Copyright © 1996 by the European Society of Cardiology.
© 1996 The European Society of Cardiology
Interventional Cardiology in Europe 1993
revised 26 January 1996; accepted 26 January 1996.
Correspondence: Bernhard Meier, MD, Professor and Head of Cardiology, University Hospital, 3010 Bern, Switzerland.
Abstract
An annual survey on cardiac interventions in Europe is performed by the working group on Coronary Circulation of the European Society of Cardiology with the help of the national societies of cardiology. A questionnaire about cardiac interventions in 1993 was mailed to a representative of the national societies of 35 members of the European Society of Cardiology. The data collection of coronary interventions was delayed by slow backreporting and from 10 of the 35 national members data were missing or grossly incomplete. They were excluded from the analysis.
Coronary anglography A total of 756 822 coronary angiograms were reported resulting in an incidence of 1146 ± 1024 per 106 inhabitants, ranging from 24 (Romania) to 3499 (Germany). This represents an increase of 12% compared to 1992. Germany (279 882 cases), France (157 237), the United Kingdom (77 000), Italy (44 934) and Spain (37 591) registered 79% of all the coronary angiograms performed.
Percutaneous transluminal coronary angioptasty A total of 183 728 percutaneous transluminal coronary angioplasty cases were reported in 1993, 24% more than in 1992. On average, they accounted for 18 ± 7% (range 8 (Romania) to 35% (Sweden)) of the coronary angiograms. Most of these percutaneous transluminal coronary angioplasties (82%) were confined to a single vessel. In 13% only, percutaneous transluminal coronary angioplasty took place immediately after the diagnostic study. Adjusted per capita, Germany ranks first with 873 percutaneous transluminal coronary angioplasties per 106 inhabitants, followed by France (737), Holland (725), Belgium (713), and Switzerland (665). The European mean of percutaneous transluminal coronary angioplasties per 106 inhabitants was 270 ± 279, representing an increase of 14% compared with 1992. A major in-hospital complication was reported in 3.8% of the patients undergoing percutaneous transluminal coronary angioplasty: 0.6% hospital deaths, 1.5% emergency coronary artery bypass graftings, and 1.7% myocardial infarctions.
New devices In 1993 stents were implanted in 6444 patients (3.5% of all percutaneous transluminal coronary angioplasty patients), equally distributed between bail-out situations (53%) and elective procedures. The 14 stent implanting countries showed a mean increase in the incidence of coronary stenting of 53% compared with 1992. Other interventional devices were applied in 7045 cases, i.e. 3.8% of all percutaneous transluminal coronary angioplasty cases. Coronary ultrasound (2194 cases) and coronary angioscopy (380 cases) were performed infrequently.
Non-coronary interventions Valvuloplasties were the most frequently performed non-coronary interventions. Six European countries performed more than 300 valvuloplasties each in 1993. Most of them were mitral valvuloplasties in southern countries.
Conclusions Although partial backreporting might bias conclusions, several findings of this survey are noteworthy for the participating countries: The number of percutaneous transluminal coronary angioplasties is universally increasing. There is an extremely wide range of coronary angiography and percutaneous transluminal coronary angioplasties performed per population. The most common additional procedure is a stent implantation while other new devices are only rarely applied. Mitral valvuloplasty is the most frequently performed non-coronary intervention. (Eur Heart J 1996; 17: 1318–1328)
Key Words: Coronary angiograms • PTCAs • stents in Europe 1993
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