Dr Shirish Hiremath, Director, Cath Lab, Ruby Hall, Pune and President, Cardiological Society of India
2016 saw a steady growth in cath lab demand in the country to the tune of 8–10 percent versus 2015. A new segment of mobile flat-panel cath labs (between a mobile and a fixed lab) was created in the market initially; however, the excitement seemed to have tapered down toward the last few months of the year. The biggest question is whether the lower price delivers image quality within the reasonable dose.
The major story of 2017 so far is the stent price cap by the government. This impacts the cash in hand with institutions looking to purchase cath labs; hence they are likely to either postpone decisions or having to downgrade on the cath lab model they originally intended to purchase. While this is sure to impact the industry immediately, this is possibly a short-term (6–8 month) trend – hospitals will find ways to cover up the loss in revenues. As stents become more affordable, the number of patients treated increases; hence the volume of stents will logically go up.
On the other side of the spectrum, we will see more interest in premium cath labs like hybrid labs or biplanes. We are seeing this in the developed markets in the last few years, and the top doctors and hospitals in our country would strive to provide the same level of treatment.
Finally, on the technology front, innovations in cath labs look to be moving toward the 2020 cm detector size for cardiac procedures (which form bulk of the procedures in our country). We have seen new applications focusing on improved image quality in terms of viewing stent positioning for better accuracy, lower X-ray dose, and a higher DQE – which remain the most important criteria in assessing a cath lab. Other important technology advances to consider for the long term are applications that support procedures like TAVI and EVAR.