Despite the best intentions and brightest innovation, start-ups haven't been able to tap into the huge potential presented by the vascular closure market. Ten years after the first generation devices made it to market, the original two leaders still dominate despite the limitations of their devices, while many start-ups have come and gone. A long list of new hopefuls believe they have the solution physicians have desired. Now all they have to do is convince the physicians, who, when it comes to vascular closure devices, are slow to recognize clinical data but quick to embrace a device that feels right to them.

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.