Peripheral artery disease driving substantial market growth in the thrombectomy devices market

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Peripheral artery disease (PAD), generally a comorbidity of coronary artery disease, refers to atherosclerosis of theaorta, iliac, femoral, and other lower-extremity arteries. Prevalence studies estimate 5.9% of US population >40 are living with PAD, with 200 million people affected worldwide.  The etiology of PAD is arterial plaque accumulation, and is associated with a 300%+ increased cardiovascular events risk, even in asymptomatic patients.PAD therapeutic management initiates with thrombolytics and progresses to endovascular revascularization most often with catheter-basedminimally invasivethrombectomy devices prior to surgical open procedures.The minimally-invasive endovascular approach supports less invasive clot removal and return to patency. Medtech healthcare consultants agree this is a rapidly expanding area of the medical device market, forecasted to be worth $1.4B by year 2022, and growing at a compound annual growth (CAGR) rate of 5.9%. Medtech research reveals growth of the thrombectomy devices market is being driven by the factors listed below:

  • An aging population with a higher incidence of PAD due to increased sedentary lifestyles for selected population segments
  • Increased demand for active lifestyle maintenance by an aging population
  • Increasing awareness and demand for minimally-invasive procedures

These drivers can result in increased occurrence of deep vein thrombosis, venous thromboembolism, and pulmonary embolism.

There are three main categories of thrombectomy devices: aspiration, rheolytic, and ultrasonic. Aspiration thrombectomy is introduced over a guidewire and includes a catheter to remove the clot via mechanical capture or negative pressure.  Rheolytic thrombectomy both lyses and aspirates the thrombus by means of a hydrodynamic aspiration mechanism, using high-speed fluid jets. Ultrasonic thrombectomy uses high-frequency, low-energy ultrasound waves to accelerate contact of thrombolytic pharmaceutical agents with the plasminogen receptor sites in the thrombus. This separates the fibrin strands in the thrombus, increasing the surface area available for drug interaction. The table below includes a selection of competitive thrombectomy technologies, provided by medtech research:

Company

Leading ThrombectomyDevice

About the device/company

AngioDynamics Inc.

Latham, NY

AngioVac Cannula & Circuit

·   AngioDynamics purchased Vortex Medical, developer of the AngioVac in 2012

·   The device is a large bore 22 F coil-reinforced cannula with a balloon-actuated and expandable funnel-shaped distal tip, designed to improve venous drainage

·   $208.6 M in revenue from all peripheral vasculardevices in 2017 (FY ending May 31, 2017)

Boston Scientific Corp.

Marlborough, MA

AngioJet Thrombectomy System

·   Acquired the rheolyticAngioJet Thrombectomy System and the Fetch 2 Aspiration Catheter with the acquisition of the Interventional Division of Bayer AG in 2014

·   AngioJet is a pharmacomechanical peripheral thrombectomy device with high-pressure pulsed lytic delivery and aspiration to remove soft thrombus

·   $1,011M in revenue from all peripheral intervention devices in 2016

BTG International plc

London/Philadelphia

EkoSonics Endovasular System

·   BTG purchased EKOS Corp. in 2013

·   The ultrasonic device includes multilumen 5.4F side-hole infusion catheter with removable coaxial low-power 2.2 MHz ultrasound transducer core

·   Also cleared for the treatment of acute, massive and submassive pulmonary embolism

·   EkoSonics lineadded $84.4Mto BTG’s2016revenue

Inari Medical Inc.

Irvine, CA

FlowTriever Infusion Aspiration System

·   Emerging venture capital-backed company formed by Inceptus Medical, founded in 2013

·   System uses three separate components:

o   Self-expanding Nitinol framework to remove emboli

o  Aspiration guide 20F catheter that facilitates delivery

o  Retraction aspirator provides a vacuum for aspiration enhancing blood flow restoration

Penumbra Inc.

Alameda, CA

Penubra Indigo

·   Penubra Indigo device launched in 2014,company markets five peripheral vascular devices in total

·   Device is a continuous aspiration mechanical thrombectomy catheter and aspiration pump to remove clots from peripheral arteries and veins specifically for below the knee and distal access

·   $77.8M in peripheral vascular revenue in 2016

As noted in the table above, some devices use a combination of techniques to remove the thrombus. Medtech research consultants agree this expanding market provides many opportunities for start-ups or larger companies looking to enter this space with innovations improving clinical outcomes. It is essential that new market entrants seek consultation with experts in the field to grasp current market needs and the full competitive landscape.

 

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