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European Heart Journal 1999 20(7):484-495; doi:10.1053/euhj.1998.1356
Copyright © 1999 by the European Society of Cardiology.
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Working Group Report

Interventional cardiology in Europe 1995

S. Windecker, W. Maier-Rudolph, T. Bonzel, G. Heyndrickx, J.M. Lablanche, M.C. Morice, V. Mühlberger, K.L. Neuhaus, F. Piscione, van den BrandM. , W. Wijns and B. Meierf1 Working Group Coronary Circulation of the European Society of Cardiology

Received August 4, 1998; accepted October 7, 1998

Abstract

The 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 1065485 diagnostic coronary angiograms were reported, a 15% increase compared with 1994. The mean incidence of coronary angiograms increased to 1937 per 106inhabitants, ranging from 4667 per 106inhabitants in Germany to 67 per 106inhabitants in Romania.

Coronary angioplasty A total of 278982 coronary angioplasty (PTCA) procedures were reported, an increase of 24% compared with 1994. The mean incidence of coronary angioplasty per capita was 507 per 106inhabitants, ranging from 1358 per 106inhabitants in Germany to 12 per 106inhabitants 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 80383 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 wasused in 4787 (1·7%) and coronary angioscopy in 543 interventions (0·2%).

Non-coronary interventions Balloon 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 106inhabitants in Europe. The number of PTCA institutions and laboratories were a mean of 0·7 and 0·9 per 106inhabitants, respectively. The mean numbers of trained operators were 11 for diagnostic cardiac catheterization and eight for PTCA per 106inhabitants. 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 European mean ratio of coronary stenting per PTCA increased to 0·29. The ratio of PTCA to CABG further increased to 1·4:1. New devices were reserved for niche indications and balloon valvuloplasty was the most frequent non-coronary intervention.

Key Words: Coronary angiography, PTCA, coronary stent

f1 Correspondence : Bernhard Meier, MD, Professor and Head of Cardiology, University Hospital, 3010 Bern, Switzerland.

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