FROM PALM LEAVES TO THERMOPLASTIC POLYURETHANES - THE HISTORY OF VASCULAR CATHETER DEVELOPMENT AND USE

Objectives: Vascular catheterization procedures are performed on millions of patients in the United States annually. Diagnostic and therapeutic, these procedures allow for the treatment of diseased vessels, resolving occlusions and delivering clot-dissolving medications. The use of catheters, however, is no new phenomenon and its history dates back to thousands of years.

Methods: This presentation discusses a literature review of the history of vascular catheterization development and use.

Results: Ancient Egyptians, Greeks, and Romans used tubes from palm leaves and hollow reeds that were tunneled through the vasculature of cadavers to study cardiovascular system function. In the 17th century, English anatomist Sir Christopher Wren fashioned a goose quill cannula, found to be capable of penetrating the veins of canines. 18th century English physiologist Stephen Hales used a brass pipe cannula to perform the first central vein catheterization on a horse to study hemodynamics. In the 19th century, French physiologist Claude Bernard attempted the first carotid artery cannulation on a horse using a mercury-based thermometer. The 20th century notably shifted away from using catheters on cadavers and animals to living humans to treat cardiovascular illness. The first right heart catheterization in a human was performed by German physician Werner Forssmann on himself in 1929. In 1953, Swedish radiologist Sven Ivar Seldinger developed the Seldinger technique which involved inserting a guide wire through a guide needle into a vessel, then withdrawing the needle and inserting a catheter over the guide wire. In 1963, American surgeon Thomas Fogarty developed a balloon embolectomy catheter later called the Fogarty catheter for embolectomies. Charles Dotter, an American vascular radiologist, performed the first transluminal angioplasty in 1963, using a rigid woven fiberglass sheath. German cardiologist Andreas Grüntzig, developed a more refined angioplasty catheter with advice from chemist Heinrich Hopff, constructing single-lumen polyvinyl chloride (PVC) balloon catheters with better rigidity than before. Vascular catheter material continued to evolve included heparin coating, antibiotic-impregnation, Silvadene incorporation, and a diverse group of construction material based on the needs of the procedure.

Conclusion: Vascular catheterization is commonly used for intravenous access, arterial blood monitoring, central access, treatment of stenosis and occlusion, and a host of other procedures. However, these innovations would not have happened without a diverse and rich history of development that spans several centuries of practice and invention.