Eberhard Zeitler (1930-2011)
Development of the Dotter approach
Eberhard Zeitler recognized Charles Dotter’s genius and started to teach this technique in Europe. He felt it was the way things needed to be done. Andreas Grüntzig also did not consider this idea to be crazy and that it just needed to be improved upon, thus he invented a balloon catheter. Truth is sometimes stranger than fiction.
In 1967, he was appointed director of the radiology department in Engelskirchen, near Köln. At that time, angiologists used thrombolysis to treat peripheral arterial disease but there were frequent failures because residual stenosis could not be lysed. Having heard about Dotter’s method, he went to Portland to learn this new technique. Back in his clinic in Engelskirchen, he decided to treat residual stenoses with simple catheters after thrombolysis. He performed the first peripheral angioplasty in Germany in 1968.
Eberhard Zeitler’s luck was to have a clinic with many patients suffering from vascular disease. Equally important, he had good relationships with the other clinicians. In 1971, Zeitler published the results of the first 141 patients suffering from occlusive arterial disease treated with Dotter’s method (tapered coaxial dilating catheters with increasing calibers). Primary success was observed in about 70% of the cases. Indications were relatively restrictive: to prevent amputation when reconstructive surgery was not feasible or accepted, or in patients with reclosure following endarterectomy. Ideal indications were short and simple lesions. In these situations, this method appeared beneficial as it eliminated general anesthesia, reducing risks related to surgery and shortening hospital stay.
Eberhard Zeitler contributed to the development of Dotter’s method in Europe, which allowed Andreas Grüntzig to create a balloon catheter in 1974 and to perform the first coronary dilatation in 1977.