Fibrin and Other Sealants — Impacts of Emerging Market Growth

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Source: MedMarket Diligence, LLC; Report #S290.

Growth of Surgical Sealants and Glues in Asia-Pacific

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Source: MedMarket Diligence, LLC; Report #S290.

Cardiovascular Surgical Procedures, Technologies Trended Globally to 2022

cardiovascular procedures

Global Dynamics of Surgical and Interventional Cardiovascular Procedures, 2015-2022. See Report #C500.

Publishing July 2016

This report covers surgical and interventional therapeutic procedures commonly used in the management of acute and chronic conditions affecting myocardium and vascular system. The latter include ischemic heart disease (and its life threatening manifestations like AMI, cardiogenic shock, etc.); heart failure; structural heart disorders (valvular abnormalities and congenital heart defects); peripheral artery disease (and limb and life threatening critical limb ischemia); aortic disorders (AAA, TAA and aortic dissections); acute and chronic venous conditions (such as deep venous thrombosis, pulmonary embolism and chronic venous insufficiency); neurovascular pathologies associated with high risk of hemorrhagic and ischemic stroke (such as cerebral aneurysms and AVMs, and high-grade carotid/intracranial stenosis); and cardiac rhythm disorders (requiring correction with implantable pulse generators/IPG or arrhythmia ablation).

The report offers current assessment and projected procedural dynamics (2015 to 2022) for primary market geographies (e.g., United States, Largest Western European Countries, and Major Asian States) as well as the rest-of-the-world.

See the complete table of contents at Report C500.

 

 

Where is the medtech growth?

Medical technology is, for many of its markets, being forced to look for growth from more sources, including emerging markets. Manufacturers are able to gain better margins through innovation, but their success varies by clinical application.

Cardiology. A demanding patient base (it’s life or death). Be that as it may, there are few new or untapped markets, only the opportunity for new technologies to displace existing markets. Interventional technologies are progressively enabling treatment of larger patient populations, but much growth will still be from emerging markets.

Wound management. Even the most well-established markets will see growth from innovation. The wound market just needs less growth to be happy, since small percentage growth becomes very large by volume. And yet, some of the most significant growth in the long run will be for more advanced

Surgery. Every aspect of surgery seems to be subject to attempts to improve upon it. Robotics, endoscopy, transcatheter, single-port, incisionless, natural orifice. Interventional options are increasing the treatable patient population, and it seems likely that continued development (e.g., materials, including biodegradables, use of drug or other coatings, including cells) will yield more routine procedures for more and different types of conditions, many of which have been inadequately served, if it all.

Orthopedics. Aging populations demanding more agility and mobility will drive orthopedic procedures and device use. Innovation still represents some upside, but more from 3D printing than other new technologies being introduced to practice.

Tissue/Cell Therapy. This is a technology opportunity (and represents radical innovation for most clinical areas), but it is also a set of target clinical applications, since tissues/cells are being engineered to address tissue or cell trauma or disease. Growth is displacing existing markets with new technology, such as bioengineered skin, tendons, bladders, bone, cardiac tissue, etc. These are fundamentally radical technologies for the target applications.

Below is my conceptual opinion on the balance of growth by clinical area coming from routine innovation (tweaks, improvements), radical innovation (whole new “paradigms” like cell therapy in cardiology), and emerging market growth (e.g., China, S. America).

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Source: MedMarket Diligence, LLC, opinion!

Growth in Advance Wound Care Product Revenues, 2014 to 2024

Even excluding the three traditional wound care dressing segments, the advanced wound care market is enormous — over the next ten years, it will grow at a compound annual growth rate of at least 7.7%, and is forecast to reach nearly $16 billion by 2024. This market is being driven by several inter-related factors: the increasing percentage of the aged (65years old and over) in country populations, the fact that people are living longer, obesity, the virtually epidemic rise of Type 2 diabetes, government policies intended to curb healthcare spending, and an increasingly sedentary population. The latter trend is seen especially in developed countries, but is also on the rise in less-developed countries as their economic standing improves and the middle class grows in numbers.

Certain product segments are forecast to have stronger growth than others. Sales of bioengineered skin & skin substitutes for wound care will increase at a CAGR of at least 15%, while sales of foam and hydrocolloid dressings will be growing at high single-digit rates, respectively.

Advance Wound Care Product Revenues, 2014 to 2024

Wound 2014 and 2024

Source: MedMarket Diligence, LLC; Report #S251.

Venous and Arterial Stents in Peripheral Vascular Applications

In the February 2016 report #V201, “Global Market Opportunities in Peripheral Arterial and Venous Stents, Forecast to 2020”, we detail the markets for peripheral stents in the management of the most prevalent occlusive circulatory disorders and other pathologies affecting the abdominal and thoracic aortic tree and lower extremity arterial bed.

Stents are also increasingly used in the management of the debilitating conditions like venous outflow obstruction associated with deep venous thrombosis and chronic venous insufficiency.

Globally, peripheral stenting procedures for arterial indications, as in abdominal and thoracic aortic aneurysm, are growing around 6% annually, while venous procedures are a little higher. More noteworthy is the actual shifts of the market as the slowing, but still relentless, growth in China and elsewhere in Asia-Pacific region is actually changing the balance of markets, and in fact will become the dominant market for peripheral arterial stents by 2020

Periph stent px arterial

Note: Proprietary data obscured.
Source: MedMarket Diligence, LLC; Report #V201.

In the less well developed venous stenting arena, the U.S. and Europe still represent the largest share of the market, and will do so through 2020.

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Note: Proprietary data obscured.
Source: MedMarket Diligence, LLC; Report #V201.

Bioengineered skin displacing traditional wound management products

Very decided shifts are taking place in the wound management market as advanced wound technologies take up caseload from traditional technologies like gauze and others. It becomes evident that traditional products once representing above average sales are now projected to be below average (gauze) as are even a moderately new technology, “negative pressure wound therapy devices” (NPWD), while bioengineered skin and skin substitutes will represent “above average”.

Global Wound Management Market,
Above/Below Average Sectors, 2015 & 2024

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Source: Report #S251.

Global Wound Management Market, Sales, 2015 & 2024

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Source: Report #S251.

Despite the tepid growth of traditional wound management products, they remain very large markets that even the most aggressively growing segments will require time to match that volume. Bioengineered skin and skin substitutes are moving fast in that direction.

Global CAGR 2016-2024 for Wound Management Segments

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Source: Report #S251.

If you would like excerpts from this report, Click Here!

Wound Markets East and West: A Comparison?

Placed on the same scale, U.S. markets for wound management technologies do not seem starkly different from those in the Asia/Pacific region, with insignificant differences, now and in the future, in the balance of different technologies used.

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Source: MedMarket Diligence, LLC; Report #S251.

However, one cannot really compare the U.S. and Asia/Pacific on the “same scale” without seeing the obvious differences:

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Source: MedMarket Diligence, LLC; Report #S251. If you would like excerpts from this report, Click Here.

Growth in wound management from trends in prevalence, technology

Worldwide, an enormous number of wounds are driving a $15 billion market that will soon pass $20 billion. What is driving wound sales is the continued growth and prevalence of different wound types targeted by medical technologies ranging from bandages to bioengineered skin, physical systems like negative pressure wound therapy, biological growth factors, and others.

Most attention in wound management is focused on improving conventional wound healing in difficult clinical situations, especially for chronic wounds, in the expansion of wound management technologies to global markets, and in the application of advanced technologies to improve healing of acute wounds, especially surgical wounds.

Global Prevalence of Wound Types, 2015

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Source: MedMarket Diligence LLC; Report #S251. Request excerpts from this report.

Total Wound Care Market as Percent of Entire Market, 2024

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Source: MedMarket Diligence LLC; Report #S251. Request excerpts from this report.


Buy the Executive Summary for “Wound Management to 2024” (purchase price may be applied to subsequent full report purchase):

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Common Peripheral Vascular Metal Stent Designs

Conceptually, a stent’s design and architecture are based on the underlying rationale of providing adequate endoluminal scaffolding support of recanalized vascular conduit for a desired period of time, with minimally possible obstruction of normal circulatory flow and propensity to reocclusions associated with healing processes or other plausible causes. Stenting device designs also tend to reflect etiological and anatomical specifics of the targeted occlusive conditions and indications, characteristics of preferred device materials, and technical capabilities of existing manufacturing tools and technologies. 

Common Peripheral Vascular Metal Stent Designs. The vast majority of peripheral vascular stents on the market (which are usually made of metal structural materials) typically feature one of three basic designs: slotted tube, wire mesh, or flattened coil/spiral. The same basic designs are used in non-vascular metallic stents, which in many instances constitute a line extension of corresponding vascular systems.

medtronicstentsThe most popular slotted tube stents – which are cut from tubular metal structures with computer-guided laser and electropolished – are available in several design sub-types including closed-cell flexsegment, open-cell multilink and micromesh versions. Generally, all slotted tube stenting devices combine good radial strength, relatively even distribution of scaffolding support, and minimal foreshortening, and compatibility with low profile delivery systems. The closed-cell flexsegment architecture (usually featuring circumferentially distributed hexagonal, heart, or diamond-shaped cells with one or more common sides) offers enhanced scaffolding and relative lesion coverage at the expense of longitudinal flexibility and kink resistance. open-cell multilink design (with sinusoidal ring-segments and evenly spaced co-axial links/ connectors) provides significantly better longitudinal flexibility (particularly with the use of corrugated links) and more even endoluminal support which come at a price of reduced stent to lesion surface ratio and reduced radiopacity. The micromesh configuration (representing a high-density hybrid version of the close-cell flexsegment and open-cell multilink architectures, with larger number of smaller zigzag cells per ring and closely linked ring segments) approximates the advantageous features of the both designs by offering significant improvement in flexibility over the former one better stent-to-vessel/lesion ratio compared to the latter one.

The wire mesh – featuring unrestricted diamond-shaped cells formed by one or several diagonally interwoven (braided) wire filaments – is arguably the oldest type of metal stent design. High stent-to-vessel/lesion surface ratio, good conformability and even scaffolding, along with technological simplicity and relatively low manufacturing cost constitute the primary benefits of braided wire mesh stenting devices. Unfortunately, such devices are also characterized by a mediocre radial strength, very significant (up to 15%) foreshortening, and poor kink resistance, which radically undercut their utility in critical indications.

Coil or spiral stents (which could be configured as a single or double helix with a flat or flattened wire struts) theoretically offer the best combination of radial strength and longitudinal flexibility. However, spiral devices are also characterized by significant foreshortening, propensity to recoil, and uneven scaffolding support in bended or bending circulatory conduits.

Comparative Advantages and Drawbacks of Most Common Stenting Device Designs

Stent-Design-table-for-blog
Report #V201 (February 2016)

See “Global Market Opportunities in Peripheral Arterial and Venous Stents, Forecast to 2020”, Report #V201. Details.