Österr.Kardiol.Gesellschaft 1990–2011 Arbeitsgruppe Intervent. Kardiologie Monitor (Auditor)...

Österr.Kardiol.Gesellschaft 1990–2011 Arbeitsgruppe Intervent. Kardiologie

Monitor (Auditor) Report: 2011

Contact and References:

http://iik.i-med.ac.at

L.Kaltenbach, H. Ulmer, C.Kobel www.kardiologie.insel.ch/2164.html MT

Maeder -B Meier - St Cook ESC-WG 10; F.Weidinger- Subregister Roland Schistek; Georg Normann www.herzbericht.de E.Bruckenberger

http://www.kardiologie.insel.ch/2164.html

http://www.herzbericht.de/

Volker Mühlberger, Quality

AUSTRIAN ANGIOGRAPHY +/- PCI- CENTERS 2011

4 Pediatric 37 Adult (11 in Vienna)

Rooms (n=50) http://iik.i-med.ac.at 2010: Großgmain (-) ; Ried (?)

http://iik.i-med.ac.at/


Wunschliste AUDIT 2012

AKH Graz Uniklinik Innsbruck Privatklinik Josefstadt Wiener Privatklinik Ried i.I.


AUSTRIA 2009 / 2010

�Angiography 52.149 55.138�PTCA=PCI 19.856 20.294�-stent 89% 92%�- - DES 69% 75%� OP-CAD (Bruckenberger : 2008=4.248) Schistek 2.737

� OP- valve (Bruckenberger: 2008=2.280) Schistek 2.583


Coronary Angiography Frequency per Million Inhabitants 1992-2010

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

2011

0

2000

4000

6000

8000

10000

12000

AU 8.12-8.38CH 7.4D 82.2-81.8CZ 10.0-10.5SL 5.5

More Centres, more Tables, but not more Angios in Austria 2005-2009?

2005 2006 2007 2008 2009 20100

10

20

30

40

50

60

70

Angiocenterstables

Volker Mühlberger, Quantity 2009 to 2010?


NUMBER OF CENTERS WITH <400 CA /year vs. <200 PCI/year vs. Number of CA/y(*t) 2000-10

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100

2

4

6

8

10

12

0

1

2

3

4

5

6

7

<400 CA/y+c

<200 PCI/y+c

CA/y x thousand

Volker Mühlberger, Quality Silber 2005 / DiMario 2006;

ESC

NUMBER OF CENTERS WITH > 36 STEMI- PCI / year vs. Number of tables 2003-2010

2003 2004 2005 2006 2007 2008 2009 20100

10

20

30

40

50

60

centers

tables

>36 STEMI-PCI/y+c


PCI Frequency per One Million Inhabitants (AU/CH/D/CZ/SL/USA) 1992-2010

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

500

1000

1500

2000

2500

3000

3500

4000

4500

USA

SL

AUCHDCZ


PCI Frequency in Austria 2006-2010 according to acute or non-acute Indications

2006 2007 2008 2009 20100

5000

10000

15000

20000

25000

5009 6014 6686 6783 6466

14254 13328 13041 13073 13828

19263 19342 19727 19856 20294

NICHT AKUTAKUT PCI


Case load per physicianPCI / CA (AU / CH)

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

50

100

150

200

250

PCI - AU

PCI - CH

CA - AU

CA - CH


% PCI/ CA 1992-2010 (AU/CH/D/CZ)

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

5

10

15

20

25

30

35

40

45

50

AU

CH

D

CZ


Ratio of: CABG-OP+PCI / per Angiography in AU CH D

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

10

20

30

40

50

60

AUCHD


PCI during Diagnostic Angio (%) in Austria / Switzerland / EU

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

10

20

30

40

50

60

70

80

90

100

AUCHEU


%-multivessel PCI Austria / EU / CH

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

5

10

15

20

25

AUCHEU


PCI Hospital-Mortality (%) in Austria, Switzerland,Germany, EU

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

0.5

1

1.5

2

2.5

AU

CH

D

EU


PCI -Mortality (%) in Austria (non-acute PCI) *ref.= only

1997

*19

98*

1999

*20

00*

2001

*20

0220

0320

0420

0520

0620

0720

0820

0920

10

0.00

0.05

0.10

0.15

0.20

0.25

0.30

0.35

0.40

non-acute PCI


PCI -Mortality (%) in Austria (acute / non-acute PCI) ref.=overall-mortality

1997

*19

98*

1999

*20

00*

2001

*20

0220

0320

0420

0520

0620

0720

0820

0920

10

0.00

0.20

0.40

0.60

0.80

1.00

1.20

acute PCInon-acute PCI


PCI -Mortality (%) in Austria (acute =without /with shock PCI) ref.=overall-mortality

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

0

1

2

3

4

5

6

7

8

9

PCI for MI with Shock

PCI for MI without Shock


PCI -Mortality (%) in Austria (non-acute / without /with shock PCI) ref.=overall-mortality

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

0.00

0.20

0.40

0.60

0.80

1.00

1.20

non-acute PCI

PCI for MI without Shock

PCI for MI with Shock


Number of PCI (n) for Myocardial Infarction in AU, CH

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100

1000

2000

3000

4000

5000

6000

7000

PCI MI with shock

PCI MI without shock

CH with shock


STEMI PCI / acute PCI/ STEMI % (n=) Austria 2007 / 2008 / 2009 / 2010

2007 2008 2009 20100

1000

2000

3000

4000

5000

6000

7000

3440 3354

51% 52%

STEMI"acute"STEMI % x10


ACUTE PCI (% of total PCI) in

AU, CZ, EU, CH (=STEMI only)

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

5

10

15

20

25

30

35

40

AUCHEUCZ


Ratio of emergency CABG due to PCI (%): Austria/Switzerland/EU

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

0.2

0.4

0.6

0.8

1

1.2

1.4

AUCHEU


EMERGENCY CABG AFTER PCI (%): MORTALITY in Austria

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

0

5

10

15

20

25

30

35

40

45

50

03.3

8.3

18.2

28.6

8.3

15.4 16

25

32

12 10.5

18.2

13.6

23.1

36.4

46.7

36.4

26.1


Ratio of STENTING per PCI (%) in AU/CH/D/CZ

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

10

20

30

40

50

60

70

80

90

100

AU

CH

D

CZ


% GP IIb/IIIa for PCI (AU/CH) % ThrombinInhibitor (TI in AU)

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

5

10

15

20

25

30

AUCHAU-TI


Infarction as Complication (%) after PCI in Austria, CH, D, EU

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1.8

2

AUCHDEU


DRUG ELUTING STENTS (DES) in AU,CH,D,EU-CZ (% of stents)

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

10

20

30

40

50

60

70

80

90

EU EU

CZAU

CH

D

EU


DRUG ELUTING STENTS (DES) in Austria (n) 2002 – 2010

2002 2003 2004 2005 2006 2007 2008 2009 20100

500

1000

1500

2000

2500

3000

3500

4000

4500

5000 Paclitaxel

Sirolimus

Zotarolimus

others/n.a.

Tacrolimus

Everolimus


DRUG ELUTING STENTS (DES/PCI) versus REDO/PCI in Austria (%)

2002 2003 2004 2005 2006 2007 2008 2009 20100

1020304050607080

7.2 6.7 4,6

DES % REDO % (reporting Centers only)


STENT REDO: Thrombus (n/%) versus chronic Restenosis (n) in Austria

2007 2008 2009 20100

100200300400500600700800900

1000

8,5%15,2%

Thrombus Restenose Thrombus x10% reporting centres


Puncture site closing devices (% of PCI in AU/CH)

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

10

20

30

40

50

60

70

80

AUCH


Brachial/Radial Approach (n=) 37 Centers Austria 2008

0

100

200

300

400

500

600

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37


Non- femoral Approach (% of PCI) in AU/ french or german-CH)

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

0

5

10

15

20

25

30

35

AU

CH

french CH

german CH


Ablation (n) / Electrophysiology (n; %) and Implantations in Austrian CathLabs

2003 2004 2005 2006 2007 2008 2009 20100

500

1000

1500

2000

2500

3000

88%76%

90%

Ablation Diagnostics

A/D % x10 Implantation


NEW DEVICES I, Austria 2002-2010

2002

2003

2004

2005

2006

2007

2008

2009

2010

0

500

1000

1500

2000

2500

3000

PTSMAREnalDenervNOGA mappingThrombin lokalOCTDefektverschl.DE Balloonclot catcher

NEW DEVICES II, Austria 2002-2010


2002

2003

2004

2005

2006

2007

2008

2009

2010

0

50

100

150

200

250

300

PTSMAREnalDenervNOGA mappingThrombin lokalMitraClipSeries3Series2Series1


NEWER and OLDER DEVICESAustria 1992 -2010

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

0

5000

10000

15000

20000

25000

30000

35000

40000

STENTDESIIb/IIIai.c.PRESSUREIVUSROTABLDCALASER


NEW DEVICES Austria 2002 – 2010 („loser“)

Brachytherapie 163/101/28/3/0/0/0/0/0 Ultraschalltherapie 1/0/0/0/0/0/0/0/0 Transmyokardialer Laser 16/0/13/0/0/0/0/0/0 Spinal Cord Stimulation 4/0/0/0/0/0/0/0/0 Herzohrverschluss links 7/4/13/0/0/0/0/? Stammzellth. -Katheter 21/16/23/12/40/3/0/0

stereotaktische Drahtnavigation -/-/-/-/-/33 /13/4


Transcatheter aortic valve implantation (TAVI; n=) in AU, CH -2010

2005 2006 2007 2008 2009 20100

50

100

150

200

250

300

350

400 Balloon onlyTransapical ValveTransarterialAU- TAVIEdwards SapienCorValveCH- TAVI

benchmarking: over the years


2000 2002 2004 2006 2008 2010 20120.000

0.500

1.000

1.500

2.000

2.500

Gesamt PCI Mortalität % AT Gesamt PCI Mortalität %

benchmarking: over the centres 2010


0 5 10 15 20 25 30 35 400

0.5

1

1.5

2

2.5

3

PCI Mortalität

benchmarking: over the centres 2010


0 5 10 15 20 25 30 350

20

40

60

80

100

120

akut PCI mit Schock Mortalität

.

DANKE SEHR



Gerinnselentferner 148/173/213/380/580/950/1065/1405/1596 (7.9%)Bis hier Intracoronary Pressure wire (CH= 4.2% 2009)

242(1,6%)/312/709/879/1184/1548/1649(8,3%) Alkoholablation = PTSMA 4/4/6/15/11/16/13/30 Defektverschlüsse

162/243/269/332/214/202/296/316 Optical coherence tomogr.(OTC) -/-/-/-/ 60/113/137 perkutaner Aortenklappenersatz –/-/-/-/30/144/188


NOGA Mapping 16/26/26/21/65/68/50 Thrombininjektion bei lokaler Gefäßkomplikation -/

88/143/115/77/96/120 Drug eluting Balloon 253 (2009)

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Österr.Kardiol.Gesellschaft 1990–2011 Arbeitsgruppe Intervent. Kardiologie Monitor (Auditor)...

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