Interventional cardiology in Europe 1995

Abstract

on behalf of the working group Coronary Circulation of the European Society of CardiologyThe working group Coronary Circulation of the European Society of Cardiology conducts, with the support of the national societies of cardiology, an annual survey on cardiac interventions in Europe. This report is the fourth consecutive summary on cardiac interventions in Europe and gives an overview of interventional cardiology activities during 1995 in 30 member countries of the European Society of Cardiology, representing a population of 550 million people.Coronary angiography A total of 1 065 485 diagnostic coronary angiograms were reported, a 15% increase compared with 1994. The mean incidence of coronary angiograms increased to 1937 per 10 6 inhabitants, ranging from 4667 per 10 6 inhabitants in Germany to 67 per 10 6 inhabitants in Romania.Coronary angioplasty A total of 278 982 coronary angioplasty (PTCA) procedures were reported, an increase of 24% compared with 1994. The mean incidence of coronary angioplasty per capita was 507 per 10 6 inhabitants, ranging from 1358 per 10 6 inhabitants in Germany to 12 per 10 6 inhabitants in Romania. The ratio of PTCAs per coronary angiogram was 0·26, ranging from 0·40 in the Netherlands to 0·08 in Cyprus. Ad hoc PTCA (combined diagnostic angiography and PTCA) accounted for 24% of all PTCA cases. The majority (85%) of PTCA procedures were restricted to a single vessel.Coronary stenting Coronary stents were used in 80 383 coronary interventions, an increase of 272% compared with 1994, representing the fastest growth. The European mean ratio of coronary stenting per PTCA procedure was 0·29.Other new devices Other new interventional therapeutic devices were employed in 9798 cases, accounting for 3·5% of all coronary interventions. Coronary ultrasound was used in 4787 (1·7%) and coronary angioscopy in 543 interventions (0·2%). Non-coronary interventionsBalloon valvuloplasty remained the most frequent non-coronary intervention during 1995 with a total of 2715 mitral, 615 pulmonary, and 719 aortic valvuloplasties.Catheterization facilities There were a mean of 2·5 diagnostic cardiac catheterization institutions with a mean of 3·4 diagnostic laboratories per 10 6 inhabitants in Europe. The number of PTCA institutions and laboratories were a mean of 0·7 and 0·9 per 10 6 inhabitants, respectively. The mean numbers of trained operators were 11 for diagnostic cardiac catheterization and eight for PTCA per 10 6 inhabitants. On average, 704 yearly coronary angiograms per diagnostic catheterization laboratory and 203 yearly PTCAs per PTCA laboratory were reported in Europe. The average operator performed 210 coronary angiograms and 78 PTCAs per year.Conclusions During 1995, coronary angiography increased at a mean annual rate of 10% and coronary angioplasty at a mean annual rate of nearly 20% in Europe. Coronary angioplasty was employed on a single vessel per procedure in the majority of cases. Coronary stenting remained the fastest growing procedure in interventional cardiology and the Europe...

Computed Tomography Coronary Angiography as Initial Work-Up for Unstable Angina Pectoris

“…Until recently invasive coronary angiography (IA) has been the gold standard for accurate assessment of the presence, extent and severity of CAD. However, it is an invasive procedure and not without complications, especially in high risk and unstable patients (2).…”

International review of the utilisation and cost of percutaneous transluminal coronary angioplasty

“…A single-vessel PTCA is defined as an intervention to dilate one or more lesions in one vessel during one catheterisation laboratory session. A multivessel PTCA is defined as an intervention to dilate more than one vessel during one catheterisation laboratory session [2].…”

“…Elective coronary stenting is also more common in France than other European nations. The European mean ratio of coronary stenting per PTCA was 0.29 in 1995, while the same figure for France was 0.51 [2]. In France the number of stent procedures has grown rapidly since the beginning of the decade, in line with the number of centres capable of performing PTCA procedures.…”

“…These figures represent 698 PTCAs p.m.p in 1992 and 1,537 in 1996, or about 85% of the US rate for 1996. The percentage of PTCA procedures using stents also increased from 1% in 1992 to 53% in 1997 [2,12]. Banz and Schwicker [13] conducted a further analysis for Germany, using patient outcomes based on the BENE-STENT II clinical trial and 1995 unit cost data for Germany.…”

“…These figures represent 128 procedures p.m.p in 1990 and 588 p.m.p in 1996, or about onethird the US rate for 1996. In parallel with the growth in the number of PTCAs performed, the rate of stent placement per PTCA procedure increased from 2% in 1992 to 30% in 1995 [2,17].…”