Andreas Gruentzig
Andreas R. Gruntzig, 1939-1985, was a German radiologist who first developed successful
angioplasty for expanding lumens of narrowed
arteries. His first successful angioplasty treatment on a human was performed in 1977, in Zurich, Switzerland. He expanded a short, about 3 mm, non-branching section of the
LAD (
Left Anterior Descending)
artery (the front branch of the left coronary artery) which supplies the front wall and tip of the
heart, aee
coronary circulation, which had a high grade
stenosis, about 80%, of the
lumen. Dr. Gruentzig presented the results of his first four angioplasty cases at the 1977 American Heart Association
AHA meeting, which lead to widespread acknowledgement of his pioneering work.
The immediate results of this treatment, despite using only a carefully
kitchen built catheter (crude by current standards), was quite good. The patient became and remained angina free after this treatment. This initial patient's result was electively rechecked, by angiography performed by Dr. Gruntzig at Emory University, on the 10 year anniversary of the initial treatment. The LAD narrowing, after this 10 year timespan, remained almost perfectly expanded. There was minimal residual narrowing, probably less than 10%, as seen in similar angle and multiple different views comparing with photographs of the original, 10 year earlier, before and after results.
The excellent results of this initial and subsequent patients were critical to the rapid development and growing acceptance of the angioplasty treatment option. Dr. Gruntzig recognized multiple important issues early: (a) the treatment would not be readily accepted by most physicians, especially bypass surgeons, (b) it could easily lead to bad outcomes without great care in selection of which patients/
lesions to treat and of the treating physicians and (c) it required careful teaching of the technique and its potential difficulties and pitfalls to other physicians, so as to proactively reduce the occurrence of poor results. Understanding these issues and tireless effort on his part are widely recognized in cardiology for being of fundamental importance to the ultimate success of the technique.
By about 1990, lumen
stenosis of the
coronary arteries was more commonly treated by the angioplasty technique than by
coronary artery bypass surgery. This treatment approach is now referred to as
POBA (plain old balloon angioplasty).
In the 1990s, further major improvements, both immediate and especially long term became possible with better understanding of disease as a result of clinical research trials using
IVUS and the development of
stents to mechanically support
POBA results.
Gruentzig and his wife died in an airplane crash on October 27, 1985
Andreas Gruntzig*
Andreas Gruntzig and Angioplasty*
Angioplasty