These days, medtech investors need to be much more selective about how they spend their capital. In pursuit of steady streams of early-stage opportunities with a high likelihood of success, VCs are establishing closer ties with entprepreneurs and executives they feel can do it again.

Analyzing the venture financings closed by 2004's new crop of biotech, diagnostics, and medical device start-ups reveals today's trends that may shape tomorrow's health care industry. Here we point out eleven 2004 Series A financings that identify and illustrate what's hot.

For 20 years, interventional cardiologists denied the need for embolic protection devices, considering embolic events to generally be the infrequent results of poor technique. Nevertheless, recent data has revealed embolization as a potentially serious and relatively common event during percutaneous coronary interventions. While embolic protection devices have been shown to dramatically reduce embolic complications, physician adoption is slow. Several companies are developing different approaches to protect against embolization, recognizing that better patient data alone isn't enough to convince interventionalists to employ these devices.

Invatec is the product of a father's natural technical skill and love of using technology to solve problems, passed on to his son and daughter. Initially based out of the Venturelli family's home, Invatec started by building custom products for interventional cardiologists in Germany and Italy, and then became an OEM supplier to larger companies. The company initially relied on the Venturellis' (father's and son's) engineering expertise to develop superior technology, while maintaining the responsiveness to physicians' demands that first brought the company to physicians' attention. The goal: to develop a broad-based interventional vascular products business globally under the Invatec name. Already selling products throughout Europe and Asia, the company is biding its time before entering the US market. Invatec's initial product lines include interventional cardiology catheters and balloons, an embolic protection system designed for carotid angioplasty, and a line of interventional peripheral vascular products. The company has also developed a radio frequency ablation system aimed at treating a variety of tumors. To this point, Invatec has largely operated beneath the radar screens of major cardiovascular device companies, which tend to see the company primarily as an OEM supplier. Invatec's efforts to launch a wide range of branded products will bring the company head-to-head with large companies in an already-consolidated market in which superior technology, while essential, is often not enough to carry the day on its own.