Abstract: The invention includes an exchange system, a guidewire anchoring means and a method of use for catheters exchangeable over a guidewire (55). The guidewire anchoring means restricts movement between the guidewire (55) and the anchoring means. The anchoring means comprises a shaft (35) with a longitudinal lumen (80) therethrough, the lumen (80) being in fluid communication with a balloon (25 or 30) disposed on the distal end of the shaft (35). A tubular split housing (5 or 10) surrounds the distal end of the shaft (35) and adheres to the balloon (25 or 30), the balloon (25 or 30) being sized to expand to a larger size than the inside diameter of the split housing (5 or 10). The inside diameter of the split housing (5 or 10) is sized to slidably receive a catheter, while the outside diameter of the split housing (5 or 10) is sized to slidably fit within a guide catheter (50 ).