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TRICENTENNIAL

Julio Palmaz, MD

The Palmaz Stent stents were used in nearly 85 percent of PCI procedures. Thanks
Julio Palmaz, M.D., Ashbel Smith Professor and radiologist at UT to the introduction of more successful and less invasive percuta-
Health San Antonio, was named a charter fellow by the National neous coronary interventional (PCI) procedures like stents, the
Academy of Inventors for his invention of the Palmaz Stent. The number of CABG is declining from a peak of 519,000 operations
Palmaz Stent is a catheter containing a wire-mesh tube with a bal- in 2000 to an estimated 300,000 cases in 2012.
loon that is inserted into clogged arteries in a procedure called an- There has also been a similar trend of a paradigm shift in the
gioplasty. The stent remains after the catheter and balloon are treatment of peripheral arterial disease from surgical bypass of the
removed in order to keep the artery open. A U.S. patent was granted occluded arteries to percutaneous interventions due to the intro-
in 1988. duction of the stent due to its long-term successful outcomes.
Before the stent, the standard of care was major invasive surgery Since the introduction of the Palmaz Stent, at least 10 million
including balloon angioplasty for percutaneous coronary interven- people in the U.S. have undergone coronary or peripheral artery
tional (PCI) procedures and coronary artery bypass grafting stenting to repair occluded arteries. Today, more than 2 million
(CABG) for surgical bypass of blocked coronary arteries. stents that derive from Dr. Palmaz’s invention are placed in patients
The concept of balloon angioplasty was described by Dotter and annually worldwide.
Judkins in 1964, and was first performed by Andreas Gruntzig in This device is lauded in medicine for its elegance and simplicity
1977. In the 1980s, the prevalence of CABG increased and safety as well as for being a model example of bench-to-bedside transla-
improved. tional research in medicine. The impact has been incalculable and
Angioplasty did revolutionize the percutaneous treatment of has stirred the imaginations of untold numbers of researchers and
coronary artery disease, but the outcomes were compromised by scientists.
re-narrowing and rebound occlusion (or blockage) of the artery, The stent was recognized in Intellectual Property Worldwide
often leading to severe complications including acute myocardial in- magazine as one of “Ten Patents that Changed the World” in the
farction (AMI/heart attack) and the need for emergency coronary last century. Dr. Palmaz’s early stent research artifacts are part of
artery bypass grafting (CABG). the medical collection of the Smithsonian Institution in Washing-
Coronary stents were developed to overcome the restenosis and ton, D.C. Dr. Palmaz continues his work in developing new vascular
re-occlusion challenges after balloon angioplasty. The Palmaz Stent devices. We are, indeed, privileged and honored to have him as a
was the first balloon-expandable, stainless steel, slotted tube device member of our community.
that could be successfully and consistently deployed across nar- At UT Health San Antonio, we believe that small observations
rowed blood vessels, and became one of the most studied and lead to big ideas from which other innovations and transformations
widely used stents since its introduction in the 1990s. In 1993, two in patient care can be made. We strive to do our very best to make
landmark trials, the Belgium Netherlands Stent Arterial Revascular- lives better for those we serve. The incidence of heart disease in
ization Therapies Study (BENESTENT) and the North American the community is high, but we are proud and honored to have had
Stent Restenosis Study (STRESS), demonstrated superiority of the such an influence on improving the health of the people in our
bare metal stents (BMS) over plain old balloon angioplasty (POBA), community and around the world.
thus replacing balloon angioplasty and establishing coronary stent
implantation as the accepted standard of care for percutaneous Dr. Robert Hromas is the Dean of the Long School of Med-
coronary intervention (PCI). icine at UT Health San Antonio.
The use of coronary stents increased exponentially and by 1999

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