Professor Martin Rothman,

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30 yrs of Angioplasty, 20 yrs of BCIS and now
unprotected LM PCI..and on
Advanced Angioplasty 2008
Professor Martin Rothman, London Chest Hospital
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(No Transcript)
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A journey in the field of interventional
cardiology
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BCS President 1995- 1997
Raphael Balcon
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Tony Rickards Raphael Balcon
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The first balloon use in treatment of CAD?1685

• Charles II - known to have 15 mistresses Moll
  the most impertinent slut in the world
• Whilst having a haircut, fell off chair with
  large MI
• Sixteen ounces blood letting - failed
• Aloe, antimony, beet root, violets, camomile
  flowers, fennel seed, saffron, cinnamon, cardamom
  seed, linseed, rock salt, mallow leaves
• with a balloon of an animal bladder had this lot
  shot up rectum

He died !!
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Management of IHD US style..1955

• Dwight Eisenhower
• Friday Sept 23rd 1955
• CP during golf attributed to eating onions
• Mj General McCrum Snyder (2130) mixed him a
  cocktail !!
• Milk of Magnesia
• 5 hrs (0230) later morphine
• Next day ECG
• 7 weeks bed rest !!!!

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Origin of Endovascular Therapies
Crazy Charlie (Dotter)
Crude interventions
with only large shafted balloons, inflexible
wires, etc.
Ream jobs
Volkswagen steering cables and guitar strings
1960s
Surgeryunfit for modern times
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World Figures in Interventional Radiology
Charles Dottor
1960s
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The Father of coronary balloon angioplasty
Andreas Roland Grüntzig June 25, 1939
Dresden October 27, 1985 Atlanta
East German refugee
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PTCA First dog October 22, 1975
Schneider J. Infobl Dt Ges Kardiol 230-32, 1995
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First Dog PTCA (LAD)
October 22, 1975
Schneider J. Infobl Dt Ges Kardiol 230-32, 1995
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First Dog PTCA Series
1-Month FU
Schneider J. Infobl Dt Ges Kardiol 230-32, 1995
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First coronary balloon catheter (Grüntzig Dilaca
DG 20-30, Schneider Medintag) Used on September
16, 1977
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First Shop for Coronary Balloon Catheters
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First PTCA, Zurich September 16, 1977
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PCI-Patient 1
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First PTCA and Follow-Up
Apr. 2000
Sep. 1977
Dec. 2000
Sep. 2000
FFR 0.83
Sep. 1987
pre
Dec. 2000
post balloon
post balloon
post stent (3.0 x 8 mm)
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PCI-Patient 1
September 16, 2007
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Emory University

• Spencer King Visionary to spot talent
• 105 million gift from Coca-Cola
• October 1980 moved to Emory

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1979 balloon inflations in coronaries during CABG
Raphael Balcon
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The Battle of the Balloons 1977-1985
John B Simpson
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My first patient at London Hospital- 1982
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European Coronary Angioplasty Workshop Sept 12th
14th 1983
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The Battle of the Balloons 1985 - onwards
Paul Yock
John B Simpson
Bonsall
Over the wire v Monorail
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Pre-
A small group of cardiologists from Yorkshire and
Lancashire met in the Railway Hotel in Sheffield
to discuss 35mm roll film angios using a Targano,
to which a number of southerners came.ME!
1983-5
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Andreas Roland Grüntzig June 25, 1939
Dresden October 27, 1985 Atlanta
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• Self-elected Group formed to write a
  constitution
• Peter Hubner
• Alan Mackintosh
• Man-Fai Shiu
• Martin Rothman

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• The British Cardiovascular Intervention Society
  (BCIS)
• first meeting at St Bartholomew's Hospital,
  London
• 5th February 1988
• Accepted its constitution and elected its
  Officers.
• Its purpose was to establish regular meetings for
  those interested in interventional vascular
  procedures, and at that time coronary angioplasty
  was still in its relative infancy in the United
  Kingdom, with a national total of just over 5,000
  procedures being undertaken that year.
• The Society has audited interventional activity
  in the UK each year since then.

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All the Presidents ..
Dr Man-Fai Shiu 1988-1992
Prof Martin Rothman 1992-1996
Dr John Perrins 1996-2000
Dr Keith Dawkins 2000-2004
Dr Martyn Thomas 2004-2008
Prof David Cumberland the President we never had
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Dr Man-Fai Shiu (President 1988-1992)Dr Martin
Rothman (President 1992-1996)Dr John Perrins
(President 1996-2000) Dr Keith Dawkins (President
2000 - 2004) Dr Martyn Thomas (President 2004
2008) Dr Marc de Belder (President 2008- ) Dr
Peter Hubner (Hon. Secretary 1988-1992) Dr Huon
Gray (Hon. Secretary 1992-1996) Dr Mike Norell
(Hon. Secretary 1997-2000) Dr David Smith (Hon.
Secretary 2000 - 2004 Dr Jim McLenachan (Hon.
Secretary 2004 - 2006) Dr Bernard Prendergast
(Hon. Secretary 2006 - ) Dr Alan Mackintosh
(Hon. Treasurer 1988-1993) Dr Stuart Shaw (Hon.
Treasurer 1993-1997)Dr Paul Silverton (Hon.
Treasurer 1997-2002)Dr Neal Uren (Hon. Treasurer
2002 - 2006) Dr Simon Redwood (Hon. Treasurer
2006 -) Dr Huon Gray (Audit Secretary
1994-1997) Dr Mark de Belder (Audit Secretary
1998 2002) Dr Peter Ludman (Audit Secretary
2002 - )
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And all the council members..
Mr Chris Brown (Industry Representative)Dr
Raphael Balcon (LCH, London)Dr Adrian Banning
(Oxford)Dr Nigel Buller (Birmingham)Dr Anoop
Chauhan (Blackpool)Prof David Cumberland
(Sheffield)Dr Simon Davies (Royal Brompton
Hospital)Dr Adam de Belder (Brighton)Dr Mark de
Belder (Middlesbrough)Dr John Dyet (Hull)Dr
Duncan Dymond (St Bart's Hospital)Dr Huon Gray
(Southampton)Prof Roger Hall (Hammersmith
Hospital)Dr Alex Harley (Liverpool)Dr Ian
Hutton (Glasgow)Dr Mazhur Khan (Belfast)Ms
Verity Lea (Industry Representative)Dr Brian
Maurer (Dublin)Dr Mike Norell (Hull)Dr Keith
Oldroyd (Glasgow)Dr Peter Quigley (Dublin)Ms
Christa Roberts (Industry Representative)Dr
David Ramsdale (Liverpool)Dr David Roberts
(Blackpool)Dr Mike Rees (Leeds)Dr Peter
Schofield (Cambridge)Dr Philip Spurrell (BJCA
Representative)Dr Rod Stables (Liverpool)Dr Ian
Starkey (Edinburgh)Mr Stephen Terry (Industry
Representative)Prof Peter Wilde (Bristol)
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British Cardiovascular Intervention, in PubMed
Central will retrieve 2091 citations.
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Intervention data collection in the UK

• 1988 National data collection started (Hubner)
• 1986 Surgical valve registry
• 1996 CCAD - funded pilot 3 yrs
• (1.2M grant Ken Taylor Martin Rothman)
• 2000 DoH agreed to continue funding
• 2002 First dataset agreed (version 5.1)

Tony Rickards instrumental in making CCAD data
collection work
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PCI vs Isolated CABG Numbers (UK)1991 to 2006
Note CABG data for financial yr all PCI v NHS
CABG
Form AB
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Tony Rickards Raphael Balcon
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30 yrs of Angioplasty, 20 yrs of BCIS and now
unprotected LM PCI..and on
1992
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PCI is 30 yrs oldBCIS is 20 yrs oldAdvanced
Angioplasty is 15 yrs old
Whats the next 20yrs for BCIS?
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British Cardiovascular Intervention Society
British Cardiac Society British Cardiovascular
Society
Whats the next 20yrs for BCIS?
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But remember the role of the cardiac surgeon
today, and his prior status, and be aware that
what goes round comes round..
unless
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Cardiac Vascular CAU
neurology
Critical care
trauma
cancer
Cardiology Cardiac thoracic surgery anaesthesia
(cardiac critical care) Diabetes Clinical
pharm Vascular surgery interventional vasc
radiology
Care of the elderly
renal
Acute medicine Stroke management respiratory
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Stenting for carotid artery disease by
cardiologists
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Acute MCA Occlusion
Initial Angiography
After PBI with Neuroform stent
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• The enemy of good is better
• He who fights and runs away lives to fight
  another day