The relationship between interventional X-ray procedures and interventional X-ray equipment is interchangeable in terms of where the influences lie. Demand for interventional X-ray systems is largely influenced by procedural developments and the reimbursement available for them. However, some complex interventional procedures would not be able to be performed without advances being made in interventional X-ray technology. These advances are allowing an increased number of complex procedures to be performed by interventional cardiologists and radiologists.
Rise in cardiac disease is the biggest clinical driver of demand for interventional cardiology systems
The increased incidence of cardiovascular disease, caused by an ageing population and behavioural risk factors, is increasing demand for interventional cardiology procedures. As a result, both the electrophysiology and general coronary markets are predicted to show more growth than the market for interventional radiology. Interventional cardiology procedures such as Transcatheter Aortic Valve Implantations (TAVI), Transcatheter Aortic Valve Replacement (TAVR), Percutaneous Coronary Intervention (PCI), and Aortic Abdominal Aneurisms (AAA) drive considerable demand for interventional cardiology systems. The number of TAVI and mitral valve procedures is increasing globally, resulting in a steady transition towards valve replacement treatment and growth in structural heart surgery. There is a rise in the number of mitral valve surgeries perfromed minimally invasively, encouraging growth in the interventional cardiology market. Open surgery has a limited future for cardiac atrial fibrillation and there is a huge shift in the cardiac area to minimally invasive surgery.
Thus, a movement in the type of clinical procedures performed, for the best possible patient outcome and recovery, is determining the future of cardiovascular patient treatment. Demand for these cardiac surgeries is fuelling the development of interventional X-ray systems tailored to perform them. This is subsequently making these procedures easier for physicians and reducing patient risk.
Left atrial appendage closure procedure is on the rise in North America for patients with chronic atrial fibrillation
Developments in interventional X-ray technology have enabled an increased number of novel interventional procedures to be performed as an alternative to drug treatment. Globally, 33.5 million people are affected by atrial fibrillation, one of the most important risk factors for stroke. According to the American Stroke Association, an estimated 15 percent of strokes are a result of untreated atrial fibrillation and 91% of strokes in people with atrial fibrillation are caused by blood clots that form in the left atrial appendage. The risk of atrial fibrillation is reduced by blood thinners; they are often prescribed, but not all patients can be successfully treated with this medication. Left atrial appendage closure (LAAC), a minimally invasive procedure, seals off a small sac in the heart where blood clots can form and be pumped out to the brain possibly to cause a stroke. This is a potential solution to reduce the risk of and prevent atrial fibrillation. The evolution of interventional cardiology systems has allowed this procedure to be performed; as the technology in interventional X-ray imaging continues to advance, the LAAC procedure will be increasingly performed. The number of LAAC procedures is predicted to increase in North America for patients with chronic atrial fibrillation that cannot be treated in other ways. As a result of the innovations in interventional X-ray technology, there is a rise in clinical demand for the LAAC procedure.
Treatment of stroke is shifting towards mechanical thrombectomy
Mechanical thrombectomy is being increasingly performed as treatment for stroke patients, with an increasing number of scientific papers supporting its benefits. This is driving demand for interventional neurology. In the United Kingdom, the National Health Service is to roll out mechanical thrombectomy, currently only offered at a handful of hospitals, to 8,000 patients a year. This will allow thousands of stroke patients to be saved from lifelong disability and UK stroke patients will benefit from a huge expansion in the number of hospitals offering mechanical thrombectomy. Angiography systems are the equipment of choice to visualize and guide thrombectomy. These systems are required to provide uncompromising image quality while having minimal interference with the interventional procedures. Demand for mechanical thrombectomy is driving further innovation for comprehensive imaging capabilities, as well as precise and flexible positioning control for interventional X-ray systems. However, without the emergence of new angiography devices that support these vascular interventions, this interventional therapy would not be able to be performed safely and efficiently.
It is apparent that technological developments in interventional X-ray systems are allowing more complex procedures to be performed. Interventional suites should therefore feature the therapeutic requirements of the interventional imaging technique and the skills of the interventional team. Patient cases are growing in complexity and are becoming more challenging. Enhanced visualisation and image quality, from interventional X-ray equipment vendors, allow these cases to be handled safely and efficiently, and increase the number of these procedures performed. Concurrently, the increased prevalence of diseases such as cardiovascular disease and stroke fuels demand for interventional X-ray systems to perform these minimally invasive procedures. According to the American Heart Association, cardiovascular disease is the leading global cause of death, accounting for more than 17.3 million deaths per year in 2013, a number that is expected to grow to more than 23.6 million by 2030. Stroke was the second-leading global cause of death behind heart disease in 2013, accounting for 11.8 percent of all deaths worldwide.
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