Josef Rosch
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Dr. Josef Rösch, who pioneered important new medical techniques and interventional procedures. Some of his innovations include the use of embolization to control gastrointestinal bleeding and the transjugular intrahepatic portosystemic shunt (TIPS) procedure.
In 1965, Dr. Dotter invited Dr. Rösch to Oregon for a one-year fellowship at the University of Oregon Medical School in Portland. Dr. Rösch was then invited by UCLA to teach there on a fellowship. In 1969, Russia invaded Czechoslovakia (now the Czech Republic) and Dr. Rösch and his family decided to stay in America, though they were sad to leave their homeland behind.
Dr. Dotter soon lured Dr. Rösch back to Portland, where he accepted a permanent position on the Oregon Health Sciences University (OHSU) faculty, and where he continued to work until his death.
The historical background behind the development of the transjugular intrahepatic portosystemic shunt (TIPS) is fascinating. The procedure was described by Dr. Joseph Rösch.
Originally from Czechoslovakia, Dr. Rösch was invited by Dr. Charles Dotter in 1968 to work as a research fellow at the University of Oregon Medical School.
Dr. Rösch worked on several of Dotter's research projects; a year later he became a visiting professor at the University of California, Los Angeles (UCLA). One of his projects at UCLA was focused on developing the technique to perform diagnostic transjugular cholangiograms in canine models.
A non-intentional entry into a peripheral portal venous branch while attempting a cholangiogram was the “lucky accident” that led to the development of transjugular portography and eventually to the development of what we know today as a transjugular intrahepatic portosystemic shunt or “TIPS.”
The development of metallic stents was the most important factor to make this procedure possible. The first animal experiments with the use of metallic stents were conducted by Dr. Palmaz and Dr. Rösch.
Dr. Palmaz and colleagues tested their hand-made balloon expandable stent prototype to perform portocaval shunts in 12 dogs with experimental portal hypertension.
These investigators were successful in creating the shunts and maintaining shunt patency in the dog model.
Animal experiments proved that metallic stents would be the key factor to maintain patency of these shunts, and this was the scientific platform that led to the development of TIPS.
The first TIPS procedure in a human was performed in Freiburg, Germany, in 1988. The procedure was performed by Drs. Richter, Noeldge, and Palmaz.
The stent used to create the first shunt in a human was the balloon expandable Palmaz stent.
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