Dr. Charles Dotter in LIFE Magazine (1964)
Who is that mad scientist in the 1964 issue of LIFE magazine? Oh, just the man who invented the concept of angioplasty; in fact he’s the man who actually coined the word “angioplasty!” And he’s the doctor who performed the first angioplasties in the leg, in order to save limbs from amputation without resorting to surgery.
Like many innovators, he had a crazy idea: to open blocked arteries from the inside out. No cutting, suturing, or stitching. Less trauma, lower morbidity, quicker recovery. His name was Charles Dotter and he was a radiologist in Portland, Oregon who, 51 years ago next week, performed an angioplasty on the blocked leg artery of an 82-year-old woman. Continue reading
Dr. Frank J. Veith
Today was day one of the 41st Annual Veith Symposium in New York City. Started by Dr. Frank J. Veith, a pioneer in the field of endovascular approaches to vascular surgery, this five-day event covers the entire field of minimally invasive approaches to clinical situations that just a couple decades ago were the exclusive purview of open surgery.
The whole field of endovascular repair and intervention has grown exponentially since the first endovascular repair of an abdominal aortic aneurysm (EVAR) was performed by Dr. Juan Parodi in 1990, but it took quite some time to be accepted as a standard of care. Today the endovascular approach is the preferred procedure to repair an AAA and this is because of the advances in medical device design and manufacturing and the dedication of physicians to this less invasive non-surgical approach, physicians who will be attending this year’s Veith Symposium.
Today is Veterans Day in the U.S., honoring the soldiers who fought in the country’s wars. Last week was the VIVA 14 meeting, presenting the latest advances and techniques in endovascular repair and therapy of blood vessels.
These two events are actually closely aligned: the development and advances made in vascular surgery, and now endovascular therapies, were pioneered on the battlefield. Continue reading
Dr. Charles Dotter in LIFE Magazine (1964)
Crazy Charlie. An August 1964 LIFE magazine photo spread on Dr. Charles Dotter reinforced that nickname, given to Dotter by the vascular surgeons who knew him and his work at Oregon Health Sciences University in Portland — and who did not like what he was doing. Unblocking arteries in the leg without surgery? From the inside, using catheters? Crazy!
So that was 50 years ago, and to call Dotter a visionary is a vast understatement because this week, radiologists, cardiologists and surgeons have gathered in Las Vegas, not to gamble (although who’s to say…) but to present and hear the latest information, late-breaking trials and reports on vascular interventional therapies at the VIVA 14 meeting and see demonstrations of an array of devices and techniques. Continue reading
On October 23-25, 2014 the 3rd Advanced International Masterclass on the Transradial Approach will be held in Chicago and, if you already perform or want to start using the wrist approach to diagnostic or interventional procedures, you need to attend. Where else will you be able to spend two-and-a-half days with the most expert and experienced radial practitioners in the world?
I went to the very successful AimRADIAL course in New York City last fall and witnessed something I hadn’t really seen since the early days of angioplasty: a relatively small meeting (i.e. less than 300) attended by the pioneers of the procedure, cardiologists who have the largest experience in the radial approach, talking among themselves and trading their latest findings and techniques with each other, and sharing this information with the newer generation of physicians in attendance.It felt like an actual community! Continue reading
Charles Dotter. MD
It was 50 years ago today that Dr. Charles T. Dotter, a radiologist in Portland, Oregon, performed the first angioplasty. But it wasn’t in the heart; it was in the leg.
An 82-year-old woman was suffering from great pain in her left foot because of blocked circulation in her leg. Her toes had become gangrenous and there was an non-healing ulcer. Amputation was recommended by the physicians at Oregon Health Sciences University, but the woman refused.
Luckily, the surgeon in charge of the case knew of Dr. Dotter’s interest in the possibility of using a catheter to open a blocked artery. Continue reading
A recent New York Times article delves into a topic not often discussed: the fact that some surgeons are more skilled than others. “A Vital Measure: Your Surgeon’s Skill” by Dr. Pauline W. Chen is a fascinating look at a taboo topic. Dr. Chen describes an innovative program where a group of expert surgeons judges how skilled a particular colleague is by looking at a close-up videotape of how he or she works with their hands, utilizes equipment, and so on. How can you tell if a surgeon is on his game? As famed sports commentator Warner Wolf would say in his catch-phrase, “Let’s Go to the Videotape!”
Video control room in an early angioplasty live demonstration course
However, watching procedures on video is nothing new to me, or to any member of the interventional cardiology community. The field of angioplasty started on Day One with live demonstration courses where procedures were performed utilizing live TV broadcasts (see my video at the bottom of this post). I designed and directed many of these early courses and we focused cameras on the operator’s hands, very similar to the videos in Dr. Chen’s article. And just last week at the TCT 2013 Annual Symposium, thousands of cardiologists watched the hands of their colleagues in HD video on a 100 foot screen, being broadcast from Germany, or South Korea, or New York. Continue reading