Written By: Stephanie Kazi
Forget to bring your blowtorch to the Radiological Society of North America (RSNA) Annual Meeting? So did Charles Dotter in 1963. However, no need to worry, because fortunately Bill Cook at the booth for Cook Incorporated was willing to loan one to Dotter for use in his hotel room that evening, in addition to some Teflon tubing to go with it.
The creation of Teflon catheters with a blowtorch in a hotel room is one example of the ingenious, although unconventional, nature of the pioneering interventional radiologist Dr. Charles Dotter. He, like many pioneers in IR, utilized great resourcefulness for the development of standard tools used today.
For example, consider guidewires. Straight edged, angled, or ‘J’ shaped, stiff or flexible, hydrophilic or non-hydrophilic—the types of guidewires available today are expansive. However, the early angiographers were slightly more limited in their ready-made options. Some, such as Sven Seldinger, used wire purchased from machine shops and coiled it by hand to make their own guides. Others, such as Dotter, used guitar strings, piano wires, and speedometer cables.1
In addition to resourcefulness, “heat and patience” were other necessary components to Dotter’s wire development. While finding the stiffness and length of a particular type of guitar string satisfactory, certain time consuming modifications were required in order to achieve its desired function. The guitar string contained a central wire core that he would remove and replace with a No. 8 piano wire, thus forming a wire with a moveable core. The retractable inner piano wire permitted increased flexibility, making catheterization of tortuous vessels and the aortic valve possible.2
Thankfully, IR’s today do not need to construct their own guide wires out of musical instrument parts. However, the resourceful and creative history behind even the most standard tools utilized in IR serves as an inspiration for further advancements.
1. Geddes LA, Geddes LE. The Catheter Introducers. Chicago, IL: Mobium Press; 1993:18, 54.
2. Roberts, AC. The 2004 Dr. Charles T. Dotter Lecture: Interventional Radiology Today — What Would Charles Dotter Say? J Vasc Interv Radiol. 2004; 15:1357-1361.