Four Big Cardiovascular Trends to Watch at this Week’s Medical Device Gathering—TCT 2010

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the PMA route. “We’ve looked at doing deals in the space, and there are significant barriers to entry,” Salmon says.

—Ancillary products for percutaneous aortic valve repair. Some of the newer cardiovascular procedures, while still not as invasive as surgery, are creating larger puncture wounds into the femoral artery that physicians need to deal with. The traditional ancillary hardware used to insert cardiac stents that prop open clogged arteries, or tools to perform angioplasty, don’t really represent a growing market anymore, Salmon says. There are various ideas for closing up puncture wounds, like mechanical devices, stitches, and clips mounted at the end of catheters. Someone who comes along with an effective new device could have a hit, Salmon says, because it would provide peace of mind to physicians who worry about a puncture wound for a minimally invasive procedure that could go wrong and create a life-threatening situation.

“It can be a very stressful situation, when you put a big hole in the vessel,” Salmon says. “They (vascular surgeons) need to see it close. Otherwise, you can bleed someone out real fast.”

Peripheral artery disease. While interventional cardiology has traditionally focused, just like the name sounds, on the heart, many of these same patients have other problems with clogged blood vessels causing problems in their legs. This condition has caused 2 million Americans to seek treatment, complaining of pain when they walk. Most people go undiagnosed now, partly because there aren’t many good options for treatment.

Healthcare giant Covidien (NYSE: COV) completed a $2.6 billion acquisition in July to get one of the leaders in this field of peripheral artery disease, ev3. This company has a technology, marketed as the SilverHawk and RockHawk, that is designed to cut through the various clots and plaque buildups that cause peripheral artery disease in the legs. Kirkland, WA-based Pathway Medical Technologies (a member of Latterell’s portfolio) has another approach, with a high-speed drill that breaks and vacuums out the blockages in the legs. Santa Clara, CA-based Bacchus Vascular is another player in the field to watch, Salmon says. C.R. Bard (NYSE: BCR) has invested in the field, Salmon says. “There’s a lot of movement,” Salmon says. “People are wondering about how much activity is here, how much growth potential.”

—Lastly, Salmon says he’s going to pay attention to what’s new in the field of neurovascular treatment. This includes big established markets, in which Boston Scientific and Johnson & Johnson are major players in sealing off aneurysms without requiring brain surgery that drills through the skull. Covidien’s acquisition of ev3 was equally focused on the smaller company’s capability in treating neurovascular diseases, Salmon says.

That’s partly why he’s attending the meeting—to learn more about it. But he did mention a couple stroke device companies to watch—Mountain View, CA-based Concentric Medical, and Alameda, CA-based Penumbra.

“There are companies coming up that seem to be dramatically improving technologies physicians have for acute ischemic stroke,” Salmon says. He hesitated to make firm predictions on who the winners will be, saying “I’m just starting to get my feet wet.” Of course, that’s partly what meetings like TCT are for, to learn more.

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