With a total market potential estimated in the multibillion-dollar range, the drug-coated balloon opportunity is attracting a growing list of competitors, including several leading multinational cardiovascular device companies that have entered the space via recent acquisitions. DCBs still need to prove their worth in large, long-term clinical trials, but the ultimate proving point for DCBs could center on cost: if they can offer an effective treatment option that is significantly less expensive than existing devices, DCBs may provide a compelling economic argument.

The presence of the first drug-eluting stent on the U.S. market to treat peripheral artery disease is certainly not the end of the discussion for how peripheral artery patients will be treated, clinicians made clear at the influential Veith Symposium this month.

Growth by innovation is almost considered a birthright in interventional cardiology, and based on presentations at this year's Transcatheter Cardiovascular Therapeutics meeting, held this September in San Francisco, it seems clear that innovation still reigns supreme in this specialty. However, as in other medical device markets, ongoing economic and regulatory pressures are taking their toll, particularly in the drug-eluting stent market, as the field adjusts to a new era of cost control and economic uncertainty.