While the debate continues about whether embolic protection devices are really necessary, the space continues to generate interest from investors, start-ups and large companies looking for new technologies. Despite the unfulfilled promise of the past decade, interest has spread to new interventional applications such as percutaneous heart valves, indicating that this area remains a viable opportunity for start-ups.

Invatec has grown to be the leading native European interventional vascular device company and has now set its sights on the US market. By focusing first on peripherals and following with drug-eluting balloons, not stents, Invatec is looking to compete against the major device companies on their home turf.

The field of stroke moves slowly; 17 years elapsed between the introduction of the thrombolytic drug tPA, the first FDA-approved intervention for acute ischemic stroke, and the clot retrieving device from Concentric Medical. The goal of these rdr rmost therapies is to quickly and safely achieve revascularization of the source of the blockage that caused the stroke. The problem has been, and continues to be, the very narrow therapeutic window of opportunity for stroke victims; that is the short time during which recovery is possible. Concentric Medical and Penumbra have both succeeded in widening the treatment window, from the three hour cut-off for tPA to eight hours. Others will follow. According to US Markets for Stroke Management Products, a report just issued by the FDC-Windhover division of Elsevier, this market will rapidly over the next few years because clinicians trained on first-generation devices are now prepared for improved neurointerventional technologies. The report estimates that cerebral revascularization and reperfusion device sales will grow at a compound annual rate of 33.4% through the year 2012.

Today, carotid artery stenting is an accepted less-invasive alternative to surgical endarterectomy for carefully selected patients, particularly those at significant surgical risk, and market projections are very positive. But, the field still has a long way to go before this procedure is considered routine.