, 26 tweets, 43 min read Read on Twitter
(1/18) A Brief History of Coronary Angioplasty and the Roots of the Interventional Cardiology Field -- a #Tweetorial

#Cardiotwitter #FOAMed #ACCFIT #histmed @ACCCardioEd

Courtesy of @PopmaJeffrey & @ACCinTouch
(2/18) Dr. Werner Forssman (🇩🇪) performs 1st human #RHC (1929) by inserting a 65cm urologic catheter into his own antecubital vein and walking up to the X-ray department for imaging. Reportedly, he did this repeatedly! He left urology for primary care & shared @NobelPrize (1956).
(3/18) Dr. Fariñas (🇨🇺) performs aortography via femoral🔪 cut down (1941). Dr. Euler (🇩🇪) performs thoracic angiography by direct aorta puncture via esophagus (1949). Drs. Cournand & Dickinson (🇺🇸) open 1st US #cath lab (1945), publish extensively, and shared @NobelPrize (1956).
(4/18) Dr. Seldinger (🇺🇸), Radiology resident, works on arterial cannualization for his doctorate thesis & publishes technique (1953). Department Chair deems approach insufficient to be awarded doctorate. 1st Seldinger access: brachial art.➡️ subclavian➡️parathyroid angiography.
(5/18) Dr. Mason Sones (🇺🇸) inadvertently performs 1st selective coronary angiogram of #RCA (1958) in a 26-year-old patient with rheumatic heart disease, thereby establishing coronary angiography as a diagnostic tool. Cine frame is shown.
(6/16) Young Andreas Grüntzig (🇩🇪) scores high on abitur and was scheduled to be a laborer. Instead, he fled for medical 🏫. He completed 7 training programs (Surgery/Gyn. ’64; Internal Medicine ’65; Vascular surgery ’66; Social Medicine ’66-’69, Epidemiology ’67, Angiology ’69)
(7/18) Radiologist Dr. Charles Dotter (🇺🇸) inadvertently cannulized occluded R iliac art. during abd aortogram (1963) & with his trainee Dr. Judkins 🔜 performed 1st angioplasty of L SFA in #CLI pt who refused amputation (1964); “dottering” lesion w/ wire & catheter, no balloon.
(8/18) Dr. Zeitler (🇩🇪) performs 1st peripheral angioplasty in Europe using the Dotter technique (1968). Dr. Grüntzig performs his 1st angiographies of peripheral arteries in 1969 and learns about peripheral recanalization from Dr. Zeitler/Dr. Dotter. He listens attentively.
(9/18) Dr. Grüntzig performs his 1st angioplasty using Dotter technique (1971) & 🔜 performs 1st balloon angioplasty of iliac artery in elderly M w/ incapacitating claudication using a hand-made single-lumen dilating catheter with 4mm balloon (1974). Spent 1 hr obtaining consent!
(10/18) For next 2.5 yrs, Dr. Grüntzig & associates custom-made🎈 catheters for each pt on his kitchen table.🎈 were tied to catheters with fine surgical threads & catheter tips tapered by 🤚 using sandpaper. Dr. Grüntzig 🔜 developed thinner, refined 🎈 used in canine coronaries
(11/18) Dr. Grüntzig presents research @ AHA meeting (Miami, 1976) & became acquainted with Dr. Richard Myler/Dr. Elias Henna ( (🇺🇸) who invite him to perform 1st feasibility intraop coronary #PTCAs during #CABG in anesthetized pts from opened thorax prior to bypass (May, 1977)
(12/18) On 9/16/1977, Dr. Grüntzig performs 1st #PTCA in an awake 38-year-old man with critical LAD stenosis in Zurich. This was successful, with no restenosis at f/u, and patient is alive today! Cath report of this historic procedure is shown (referred to as “Coronary Dotter”).
(13/18) Dr. Grüntzig was a great clinical teacher & educator. He taught coronary angioplasty to physicians from around the 🌍 via live demonstrations (1978-1980). Despite overwhelming success, his 🏠 institution & superiors were unwilling to provide the needed support.
(14/18) US Institutions (Harvard, Cleveland Clinic, etc) offered him positions; however, in 1980 he accepted Professorship @ Emory 🏫 (joining Dr. Spencer King, Dr. John Douglas & Dr. Willis Hurst. Emory had just received 105 million USD research grant from Coca-Cola Foundation!
(15/18) Dr. Grüntzig spent ~ 5 years @ Emory, from 1980 until his tragic death in 1985. During those yrs, Dr. Grüntzig w/ Dr. King and their team forged ahead, developing the specialty of interventional cardiology. Following his death, their group conducted 1st RCT in the field!
(16/18) The field of Interventional Cardiology was born on the shoulders of Dr. Grüntzig with a foundation laid forth by many incredible pioneers across medical disciplines who dared to break ground in thinking, research, innovation, teaching, and collaboration.
(17/18) The knowledge of history enables us to better understand & appreciate the present & envision the future. Thanks to the work of many pioneers in our field, there are > 50,000 men & women interventional cardiologists treating millions of pt with CV diseases around the 🌍!
(18/18) #Cardiotwitter colleagues, I hope you found this #Tweetorial of interest and educational value. Feel free to comment and share any thoughts.
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