Back in the 1970s, while watching an angioplasty to widen clogged coronary arteries, John Simpson, Ph.D., M.D., thought there had to be an easier way to perform the procedure.

There was, and Simpson, who trained at The University of Texas Graduate School of Biomedical Sciences at Houston (GSBS), invented the medical device to do it. It was the first of a series of inventions by the cardiologist that have helped many with coronary artery disease.

On Oct. 16, Simpson was named the 2009 Distinguished Alumnus for the UT Graduate School of Biomedical Sciences at Houston for four decades of achievement. He received both a master's degree and doctoral degree at the GSBS. The school is a joint program operated by The University of Texas Health Science Center at Houston and The University of Texas M. D. Anderson Cancer Center.

"Dr. Simpson is a great role model for our students as they launch their own independent careers as they leave the GSBS. He also illustrates how discoveries can be used to generate new ideas and products in the business world, especially in entrepreneurial ventures," said George Stancel, Ph.D., dean of the GSBS and holder of the John P. McGovern Distinguished Professor in Biomedical Sciences.

Coronary artery disease is the leading cause of death in the United States. It results from the buildup of plaque inside coronary arteries, which crimps the supply of oxygen-rich blood to the heart and can lead to chest pain or a heart attack.

"My training at the GSBS helped me stay focused on always asking why, why not and what if," recalled Simpson, whose dissertation chairman was the late John Hampton, Ph.D.

Not too long after graduating from the GSBS, while at Stanford University, Simpson put his scientific curiosity to the test while listening to a presentation on balloon angioplasty by the late German cardiologist Andreas Gruentzig, M.D.

"I couldn't miss this. I heard someone was going to put a balloon catheter into a coronary artery. Blow it up. And, the patient was going to get better," Simpson exclaimed. "I thought Gruentzig was going to revolutionize the treatment of clogged arteries or go to jail. And, I thought jail was more likely."

Awestruck at the potential of the procedure, Simpson at his own expense traveled to Europe to observe Gruentzig successfully treat a patient in Frankfurt, Germany. Though the results were impressive, Simpson thought the instrument appeared hard to use and that doctors without Gruentzig's formidable skills would have a hard time manipulating the balloon catheter.

Afterward, Simpson ordered the instrument so he could check it out for himself. "When the box arrived, it only had the accessories but there was no balloon," Simpson said. "Consequently, I had to buy some tubing and make the instrument."

Necessity truly is the mother of invention and while developing his own version of Gruentzig's device, Simpson came up with a better way to manipulate the movement of a tiny balloon along a guide wire. He secured a patent for the invention, which physicians know as the over-the-wire balloon angioplasty catheter.

This instrument was the foundation of a company called Advanced Cardiovascular Systems, Inc., in 1978. Once inflated, the balloon compresses plaque against the arterial wall. The device is also used to implant stents, which keep the widened areas open. Other treatments for coronary artery disease include grafts to bypass narrowed arteries.

"I have known Dr. Simpson since the early days of coronary angioplasty. His invention of the over-the-wire coronary angioplasty catheter was one of the pivotal developments leading to the broad application of interventional cardiology techniques in the area of coronary and peripheral revascularization utilizing a percutaneous approach," said Richard Smalling, M.D., Ph.D., Jay Brent Sterling Professor and James D. Woods Distinguished Chair in Cardiovascular Medicine at The University of Texas Medical School at Houston.

"Dr. Simpson's inventions have touched millions of patients around the world through the years. He is truly one of the major pioneers of interventional cardiology. At the same time, he is a soft spoken approachable man with an excellent sense of humor and easy going demeanor. He is certainly a model for young interventionalists who have an aptitude for invention. The UT Graduate School of Biomedical Sciences should be extremely proud of their graduate. Although he now resides in California, he is truly one of Texas' outstanding sons," said Smalling, who performs interventional procedures at the Memorial Hermann Heart & Vascular Institute - Texas Medical Center.

The over-the-wire balloon angioplasty catheter and his other inventions led to the formation of several companies. His research also includes a device designed to reduce amputations by clearing blocked arteries in legs. In the future, he would like to place a tiny camera on a catheter for therapeutic purposes.

"You've probably heard the expression 'thinking outside the box'," said David Smith, Ph.D., the GSBS graduate who nominated Simpson for the award. "For John Simpson, there is no box." Smith is a biochemistry professor at Emory University School of Medicine in Atlanta.

Simpson said Hampton, his dissertation chairman, taught his students to be critical thinkers. "He said your job is to improve the approximation of the truth. You will never get to the truth. But if you work hard, you can get to a better explanation. Consequently, I always ask myself if there is a better way," Simpson said.

After receiving his doctorate at the UT Graduate School of Biomedical Sciences, Simpson went to Duke University where he received a medical degree. He later received a fellowship in cardiology at Stanford University School of Medicine. Today, he is a professor at Stanford University and a staff cardiologist at Sequoia Hospital in Redwood City, Calif.

Source: Robert Cahill
University of Texas Health Science Center at Houston