Richard Schatz
Cardiologist Richard Schatz collaborated with fellow National Inventors Hall of Fame® Inductee Julio Palmaz to invent a vascular stent suitable for treating coronary artery disease. Since 1988, the Palmaz-Schatz coronary stent and its derivatives have been used to treat millions of patients worldwide.
Schatz was born in Queens, New York, in 1952 and grew up on Long Island. In addition to getting involved in many sports, Schatz enjoyed science from a young age. His interests were supported by his father, an aerospace engineer who taught him and his brother the basics of math, science and aviation, and his mother, an Italian immigrant. She emphasized the importance of education and encouraged her children to become doctors. In an interview with the National Inventors Hall of Fame, Schatz said he received an excellent education. “Every class and teacher from grade school to high school was incredible,” he said. “My math and science curricula in particular were very advanced. I had many of my college classes in high school.”
Schatz received a partial gymnastics scholarship to attend Dartmouth College. However, his parents believed their children should fund their own educations, and he couldn’t afford the tuition. So, he used money he earned by working a paper route, landscaping and construction jobs along with a scholarship to attend the State University of New York at Buffalo, where he chose to study biology. “I knew it was a path toward medicine, and I knew that's what I wanted to do,” he explained. “I was so eager to start medical school that I applied a year early and was accepted to Duke Medical School and never graduated from college.”
To make his way through medical school, Schatz joined the U.S. Army, which paid for his education in exchange for a service commitment. “I was a young lieutenant, and in the summertime, I had to go work in an Army hospital somewhere,” he recalled. “So, I went to Georgia my first year, then Colorado my second year and Hawaii my third year. Everywhere I went, I met all these amazing doctors. It's like I had a whole extra year of medical school. It was a great experience – I think it really helped me learn to be a better doctor.” He graduated from Duke University with his medical doctorate in 1977.
After completing his internship and residency at Letterman Army Medical Center in San Francisco in 1980, Schatz moved to Brooke Army Medical Center in San Antonio to complete his cardiology fellowship. Upon completion, he became the director of the cardiac catheterization laboratories, then the acting chief of cardiology. After attending Andreas Gruentzig’s first angioplasty course in 1981, he began performing balloon angioplasty (using a percutaneous balloon to stretch open a narrowed or blocked artery). Schatz quickly became frustrated with the procedure’s failure rate. When he met Palmaz, a radiologist, in 1985, Schatz immediately recognized that Palmaz’s balloon-expandable stent design could be adapted to treat blocked coronary arteries.
Having described their invention journey as a series of “uphill battles,” Schatz said, “No one would give us the time of day, so we decided to just do it ourselves. They kept telling us no, and we kept saying yes. Eventually, it turns out by good fortune, we were right.” To help turn their idea into a reality, Schatz introduced Palmaz to his friend, restaurant entrepreneur Philip Romano, who provided funding for further research into the stent’s development, and together, they began filing a series of patents.
Palmaz’s original design was a 15-millimeter slotted, straight metal tube, which did not flex or bend. Its rigidity made it suitable only for the straight vessels of the iliac or femoral arteries, but it would not work in the smaller, tortuous and more delicate coronary arteries. So, Schatz found a way to make it flexible by creating a “boxcar” design, connecting two 7.5-millimeter segments with a short 1-millimeter bridge while preserving the strength of each component of the stent after balloon expansion.
In addition to improving flexibility, Schatz also ensured the new stent design would not cause clotting. “That, to me, was my biggest contribution – not just redesigning the stent, but also figuring out exactly how to deliver it perfectly each time, how to inflate it properly, then figuring out the ideal pharmacological cocktail to prevent the stent from clotting,” Schatz explained. “If something clots in the coronaries, it can be fatal. That's why we worked so hard on the basic principles of pharmacology and the blood metal interface. All of this is taken for granted today, but these were all unknowns back then, there was no playbook. It took a long time to figure it all out, so we had the confidence to proceed safely in humans.”
Prior to the introduction of the coronary stent, treatment of coronary artery disease was largely limited to open heart surgery and unpredictable angioplasty. In 1994, the Palmaz-Schatz coronary stent was the first stent approved by the Food and Drug Administration for restenosis based on two successful randomized trials. The Palmaz-Schatz coronary stent has since provided access to minimally invasive treatment of coronary disease for nearly 150 million patients throughout the world and has significantly reduced mortality and morbidity, while also lowering healthcare costs.
The National Academy of Engineering awarded Schatz, Palmaz and three colleagues with the Russ Prize in 2019. Schatz served as research director of cardiovascular interventions at Scripps Heart, Lung and Vascular Center, and adjunct professor of medicine and cardiology at Duke University School of Medicine. He advises the next generation of inventors and innovators to take risks without fear of failure. “When doors open in your life, don’t be afraid to go through them because your life could take many different directions in ways you can’t imagine,” Schatz said. “Above all, don’t be afraid to fail. Put yourself out there. If you see an opportunity, go for it.”