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A collection of visionaries

Charles Dotter (1920–1985)

There were many precursors to Andreas Grüntzig whose work made his achievement possible. The Exposition features a gallery of six of these pioneers. One such visionary was Charles Dotter (1920–1985), who in 1963, with the first use of a diagnostic catheter for a therapeutic purpose, invented interventional radiology.

C. Dotter become chief of the radiology department at Oregon State University (Corvallis, USA) at just 32 years old. His first arterial recanalisation was actually unintentional; when using an abdominal aortography to assess a renal artery stenosis, he saw the he had involuntarily recanalised an occluded right iliac artery by retrogradely introducing a catheter via the femoral artery. When the catheter was removed, the channel remained open, demonstrating improved leg perfusion.

This experience gave C. Dotter his vision of treating vessels without surgery. C. Dotter went on to perform the first intentional transluminal angioplasty in January 1964. The 82-year-old female patient had previously refused amputation for her left leg ulcer with gangrenous toes, and had a short stenosis of the left superficial femoral artery — an ideal lesion in which to test C. Dotter’s percutaneous dilatation catheters.

Charles Dotter

The final result was complete healing of the ulcer, with femoral artery patency confirmed at three weeks. Although the patient died three years later from congestive heart failure, until then she walked on two feet without difficulty.

Known by some as “Crazy Charlie” his unconventional and innovative ideas — for example that atheromatous plaque could be compressed like snow, a.k.a. “the Dotter effect” — remained relatively unknown and were criticised for some time, especially in his home country.