Saturday, February 13, 2010

Why Bill Clinton should thank Marcroni Grill and a British Dentist

 What connects a chain of Italian restaurants and a British dentist with Bill Clinton?

The answer is coronory stents, two of which President Clinton got yesterday.

In the nineteenth century the principal dental impression materials were bees wax and plaster of paris, and neither was easy nor appropriate for the task. Bees wax distorted very quickly and plaster of paris was unwieldy to use. Subsquently gutta percha a form of rubber was used, which was an improvement over the current technology but not perfect, as gutta percha distorted quickly and shrank on cooling. Enter Charles Stent, a London dentist who added several materials to gutta purcha and improved its plasticity and stability. It was a huge success in the dental world and Charles Stent patented his compound and began selling it as 'Stent's impression compound' to other dentists.

Stent's compound stayed in the domain of dentists till the first world war when the trench warfare was introduced. Soldiers in the trenches were fairly well protected so long as they stayed below ground level. In order to fire their rifles, however, they had to raise themselves above the edge of the trench, and thus were very susceptible to facial wounds. The number of these disfiguring wounds was staggering, and surgeons had little experience in handling them. One Dutch physician, J. F. Esser, who was Special Surgeon for Plastic operations figured out that he could use the Stent's compound to fix in place the skin grafts for his surgeries. From there on , stenting became the word of choice for any medical procedure where a man-made object is used in natural passage/conduit in the body to prevent, or counteract, a disease-induced, localized flow constriction.

Some 70 years later at a lecture in New Orleans, Julio Palmaz got the idea of using the similar concept for coronory arteries. His early solution was inspired by a metal lathe with a structure of staggered openings that a mason had left in his garage. He developed the coronaryw stent prototype by cutting holes in metal tubing to create a collapsible structure that would remain rigid once expanded. His prototype was successful with animals and Palmaz shopped the idea around to medical companies without much success. He was finally able to secure funding for the venture from Phil Romano, the founder of restaurant chain Macroni Grill and Fuddruckers. He went against his lawyers and accountants advice to invest $250,000 of his money in the idea. Finally in early nineties, J&J bought the idea from Palmaz and his partners and became a leader in the field.

A million people in the US are implanted with coronary stents each year and President Clinton become one of them last week.

Photo credit: Creativity+ Timothy K Hamilton

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