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History of Angioplasty

First treatment option – The coronary balloon catheter
The starting point of coronary catheter based angioplasty was defined by Dr. Andreas Gruentzig in September 1977. He laid the groundwork for today’s interventional cardiology, a sub field of cardiology which utilizes catheter and guidewires to re-open coronary arteries so that the blood flow to the heart muscle is restored. In contrast to the highly invasive "open heart" surgery which was the standard clinical practice in all patients during that time, the catheter treated patients are fully awake while the procedure is done.

Biograhical Sketch of Andreas Gruentzig on Angioplasty.Org

The invention of bare metal stents reduces unwanted arterial recoil
In 1986, a selfexpanding metallic scaffold was used by Jacques Puel and Ulrich Sigwart to combat the elastic response of the treated coronary artery. Richard Schatz and Julio Palmaz introduced their so-called Palmaz-Schatz stent that was mounted onto a balloon catheter. This so called balloon expandible stent was deployed by balloon inflation. With the use of dual antiplatelet therapy the use of metallic stents became the standard practice starting in the late 90’s.

Drug eluting stents caused unexpected complications
In addition to the mechanical function of balloon dilatation and stents to keep an occluded coronary open, the concept of drug release evolved to respond to excessive cell growth in the treated coronary artery. Stents were coated with a polymer reservoir containing a drug that was subsequently released into the vessel wall. With the onset of the first Drug Eluting Stents in 2002, the rates of reblockage or restenosis of the treated artery could be further reduced. However, the price of a lower restenosis rate was counterbalanced by increased rates of blot clots or thrombotic events that tend to form more often on the inside surfaces of these Drug Eluting Stents.

Drug Eluting Stent Overview on Angioplasty.Org

The drug coated balloon will overcome current DES limitations
In 2004, Bruno Scheller and Ulrich Speck developed a catheter with a drug coated balloon that was initially used in re-occluded stents. Since then there is an increasing body of evidence to use this Drug Coated Balloon in cases of In-Stent Restenosis.

Furthermore, recent studies in certain subgroup of patients treated with the drug-coated balloon have shown favourable results.

Scientific Information