The rapid discovery of treatments for vascular diseases demands rapid development of device initiatives. The recent introduction of intravascular balloons, stents and coils have popularized new therapies as alternatives to traditional surgeries such as coronary artery bypass surgery (CABG), carotid endarterectomy, and aneurysm clipping.
New developments in stent graft technology like low profile stent grafts, more flexible delivery systems, and increasingly reliable methods of branch attachment have emerged as potential options. The use of special covered stents to seal off defects in blood vessels for endovascular repair of aortic aneurysms using materials known as embolics is increasing.
New analysis from Frost & Sullivan's (technicalinsights.frost.com) Endovascular Surgical Intervention - Technology Market Penetration Analysis research finds that the global market for endovascular abdominal aortic aneurysm (AAA) repair, which was valued at $1 billion in 2010, is expected to reach $1.6 billion by 2015.
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Further, this constant availability of innovative products in the market has helped to drive back the trend of price erosion and aided market expansion. Constant innovations have facilitated and promoted endovascular surgery techniques and are currently undergoing testing for their long-term outcomes and complications.
"Several clinical trials are underway, including carotid revascularization endarterectomy versus stent trial (CREST) and international subarachnoid aneurysm trial (ISAT), to assess the long-term effects of the procedures," said Technical Insights Senior Research Analyst Prasanna Vadhana Kannan. "The most common and advanced form of endovascular surgery is an endovascular aneurysm repair (EVAR)."
There are more than 2,500 active endovascular surgeons worldwide, and they comprise the primary market for endovascular surgical interventional devices. Apart from the spate of product innovations, the advancement of the Japanese market has ensured continued double-digit growth in recent years.
Endovascular surgical techniques are expected to find considerable application in AAA, with approximately 4.5 million people estimated to be suffering from it in the developed world. Of these cases, the United States alone accounts for 1.5 million and, each year, the country diagnoses 600,000 new cases.
Endovascular repair has also become a widely accepted treatment for aortic aneurysms, with penetration rates reaching 80 percent in the best centers; however, overall penetration rates in the developed world are still below 30 percent. One effective way to increase the penetration rates of vascular therapy is using informative Web portals to educate patients about the various diagnostic and therapeutic options available to them.
The importance of greater patient awareness becomes evident when, despite increased patient screening for aneurysms, the lack of understanding of AAAs often results in late detections. Even if an aneurysm is identified, due to the tortuosity of the infrarenal necks, close to 60 percent of female patients and 30 percent of male patients have anatomical features unsuited to an AAA stent graft.
"Owing to the risks of endoleaks and migration, most stent grafts are only applicable for patients with an aneurysm developing in certain locations of the abdominal aorta; in other cases, open cavity bypass surgeries are still the preferred method of treatment," said Technical Insights Senior Research Analyst Darshana De. "Moreover, due to the different sizes of the main and descending legs of the aorta, some patients might not have an anatomy that permits the use of devices that are currently available."
For patients who are treatable using graft techniques, the chances of morbidity are 11 percent less than in open endovascular surgeries.
As conventional management of clinically significant aortic aneurysm consists of surgical excision, it results in a high peri-operative mortality rate. This has led to the emergence of endovascular prosthesis as a minimally invasive, catheter-based alternative to open surgical excision. These minimally invasive devices, in the form of endovascular stent grafts, are deployed across the aneurysm in a way that the aneurysm is effectively excluded from the circulation, with subsequent restoration of normal blood flow.
Post-operative recovery in the intensive care unit is rarely required after the insertion of endovascular stents as the grafts are characterized by reduced blood transfusion requirements and hospital stays. Further, patients return to pre-intervention levels of activity more rapidly post usage of endovascular stent grafts for AAA repair.
Endovascular Surgical Intervention - Technology Market Penetration Analysis, a part of the Technical Insights subscription, identifies the emerging developments in the field of endovascular surgery and devices on a global scale. This research provides a snapshot of the global corporate and academic initiatives, a Porters five forces analysis of the competitive behavior in the industry, strategic initiatives needed, and a technology adoption cycle from the developer's perspective. Further, this research service includes detailed technology analysis and industry trends evaluated following extensive interviews with market participants.
Frost & Sullivan's Technical Insights research group is an international technology analysis business that produces a variety of technical news alerts, newsletters and research services.
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Endovascular Surgical Intervention - Technology Market Penetration Analysis / D29B