Percutaneous Interventions: Registry 2009-2010 results

Stéphane Cook, MD; Aris Moschovitis, MD and Bernhard Meier, MD - On behalf of the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Topics: Percutaneous Cardiovascular Intervention (PCI)

Date: 30 Jun 2011

The registry was launched in 1992 by Bernhard Meier under the Auspices of the European Society of Cardiology and has aimed to collect data on cardiac catheterisation procedures in Europe since then. Numbers and types of procedures are collected yearly by means of a standardised questionnaire from all adult percutaneous cardiac intervention centres in Europe. Due to ongoing data collection (22 of 30 countries provided data for 2009 and 15 of 30 countries for 2010), the present figures are provisory and conclusion should be considered with precaution. The analyses are performed for all countries based on the most up-to-date available data.

Catheterisation facilities and PCI operators (Figure 1)

The numbers of cardiac catheterisation centres per million inhabitants in Europe remained basically virtually unchanged since 2005, with still the highest density in Germany (6.8) and the lowest in Romania (0.7). (Figure 1 - left) The same hold true for the number of PCI operators per million inhabitants, with the highest density in Austria (31) and the lowest in Romania (2). (Figure 1 – right)

Catheterisaton facilites -Figure 1

Coronary procedures (Figures 2-4)

With almost 2.7 mio coronary angiographies performed the overall number of diagnostic procedures continues to increase (+2%). (Figure 2). The number of percutaneous coronary interventions (PCI; >1 Mio) and the stenting/PCI ratio paralleled this increment. (Figure 3 – top left). A marked disparity prevails between the European nations with the highest annual growth in small countries reporting up to 2010 and minute growth in the 6 larger countries with >30 mio inhabitants (Figure 3 – right and bottom). PCI for ongoing myocardial infarction, multivessel PCI and ad hoc PCI remain unchanged (Figure 4 – left). Use of radial or brachial access and use of drug-eluting stents (DES) steadily increase with still a marked disparity between the European nations (Figure 4 – right). From the additional investigational modalities, use of pressure or Doppler wire seem to be boosted by the FAME study and represent 10% of the PCI in the 11 countries reporting these data for 2010.

Coronary angiograms-Figure 2	Percutaneous Coronary Interventions-Figure 3

Radial brachial access-Figure 4

Structural heart procedures (Figure 5&6)

In 2009 and 2010, interventional cardiology in European countries expands mostly through the growing numbers of structural heart procedures, such as the use of ductal, septal or left atrial appendage occluders (Figure 5), as well as the booming increase in transcatheter aortic valve implantation (TAVI – Figure 6).

Figure 5

Other structural heart interventions-Figure 6