Assume for a moment that in 25–30 years, the prevalence of atherosclerotic cardiovascular disease is drastically reduced to the point that it will not be the leading cause of death in industrialized countries. This scenario may be possible by the combined effect of biological agents like RNA interferences (RNAis) making a big dent on cardiovascular disease risks. Interventional cardiology may have to switch to cancer interventions (unlikely) or to “interventional cardiovascular prevention.” The therapeutic window of many current biological agents seems to be dependent on target selectivity, and this can be accomplished by skilled interventionalists who have the ability to put a catheter or a device anywhere in the body. Delivery of these agents may be possible by different smart embodiments such as biological-agent-eluting vascular stents, interactive therapeutics reservoirs of biological agents, or cell organoid enclosures. The focus of treatment may switch from the heart and vessels to the liver, gut, pancreas, and other organs with a high concentration of relevant molecular targets. Of course, there always will be obstructive vascular and structural heart disease, but the interventional practice mix may change significantly. This scenario may be disruptive to the interventional cardiologist but even more so to the traditional dynamics of pharmacotherapy.
Julio C. Palmaz, MD
Julio C. Palmaz, MD, is the inventor of the first U.S. Food and Drug Administration (FDA)-approved vascular stent. He is currently an Ashbel Smith Professor at the University of Texas Health Science Center at San Antonio and a scientific advisor at Vactronix Scientific. He has 62 issued patents and has authored 36 books/book chapters and 115 peer-reviewed publications. In addition, he is a fellow of the American Institute of Medical and Biological Engineering (AIMBE), the American Heart Association (AHA), and the Society of Interventional Radiology (SIR).
Dr. Palmaz received the designation of Distinguished Scientist by the AHA in 2005; was inducted into the National Inventors Hall of Fame in 2006; was a gold medalist of SIR in 2007; was inducted into the National Academy of Inventors in 2013; received the Fritz J. and Dolores H. Russ Prize from the National Academy of Engineering in 2019; and most recently, became a gold medalist of the Cardiovascular Interventional Radiology Society of Europe (CIRSE) in 2021. Dr. Palmaz received his medical degree in 1971 at the National University of La Plata, Argentina. His vascular stent invention is currently on display at the Smithsonian National Museum of American History in Washington, DC.