Global Opportunities in Endovascular Acute Stroke Therapies

Companies Covered

Abbott Laboratories 

Boston Scientific

C.R.Bard 

Cook Group

Covidien plc 

Johnson & Johnson (Codman Neuro, Cordis) 

Penumbra 

St. Jude Medical

Stryker

Terumo (MicroVention)

Table of Contents

EXECUTIVE SUMMARY 

Stroke Types and Incidence 

Endovascular Stroke Management Techniques and Tools 

Procedures and Markets

Procedures and Markets by Geography 

Suppliers 

Summary Exhibit 1: Global Incidence of Stroke by Major Type, 2013-2019 

Summary Exhibit 2: Global Endovascular Interventions for Acute Stroke Management by Major Type, 2013-2019 

Summary Exhibit 3 Global Market for Acute Stroke Therapy Products by Major Type, 2013-2019 

Summary Exhibit 4: Endovascular Interventions for Acute Stroke Management by Major Geography, 2013-2019

Summary Exhibit 5: Global Endovascular Acute Stroke Therapies Market by Major Geography, 2013-2019

Summary Exhibit 6: Global Endovascular Acute Stroke TherapiesMarket, Estimated Supplier Shares, 2014 

1.0 ETIOLOGY & EPIDEMIOLOGY OF ACUTE STROKE

1.1 Overview of the Brain

1.1.1 Cerebral Arterial Blood Supply 

1.1.2 Sites of Plaque and Emboli Formation 

1.2 Etiology of Stroke 

1.2.1 Ischemic Stroke

1.2.1.1 Major Types

1.2.1.1.1 Thrombotic Stroke 

1.2.1.1.2 Embolic Stroke

1.2.1.1.3 Hypoperfusion Stroke 

1.2.1.2 Symptoms 

1.2.1.3 Risk Factors 

1.2.1.4 Diagnosis

1.2.1.5 Treatment 

1.2.1.6 Incidence

1.2.2 Hemorrhagic Stroke 

1.2.2.1 Intracerebral Hemorrhage 

1.2.2.1.1 Causes and Risk Factors 

1.2.2.1.2 Symptoms 

1.2.2.1.3 Treatment 

1.2.2.2 Subarachnoid Hemorrhage

1.2.2.2.1 Causes and Risk Factors 

1.2.2.2.2 Symptoms 

1.2.2.2.3 Diagnosis

1.2.2.2.4 Treatment 

1.2.2.3 Incidence

1.2.3 Transient Ischemic Attack 

Exhibit 1-1: Overview of the Brain

Exhibit 1-2: Arterial Blood Supply to Brain 

Exhibit 1-3: Comparison of Ischemic and Hemorrhagic Stroke

Exhibit 1-4: Global Incidence of Ischemic and Hemorrhagic Stroke, 2013-2019

Exhibit 1-5: Incidence of Ischemic and Hemorrhagic Stroke, United States, 2013-2019

Exhibit 1-6: Incidence of Ischemic and Hemorrhagic Stroke, Major Europe, 2013-2019

Exhibit 1-7: Incidence of Ischemic and Hemorrhagic Stroke, Major Asia-Pacific, 2013-2019

Exhibit 1-8: Incidence of Ischemic and Hemorrhagic Stroke, Rest-of-World, 2013-2019

Exhibit 1-9: Comparison of Intracerebral and Subarachnoid Hemorrhage

2.0 ENDOVASCULAR APPROACHES TO STROKE MANAGEMENT 

2.1 Hemorrhagic Stroke Prevention

2.1.1 Targeted Pathologies

2.1.1.1 Intracranial Aneurysms

2.1.1.2 Arteriovenous Malformations (AVMs) 

2.1.2 Management Options

2.1.2.1 Surgical Repair

2.1.2.2 Endovascular Embolization 

2.1.2.2.1 Microcoil Systems 

2.1.2.2.2 Liquid Embolic Systems 

2.1.2.2.3 Coil-Containing Stent Systems 

2.1.2.2.4 Flow Diverting Systems

2.1.2.3 Procedures

2.2 Prophylaxis & Treatment of Ischemic Stroke

2.2.1 Advanced Carotid Artery Stenosis

2.2.1.1 Carotid Endarterectomy

2.2.1.2 Carotid Artery Stenting

2.2.1.2.1 CREST Trial Results

2.2.1.2.2 Carotid Stenting Procedures 

2.2.2 Left Atrial Appendage Closure

2.2.2.1 Surgical Exclusion of Left Atrial Appendage

2.2.2.2 Endovascular Closure of Left Atrial Appendage

2.2.2.2.1 Clinical Experience

2.2.2.2.2 Procedures

2.2.3 Cerebral Thrombectomy 

2.2.3.1 Clinical Experience

2.2.3.2 Procedures

2.2.4 Intracranial Stenting

2.2.4.1 Clinical Experience

2.2.4.2 Procedures

Exhibit 2-1: Cerebral Aneurysm and Arteriovenous Malformation 

Exhibit 2-2: Major Types of Cerebral Aneurysms

Exhibit 2-3: Surgical Aneurysm Clipping

Exhibit 2-4: Comparison of Cerebral Embolic Agents and Approaches 

Exhibit 2-5: Results of Selected Clinical Trials of Flow Diversion Systems 

Exhibit 2-6: Global Endovascular Interventions for Cerebral Aneurysms and AVMs, 2013-2019

Exhibit 2-7: Endovascular Interventions for Cerebral Aneurysms and AVMs, United States, 2013-2019 

Exhibit 2-8: Endovascular Interventions for Cerebral Aneurysms and AVMs, Major Europe, 2013-2019

Exhibit 2-9: Endovascular Interventions for Cerebral Aneurysms and AVMs Major Asia-Pacific, 2013-2019

Exhibit 2-10: Endovascular Interventions for Cerebral Aneurysms and AVMs, Rest-of-World, 2013-2019

Exhibit 2-11: Carotid Artery Stenting, Global Procedures, 2013-2019

Exhibit 2-12: Carotid Artery Stenting Procedures, United States, 2013-2019 

Exhibit 2-13: Carotid Artery StentingProcedures, Major Europe, 2013-2019 

Exhibit 2-14: Carotid Artery Stenting Procedures, Major Asia-Pacific, 2013-2019

Exhibit 2-15: Carotid Artery Stenting Procedures, Rest-of-World, 2013-2019 

Exhibit 2-16: Major Outcomes of Mayo Clinic Retrospective Analysis of Patients Undergoing Left Atrial Appendage Closure During Open Heart Surgery 

Exhibit 2-17: Selected Clinical Trials of Endovascular Left Atrial Appendage Closure Technologies

Exhibit 2-18: Endovascular Left Atrial Appendage Closure, Global Procedures, 2013-2019 

Exhibit 2-19: Endovascular Left Atrial Appendage Closure Procedures, United States, 2013-2019

Exhibit 2-20: Endovascular Left Atrial Appendage Closure Procedures, Major Europe, 2013-2019

Exhibit 2-21: Endovascular Left Atrial Appendage Closure Procedures, Major Asia-Pacific, 2013-2019

Exhibit 2-22: Endovascular Left Atrial Appendage Closure Procedures, Rest-of-World, 2013-2019

Exhibit 2-23: Results of Selected Clinical Trials of Cerebral Thrombectomy Technologies 

Exhibit 2-24: Global Cerebral Thrombectomy Procedures, 2013-2019

Exhibit 2-25: Cerebral Thrombectomy Procedures, United States, 2013-2019 

Exhibit 2-26: Cerebral Thrombectomy Procedures, Major Europe, 2013-2019 

Exhibit 2-27: Cerebral Thrombectomy Procedures, Major Asia-Pacific, 2013-2019 

Exhibit 2-28: Cerebral Thrombectomy Procedures, Rest-of-World, 2013-2019

3.0 PRODUCTS & MARKETS

3.1 Embolization Technologies 

3.1.1 Embolics and Associated Delivery Devices 

3.1.2 Coil-Containing Stent Systems 

3.1.3 Flow Diversion Systems 

3.1.3.1 Acandis 

3.1.3.2 Balt Extrusion 

3.1.3.3 Covidien/Medtronic 

3.1.3.4 MicroVention/Terumo 

3.1.3.5 Stryker

3.1.4 Embolization Product Markets 

3.1.5 Competitive Analysis

3.2 Carotid Stenting Systems and Embolic Protection Devices 

3.2.1 Current Products 

3.2.2 Emerging Technologies 

3.2.2.1 Flow Reversal Neuroprotection Systems

3.2.2.2 Covered Carotid Stenting Systems 

3.2.3 Market

3.2.4 Competitive Analysis

3.3 Left Atrial Appendage Closure Systems

3.3.1 Products

3.3.1.1 Boston Scientific

3.3.1.2 Coherex Medical

3.3.1.3 Covidien

3.3.1.4 Lifetech Scientific

3.3.1.5 St. Jude Medical

3.3.2 Market

3.3.3 Competitive Analysis

3.4 Cerebral Thrombectomy 

3.4.1 Products

3.4.2 Market

3.4.3 Competitive Analysis

Exhibit 3-1: Selected Microcoils, Liquid Embolics and Associated Delivery Systems, 2014

Exhibit 3-2: Selected Coil-Containing Stent Systems, 2014 

Exhibit 3-3: Selected Flow Diversion Device Technologies, 2014 

Exhibit 3-4: Cerebral Endovascular Embolization Technologies, Global Market by Product Type, 2013-2019 

Exhibit 3-5: Cerebral Endovascular Embolization Technologies, U.S. Market by Product Type, 2013-2019

Exhibit 3-6: Cerebral Endovascular Embolization Technologies, Major Europe Market by Product Type, 2013-2019

Exhibit 3-7: Cerebral Endovascular Embolization Technologies, Major Asia-Pacific Market by Product Type, 2013-2019 

Exhibit 3-8: Cerebral Endovascular Embolization Technologies, Rest-of-World Market by Product Type, 2013-2019

Exhibit 3-9: Cerebral Embolization Technologies, Supplier Shares, 2014 

Exhibit 3-10: Selected Carotid Artery Stenting Systems and Embolic Protection Devices, 2014 

Exhibit 3-11: W.L. Gore Flow Reversal System 

Exhibit 3-12: Silk Road Medical ENROUTE Transcarotid Procedure 

Exhibit 3-13: Carotid Stenting Systems and Embolic Protection Devices, Global Market by Major Geography, 2013 – 2019

Exhibit 3-14: Carotid Stenting Systems and Embolic Protection Devices, Supplier Shares, 2014 

Exhibit 3-15: Selected Endovascular Left Atrial Appendage Closure Systems, 2014 

Exhibit 3-16: Endovascular Left Atrial Appendage Closure Technologies, Global Market by Major Geography, 2013-2019 

Exhibit 3-17: Endovascular Left Atrial Appendage Closure Systems, Supplier Shares, 2014 

Exhibit 3-18: Selected Cerebral Thrombectomy Systems, 2014 

Exhibit 3-19: Cerebral Thrombectomy Systems, Global Market by Major Geography, 2013-2019

Exhibit 3-20: Cerebral Thrombectomy Systems, Supplier Shares, 2014

4.0 COMPANY PROFILES

4.1 Abbott Laboratories 

4.2 C.R.Bard 

4.3 Boston Scientific

4.4 Cook Group

4.5 Covidien plc 

4.6 Johnson & Johnson (Codman Neuro, Cordis) 

4.7 Penumbra 

4.8 St. Jude Medical

4.9 Stryker

4.10 Terumo (MicroVention)

5.0 MAJOR COUNTRY PROFILES

5.1 United States 

5.2 Major Western Europe

5.2.1 Overview of European Healthcare

5.2.1.1 Health Care Spending and Reforms

5.2.1.2 Health Care Facilities and Manpower

5.2.1.3 Reimbursement 

5.2.1.4 Impact of the European Union

5.2.2 National Healthcare Profiles 

5.2.2.1 France

5.2.2.2 Germany

5.2.2.3 Italy 

5.2.2.4 Spain 

1.2.2.5 United Kingdom

5.3 Major Asia-Pacific 

5.3.1 China

5.3.2 India 

5.3.3 Japan

Exhibit 5-1: United States, Selected Health Care Indicators, 2014 

Exhibit 5-2: France, Selected Health Care Indicators, 2014

Exhibit 5-3: Germany, Selected Health Care Indicators, 2014

Exhibit 5-4: Italy, Selected Health Care Indicators, 2014 

Exhibit 5-5: Spain, Selected Health Care Indicators, 2014

Exhibit 5-6: United Kingdom, Selected Health Care Indicators, 2014

Exhibit 5-7: China, Selected Health Care Indicators, 2014 

Exhibit 5-8: India, Selected Health Care Indicators, 2014

Exhibit 5-9: Japan, Selected Health Care Indicators, 2014