Global revenues for interventional cardiology ultrasound equipment were $131 million in 2016 and are forecast to reach $161 million in 2021. The interventional cardiology ultrasound market is comprised of ultrasound systems used for image guidance during interventional structural heart and electrophysiology procedures. It includes transesophageal echo (TEE) systems, intravascular ultrasound systems (IVUS), and ultrasound systems used for minimally invasive trans-aortic valve replacement (TAVR). Interventional cardiology ultrasound is one of the fastest growing clinical applications in the world, and its growth is particularly strong in the advanced healthcare systems of Western Europe and North America.
Global demographic changes, fears regarding radiation dose, and the increasing accessibility of ultrasound are driving growth for the interventional cardiology market
Several factors are driving growth for interventional cardiology ultrasound. Most alarmingly is the global cardiovascular disease epidemic. According to the World Health Organization, an estimated 17.7 million people died from cardiovascular diseases in 2015, which made cardiovascular disease the number one cause of death globally. Urbanization and population aging have all contributed to the rise of cardiovascular disease, whose risk factors include high blood pressure, high cholesterol, smoking, obesity, physical inactivity and diabetes. Urbanization has facilitated the increased availability of inexpensive processed foods to low-income populations. The proliferation of the urban lifestyle—characterized by tobacco use, unhealthy diets, physical inactivity, and alcohol abuse—has contributed to the growing incidence of cardiovascular disease. In addition to these factors, cardiovascular disease is strongly associated with age, so as the population becomes older, the incidence of cardiovascular disease will continue to increase. Assuming no changes to the risk factors and treatments, the aging population alone will lead to substantial increases in the prevalence and costs of cardiovascular disease. Interventional cardiology procedures and equipment purchases will grow to meet the expanding demand for the minimally invasive treatment of cardiovascular diseases.
Reducing patients’ radiation exposure is also driving growth for interventional cardiology ultrasound. The U.S. Food and Drug Administration (FDA) launched an initiative to reduce unnecessary radiation exposure in 2010 following several decades of radiation dose increases in medical procedures. Since the initiative’s enactment, healthcare providers have created new medical imaging guidelines and have closely tracked radiation safety metrics. The UK Radiological Conference held in June 2017 even dedicated a full day to the discussion of medical radiation called “Dose Awareness Day” which IHS Markit covered in a previous article. To accomplish the goals of this initiative, physicians are choosing to use ultrasound in place of traditional imaging techniques like CT and x-ray because ultrasound reduces exposure to harmful radiation.
Two more factors unique to ultrasound equipment—portability and affordability—have further encouraged the adoption of ultrasound for interventional cardiology. Advancements in compact and handheld ultrasound equipment, including smaller footprints, higher image quality, and advanced software, have made portable ultrasound systems ideal for tight operating rooms. Additionally, ultrasound systems are less expensive than CT and x-ray equipment, making them more accessible to interventional cardiologists than other imaging modalities.
Interventional cardiology advancements driving growth for minimally invasive procedures
Innovations and advancements to interventional cardiology ultrasound technology are driving demand for interventional procedures. A similar trend is occurring for other medical imaging modalities, including x-ray. Procedures that were impossible in the past have been made possible through the development of 3D transesophageal (TEE) echocardiography and advanced cardiology ultrasound systems. The most widespread interventional cardiology ultrasound procedure, the transcatheter aortic valve replacement (TAVR), relies on TEE imaging to guide the surgeon as he operates on the heart endoscopically. Ultrasound-guided transcatheter mitral valve replacement is also becoming a viable alternative to the traditional invasive surgery. Although this procedure remains confined to advanced facilities, it will follow TAVR as the next widespread interventional cardiology procedural trend. Many other interventional cardiology procedures are being researched, including minimally invasive tricuspid valve repair. The procedure remains in clinical trials, but physicians are hopeful that advanced ultrasound imaging can lower the high mortality and morbidity rates associated with open heart surgery to repair the tricuspid valve.
Fusion imaging and the growing number of hybrid operating rooms in advanced healthcare markets has also driven demand for interventional cardiology ultrasound procedures. Fusion imaging, where ultrasound is used in conjunction with computed tomography (CT), magnetic resonance (MR), or positron emission tomography (PET), allows for real-time assessment of interventional procedures. Minimally invasive surgeries that use ultrasound and fusion imaging offer substantial cost-benefits to healthcare providers by increasing patient safety and decreasing the length of hospital stays.
Interventional cardiology ultrasound will be at forefront of medical imaging innovation during the next five years. The field is growing quickly and will continue to expand as advanced equipment becomes accessible to more physicians.