Majors developments in the interventional X-ray market through the COVID-19 pandemic as widespread adoption of minimally invasive surgeries continues.

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2020 will be only a blip in the rapid expansion of interventional radiology (IR)

The market for IR has experienced unprecedented growth over the last few years. In 2019, the market outgrew forecasts as IR procedures continued to gain popularity. Procedures have evolved from limb saving angioplasties in 1960s to over 50 therapeutic procedures today. However, the market in has faced significant challenges in 2020 due to the coronavirus disease 2019 (COVID-19) pandemic.  Procedural volumes plummeted, resulting in depressed demand for systems (Figure 1), and hospital spending was diverted to critical care equipment. Nevertheless, after 2020, the market is forecast to return to growth over the next five years, as the clinical benefits of minimally invasive procedures over traditional procedures drive demand higher.

Figure 1: IR systems market growth, 2019 vs. 2020 Figure 1: IR systems market growth, 2019 vs. 2020 Source: Omdia

Overcoming the COVID-19 hurdle in interventional cardiology (IC)

IC has been rapidly evolving, as there have been major developments in system integration tools, clinical applications for procedure guidance, dose management systems, and an increased understanding of optimal treatment methods. Procedure length and complexity has increased year-on-year (YoY) and manufacturers are swiftly developing new tools and software capabilities to support clinicians.

Demand for general coronary and structural heart lab systems have continued to rise and over 45% of all interventional systems shipped in 2020 have been in the IC segment. Procedural volumes also rose YoY. There were approximately 80,500 procedures for transcatheter heart valve management (TAVR) in the US market in 2019 and the procedure is projected to increase at a compound annual growth rate (CAGR) of over 10% between 2019 and 2023.

Early studies have shown the wider implications of COVID-19 on the heart. COVID-19 in conjunction with lifestyle diseases and aging populations are major market drivers (Figure 2). Other market drivers include changes in systems preference that are placing an increased focus on the incorporation of robotic gantries, quick lab turnaround times, dose management, and image quality optimization.

Figure 2: Interventional cardiology market growth drivers Figure 2: Interventional cardiology market growth drivers Source: Omdia

Continued demand for hybrid operating rooms (HOR)

In 2019, the market for hybrid operating rooms (HOR) grew by over 10%, as the total number of HORs being installed worldwide continued to grow. The systems aim to meet the changing treatment demands and sterility and image quality requirements. However, HORs are more expensive than traditional ORs due to inventory, construction, and personnel costs and utilization rate.

Despite the high cost, HORs enhance the surgical space by combining a conventional operating room with advanced medical imaging devices and their use has increased in 2020. Cardiac and vascular surgery usage accounted for the largest percentage of systems shipped in 2019 due to the high rate of cardiovascular disease (CVD), and the category is forecast to grow due to rising procedural volumes (Figure 3). Rising procedural volumes also drove an increase of neurosurgeries and orthopedic-trauma-spine surgeries in 2019.

Figure 3: Hybrid operating room market by use – World, 2019 Figure 3: Hybrid operating room market by use – World, 2019 Source: Omdia

While the market for HOR systems declined in 2020 due to COVID-19, demand for the rooms is forecast to grow at a CAGR of over 5% from 2019 to 2024. The market is focusing increasingly on implementing the next generation of innovations such artificial intelligence (AI), parameter adjustments, and robotics, which are forecast to drive strong global market growth.

2020 and beyond

The global market for interventional systems has not been immune to the wider implications of COVID-19. Although minimally invasive surgeries have shown improved short-term outcomes in patients and are associated with a faster recovery, less bleeding, etc., concerns have been raised about the use of minimally invasive surgery for patients potentially infected by COVID-19. In 2020 procedural volumes dropped sharply as hospitals took countermeasures to limit the spread of the virus, including suspending system installations and non-essential work. These measures are forecast to drive unit shipments to decline significantly in 2020 (Figure 4). To combat the challenges associated with COVID-19, manufacturers have improved customer service by offering fast and responsive remote support and equipment servicing when possible.

Beginning in 2021, the interventional market is expected to return to strong growth that will last for the next five years, as demand grows for minimally invasive procedures, such as angioplasty/percutaneous transluminal angioplasty (PTA), peripheral atherectomy, transcatheter aortic valve replacement (TAVR), and transcatheter mitral valve repair (TMVRep).

Figure 4: Impact of COVID-19 on the interventional equipment market Figure 4: Impact of COVID-19 on the interventional equipment market Source: Omdia

Omdia’s Healthcare team recently published the Interventional, Mobile, and Mini C-arm X-ray Equipment Report – 2020 (, which provides a deep dive into the market dynamics for twelve types of systems – general vascular angiography, oncology/body, neurology, interventional gastro/multi-purpose, general coronary, general coronary and structural heart lab, electrophysiology, hybrid operating room systems, image intensifier C-arm, 2D FPD C-arm, 3D FPD C-arm, and mini C-arm, with market size and forecasts for 2019-2024. The report is based on the collection of primary data from system manufacturers.



Further reading


Sharjeel Ahmad, Analyst, Healthcare Technology