Multiple clinical applications of multiple ablation technologies

One of the more active areas of medical technology development is the use of a different, typically energy-based technologies to cause the ablation of tissue for various therapeutic benefits, whether the excision or destruction of cancerous or other diseased tissue, the dissection and ligation of tissue, or other therapeutic benefit such as creation of therapeutic lesions in treatment of atrial fibrillation.  The fundamental mechanism, the destruction of tissue, is central to many different technologies that cause such ablation.  These include microwave, radiofrequency, ultrasound, laser/light, thermal, hydromechanical, radiation, cryotherapy and others.

Each of these technologies has features that make them applicable to a wide range of tissue types and applications. In few cases does one modality hold sway over a significant share of disease type or tissue target.

Yet, manufacturers are interested in knowing how many ablation procedures are performed, per ablation technology type per specific clinical application AND, moreover, the manufacturer revenues associated with each modality/clinical application combination.

But it really is a morass of overlapping applications, modalities and revenues.  We learned this clearly in a gargantuan study of the worldwide ablation technologies market.  Narrowed as it was to characterize clinical applications, products, markets and companies, the scope of the analysis of ablation technologies was so extensive as to result in a nearly 500 page document.

For the sake of those who are interested, we wanted to summarize the aggregate target of ablation technology applications, at least in terms of the major clinical targets.

CompanyDeviceFeaturesVessel RangeDevice Sizes (D/L)Regulatory Status
AcandisAperioSelf-expanding nitinol stent-based device with hybrid cell design and adaptable working length1.5 to 5.5 mm3.5, 4.5, 6.0 mm / 28, 30 or 40 mmCE Marked
BALTCatch+ Mini/, Catch+, Catch+ Maxi, Catch+ MegaSelf-expanding 16-wire nitinol baskets with tapering cell size design, closed distal tip and 3 distal-1 proximal radiopaque markers2.0 to 7.0 mm3.0, 4.0, 6.0, 9.0 mm / 15, 20, 30, 55 mmCE Marked
Codman /DePuyRevive SESelf-expanding nitinol basket with hybrid cell design, closed distal tip, and 3 radiopaque markers1.5 to 5.5 mm2.5, 3.0, 3.5, 4.0, 5.0, 6.0 mm / 20, 30, 40 mmCE Marked, Approved in China, South Korea, and Taiwan
CovidienSolitaire FRSelf-expanding nitinol stent-based device with Parametric design (for multiple planes of clot contact to enhance capture). Features 3 or 4 distal and 1 proximal markers2.0 to 5.5 mm4.0, 6.0 mm /26, 31, 42 mmCE Marked, FDA approved
NeuraviEmbotrapSelf-expanding nitinol stent-based device with open cell design, closed distal tip, and 3 radiopaque markers. Features dilating inner channel for rapid flow restoration and integrated distal and side branch protection2.0 to 5.5 mm3.0, 4.0, 6.0 mm / 15, 20, 30, 55 mmCE Marked
PenumbraPenumbra SystemAspiration based system comprised of vacuum pump, specialty clot capture & retrieval catheters, and Separator> 3 mm3.0, 4.0, 5.0 mm / 26 mmCE Marked, FDA approved, available in Asia, Australia, and South America
PhenoxpREsetSelf-expanding nitinol stent-based tapering device with closed ring design, and stable proximal opening2.0 to 4.0 mm4.0, 6.0 mm / 30, 45 mmCE Marked
StrykerTrevo Pro, Trevo View, Trevo XPLine of self-expanding nitinol stent-based devices (standard, all radiopaque, oversized) with spiral cell design and soft, guidewire-like closed distal tip1.5 to 4.0 mm4.0, 5.0, 6.0 mm / 20, 30, 40 mmCE Marked, FDA approved

Source: MedMarket Diligence, LLC, Report #A145, “Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities.”

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