In the first or second year of his medical residency training in the US in 1978, Palmaz went to an early meeting of the Society of Cardiovascular Intervention and Radiology in New Orleans. The keynote speaker was a young professor from Germany, Andreas Grunzig, who was coming to the states to report on his early experience with balloon angioplasty. Grunzig was charasmatic and intelligent, and explained balloon angioplasty so clearly--benefits and potential risks--that when he came to the reasons for failure, Palmaz immediately began to think of solutions to the problem. Palmaz describes the problem: early failures showed that balloon angioplasty was inconsistent. Palmaz describes how he began to work on a solution--he first wrote down his idea. He described his idea to his chairman on the way to the airport, and was encouraged to write it up to put his thoughts down on paper.

[Introduction by David Cassak] Tom Fogarty explains that he became interested in medicine "by accident." He discusses his early design development and how he turned a clinical problem into a device that could solve the problem: "In this situation...it was almost like a lightbulb that went off. If you put a thin catheter system down, and you can make it bigger and then withdraw it and control the volume during withdrawal, you get the clot out. Essentially, I took what they call uretheral catheters, which are long, thin tubes. I cut the baby finger off a number 5 glove. I tied it on the cather system...and that was the first balloon catheter.