[Spanish Registry on Cardiac Catheterization Interventions. 11th official report of the Working Group on Cardiac Catheterization and Interventional Cardiology of the Spanish Society of Cardiology (years 1990-2001)] (original) (raw)
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Interventional cardiology in Europe 1994
European Heart Journal, 1998
M. van den Brand and B. Meier on behalf of the working group Coronary Circulation of the European Society of Cardiology The working group Coronary Circulation of the European Society of Cardiology conducts an annual survey of cardiac interventions in Europe with the support of the national societies of cardiology. A detailed questionnaire about cardiac interventions performed during 1994 was mailed to all members of the European Society of Cardiology. Incomplete or absent data from eight national members precluded their inclusion in the final analysis. Thus, this report summarizes the cardiac interventions performed during 1994 in 29 of 37 members of the European Society of Cardiology, representing a total population of approximately 490 million inhabitants. Coronary angiography A total of 922 687 coronary angiograms were reported during 1994, representing an increase of 22% compared with 1993 and of 35% compared with 1992. The mean incidence of coronary angiograms was 1881/10 6 inhabitants, ranging from 4417/ 10 6 inhabitants in Germany to 35/10 6 inhabitants in Romania. Germany, France, Great Britain, and Italy with 50% of the European population performed 73% of all cardiac interventions. Coronary angioplasty During 1994, a total of 224 722 coronary angioplasty (PTCA) procedures were reported in Europe, an increase of 22% compared with 1993 and of 52% compared with 1992. Adjusted per capita, the mean incidence of coronary angioplasty was 458/10 6 inhabitants, ranging from 1091/10 6 inhabitants in Germany to 6/10 6 inhabitants in Romania. On average, the ratio PTCA per coronary angiogram was 0•24, ranging from 0•37 in the Netherlands to 0•06 in Cyprus. Ad hoc PTCA accounted for 22% of all PTCA cases. The majority (81%) of PTCAs were restricted to a single vessel. Major complications were reported in 2% of patients undergoing PTCA, including death (0•3%), myocardial infarction (1•0%) and need for emergency coronary artery bypass grafting (0•7%). Coronary stenting Coronary stents were utilized in 21 599 coronary interventions during 1994, an increase of 235% compared with 1993 and thus representing the fastest growth in interventional cardiology. The number of European countries employing stents during coronary angioplasty grew from 14 during 1993 to 24 during 1994. Elective use (38%) became the most frequent indication for coronary stenting during 1994, replacing bail-out stenting as the primary indication during 1993. Other new devices Other new interventional therapeutic devices were employed in 8827 cases. Only the Rotablator was used more frequently during 1994 as compared with 1993. All other new therapeutic devices showed a decline. Coronary ultrasound was utilized in 3032 interventions and coronary angioscopy in 304 cases during 1994. Non-coronary interventions Valvuloplasty remained the most frequent non-coronary intervention in Europe during 1994 with a total of 2622 mitral, 609 pulmonary and 506 aortic valvuloplasties. Catheterization facilities The number of facilities per 10 6 inhabitants performing invasive cardiac procedures in Europe during 1994 ranged from 7•7 in Iceland to 0•2 in Romania (European mean 2•9). The number of trained operators per 10 6 inhabitants ranged from 24 in Germany to 0•4 in Romania (European mean 10). During 1994, a mean of 701 coronary angiograms and 170 PTCAs were performed per catheterization facility in Europe (range: 1052 coronary angiograms and 293 PTCAs per facility in Norway to 218 coronary angiograms and 37 PTCAs per facility in Romania). Conclusions The number of both coronary angiograms and coronary angioplasties continues to grow at an annual rate of approximately 20% in Europe. There is a wide range
Interventional cardiology in Europe 1995
European Heart Journal, 1999
and B. Meier on behalf of the working group Coronary Circulation of the European Society of Cardiology 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 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 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 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 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.
Spain: coronary and structural heart interventions from 2010 to 2015
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2017
Since 1990 The Spanish Society of Cardiology Working Group on Cardiac Catheterization and Interventional Cardiology has presented a yearly report on the data collected in the National Registry, with online support since 2010. The Steering Committee has analysed all data provided voluntarily by institutions, which consisted of a total of anywhere between 105 and 113 hospitals. Medical care was provided to a population of 46.8 million inhabitants in 2015. During this period, diagnostic procedures increased progressively from 2010, reaching a maximum of 145,836 in 2015, 86% (125,484) corresponding to coronary angiograms. This means a ratio of 3,127 diagnostic studies per million inhabitants and 2,746 coronary angiograms per million inhabitants. Total percutaneous coronary interventions have increased to 67,671 procedures, with a ratio of 1,466 per million inhabitants where 18,418 were carried out during the acute phase of myocardial infarction (21.7%). Radial access has been successful...
Arquivos Brasileiros de Cardiologia, 2010
Background: Knowing the risk factors and clinical manifestations of coronary artery disease (CAD) allows us to intervene more effectively with a particular population. Objective: To identify clinical and angiographic profiles of patients undergoing cardiac catheterization, treated at a tertiary hospital and treated by percutaneous coronary interventions (PCI). Methods: The study of 1,282 patients who underwent 1,410 cardiac catheterizations, selected from March/2007 to May/2008 from a database in a general hospital for diagnosis of coronary artery disease (CAD). Risk factors, indication for examination, technical details of PCI and in-hospital outcomes were prospectively collected. Results: There were 688 (54.0%) males, mean age 65.4 ± 10.9 years and 20.0% above 75 years age. The most frequent clinical condition was acute coronary syndrome (ACS) without ST-segment elevation (STS) (38.7%). The multi artery CAD occurred in 46.4%, PCI was indicated in 464 patients, 547 target lesions were treated (type B2 or C, 86.0%), and of these, 14.0% treated with drug eluting stents. Among those with AMI with STS, primary PCI was performed in 19.0% of the patients, from these, 77.0% were transferred from the origin hospitals late (late PCI) and had not received prior thrombolytic, and 4.0% had PCI rescue. Angiographic success was achieved in 94.2% of PCIs. Death occurred in 5.6% of patients, with average age of 75.2 ± 10.2 years. Conclusion: The prevalence of elderly (20.1% being ≥ 75 years) and male was observed. From the risk factors for CAD, the most common were systemic hypertension and dyslipidemia. There was a predominance of ACS. Age ≥ 75 years old, multiarterial CAD and chronic renal failure were predictors of in-hospital deaths. (Arq Bras Cardiol 2010; 95(4): 422-429
Experience with Four French catheters for outpatient coronary angiography
International Journal of Angiology, 2000
Previous studies have demonstrated the efficacy and safety of outpatient cardiac catheterization on stable patients at low risk. We present our experience with four French catheters in 104 patients (72 male, 32 female, mean age 51 years old) with coronary angiography done as an outpatient procedure. No heparin was given during the procedure. After initial hemostasis had been attained, the patients returned to day center with vital signs monitored regularly. Patients were allowed ambulation after 4 hours' bed rest and were discharged the same afternoon. Normal coronary angiogram study was found in 76% of the study population. Single-vessel disease, double-vessel disease, triplevessel disease, and left-main disease were found in 12%, 9.6%, 2%, and 1%, respectively. Nearly all of the patients demonstrated normal ventricular contraction (99%). Average procedural time was 20.2 + 4.4 minutes. Average hemostatic time was 8.4 _+ 3.1 minutes. No mortality directly attributed to the catheterization occurred in our study population. Moreover, there were no myocardial infarction, acute pulmonary edema, severe allergic reaction, and cerebrovascular accident. Femoral puncture site complication was only limited to superficial skin bruise. Quality of the cineangiogram was good in majority of the patients. Therefore, this study demonstrates that outpatient cardiac catheterization using four French Judkins catheter is a safe and costeffective procedure.
Efetividade e segurança dos stents farmacológicos em um serviço de cardiologia em Curitiba-PR
Arquivos Brasileiros De Cardiologia, 2010
Background: The effectiveness and safety of drug-eluting stents (DES) have still been questioned. Objective: The objective of this study was to evaluate the effectiveness and safety of these stents, as well as the incidence of target lesion revascularization (TLR), in addition to identifying possible variables influencing the need for TLR. Methods: A total of 203 patients from Hospital Costantini who were clinically followed up for one to 3 years were selected. Results: The sample characteristics were as follows: 470 lesions; 171 (84.24%) male patients; 54 (26.6%) had diabetes; 131 (64.35%) had hypertension; 127 (62.56%), dyslipidemia; 40 (19.70%) were smokers; and 79 (38.92%) had a family history of coronary artery disease. Also: 49 (24.14%) patients presented with stable angina; 58 (28.57%), unstable angina; and 6 (2.96%), myocardial infarction. Eighty five (41.87%) patients were asymptomatic, and 146 (71.92%), had multivessel disease. As for the characteristics of the lesions, 77.45% were B2/C (AHA/ACC). Taxus was implanted in 73.62% of the patients. Stents with diameter > 2.5 mm were used in 381 (81.96%) patients. The stent length was < 30 mm in 67.87% of the lesions, with a mean of 2.3 stents per patient. After follow-up, 19 patients (9.3%) underwent TLR. Four patients died (1.97%), two of them of MI (0.98%), one of stroke (0.49%), and one of abdominal aneurysm (0.49%). Also, one patient died of late thrombosis (0.49%), and one of reinfarction (0.49%). In the statistical analysis carried out, only the bifurcation lesions variable reached values close to the statistical significance level, with p < 0.06. Conclusion: In conclusion, drug-eluting stents have good effectiveness and safety profiles; the incidence of TLR was 9.3%, and we did not identify a variable correlated with the need for TLR. (Arq Bras Cardiol. 2010; [online]. ahead print, PP.0-0) Key words: Drug-eluting stents/utilization; effectiveness; safety/economics; diagnostic services; Curitiba (PR); Brazil. coronary angioplasty (PTCA). Palmaz et al 3 and Sigwart et al 4 were the first to use the percutaneous treatment by means of a solid structure-a coronary endoprosthesis, the stent-which kept the dilated vessel lumen open. This was a major landmark in interventional cardiology, with the purpose of combating restenosis. In 1995, the idea emerged of using drugs capable of preventing the restenotic process using the stent itself as the drug-delivery vehicle 5. Polymers were used as the drug bond, and thus the successful triad of pharmacological stents was formed: stent, polymer and drug. Revascularization of a previously treated lesion, known as target lesion revascularization, has been associated with the assessment of percutaneous treatment effectiveness, whereas thrombosis is associated with stent safety. Therefore, although this safety has been recently questioned 6 , several meta-analyses were later carried out and demonstrated the effectiveness and safety of drug-eluting stents in comparison to bare metal stents 7-9. In a single-center registry from Ontario, Canada 7 , a decrease in the frequency of repeat revascularization procedures was observed in high-risk patients using drug-eluting stents in comparison to bare metal stents; no differences were observed as regards death and infarction. The objective of the present study was to evaluate the effectiveness and safety of drug-eluting stents in the
Catheterization and Cardiovascular Interventions, 2001
The aim of this study was to assess the quality of angiograms obtained using 4 Fr catheters compared with 6 Fr catheters, the ease of use of the 4 Fr catheters, and the safety of patient mobilization 1 hr following 4 Fr angiography. Details of catheter performance and procedural details were recorded at the time of the angiogram. The angiographic images were scored on the quality and completeness of vessel opacification throughout systole and diastole. A total of 410 patients were recruited. There was no difference between 4 and 6 Fr for procedural variables. All angiograms were considered to be of diagnostic quality. The angiographic scores for the right coronary artery and left ventricular injections were no different between 4 and 6 Fr. However, the angiographic scores for the left anterior descending and circumflex arteries were lower with 4 than with 6 Fr (both P < 0.05). Patients who had 4 Fr angiography mobilized safely at 1 hr and reported significantly less discomfort and bruising than 6 Fr patients. Good-quality diagnostic coronary angiograms can be achieved using 4 Fr catheters with the advantage of earlier postprocedural mobilization and reduced discomfort and bruising for the patient. Cathet Cardiovasc Intervent 2001;54:269 -275.