Category Archives: Video

Angioplasty: From the Legs to the Heart and Back to the Legs

Charles Dotter, MD in LIFE Magazine

Charles Dotter, MD in LIFE Magazine, August 1964

Angioplasty! A word at the center of the recent TCT meeting in Miami, attended by 12,000 healthcare professionals. A word coined half-a-century ago by Dr. Charles Dotter, a radiologist who practiced at Oregon Health & Science University in Portland, Oregon.

Dotter’s idea was simple: to open up arterial blockages in the legs from the inside out: by snaking a catheter down the circulatory system to the blockage, instead of cutting through the various layers of body tissue to repair the artery through open surgery. Continue reading

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Filed under History, Innovators, Meetings & Conferences, Peripheral Artery Disease (PAD), Video

The Question of Angioplasty in the Elderly

We just posted a report on the XIMA Trial which studied stents in octogenarians. The trial compared drug-eluting with bare-metal stents and the results are very interesting: while the trial didn’t find a difference in these two types of stents for the pre-specified composite endpoint of death, heart attack, revascularization, stroke and major bleeding…it did find significantly lower incidence of revascularization and heart attack in those patients who received the drug-eluting Xience stent.

But the real take-away from the XIMA Trial is that stenting and angioplasty in the elderly is safe and effective. Mortality from cardiac causes in this trial was 4% at one year, no matter which stent was used. Continue reading

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Filed under Antiplatelet Medications, Bare Metal Stents, Clinical Trials / Studies, Drug-Eluting Stents, Heart Attack, Meetings & Conferences, Patients, Stent, Video

35th Anniversary of Coronary Angioplasty

Angioplasty balloon being manufactured on the kitchen table in Gruentzig’s apartment

Today is the 35th anniversary of the first percutaneous transluminal coronary angioplasty (PTCA) which was performed in 1977 by Dr. Andreas R. Gruentzig in Zurich, Switzerland. This angioplasty procedure utilized an expandable balloon, fashioned on a kitchen table in Gruentzig’s apartment by Gruentzig’s assistant, Maria Schlumpf (note the bottle of wine…and yes, she used Krazy Glue).

The patient was Adolph Bachman, age 37 (the same age as Gruentzig), who was scheduled for bypass surgery. Gruentzig has been working on this idea for several years; it was an idea first germinated by a U.S. radiologist, Dr. Charles Dotter, in the early 60’s. Dotter in fact coined the term “angioplasty” to describe opening up a blocked artery not through open surgery, but by threading a catheter into the artery and opening it up from the inside out: less traumatic, quicker, and possibly (he thought) more durable.

Dotter’s idea was mocked as crazy (he became known as “Crazy Charlie”) by the surgical community of the day and it took years for Dotter’s concept to travel across the world to Europe, where Gruentzig learned about it. He added a balloon to the tip of the catheter and, after experimenting in the lab in Zurich, he teamed up with Dr. Richard K. Myler of San Francisco to try the idea intraoperatively in patients who were having open heart surgery.

When the concept had been proven in a few of these surgical cases, Gruentzig returned to Zurich to attempt doing an angioplasty in the cath lab without surgery: percutaneously — just through a needle stick, the same procedure as a diagnostic angiogram. Except with a balloon. That’s where our video below begins: the story of the first angioplasty.

(By the way, the clip below is excerpted from my feature-length award-winning documentary, “PTCA: A History,” which tells the whole tale of how this “crazy” idea turned into a major branch of modern medicine. The complete 72 minute DVD is available for sale on our web site — of course!)

Continue reading

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Filed under History, Innovators, Video

Jerry “The King” Lawler Has Heart Attack (on the air) and Stents (not on the air)

Jerry Lawler

Jerry Lawler, announcing during a match in 2007 (courtesy Mshake3)

Jerry “The King’ Lawler, semi-retired professional wrestler, holder of 168 championships (reportedly) and commentator for WWE’s “Monday Night Raw” collapsed on September 10, during a live broadcast in Montreal, Canada.

62-year-old Lawler was having a heart attack.

EMTs performed CPR and defibrillated him (seven times, it is reported). He was revived and rushed to a Montreal hospital where he received an angioplasty with two stents. Continue reading

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Filed under Celebrity Patients, Heart Attack, Stent, Video

Cost Effectiveness of Wrist Angioplasty from Japan

Patient exchange in cath lab at Kihara Cardiovascular Hospital in Japan

Patient exchange in cath lab at Kihara Cardiovascular Hospital in Japan

Earlier today I reported on an important study, published online first in Circulation: Cardiovascular Quality and Outcomes. The study fed the results from 14 radial vs. femoral trials (RIVAL et al) into the cost-benefit analysis machine at Penn Medicine’s Center for Evidence-based Practice (CEP).

And the results? The transradial wrist approach to catheter-based procedures (angiograms, stents, etc.) was less expensive ($275 per procedure) and resulted in two-thirds less complications than the femoral/groin approach. Continue reading

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Filed under Clinical Trials / Studies, Cost Effectiveness, Japan, Patient Experience, Video

Thomas Fogarty on the Process of Innovation and Angioplasty Pioneer Charles Dotter

Thomas Fogarty, MD

Thomas Fogarty, MD

Few people in the field of medical devices are as qualified to talk about innovation as is Dr. Thomas Fogarty, founder, chairman or board member of over 30 business and research companies and holder of over 130 patents.

So, as we are on the verge of a new age in medicine, incorporating SmartPhones, mobile technology and individualized medicine, courtesy of genomics, it is worthwhile remembering what “change” in this field entails — in the words of Dr. Fogarty: “The process of innovation always involves overthrowing the establishment” and that the people who drive this innovation have “always been perceived as crazy…and inappropriate.” Continue reading

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What We Can Learn from Tommy Lasorda’s “Mild” Heart Attack

Tommy Lasorda, photo by Phil Konstantin

Tommy Lasorda, photo by Phil Konstantin

Before he was Hall of Fame manager of the Los Angeles Dodgers, Tommy Lasorda was a scout and coach for the team. And part of his duties was to teach the rookies. So, in that tradition, there is a lesson in Tommy’s latest health scare: if you think you may be having a heart attack, get to the hospital ASAP, preferably a hospital that performs emergency angioplasty. Continue reading

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Filed under Celebrity Patients, Heart Attack, Video