Charles Dotter (1920-1985)
At the age of 32, Charles Theodore Dotter, became the chief of the radiology department at Oregon State University in Portland. His first arterial recanalization was unintentionally performed in 1963. Using an abdominal aortography to assess a renal artery stenosis, he saw that he had involuntarily recanalized an occluded right iliac artery by retrogradely introducing a catheter via the femoral artery. During the removal of the catheter, he noted that the inadvertently created channel remained open, with demonstrated improvement in leg perfusion. In view of this experience, Charles Dotter had the vision of treating vessels without surgery.
The first intentional transluminal angioplasty was performed on January 16th, 1964 on an 82-year-old female patient suffering from a left leg ulcer with gangrenous toes and who refused amputation. The general surgeon referred the sickly woman to him. She had a short stenosis of the left superficial femoral artery which was an ideal lesion in which to test his percutaneous dilatation catheters. The procedure went well and, with the reduced stenosis, it resulted in the overall warming of the leg and the progressive disappearance of the pain. The final result was complete healing of the foot ulcer. The patency of the femoral artery was confirmed via angiography at 3 weeks. This patient died 3 years later of congestive heart failure, but until then, she walked on her two feet without difficulty. With the first use of a diagnostic catheter for a therapeutic purpose, Charles Dotter had just invented interventional radiology.
Charles Dotter believed that atheromatous plaque could be compressed like snow and this became known as ¨the Dotter effect¨. His ideas remained relatively unknown and were disapproved of in the United States. He became known as ¨Crazy Charlie¨ because little credit was given to his unconventional, innovative ideas.