Jacques Puel (1946-2008)
Professor Jacques Puel is recognized as one of the early pioneers in interventional cardiology. He was the first to implant a coronary stent in humans in 1986. This operation was considered one of the greatest medical advances of the last thirty years and has saved thousands of lives around the world. Without knowing it, he changed coronary angioplasty for both the short and the long term.
Jacques Puel spoke about his early experiences with sheep. He successfully implanted an endoprosthesis, but the sheep died 10 days later. Anatomical study revealed a patent stent. A second sheep implantation behaved in the same way. It turns out that sheep, having a herd instinct, die of loneliness. It would be sufficient to simply not leave them alone after stent implantation.
In this experimental study, no anticoagulants or antiplatelet agents were used before or after implantation of the Wallstent. Rapid endotheliaziation (at 3 weeks) of the endoprosthesis allowed the cardiology community to look upon this new therapeutic approach for humans favourably. Unfortunately, the low thrombogenicity of this endovascular prosthesis was not confirmed in human coronary arteries. Jacques Puel, together with Ulrich Sigwart and Patrick Serruys, were at the beginning of the second revolution in coronary angioplasty, permitting more secure balloon angioplasty through metallic stent endoprosthesis implantation. It took a long time and many trials to clearly identify how to avoid the risk of stent thrombosis by adequate stent expansion and the use of dual antiplatelet therapy.