Fraser D 201304
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Worldwide Uptake of Radial Access
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Fraser D 201304
- 1. Worldwide uptake of radial access D Fraser Manchester Heart Centre, UK TRM 2010
- 2. Outline • History and spread • Temporal trends • Worldwide data • Patterns of uptake • Conclusions TRM 2010
- 3. History and Spread 1 • 1964 Campeau Montreal • 1994 Fajadet – Angiography RA sutured Toulouse – PTCA Live case • 1989 Campeau – Angiography Percutaneous • 1997 Lefevre / Louvard Paris • 1992 Kiemeneij Amsterdam – TRA course Paris – PTCA balloon TRM • 1992 Kiemeneij • 1998 Nolan Stoke-on-Trent – PTCA stent – TRA program 2010
- 4. History and Spread 2 • 1995 Wu Taiwan • 1995 Saito Japan • 1997 Sakai Japan • 1997 Yoon Korea TRM 2010
- 5. Temporal trends • France French national db 2004 – 2008 data Lefevre ICPS 1994 – 2003 • UK BCIS data 2004 – 2009 equipment sales data 2001 – 2003 • Sweden SCAAR 2003-2009 • Europe EAPCI + above • USA NCDR reports TRM • Japan Japanese Society Cardiology 1997-2004 Saito estimates 2008, 2009 2010
- 6. France - PCIs performed / yr Total Radial Femoral TRM 2010
- 7. UK - PCIs performed / yr Total Femoral Radial Transradial course TRM 2010
- 8. Sweden - PCIs performed / yr Total Femoral Radial TRM 2010
- 9. Percent Radial TRM 2010
- 10. European data : radial + brachial TRM 2010
- 11. Radial in USA Interest gains momentum Radial courses set up Duke paper MORTAL study TRM 2010
- 12. Study: worldwide uptake radial access TRM • Aim: assess worldwide proportion radial PCI 2010
- 13. Methods • Obtain national database information when available • Search published literature • Contact national interventional societies • Ask industry for estimates TRM 2010
- 14. Results • Europe – UK and Sweden db 2009 – France and Poland db 2008 – Spain, Germany, Italy, Netherlands industry 2009 – Belgium, Austria, Czech, Greece, Hungary, Turkey db EAPCI 2006 – Miscellaneous db EAPCI 2006 • Asia – Japan estimate 2009 Dr Saito, db 2004 – Other countries industry estimates • Middle East / Africa industry estimate 2009 • Central and South America industry estimate 2009, totals SOLACI • North America – USA NCDR db 2009 – Canada National Society 2009 TRM • Overall coverage: near 100% outside central Africa industry estimates approx 50% 2010
- 15. Europe PCI 1,069,000 Radial 29% TRM 2010
- 16. Europe >20K PCI 920,000 Radial 31% TRM 2010
- 17. Europe >20K PCI 920,000 Radial 31% 115K 83K 61K 23K 24K 340K 132K 90K 22K 28K TRM 2010
- 18. Middle East and Africa PCI 109,000 Radial 9% 20K 11K 12K TRM 2010
- 19. Asia / Pacific PCI 632,000 Radial 39% TRM 2010
- 20. Asia / Pacific >20K PCI 597,000 Radial 40% TRM 2010
- 21. Asia / Pacific >20K PCI 597,000 Radial 40% 220K 33K 143K 40K 75K 50K 35K TRM 2010
- 22. Central / S America PCI 240,000 Radial 16% TRM 2010
- 23. Central / S America ≥ 20K PCI 202,000 Radial 15% 128K 20K 24K 30K TRM 2010
- 24. N America PCI 1,060,000 Radial 7.1% 60K 1,000 K 4.5% TRM 2010
- 25. World data PCI 3,111,000 Radial 22% TRM 2010
- 26. World data 632 K 1,069 K PCI 3,111,000 Radial 22% 240 K 109 K 1,060 K TRM 2010
- 27. Patterns of radial access • Between centres BCIS, SCAAR • Clinical syndromes BCIS TRM 2010
- 28. BCIS 2008 centres / % radial TRM 2010
- 29. BCIS 2009 centres / % radial TRM 2010
- 30. SCAAR 2007 TRM 2010
- 31. TRM 2010
- 32. Conclusions • Spread influenced by pioneers • Phase of rapid growth continues • Wide variation between / within continents • Highests Europe, Asia Pacific several > 50% • Lowest N America, Middle East / Africa • No relation centre volume / proportion radial • Little relation clinical syndrome / proportion TRM radial 2010
- 33. PS If you have access to nationally collected data that could replace industry estimates - I would be very grateful ! TRM 2010