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Interventional Radiology

SynIRgy: Medical Specialty, Professional Identity, and Cook’s Legacy


Physicians are problem-solvers at heart. Those physicians who were working with pacemakers began to see the need for removing leads, and saw the risks to the patient associated with the methods being used. Several physicians began to tinker and identified the first challenges that needed to be overcome in the procedure: Stability, binding scar tissue, and fragile materials. Some of the efforts to improve lead management include the following:

• Dr. Jorgen Meibom of Demark began working on a locking stylet that locks at the tip of the lead.

• Dr. Charles Byrd of the United States was working on telescoping dilators to create counter traction during the removal procedure.

I had two goals: one is safety and the other is success…I’m not talking about financial success or all that, I’m talking about success in liberating leads from the body.
quote— Dr. Charles ByrdPhysician, Inventor

• The product and engineering team from Cook Medical in the United States was working on a locking stylet and sheaths also, based on the needs they saw watching pacemaker procedures.

The locking stylet and the concept of counter traction became the core principals behind lead extraction tools.

Dotter Coaxial Catheter Pair

A product development sketch from 1988.

Charles Dotter Plumber Pipes Sketched

This image visually explaining counter traction was used in a training PowerPoint developed by Cook Medical.