 is the proximal end. However, the orientation of the guide wire 100 may be reversed such that the second end 106 is inserted into the patient. When the second end 106 of the long member 102 is inserted into the patient, the second end 106 is the distal end and the first end 104 is the proximal end. In one embodiment, the first end 104 and / or the second end 106 may be configured as a straight tip. In some embodiments, the opposite end (i.e., the first end 104 and / or the second end 106) may be configured as a different tip such as an angled tip or a J - tip.

[0022] The elongate member 102 of the guide wire 100 may include a core wire 108. The core wire 108 may be a solid wire. In some embodiments, the core wire 108 may be wound with a coil wire 110 or a braided wire. The core wire 108 may be tapered near the first end 104 and / or the second end 106 of the elongate member 102 (i.e., configured as a short taper or a long taper). The core wire 108 can have a length that is less than or equal to the length of the elongate member 102. In one example, the core wire 108 may extend between the first end 104 and the second end 106 of the elongate member 102. In another example, the core wire 108 may not extend to the first end 104 and / or the second end 106 of the elongate member 102.

[0023] The elongate member 102 may further include a coil wire 110. The coil wire 110 may be an outer spring that completely or partially wraps around the core wire 108. The coil wire 110 can have a length that is less than or equal to the length of the elongate member 102. In one example, the coil wire 110 may extend between the first end 104 and the second end 106 of the elongate member 102. In another example, the coil wire 110 may not extend to the first end 104 and / or the second end 106 of the elongate member 102.

[0024] The elongate member 102 may further include a ribbon wire 112. The ribbon wire 112 may be a wire arranged along the core wire 108 or a part thereof and wrapped by the coil wire 110. The ribbon wire 112 can have a length that is less than or equal to the length of the elongate member 102. In one example, the ribbon wire 112 may extend between the first end 104 and the second end 106 of the elongate member 102. In other examples, the ribbon wire 112 may not extend to the first end 104 and / or the second end 106 of the elongate member 102.

[0025] The core wire 108 and / or the ribbon wire 112 may be made of metal. For example, the core wire 108 and / or the ribbon wire 112 may be made of stainless steel, nitinol, or any shape memory metal. Similarly, the coil wire 1(10) may be made of metal. By way of non-limiting example, the coil wire 110 may be made of stainless steel, nitinol, platinum, tungsten, nickel, titanium, or combinations thereof. The outer surface of the guide wire 100 may be coated, either in whole or in part. For example, the guide wire 100 may be coated with a hydrophilic coating, a hydrophobic coating, and / or a lipophobic coating. The hydrophilic coating may be configured to attract water, while the hydrophobic coating may be configured to repel water. The lipophobic coating may be configured to repel oil. For example, the guide wire 100 may be coated with a polymer. The polymer coating may be silicone or polytetrafluoroethylene (PTFE). Additionally, the guide wire 100 may include one or more radiopaque markers made of a suitable radiopaque material. For example, the radiopaque marker may be made of gold or platinum. In some embodiments, the radiopaque marker may be incorporated into the coil wire 110.

[0026] In some embodiments, the straight tip may be flexible or floppy. For example, the straight tip portion may comprise a coil wire 110 that extends to the end of the tip portion (i.e., the first end 104 or the second end 106) and a core wire 108 that does not extend to the end of the tip portion. In other embodiments, the straight tip may be more rigid or stiff. For example, the straight tip may comprise a core wire 108 that extends to the end of the tip.

[0027] Figures 2A - B show a guide wire 200 having a J - tip. The guide wire 200 includes an elongate member 202 (i.e., an elongated body) that can be made from a single flexible material or multiple flexible materials. The elongate member 202 defines a longitudinal axis that points along an axis along the centerline of the elongate member 202 between a first end 204 and a second end 206. In other words, the longitudinal axis follows the path of the elongate member 202, which can be bent, curved, or otherwise manipulated. Thus, when the elongate member 202 is being manipulated during use, the longitudinal axis changes along with the centerline of the elongate member 202. The outer diameter of the guide wire 200 may range from 0.010 inches (0.025 cm) to 0.038 inches (0.097 cm). According to various embodiments, the length of the guide wire 200 may range from 40 cm to 450 cm. For example, the guide wire 200 may be about 180 cm in length. In other examples, the guide wire 200 may be 50 cm, 100 cm, 150 cm, 260 cm.

[0028] The elongate member 202 defines a first end 204 and a second end 206. Since the double - sided guide wire 200 has two usable ends, it does not have a designated proximal end and distal end. When the first end 204 of the elongate member 202 is inserted into a patient, the first end 204 is the distal end and the second end 206 is the proximal end. However, the orientation of the guide wire 200 may be reversed such that the second end 206 is inserted into the patient. When the second end 206 of the elongate member 202 is inserted into a patient, the second end 206 is the distal end and the first end 204 is the proximal end. In one embodiment, the first end 204 and / or the second end 206 may be configured as a J - tip. The J - tip can include a bent tip. In some embodiments, the opposite end (i.e., the first end 204 and / or the second end 206) can be configured as a different tip, such as a straight tip or an angled tip.

[0029] The elongate member 202 of the guide wire 200 may include a core wire 208. The core wire 208 may be a solid wire. In some embodiments, the core wire 208 may be wound with a coil wire 210 or a braided wire. The core wire 208 may be tapered near the first end 204 and / or the second end 206 of the elongate member 202 (i.e., configured as a short taper or a long taper). The core wire 208 may have a length that is less than or equal to the length of the elongate member 202. In one example, the core wire 208 may extend between the first end 204 and the second end 206 of the elongate member 202. In another example, the core wire 208 may not extend to the first end 204 and / or the second end 206 of the elongate member 202.

[0030] The elongate member 202 may further include a coil wire 210. The coil wire 210 may be an outer spring that completely or partially wraps around the core wire 208. The coil wire 210 may have a length that is less than or equal to the length of the elongate member 202. In one example, the coil wire 210 may extend between the first end 204 and the second end 206 of the elongate member 202. In another example, the coil wire 210 may not extend to the first end 204 and / or the second end 206 of the elongate member 202.

[0031] The elongate member 202 may further include a ribbon wire 212. The ribbon wire 212 may be a wire disposed along the core wire 208 or a portion thereof and wrapped by the coil wire 210. The ribbon wire 212 may have a length that is less than or equal to the length of the elongate member 202. In one example, the ribbon wire 212 may extend between the first end 204 and the second end 206 of the elongate member 202. In other examples, the ribbon wire 212 may not extend to the first end 204 and / or the second end 206 of the elongate member 202.

[0032] The core wire 208 and / or the ribbon wire 212 may be made of metal. For example, the core wire 208 and / or the ribbon wire 212 may be made of stainless steel, nitinol, or any shape memory metal. Similarly, the coil wire 210 may be made of metal. For example, but not limited to, the coil wire 210 may be made of stainless steel, nitinol, platinum, nickel, titanium, or tungsten. The outer surface of the guide wire 200 may be coated entirely or partially. For example, the guide wire 200 may be coated with a hydrophilic coating, a hydrophobic coating, and / or a lipophobic coating. The hydrophilic coating may be configured to attract water, while the hydrophobic coating may be configured to repel water. The lipophobic coating may be configured to repel oil. For example, the guide wire 200 may be coated with a polymer. The polymer coating may be silicone or polytetrafluoroethylene (PTFE). Further, the guide wire 200 may include one or more radiopaque markers made of a suitable radiopaque material. For example, the radiopaque marker may be made of gold or platinum. In some embodiments, the radiopaque marker may be incorporated into the coil wire 210.

[0033] In some embodiments, the J-chip may be flexible or floppy. For example, the J-chip may include a coil wire 210 that extends to an end of the chip (i.e., the first end 204 or the second end 206) and a core wire 208 that does not extend to the end of the chip. In other embodiments, the J-chip may be more rigid. For example, the J-chip may include a core wire 208 that extends to an end of the chip. The J-chip may be a larger-sized J-chip or a smaller-sized J-chip. For example, in one embodiment, the J-chip can have a radius curve of 1.5 mm, and in another embodiment, the J-chip can have a radius curve of 3 mm.

[0034] Figures 3A - 3B show a guidewire 300 having an angled (i.e., curved) tip. The guidewire 300 comprises a elongate member 302 (i.e., an elongated body) that can be made of a flexible material or from flexible materials. The elongate member 302 defines a longitudinal axis that points along an axis along the centerline of the elongate member 302 between a first end 304 and a second end 306. In other words, the longitudinal axis follows the path of the elongate member 302, which can be bent, curved, or otherwise manipulated. Thus, when the elongate member 302 is manipulated during use, the longitudinal axis changes along with the centerline of the elongate member 302. The outer diameter of the guidewire 300 may range from 0.010 inches (0.025 cm) to 0.038 inches (0.097 cm). The length of the guidewire 300 may range from 40 cm to 450 cm. For example, the guidewire 300 may be about 180 cm in length.

[0035] The elongate member 302 defines the first end 304 and the second end 306. Since the double-sided guidewire 300 includes two usable ends, the elongate member 302 does not have a designated proximal end and distal end. When the first end 304 of the elongate member 302 is inserted into the patient, the first end 304 is the distal end and the second end 306 is the proximal end. However, the orientation of the guidewire 300 may be reversed such that the second end 306 is inserted into the patient. When the second end 306 of the elongate member 302 is inserted into the patient, the second end 306 is the distal end and the first end 304 is the proximal end. In one embodiment, the first end 304 and / or the second end 306 may be configured as an angled tip. The angled tip can include a bend of less than 90 degrees. In some embodiments, the opposite ends (i.e., the first end 304 and / or the second end 306) may be configured as different tips, such as a straight tip or a J-shaped tip.

[0036] The elongate member 302 of the guide wire 300 may include a core wire. The core wire may be a solid wire. In some embodiments, the core wire may be wound with a coil wire or a braided wire. The core wire may be tapered (i.e., configured as a short taper or a long taper) near the first end 304 and / or the second end 306 of the elongate member 302. The core wire can include a length that is less than or equal to the length of the elongate member 302. In one example, the core wire may extend between the first end 304 and the second end 306 of the elongate member 302. In another example, the core wire may not extend to the first end 304 and / or the second end 306 of the elongate member 302.

[0037] The elongate member 302 may further include a coil wire. The coil wire may be an outer spring that completely or partially wraps around the core wire. The coil wire can include a length that is less than or equal to the length of the elongate member 302. In one example, the coil wire may extend between the first end 304 and the second end 306 of the elongate member 302. In another example, the coil wire may not extend to the first end 304 and / or the second end 306 of the elongate member 302.

[0038] The elongate member 302 may further include a ribbon wire. The ribbon wire may be a wire that is disposed along the core wire or a portion thereof and is wrapped by the coil wire. The ribbon wire can include a length that is less than or equal to the length of the elongate member 302. In one example, the ribbon wire may extend between the first end 304 and the second end 306 of the elongate member.

[0039] In other examples, the ribbon wire may not extend to the first end 304 and / or the second end 306 of the elongate member 302.

[0040] The core wire and / or the ribbon wire may be made of metal. For example, the core wire and / or the ribbon wire may be made of stainless steel, nitinol, or any memory metal. Similarly, the coil wire may be made of metal. For example, the coil wire may be made of stainless steel, nitinol, platinum, or tungsten. The outer surface of the guide wire 300 may be coated entirely or partially. For example, the guide wire 300 may be coated with a hydrophilic coating, a hydrophobic coating, and / or a lipophobic coating. The hydrophilic coating may be configured to attract water, while the hydrophobic coating may be configured to repel water. The lipophobic coating may be configured to repel oil. For example, the guide wire 300 may be coated with a polymer. The polymer coating may be silicone or polytetrafluoroethylene (PTFE). Further, the guide wire 300 may include one or more radiopaque markers made of a suitable radiopaque material. For example, the radiopaque marker may be made of gold or platinum. In some embodiments, the radiopaque marker may be incorporated into the coil wire.

[0041] In some embodiments, the tapered tip may be flexible or floppy. For example, the tapered tip portion may include a coil wire extending to the end of the tip portion (i.e., the first end 304 or the second end 306) and a core wire not extending to the end of the tip portion. In other embodiments, the tapered tip may be more rigid or stiff. For example, the tapered tip portion may include a core wire extending to the end of the tip portion. By way of example and not limitation, the dual-end guide wire may have a combination of wire tips selected, inter alia, from standard J-tips, floppy tips, baby J-tips, and angled guide tips.

[0042] The guidewires 100, 200, 300 can be configured for use in a patient's neurovascular, cardiovascular, or peripheral vascular system. In other words, the guidewires 100, 200, 300 can be configured to provide a list of procedures in which the levels of trackability, torqueability, flexibility, crossing ability, and supportability, which are determined by the physical characteristics of the guidewires 100, 200, 300, vary. The guidewires 100, 200, 300 can be used by any operator who uses a wire to advance a catheter or other device into a patient's blood vessel. For example, such operators can include cardiologists, radiologists, and vascular surgeons.

[0043] The operator can insert a first end 104, 204, 304 including a first tip of the elongate members 102, 202, 302 of the guidewires 100, 200, 300 into a patient's blood vessel lumen. The blood vessels can include arteries, arterioles, capillaries, venules, and veins. The operator can advance the first ends 104, 204, 304 to a desired position within the blood vessel. The desired position can be a lesion, a blood vessel segment, or other treatment site. To advance the first ends 104, 204, 304 and cross the blood vessel, the operator can move, manipulate, or torque the elongate members 102, 202, 302 of the guidewires 100, 200, 300.

[0044] The blood vessel may include an obstacle that prevents or impedes the first ends 104, 204, 304 of the elongate members 102, 202, 302 of the guidewires 100, 200, 300 from crossing the obstacle. A blood vessel occlusion may include a stenosis of the blood vessel and / or a tortuous (i.e., twisted) blood vessel. If the first ends 104, 204, 304 cannot cross the obstacle, the operator can remove the guidewires 100, 200, 300 from the patient's blood vessel lumen. The operator can then insert a second end 106, 206, 306 including a second tip of the elongate members 102, 202, 302 of the guidewires 100, 200, 300 into the patient's blood vessel lumen and advance the second ends 106, 206, 306 to a desired position within the blood vessel. The second tip at the second ends 106, 206, 306 may be more flexible than the first tip at the first ends 104, 204, 304 of the elongate members 102, 202, 302 of the guidewires 100, 200, 300.

[0045] After reaching the desired position within the patient's blood vessel, the guidewires 100, 200, 300 can be used to advance a larger device to the desired position by guiding the larger device to the position within the blood vessel. In other words, the guidewires 100, 200, 300 can be used as a guide for delivering a larger device to a position within the blood vessel. The position can be a desired position within the blood vessel, and the larger device can include a catheter. The operator can remove the guidewires 100, 200, 300 from the patient's blood vessel lumen, and in some cases, the operator can remove the device from the patient's blood vessel lumen.

Claims

1. A guide wire for use within a body lumen, comprising an elongate member defining a longitudinal axis and having a first end configured for placement within a lumen and a second end configured for placement within a lumen, wherein the first end has a first tip and the second end has a second tip different from the first tip, a guide wire for use within a body lumen.

2. The guide wire for use within a lumen according to claim 1, wherein the first tip is a straight tip, an inclined tip, or a J-shaped tip.

3. The guide wire for use within a lumen according to claim 2, wherein the first tip is rigid.

4. The guide wire for use within a lumen according to claim 1, wherein the second tip is a straight tip, an inclined tip, or a J-shaped tip.

5. The guide wire for use within a lumen according to claim 4, wherein the second tip is highly flexible.

6. The guide wire for use within a lumen according to claim 1, wherein the diameter of the guide wire is from 0.018 inches (0.046 cm) to 0.038 inches (0.097 cm).

7. The guide wire for use within a lumen according to claim 1, wherein the length of the guide wire is from 80 cm to 260 cm.

8. The guide wire for use within a lumen according to claim 1, wherein the guide wire is made of stainless steel, nitinol, or a shape memory metal.

9. The guide wire for use within a lumen according to claim 1, wherein the guide wire is wholly or partially coated.

10. A method of using a guide wire having a first end configured for placement within a lumen and a second end configured for placement within a lumen, comprising inserting the first end of the guide wire, the first end having a first tip, into a patient's blood vessel, advancing the first tip of the guide wire toward a desired location within the blood vessel, encountering an obstruction within the blood vessel where the first tip of the guide wire cannot cross the obstruction, removing the guide wire from the patient's blood vessel, inserting the second end of the guide wire, the second end having a second tip different from the first tip, into the patient's blood vessel, advancing the second tip of the guide wire within the blood vessel, and removing the guide wire from the patient's blood vessel. A method comprising the above steps.

11. The method of claim 10, further comprising using the guide wire as a guide for delivering a device to a position within the blood vessel.

12. The method of claim 10, wherein the first distal end is a straight distal end, an inclined distal end, or a J-shaped distal end.

13. The method of claim 12, wherein the first distal end is rigid.

14. The method of claim 10, wherein the second distal end is a straight distal end, an inclined distal end, or a J-shaped distal end.

15. The method of claim 14, wherein the second distal end is highly flexible.

Images