Angioplasty: The Lifesaving Procedure is 50 Years Old This Month

Angioplasty Angioplasty: The Lifesaving Procedure is 50 Years Old This MonthOn January 16, 1964, a doctor named Charles Dotter performed the first angioplasty procedure.  But, at that time, it wasn’t done on the heart as it typically is today.  Instead, it was done on the leg of an 82-year-old woman suffering with pain and a severe, non-healing ulcer from blocked blood flow to her lower leg. Other doctors had recommended amputation, but the woman had refused.

Charles Dotter, was working on an experimental procedure that he felt would restore blood flow in heart attacks caused by blockages.  He called it “angioplasty”, which means to remake, or reform, a vein, resulting in re-establishing blood flow in veins and arteries that feed tissues and organs.

Angioplasty is a non-surgical procedure that is done by inserting a very small catheter into an “occluded”, or blocked, blood vessel, vein or artery to create an opening through which blood can start to flow again.  Sometimes a series of different sizes need to be used to achieve the goal.  In the procedure, a catheter is gently pushed through the blockage – usually plaque – under x-ray (angiogram) guidance to create an opening through it.

Dr. Dotter x-rayed the 82-year old woman’s leg by inserting a highlighting dye via a catheter.  They showed that she had a short blockage in the largest artery of the leg – the SFA, or superficial femoral artery, not far from the puncture site for the dye needle.

Through this same opening, Dr. Dotter started to insert a variety of sizes, working from smaller to larger, to finally create a wide enough opening through the blockage that allowed blood to flow again.  After a week, the patient’s pain in her leg had stopped and the non-healing ulcer had gone on to heal. Dr. Dotter’s procedure had been a limb-saving success.

After this initial success, Dr. Dotter went on to refine the angioplasty procedure, developing different catheters to use.  Yet, even though the initial procedure was successful and saved the woman’s leg, American heart doctors were not thrilled with Dr. Dotter’s procedure.  In fact, they referred to him as “Crazy Charlie”.

But, more innovative European doctors were inspired by Dr.  Dotter’s procedure and wanted him to teach them his techniques. Another doctor from Germany added to the procedure by creating the balloon catheter technique of angioplasty.  It was this doctor, Dr. Gruentzig, who eventually went on to use Dr. Dotter’s initial procedure on the heart in 1977.  Today, innovations in angioplasty include the use of stents that hold the vein or artery open after catheterization.

 

Charles Dotter, MD and Angioplasty,  http://www.ptca.org/voice/

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