Early development of bioresorbable scaffold
In September 1986, I had the privilege to implant the first endoluminal prosthesis (wall stent), as we called the stent at that time, in our first patient in Rotterdam just a few months after the pioneering cases of Jacques Puel in Toulouse and Ulrich Sigwart in Lausanne. In 1986, there was not yet an official Ethics Committee established at the Thoraxcenter, and it was only with the blessing of the chairman of cardiology and the permission of Paul Hugenholtz and with the support of the chief of surgery Egbert Bos that I was allowed to implant the first stent. Following the implantation, I performed an angioscopy, as it was available in Europe at that time. I was shocked by the vision of the shiny metal embedded in this delicate structure that is a human coronary artery. I felt guilty to have introduced in that very delicate biological structure such a rough device as a self-expanding stent. Honestly, I left the cath-lab with a tremendous feeling of guiltiness, having the impression that I had carried out something irreversible that would leave this human coronary artery caged forever. As ominously predicted by our chief surgeon… by the third case, I experienced my first stent thrombosis despite extensive platelet antiaggregation and anticoagulation with aspirin, heparin, warfarin, persantine and reomacrodex. On the same, day I started to reflect on the fact whether it could be possible to scaffold a vessel without using a permanent metallic implant to keep the vessel largely patent.