Grüntzig's coronary balloon angioplasty

Andreas Grüntzig, a German-born physician working at the Medical Policlinic of the University of Zürich, first used a balloon-tipped catheter in 1974 to reopen a severely narrowed femoral artery. He called the procedure percutaneous transluminal dilatation. He had made the balloons himself; by his own account, most of the hundreds of trial runs took place in his kitchen. Heinrich Hopff, a retired professor of organic chemistry at the Federal Institute of Technology who knew polyvinyl chloride well, advised him on materials, and the engineer Helmuth Schmid helped him build a double-lumen catheter.

Four months after the first coronary dilatations performed during open surgery in San Francisco, and with the backing of the surgeon Senning, Grüntzig tried the method in a conscious patient. On 16 September 1977, at Zurich University Hospital, he dilated an isolated stenosis of the left anterior descending artery in Adolf Bachmann, 38, who had been scheduled for bypass surgery.

He first described coronary dilatation in a letter to The Lancet published on 4 February 1978. In July 1979, writing with Senning and Siegenthaler in the New England Journal of Medicine, he described 50 patients treated over 18 months. The procedure succeeded in 32, reducing stenosis from a mean of 84 to 34 percent and the pressure gradient across it from 58 to 19 mm Hg. Five patients needed emergency bypass surgery. Grüntzig estimated that only 10 to 15 percent of bypass candidates had suitable lesions and called for a randomized trial against surgery and medical treatment.

In 1980 he moved to Emory University in Atlanta to work with Spencer B. King III and John S. Douglas, where steerable guide wires and over-the-wire catheters raised success rates. Grüntzig died in 1985. Around that year the retired radiologist Cesare Gianturco brought him a prototype coronary stent, and Grüntzig assigned his senior fellow, Gary Roubin, to the preclinical studies.