All of our reports are available via individual purchase or as part of a subscription to our Medtech Pro platform, which includes a full library of reports.
Abbott Laboratories
Angiotech Pharmaceuticals Inc.
Biocompatibles International plc
Boston Scientific Corporation
Cook Group
Guidant Corporation
Implant Sciences Corporation
Johnson & Johnson
JOMED NV
Medtronic Inc.
Merit Medical Systems Inc.
Novoste Corporation
Radiance Medical Systems Inc.
EXECUTIVE SUMMARY
Trends in Coronary Revascularization
PTCA Products
Coronary Stents
Antirestenosis Technologies
Companies
Summary Exhibit 1: U.S. Interventional Coronary Revascularization Market by Major Category, 1999-2006
Summary Exhibit 2: Coronary Revascularization Procedures by Type, 1999-2006
Summary Exhibit 3: U.S. PTCA Product Markets, 1999-2006
Summary Exhibit 4: Coronary Stents, Market Forecast, 1999-2006
Summary Exhibit 5: Endovascular Brachytherapy, Market Forecast, 2000-2006
Summary Exhibit 6: Interventional Coronary Revascularization Supplier Shares, 2001
Summary Exhibit 7: Interventional Coronary Revascularization Supplier Shares by Segment, 2001
1.0 OVERVIEW OF CARDIOVASCULAR DISORDERS
1.1 Components and Function
1.1.1 Heart
1.1.2 Cardiac Cycle
1.1.3 Blood Vessels
1.2 Disorders of Heart and Circulation
1.2.1 Hypertension
1.2.2 Coronary Artery Disease
1.2.3 Congestive Heart Failure
1.2.4 Cardiac Arrhythmias
1.2.5 Stroke
1.2.6 Rheumatic Heart Disease
1.2.7 Acquired Valve Disorders
1.2.8 Congenital Heart Defects
1.3 Cardiovascular Disease Diagnosis
1.3.1 Non-Imaging Techniques
1.3.2 Imaging Techniques
1.3.2.1 Radiographic Imaging
1.3.2.2 Echocardiography
1.3.2.3 Radionuclide Scanning
1.3.2.4 Magnetic Resonance Imaging
1.3.2.5 Coronary Angiography
1.3.2.6 Intravascular Ultrasound
1.3.2.7 Intracoronary Angioscopy
1.3.3 Emerging Diagnostic Modalities
1.3.3.1 In Vitro Cardiac Markers
1.3.3.2 Predictor Tests
1.3.3.3 Monoclonal Antibody-Based Imaging of Thrombosis
1.4 Treatment of Cardiovascular Disease
1.4.1 Medical Management
1.4.1.1 Traditional Medical Management
1.4.1.2 Lipid-Lowering Drugs
1.4.2 Surgical Intervention
1.4.2.1 Coronary Artery Bypass Surgery
1.4.2.2 Valve Surgery and Treatment of Congenital Heart Defects
1.4.2.3 Transmyocardial Revascularization
1.4.2.4 Surgical Management of Atrial Fibrillation
1.4.3 Transcatheter Therapies
1.4.3.1 Percutaneous Transluminal Coronary Angioplasty
1.4.3.2 Coronary Stenting
1.4.3.3 Laser Angioplasty
1.4.3.4 Atherectomy
1.4.3.5 Transcatheter Thrombectomy and Thrombolysis
1.4.3.6 Transcatheter Defect and Valve Repair
1.4.3.7 Percutaneous Transmyocardial Revascularization
1.4.3.8 Catheter Ablation of Arrhythmias
Exhibit 1-1: The Heart
Exhibit 1-2: Selected Data on Deaths and Heart Diseases, 1999
Exhibit 1-3: Estimated Costs of Cardiovascular Disease and Stroke, 2002
Exhibit 1-4: Overview of Major Heart and Circulatory Disorders
Exhibit 1-5: Comparison of Left and Right-Sided Heart Failure
Exhibit 1-6: Selected Types of Arrhythmia
Exhibit 1-7: Major Congenital Heart Defects
Exhibit 1-8: Techniques Used for Diagnosing Cardiovascular Disease
Exhibit 1-9: Principal Drugs Used in the Treatment of Cardiovascular Disease, 2002
Exhibit 1-10: Major Surgical Interventions for Cardiovascular Disease, 2002
Exhibit 1-11: Major Surgical Approaches Used to Perform Cardiothoracic Surgery
Exhibit 1-12: Transcatheter Interventions for Cardiovascular Disease, 2002
2.0 PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY
2.1 Technique
2.2 Clinical Use and Efficacy
2.2.1 Complications
2.2.2 Outcomes versus Competitive Techniques
2.2.3 Non-Femoral Access
2.2.4 Expanding Applications
2.3 Products and Suppliers
2.3.1 Traditional PTCA Devices
2.3.1.1 Balloon Catheters
2.3.1.1.1 Major Designs
2.3.1.1.2 Products
2.3.1.1.3 Pricing
2.3.1.1.4 Emerging Products
2.3.1.2 Guiding Catheters
2.3.1.2.1 Design Goals
2.3.1.2.2 Other Features
2.3.1.2.3 Pricing and Suppliers
2.3.1.3 Guidewires
2.3.1.4 Vascular Access Sheaths
2.3.1.5 Other PTCA Accessories
2.3.2 New and Emerging PTCA Devices
2.3.2.1 Cutting Balloon
2.3.2.1.1 Regulatory Status
2.3.2.1.2 Clinical Results
2.3.2.2 Total Occlusion Crossing Devices
2.3.2.2.1 Corazon Technologies
2.3.2.2.2 IntraLuminal Therapeutics
2.3.2.2.3 LuMend
2.3.2.2.4 Spectranetics
2.3.2.2.5 Stereotaxis
2.4 Procedure Forecasts
2.5 Market Analysis
2.5.1 Balloon Catheters
2.5.1.1 Boston Scientific Market Share
2.5.1.2 Other Supplier Shares
2.5.2 Guiding Catheters
2.5.3 Guidewires
2.5.4 PTCA Accessories
2.5.5 Total Occlusion Crossing Devices
Exhibit 2-1: Impact of Age on Results of Angioplasty
Exhibit 2-2: Comparison of PTCA and New Approaches to Coronary Intervention
Exhibit 2-3: Indications for Percutaneous Transluminal Coronary Angioplasty
Exhibit 2-4: Standard PTCA Balloon Catheter Designs
Exhibit 2-5: Selected Standard PTCA Balloon Catheters, 2002
Exhibit 2-6: Selected Guiding Catheters, 2002
Exhibit 2-7: Selected PTCA Guidewires, 2002
Exhibit 2-8: Overview of Selected PTCA Accessories
Exhibit 2-9: New and Emerging PTCA Devices
Exhibit 2-10: Boston Scientific's Cutting Balloon
Exhibit 2-11: IntraLuminal Therapeutics' Safe-Steer System
Exhibit 2-12: LuMend's Frontrunner CTO Catheter
Exhibit 2-13: Coronary Revascularization, Procedure Forecast by Type, 1999-2006
Exhibit 2-14: PTCA Products, Market Forecast by Segment, 1999-2006
Exhibit 2-15: PTCA Balloon Catheters, Market Forecast, 1999-2006
Exhibit 2-16: PTCA Balloon Catheters, Supplier Shares, 2001
Exhibit 2-17: PTCA Guiding Catheters Market Forecast, 1999-2006
Exhibit 2-18: PTCA Guiding Catheter Supplier Shares, 2001
Exhibit 2-19: PTCA Guidewires, Market Forecast, 1999-2006
Exhibit 2-20: PTCA Guidewires, Supplier Shares, 2001
Exhibit 2-21: PTCA Accessories Market, 1999-2006
Exhibit 2-22: PTCA Accessories, Supplier Shares, 2001
Exhibit 2-23: Total Occlusion Crossing Devices Market Forecast, 2000-2006
3.0 CORONARY STENTS
3.1 Technique
3.1.1 Stent Deployment
3.1.1.1 Direct Stenting
3.1.1.2 Delivery Systems
3.1.2 Adjuvant Anti-Thrombotic Therapy
3.1.2.1 Current Regimens
3.1.2.2 Coated Stents
3.1.2.2.1 Abbott Laboratories/Biocompatibles International
3.1.2.2.2 Cordis
3.1.2.2.3 JOMED
3.1.2.2.4 Medtronic
3.1.2.2.5 PHYTIS Medical Devices
3.1.2.2.6 Sorin Biomedica
3.1.2.2.7 Other Developments
3.1.3 Stent Imaging
3.1.3.1 Potential Benefits and Limitations
3.1.3.2 JOMED Josonics Flex Delivery System
3.2 Indications
3.2.1 Small Vessel Stenting
3.2.2 Saphenous Vein Graft Stenting
3.2.3 Stenting in Long Lesions and Diffuse Disease
3.2.4 Multivessel Stenting
3.2.5 Stenting in Acute Myocardial Infarction
3.2.6 Left Main Coronary Artery Stenting
3.3 Training Requirements
3.4 Cost of POBA versus PTCA with Stenting
3.5 Products and Suppliers
3.5.1 Bare Stents
3.5.1.1 Abbott Laboratories/Biocompatibles International
3.5.1.2 Boston Scientific
3.5.1.2.1 Medinol NIR Stents
3.5.1.2.2 Self-Expanding Stents
3.5.1.2.3 Emerging Products
3.5.1.2.4 Relationship with Medinol
3.5.1.3 Cook
3.5.1.4 Cordis
3.5.1.4.1 Palmaz-Schatz Stents
3.5.1.4.2 Bx Velocity Stents
3.5.1.4.3 Emerging Products
3.5.1.5 Guidant
3.5.1.5.1 Multi-Link Duet
3.5.1.5.2 Multi-Link Tristar
3.5.1.5.3 Multi-Link Tetra
3.5.1.5.4 Multi-Link Penta, Zeta
3.5.1.5.5 Multi-Link Vision
3.5.1.5.6 Multi-Link Specialty Stents
3.5.1.6 JOMED
3.5.1.6.1 JOSTENT Flex
3.5.1.6.2 JOSTENT Coronary Stent Graft
3.5.1.6.3 JOSTENT Bifurcation and Sidebranch
3.5.1.6.4 U.S. Strategy
3.5.1.7 Medtronic
3.5.1.7.1 Wiktor Stents
3.5.1.7.2 BeStent Products
3.5.1.7.3 Arterial Vascular Engineering Products
3.5.1.7.4 Current and Emerging Products
3.5.1.7.5 Loss of Rapid Exchange
3.5.1.8 Other Developments
3.5.1.8.1 CardioVasc
3.5.1.8.2 MIVI Technologies
3.5.1.8.3 Advanced Stent Technologies
3.5.2 Drug Eluting Stents
3.5.2.1 Cordis
3.5.2.1.1 Early Results
3.5.2.1.2 RAVEL
3.5.2.1.3 SIRIUS and Other Studies
3.5.2.1.4 SurModics
3.5.2.1.5 NitroMed
3.5.2.2 Abbott Laboratories/Biocompatibles International
3.5.2.2.1 Abbott Laboratories
3.5.2.2.2 Batimastat
3.5.2.2.3 Dexamethasone
3.5.2.2.4 Estradiol
3.5.2.2.5 Other Compounds
3.5.2.3 Boston Scientific
3.5.2.3.1 Angiotech Pharmaceuticals
3.5.2.3.2 Quanam Medical Corporation
3.5.2.4 Cook
3.5.2.4.1 ASPECT
3.5.2.4.2 ELUTES
3.5.2.4.3 Other Studies
3.5.2.4.4 Guidant Agreement
3.5.2.5 Guidant
3.5.2.5.1 PharmaLink
3.5.2.5.2 Achieve
3.5.2.6 Medtronic
3.5.2.7 Other Drug Eluting Stent Programs
3.5.2.7.1 Biosensors International
3.5.2.7.2 Conor Medsystems
3.5.2.7.3 Endovasc
3.5.2.7.4 Implant Sciences/CardioTech International
3.5.2.7.5 JOMED
3.5.2.7.6 Terumo
3.5.2.7.7 Other Stent Coatings
3.5.2.8 Gene Therapy Stents
3.5.2.9 Biodegradable Stents
3.5.2.9.1 Igaki-Tamai Stent
3.5.2.9.2 Other Biodegradable Stent Programs
3.5.2.10 Other Developments
3.6 Procedure Forecasts
3.7 Market Analysis
3.7.1 Sales Model and Forecast
3.7.1.1 Bare Stents
3.7.1.2 Drug Eluting Stents
3.7.2 Supplier Shares
3.7.3 Near-Term Competitive Scenario
3.7.4 Future Competitive Scenario
Exhibit 3-1: Study Outcomes Showing Benefits of Direct Stenting
Exhibit 3-2: Comparison of Three Post-Stenting Antithrombotic Drug Regimens
Exhibit 3-3: Current and Emerging Antithrombotic Coronary Stents, 2002
Exhibit 3-4: Emerging Indications for Coronary Stenting
Exhibit 3-5: FDA Coronary Stent Approvals by Year, 1998-2001
Exhibit 3-6: Selected Coronary Stents
Exhibit 3-7: Overview of Drug-Eluting Stent Technology
Exhibit 3-8: Necessary Drug Properties for Drug Eluting Stents
Exhibit 3-9: Selected Drug Eluting Stent Programs, 2002
Exhibit 3-10: Selected Results of RAVEL Study
Exhibit 3-11: Results of TAXUS I Trial
Exhibit 3-12: Final Results of the SCORE Trial
Exhibit 3-13: Results of ASPECT Trial
Exhibit 3-14: Results of ELUTES Study
Exhibit 3-15: Clinical Results with the Igaki-Tamai Biodegradable Stent
Exhibit 3-16: CABG Surgery versus Transcatheter Approaches for Revascularization
Exhibit 3-17: Coronary Stenting by Type, Procedure Forecast, 1999-2006
Exhibit 3-18: Coronary Stent Usage by Vessels Treated, Device Forecast, 1999-2006
Exhibit 3-19: Coronary Stents by Type, Market Forecast, 1999-2006
Exhibit 3-20: Coronary Stents, Supplier Shares, 1998-2001
Exhibit 3-21: Anticipated Timing of Selected Drug Eluting Stent Programs
Exhibit 3-22: Comparison of Drug-Eluting Stent Studies
4.0 ANTIRESTENOSIS TECHNOLOGIES
4.1 Mechanisms of Restenosis
4.2 Overview of Antirestenosis Technologies
4.3 Stent-Based Antirestenosis Programs
4.4 Endovascular Brachytherapy
4.4.1 Radiation Sources
4.4.2 Radioactive Stents
4.4.2.1 Clinical Experience
4.4.2.2 Cordis/IsoStent
4.4.2.3 Guidant
4.4.2.4 Implant Sciences
4.4.2.5 InnerDyne
4.4.2.6 MoBeta
4.4.2.7 Other Developments
4.4.2.7.1 On-Site Radioactive Stent Preparation
4.4.2.7.2 Intravascular Activation Brachytherapy
4.4.2.8 Market Limiters
4.4.3 Guidewire/Sourcetrain Systems
4.4.3.1 Boston Scientific
4.4.3.2 Cordis
4.4.3.3 Guidant
4.4.3.3.1 Galileo
4.4.3.3.2 Peripheral System
4.4.3.4 JOMED
4.4.3.5 Novoste
4.4.3.6 Theragenics
4.4.3.7 Indications
4.4.4 Other Endovascular Brachytherapy Platforms
4.4.4.1 Balloon-Based Systems
4.4.4.1.1 Radiance Medical Systems
4.4.4.2 X-Ray Catheter Delivery Systems
4.4.4.2.1 Medtronic
4.4.4.2.2 Photoelectron
4.4.4.2.3 Xoft microTube
4.4.4.3 Intracoronary Infiltrating Catheter
4.5 Drug Therapy
4.5.1 Systemic Drug Delivery
4.5.1.1 AtheroGenics
4.5.1.2 Sirolimus
4.5.2 Localized Drug Delivery
4.5.2.1 Coatings
4.5.2.2 Liposomes (Endovasc)
4.5.2.3 Specialized Drug Delivery Catheters
4.5.2.3.1 Angiogene
4.5.2.3.2 Boston Scientific
4.5.2.3.3 EndoBionics
4.6 Gene Therapy
4.6.1 AVI BioPharma
4.6.2 Cardion
4.6.3 Cell Genesys
4.6.4 GenVec
4.6.5 Introgen Therapeutics
4.6.6 Transgene
4.6.7 Valentis
4.7 Energy-Based Therapies
4.7.1 Cryotherapy
4.7.1.1 CryoCath Technologies
4.7.1.2 CryoVascular Systems
4.7.2 Intravascular Sonotherapy
4.7.2.1 Angiosonics
4.7.2.2 PharmaSonics
4.7.3 Photodynamic Therapy/Photoangioplasty
4.7.3.1 DUSA Pharmaceuticals
4.7.3.2 Miravant Medical Technologies
4.7.3.3 Pharmacyclics
4.7.3.4 QLT
4.7.4 Thermal Therapy
4.8 Market Analysis
4.8.1 Endovascular Brachytherapy
4.8.1.1 Procedure Forecast
4.8.1.2 Market Forecast
4.8.1.3 Supplier Shares
4.8.2 Other Competing Technologies
Exhibit 4-1: Mechanisms of Restenosis
Exhibit 4-2: Summary of Antirestenosis Technologies
Exhibit 4-3: Comparison of Endovascular Brachytherapy Approaches
Exhibit 4-4: Overview of Radioactive Stents
Exhibit 4-5: Selected Radioactive Stent Programs, 2002
Exhibit 4-6: Endovascular Brachytherapy: Guidewire and Sourcetrain Systems and Suppliers, 2001
Exhibit 4-7: Cordis' Checkmate System
Exhibit 4-8: Guidant's Galileo System
Exhibit 4-9: Clinical Summary of the INHIBIT Trial
Exhibit 4-10: Novoste's Beta-Cath System
Exhibit 4-11: Clinical Results of START and START 40 Trials
Exhibit 4-12: Other Endovascular Brachytherapy Products and Suppliers, 2002
Exhibit 4-13: Radiance Medical Systems’ RDX System
Exhibit 4-14: Results from the BRITE Study
Exhibit 4-15: Selected Pharmaceutical Agents Ineffective Against Restenosis
Exhibit 4-16: Selected Pharmaceutical Agents Being Investigated for Restenosis, 2002
Exhibit 4-17: Overview of Localized Drug Delivery Methods as Restenosis Therapy
Exhibit 4-18: Selected Gene Therapy Approaches to Treating Restenosis
Exhibit 4-19: Selected Energy-Based Therapies for the Treatment of Restenosis, 2002
Exhibit 4-20: SILENT vs. Beta-Cath Studies: Angiographic Restenosis Rates
Exhibit 4-21: Selected Photodynamic Therapy Programs for Restenosis, 2002
Exhibit 4-22: Preclinical Results of Miravant’s PhotoPoint Technology for Restenosis
Exhibit 4-23: Endovascular Brachytherapy, Procedure Forecast, 2000-2006
Exhibit 4-24: Endovascular Brachytherapy Products, Market Forecast, 2000-2006
Exhibit 4-25: Endovascular Brachytherapy, Supplier Shares, 2001
5.0 COMPANY PROFILES
5.1 Abbott Laboratories
5.2 Angiotech Pharmaceuticals Inc.
5.3 Biocompatibles International plc
5.4 Boston Scientific Corporation
5.5 Cook Group
5.6 Guidant Corporation
5.7 Implant Sciences Corporation
5.8 Johnson & Johnson
5.9 JOMED NV
5.10 Medtronic Inc.
5.11 Merit Medical Systems Inc.
5.12 Novoste Corporation
5.13 Radiance Medical Systems Inc.
APPENDIX: COMPANY LIST