Meet the ESC Gold Medallists: Professor Ulrich Sigwart
30 Aug 2025
ESC Gold Medallist The pioneering work of Professor Ulrich Sigwart (Geneva, Switzerland), in conceiving vascular stenting and alcohol septal ablation, revolutionised the field of invasive cardiology and continues to save the lives of countless patients around the world on a daily basis.
“I have always been fascinated by the physics and mechanics of moving objects, so it is perhaps no surprise that, as a medical student, I was attracted to working on the heart and circulation. After finishing medical school and gaining a fellowship in cardiology at Baylor College of Medicine, Houston, Texas, I was allowed to start performing the first coronary angiograms and, in light of their success, was given carte blanche to continue. It came as a bit of a shock, therefore, when I returned to Europe and found that I was relegated to the role of assistant, despite having carried out many more procedures than my superiors!
In terms of career achievements, probably my greatest would be regarded as the introduction of vascular stents. My initial conception of stenting was prompted by the often-poor results I observed with balloon angioplasty (which I started some weeks after its introduction by Andreas Grüntzig), in particular cases of abrupt occlusion after retraction of the angioplasty balloon. It became obvious to me that some kind of mechanical scaffolding was required to prevent this. And that was the beginning of stenting; the first procedures – after appropriate preclinical testing – being carried out in the mid-1980s.1 The original self-expanding stents, made in Lausanne, were subsequently replaced by more user-friendly balloon-expandable stents, and the technique became adopted rapidly by clinics all over the world. Nowadays everybody agrees that stents have made angioplasty predictable.
My other main achievement is the development of alcohol septal ablation for hypertrophic obstructive cardiomyopathy (HOCM). As far back as the early 1980s, I had suggested that non-surgical ablation of the left ventricular septal bulge – by creating local necrosis through injection of some sort of poison into the septal artery supplying the area in question – might relieve the pressure gradient caused by obstruction of the left ventricular outflow tract. Given the early stage of my career, the idea was not taken too seriously. Fast-forward a decade or so, when I was working at the Royal Brompton Hospital in London, and the same proposal was received much more positively. This eventually led to my conducting the world’s first alcohol septal ablation in 19942 and it is now an integral part of treatment for HOCM.
Looking to the future, I think that prevention is key to tackling the growing problem of cardiovascular disease. The possibility of developing an anti-atherosclerotic disease vaccine, which could be administered at an early age, may seem far-fetched, but then so did stenting and alcohol septal ablation at their inception.”
References
- Sigwart U, et al. N Engl J Med. 1987;316:701–706.
- Sigwart U. Lancet. 1995;346:211–214.
