Interventional procedures are growing rapidly and becoming more specialized in diverse areas of care. In the next decade, the number of people living in the United States who have heart conditions is expected to continue to increase, as is the elderly segment of the population and the number of people with chronic disorders such as cardiovascular disease cancer, diabetes and obesity. Driven by these trends and enabled by breakthrough technology allowing new, less invasive approaches to therapy, hospitals are looking at the interventional suite as a strategic area of investment.
Interventional procedures provide minimally invasive therapies that give patients an alternative to open surgery with the goal of improved outcomes and reduced hospitalization and recovery. Technology enabling such procedures is driven by device companies including Edwards Lifesciences, Medtronic and Boston Scientific, in combination with leaders in vascular imaging, such as GE Healthcare.
It is expected that the number of interventional cardiology procedures performed in the United States will climb to approximately 8.1 million in 2013. Percutaneous coronary interventions (PCIs) are one of the most common interventional procedures. Its growth has been remarkable, as new technologies have resulted in improved outcomes.
Medical device innovation is contributing to growth in procedures beyond PCI and other common interventional procedures as well. For example, treating structural heart disease with interventional cardiology is seen as a viable alternative to open heart surgery for patients where conventional surgery is considered too risky. A minimally invasive interventional approach offers the potential to shorten a patient’s length of stay and reduce complications often seen in surgical procedures, such as scarring, blood loss and pain.
Cath Lab Expands Beyond the Coronaries
Interventional cardiology is not the only area seeing medical device innovation. Interventional radiology has also undergone tremendous advances, leading to the development of new imaging technologies and interventional devices for use in oncology, hybrid OR, interventional neuroradiology and vascular interventions. Procedures such as angioplasty, drainage procedures, tumor ablations and embolizations are applied to a vast number of medical conditions that are otherwise treated using more invasive methods. Advances in interventional radiology have simplified procedures and offered an alternative therapeutic approach for patients and clinicians to consider.
According to the Heart Rhythm Society, electrophysiology (EP) is the fastest growing of all the cardiovascular disciplines. An aging U.S. population and the rising rates of obesity are expected to contribute to an increasing incidence of cardiac arrhythmia. Electrophysiology studies are often used to confirm the diagnosis of atrial fibrillation, the most common complex arrhythmia, and determine the most appropriate treatment. Technological advancements are being developed to increase safety, decrease procedure times and improve success rates.
To adapt to the upward growth of interventional technologies, companies are developing innovative medical device and visualization technologies that allow clinicians the ability to plan, guide and treat more effectively. Naturally, the products and technologies being introduced today reflect the current trends and advancements important to clinicians.
Each area of patient care requires a comprehensive understanding of the clinical needs and workflow. A couple of years ago, GE restructured its interventional systems business to more closely align around segmentations within the cath lab, including interventional cardiologists, interventional radiologists (including interventional oncology and neuroradiology), electrophysiologists, and vascular and cardiac surgeons.
Vendors have been expanding offerings with advanced applications to provide excellent visualization and guidance techniques like 3-D imaging and road mapping. Solutions are now available to help support device localization and guidance during structural heart procedures. For example, Innova HeartVision dynamically fuses in real time 2-D X-ray images and 3-D models, such as the 3-D cardiac model, from multiple modalities. It can be synchronized with ECG gating and can help compensate for patient heart and respiratory motion throughout the procedure. These types of advancements can reduce procedure time and dose, and increase physician confidence by providing the visual tools to make challenging interventions more accessible.
But innovation is not just about providing breakthrough technology. It is also about putting quality healthcare solutions within reach of more healthcare providers and patients. Hospitals around the world are struggling to balance the possibilities of medicine and public expectations against the willingness and ability to finance them. Meanwhile, cases of cardiovascular disease and cancer continue to rise.
Based on feedback, segmentation is resonating with customers. For example, in the United States in 2011, GE’s order rate for single plane interventional systems rose to half the market segment volume by mid-year. In addition, interventional radiology system orders have grown at an industry-leading pace while our EP products have continued their majority segment share.
Companies are constantly developing and refining technologies to support clinicians’ abilities to diagnose and treat patients by providing greater visualization to guide therapies, improve workflow, and perform at the cutting edge of where the interventional space can go. With the continued upward trend in interventional technologies, clinical procedures will continue to evolve, as will innovative solutions from vendors.
1. U.S. Markets for Interventional Cardiology Products, Report #A208, February 2010, www.medtechinsight.com
2. U.S. MARKETS FOR INTERVENTIONAL CARDIOLOGY PRODUCTS, 2010 Analysis, www.lifescienceintelligence.com
3. Percutaneous Coronary Interventions, Medscape, Oct 12, 2011, George A Stouffer III, MD, Chief Editor; Karlheinz Peter, MD, PhD, http://emedicine.medscape.com/article/161446-overview
4. Electrophysiology Key Facts, http://www.heartrhythmfoundation.org/facts/electrophysiology.asp