A Conversation with Mark H. Wholey, MD, MS

Issue: May/June 2015

For this issue, Dr. Bhatt talks with Mark H. Wholey, MD, MS, director for vascular and neurovascular interventions at the Allegheny Health Network, Pittsburgh, and adjunct professor of engineering in medicine at Carnegie Mellon University. Wholey was chairman of the department of radiology at the University of Pittsburgh Medical Center Shadyside Hospital from 1970 to 2007, as well as the head of the Pittsburgh Vascular Institute, and he was a clinical professor of radiology from 1980 to 2002. He is a serial entrepreneur, having co-founded more than a dozen medical device companies, including Medrad Inc., Endotex and Embolic Protection Inc.

Wholey completed his medical degree at the Drexel University School of Medicine in Philadelphia, his residency at Case Western Reserve University Hospital and his radiology fellowship at Mayo Clinic. As an NIH special fellow from 1961 to 1963, he was trained at University Hospital, Lund, Sweden, in the then-new discipline of angiography, and became one of the first U.S. physicians to perform and train others in percutaneous, minimally invasive angiographic procedures.

He has been a leader in interventional radiology for more than 50 years, pioneering technologies such as the angiographic injector system, the Wholey Wire, the carotid artery stent and the embolic protection system.

What are your hobbies outside of practicing medicine?

Dr. Wholey: I enjoy traveling with my family, especially to Hawaii, which I find very relaxing. I am also a huge sports fan. I enjoy playing golf as frequently as possible during the summer months. I have a 16-year-old daughter who keeps me busy, as well as four other grown children and nine grandchildren. My wife and I are very involved with the Pittsburgh Opera.

Who has had the greatest influence on your career?

Dr. Wholey: My family has been in the fish business for more than 100 years; if you travel to Pittsburgh, one of the first signs that you will see is a huge illuminated “Wholey” fish on top of a building in the Strip District. When I was a child, I worked with my father at the store; however, he told me, “You are not nice to the customers. Find another job.” My mother got me started in the right direction by suggesting medicine and I never looked back.

The person who had the most influence on my career in medicine is Olle Olsson, MD, my former professor and chairman of the department of radiology in Lund, Sweden, where I had an NIH special fellowship in neuroradiology and CV radiology. My time in Sweden, which was light-years ahead of every other country in terms of angiographic procedures, shaped my whole career in terms of device development and introducing new procedures when I came back to the United States.

Deepak L. Bhatt

Mark H. Wholey

What has been the greatest challenge of your professional career thus far?

Dr. Wholey: My greatest challenge has been my inability, along with others, to convince CMS to reimburse for a broader indication for carotid stenting in patients, both symptomatic and asymptomatic, who would benefit from the procedure. Hopefully now that we are doing another trial, CREST-2, there will be reimbursement, but that is 7 years away.

Another challenge was my failure to develop a multidisciplinary vascular institute where cardiologists, radiologists and vascular surgeons would work together. In spite of several attempts, we failed, either for economic reasons in the private hospital environment or for political reasons in the university. Turf protection driven by economics was a major issue and they failed to see the advantage of the power of consolidation.

What area of research in intervention interests you right now?

Dr. Wholey: Presently, we are working on signal processing in an attempt to isolate the neural plexus in the renal artery adventitia. We have developed a neurotropic drug in the space of renal denervation for hypertension control. The drug is delivered to the renal artery with a micro-needle that is only 60 µ. Renal denervation is a hot space presently, but most research has focused on energy sources such as radiofrequency ablation or high-intensity ultrasound or beta-radiation. The drug has a receptor that attaches to the neuron and creates apoptosis. We had successful results in a small first-in-man study and encouraging results at 9-month follow-up, with consistent reduction in systolic BP and diastolic BP greater than 20 mm Hg. We are in the process of doing a 100-patient trial, and are anxious to see the long-term results. I am also working on a microcatheter and balloon for recanalizing occluded infratibial vessels from either a retrograde or antegrade approach. Finally, I am working on a handheld ultrasound vascular probe with electronics built into the probe and a “line of sight” reflecting mirror designed for small vessel access.

Have you ever been fortunate enough to witness or to have been a part of medical history in the making?

Dr. Wholey: I co-founded the first carotid stent company in the United States. We obtained the first embolic filter patent in the United States and developed an embolic filter for stroke prevention during stenting. When I came back from Sweden in the mid-60s, I introduced angiography and coronary arteriography by the percutaneous Judkins technique to Pittsburgh. At that same time, I co-founded Medrad Inc., which made the first physiologic flow-rate-controlled angiographic injector. That became the universal injection system for all the angiograms in the country, and for much of the world.