With his gifted hands and feather touch, Ronald Colapinto might have excelled at the concert violin or maybe safecracking. Instead, he was able to thread a wire-thin catheter with precious little tension on it through a human body's ultrafine veins and arteries, inflate a tiny balloon to open a plugged passage, and gently twist the thing back out. He was mystified when younger doctors had difficulty advancing the device. "Just push it in," he would say with a shrug.
Colapinto's innovations in vascular treatments made him world renowned and saved thousands of lives, not to mention millions of dollars in health-care costs. A pioneer of the now-routine angioplasty, he performed the first balloon dilation of a clogged blood vessel in Canada and, according to his brother, Nicholas Colapinto, also a doctor, probably in the English-speaking world.
"It was like watching Roger Federer," said Ronald Colapinto's son, David, also a doctor, referencing the tennis ace who seemingly accomplishes whatever he wants. "He made it look so easy." His father once estimated he performed some 10,000 angioplasties (though none of them heart-related) and 30,000 angiograms, a procedure in which a tracer dye is injected into the circulatory system to find problems.
He went on to become among the first doctors to treat leg pain caused by clogged or narrowed arteries by snaking catheters through the groin to inflate balloons or implant stents.
"He was a very careful, studious radiologist," said Thomas Lindsay, chair of vascular surgery at the University of Toronto's medical school. "He wasn't one of these fly-by-night guys. He was the kind of guy who would persist and work hard to maximize what he could do for somebody with the least intervention. He was quiet, careful. He knew what he could do. He was not a cowboy. Patients trusted him."
Colapinto's specialty was interventional vascular radiology, and he stressed being an interventionist, someone who could treat clogged arteries with minimally invasive techniques on an outpatient basis.
"For thousands of Canadians," he said in a 1988 interview, "especially the elderly and heavy smokers who sometimes experience leg cramps as a result of blocked arteries, the traditional method of treatment has been bypass surgery, which requires several days' hospitalization and approximately one to two months recovery treatment." His way avoided expensive and risky surgery, and had a high success rate.
Readers may have noticed three Colapinto doctors; there are more family members in the health-care field.
Ronald Colapinto died on Jan. 3 of liver cancer at the age of 79 in Toronto, where he was born in 1931. His father, Pietro, had arrived in the city a decade before Ronald's birth, a penniless immigrant from Italy who opened a barber shop. He went on to own an eight-chair shop on the Bloor Street subway concourse from 1954 to 1975 and another outlet nearby. Peter, as he was known, worked 15 hours a day to put his three sons through medical school.
Ronald graduated from the University of Toronto's medical school in 1955 and later certified in diagnostic radiology. Nicholas is a general surgeon and former chief of surgery at North York General Hospital. The eldest brother, Vincent, was chief of urology at Toronto's St. Michael's Hospital. He died in 1985 after contracting hepatitis B from a patient.
Ronald's son David is a hospital physician north of Toronto; Vincent's son Edward is a neurosurgeon in Denver; Nicholas's son Michael is a Toronto radiologist; his daughter Nicole is a veterinarian; daughter Kim is a nurse practitioner at Toronto's Hospital for Sick Children; and another daughter, Cynthia, is completing a PhD in Ottawa in public health nutrition.
"No one pushed us into the field," David said. "We were supported in anything we wanted to do."
After treating injuries to miners in Northern Ontario for a year after graduation, Ronald Colapinto returned to Toronto for training in radiology. At Toronto General, he pushed past the traditional role of interpreting film to work on a novel technique to X-ray blood vessels.
At the time, standard procedure was to insert a needle into the patient's back and inject a dye. Trouble was, by the time the dye migrated to smaller blood vessels, it had diluted and pictures were fuzzy and sometimes unreliable.
Colapinto put the catheter in the groin instead and threaded it into smaller vessels before injecting the dye. The results were markedly clearer pictures and better diagnoses. His technical precision became legendary.
He was not yet 40 when he started teaching medicine at his alma mater, a position that lasted until 1984.
After winning a fellowship to study in England and Sweden, he discovered a German medical text - no seems to know how - that described the use of a balloon to widen a narrowed artery in order to save a patient's leg and avoid major surgery. Translated for him by a Dutch-speaking nurse, he performed the procedure in 1977 for the first time in Canada.
Four years later came another breakthrough, with Colapinto's pioneering of TIPS, or transjugular intrahepatic portosystemic shunt, a procedure to treat liver blockages.
TIPS revolutionized the treatment of liver cirrhosis and is now routine around the world, said Nicholas Colapinto. His brother "essentially pioneered so much of what we take for granted as standard treatment today."
Spurning well-paying job offers in the U.S., he left Toronto General and in 1985 opened a private clinic, the Toronto Vascular Institute, the world's first ambulatory care facility for vascular treatments. "It was private in the sense he owned it," said Nicholas, "although he never charged above public health-care-plan rates despite tremendous demand for his work. It saved the Canadian health-care system millions each year." Procedures at the clinic, except for laser treatment of varicose veins, are covered by the provincial health plan.
Colapinto was a calm, avuncular man; no one ever saw him panic. If there was a problem with a procedure, he would duck out for a quick smoke and return with a solution. An on-the-job innovator, Colapinto kept a pot of water boiling during procedures so he could bend and shape plastic catheters to his needs. He designed his own specialized tools - a needle, a catheter and a pressure device that today bear his name.
An accomplished Italian cook, he took up golf in his seventies, as well as online video games at which he progressively excelled, often beating opponents one-tenth his age.
He leaves his companion, Janice Davey, his brother, sons David and Peter and two grandchildren.
