Austria's Angiography and PCI Centers: Overview of Cardiac Care Facilities

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Explore Austria's angiography and PCI centers with insights into practice patterns, trends, and procedures. Discover key data and reports related to coronary angiography and PCI frequency, highlighting quality assurance measures and outcomes over the years.

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AUSTRIAs ANGIOGRAPHY and PCI - CENTRES 2016 n = 34 locations * n = 53 rooms *) Herzkatheter -Barmherzige Schwestern LINZ am 31.7.2015 geschlossen Volker M hlberger, Quality

Monitor (Auditor) Report: 1989 2016 (update 29 VII 16) www.iik.i-med.ac.at Lalit Kaltenbach, Hanno Ulmer www.ptca.ch: Marco Roffi Fabio Rigamonti, Bernhard Meier, Stephane Cook,Micha T. Maeder M.Vestweber www.herzbericht.de R ckmeldequote 75% f r 2014 E. Bruckenberger: bis 2011 sterreichische Spezialregister Volker M hlberger, Quality

AustrianNationalCAthLAbRegisty ANCALAR to describe practice patterns and trends, to identify outliers and to detect safety signals Lauer MS, D Agostino RB NEJM 2013; 369:1579-81 Volker M hlberger, Quality

AUSTRIA 2013 / 2014 / 2015 Angiography 54.566 56.062 54.853 PCI 21.698 23.044 22.538 - stent 92% - - DES 85% 92% 96% i.c. device without PCI .. 1.808 (2015: 7,4% -bei meldenden 13,1% ) 91% 92% Volker M hlberger, Quality

Coronary Angiography Frequency per Million Inhabitants 1992-2016 12000 10000 8000 AU 8.1-8.4-8.6-8.7 CH 7.4 - 7.95 D 82.2 - 80.8 - 81.2 CZ 10.0-10.5 SL 5.5 -5.4 6000 4000 2000 0 Volker M hlberger, Quality

% PCI/ CA 1992 - 2015 (AU/CH/D/CZ) 60 50 40 AU 30 CH 20 D CZ 10 0 Volker M hlberger, Quality

PCI per One Million Inhabitants (AU/CH/D/CZ/USA) 1991-2015 5000 4500 4000 USA 3500 3000 AU 2500 2000 CH 1500 D 1000 CZ 500 0 Volker M hlberger, Quality

Number of tables and CENTERS (AU) with > 36 STEMI - PCI / year + center 60 53 52 50 40 34 34 30 27 24 24 23 centers 20 10 tables 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 >36 STEMI- PCI/y+c Volker M hlberger, Quality Silber 2005 / DiMario 2006; ESC

PCI Frequency in Austria 2006-2015 acute or non-acute Indications 25000 2304422538 21698 19263 1934219727 1985620294 20295 20543 20000 15253 14454 15000 142541332813041 13073 13828 13349 1351714550 10000 NICHT AKUT 5000 8084 7791 7148 7026 6946 6783 6686 6466 6014 5009 AKUT PCI 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Volker M hlberger, Quality

Acute PCI/ STEMI PCI / (n=) Austria 2007 2015 % 9000 8000 7000 6000 5000 4000 STEMI 3000 "acute" 2000 55 % 51% 49 % 1000 STEMI % x10 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 Volker M hlberger, Quality

ACUTE versus STEMI PCI (% of total PCI) in AU, CH 45 40 35 30 25 AU + CH acute 20 15 CH + AU STEMI 10 5 0 Volker M hlberger, Quality

Non- femoral (radial) approach (% of procedure) AU- 2011/2012 /2013/2014/ 2015 60 50 40 30 20 10 2011 2012 2013 2014 2015 0 PCI elektiv PCI akut 2011 2012 2013 2014 2015 2012 2013 2014 2015 2012 2013 2014 2015 2012 2013 2014 2015 PCI 2011 ANGIO 2011 Volker M hlberger, Quality

Non- femoral (trans-radial) access (AU): % - switch to femoral during /before PCI 10 % of ALL PCI % of reporting centers only 9 8 7 6 5 4 3 2 1 0 2014 2015 2014 2015 Volker M hlberger, Quality

Trans - radial Access (% of PCI) in AU/ french or german-CH 60 50 40 30 AU CH 20 french CH 10 german CH 0 Volker M hlberger, Quality

Trans - radial access (% of CA) in diagnostic Angiography in AU/ CH 60 50 40 30 20 AU CH 10 0 Volker M hlberger, Quality

Severe bleeding (% of reporting only) AUT 2010 / 2011 / 2012 / 2013/ 2014/ 2015 40 35 30 25 20 15 10 5 0 % of CA bleeding % of PCI nonacute % of PCI acute Volker M hlberger, Quality

Bifurcation PCI, left main stent Austria (% of PCI reporting centers only ) left main stent bifurcation pci 10.0 9.0 8.0 7.0 6.0 5.0 4.0 3.0 2.0 1.0 0.0 2008 2009 2010 2011 2012 2013 2014 2015 Volker M hlberger, Quality

% GP IIb/IIIa for PCI (AU/CH) % ThrombinInhibitor (TI-AU) 30 25 20 AU CH AU-TI 15 10 5 0 Volker M hlberger, Quality

Ratio of emergency CABG due to PCI (%) in AU/CH/EU 1.4 1.2 1 0.8 AU CH EU 0.6 0.4 0.2 0 Volker M hlberger, Quality

PCI Hospital-Mortality (%) in Austria, Switzerland,Germany, EU 2.5 2 1.5 AU CH D EU 1 0.5 0 Volker M hlberger, Quality

PCI -Mortality (% of procedure) Austria 2011 / 2012 / 2013 / 2014/ 2015 35 30 25.6 25 20 15 10 5 2.4 1.06 0.91 0.09 0 PCI gesamt PCI nicht-akut PCI akut PCI akut ohne Schock PCI akut + Schock Volker M hlberger, Quality

PCI -Mortality (ref.=overall-% mortality in Austria) (non-acute / without /with shock) 1.20 1.00 0.80 non-acute PCI bezogen auf Gesamt PCI 0.60 0.40 PCI for MI without Shock bezogen auf Gesamt PCI PCI for MI with Shock bezogen auf Gesamt PCI 0.20 0.00 Volker M hlberger, Quality

Intra aortic balloon pump for PCI in Austria 2005 -2014 (CH 2012/13) 500 450 400 350 300 AUT CH 250 200 150 100 50 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Volker M hlberger, Quality

DRUG ELUTING stents (DES) in AU,CH,D,EU-CZ (% of stents) 120 100 80 60 AU CH D EU CZ CZ 40 EU EU 20 0 Volker M hlberger, Quality

DES/stent and re-stenosis REDO reporting Centres (% of stent - AU) DES % REDO % (reporting Centers only) 100 80 60 40 6.3 6.6 20 4,7 4.64 0 20022003200420052006200720082009201020112012201320142015 Volker M hlberger, Quality

REDO for all chronic restenoses vs. thrombus reporting centres (n/%) Thrombus Restenose Thrombus x10% reporting centres 1000 800 600 400 15,4 % 15,2% 15,1 % 200 8,5% 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 Volker M hlberger, Quality

AUT 2012 / 2013/ 2014 / 2015 (% der PCI) 14 12 2012 2013 2014 2015 10 8 6 4 2 0 Volker M hlberger, Quality

AUT 2012 / 2013/ 2014 / 2015 (n = ) 450 2012 2013 2014 2015 400 350 300 250 200 150 100 50 0 Volker M hlberger, Quality

AUT 2012 (%) CH 14 12 10 8 AUT CH 6 4 2 0 Volker M hlberger, Quality

AUT 2013 (%) CH 14 12 10 8 AUT CH 6 4 2 0 Volker M hlberger, Quality

AUT 2014 (%) CH 12 10 8 AUT CH 6 4 2 0 Volker M hlberger, Quality

AUT 2012 (n) CH 900 800 700 600 AUT CH 500 400 300 200 100 0 Volker M hlberger, Quality

AUT 2013 (n) CH 900 800 700 600 AUT CH 500 400 300 200 100 0 Volker M hlberger, Quality

AUT 2014 (n) CH 900 800 700 AUT 600 500 CH 400 300 200 100 0 Volker M hlberger, Quality

Austria vs. CH 2002 2015 LAA closure (n) 300 250 200 150 AU CH 0 100 50 0 Volker M hlberger, Quality

OLD and NEW DEVICES (n<40.000/a) Austria 1992 -2015 50000 45000 40000 35000 STENT DES 30000 25000 IVUS ROTABL i.c.PRESSURE 20000 15000 10000 5000 0 Volker M hlberger, Quality

OLD and NEW DEVICES (n<3000/a) Austria 2002-2015 3500 Catheter Trombectomy/clot catcher 3000 DE Balloon 2500 Defektverschl. 2000 1500 1000 500 0 Volker M hlberger, Quality

OLD and NEW DEVICES (n<400/a) Austria 2002-2015 400 350 300 250 MitraClip Thrombin lokal NOGA mapping REnalDenerv PTSMA 200 150 100 50 0 Volker M hlberger, Quality

Myocardial biopsies (n) in Austria 2006 -2015 myocardial biopsies 450 400 350 300 250 200 150 100 50 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Volker M hlberger, Quality

Ablation (n) / Electrophysiology (n; %) & CathLab Implantations / Austria Ablation Diagnostics A/E % x10 Implantation 92,4 % 4000 3500 72% 3000 2500 2000 1500 1000 500 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Volker M hlberger, Quality

Austria 2013 / 2014 /2015 reporting centres Ablation (n) for AFib / for VTac Ablation Afib Vtac 3500 3000 2500 2000 1500 1000 500 0 2013 2014 2015 Volker M hlberger, Quality

Transcatheter aortic valve implantation (TAVI; n = ) in AU 2015, CH - 2014 1200 1000 800 600 400 200 0 20052006200720082009201020112012201320142015 Volker M hlberger, Quality

Transcatheter aortic valve implantation (TAVI; n = ) in AU 2015, CH - 2014 1200 AU transaortal AU- TAVI CH transapical CH tao CH- TAVI 1000 800 600 400 99 200 78 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Volker M hlberger, Quality