Cardiovascular Surgical and Interventional Procedures Worldwide, 2015-2022

In 2016, the cumulative worldwide volume of the the following CVD procedures is projected to approach 15.05 million surgical and transcatheter interventions:

  • roughly 4.73 million coronary revascularization procedures via CABG and PCI (or about 31.4% of the total),
  • close to 4 million percutaneous and surgical peripheral artery revascularization procedures (or 26.5% of the total);
  • about 2.12 million cardiac rhythm management procedures via implantable pulse generator placement and arrhythmia ablation (or 14.1% of the total);
  • over 1.65 million CVI, DVT, and PE targeting venous interventions (representing 11.0% of the total);
  • more than 992 thousand surgical and transcatheter heart defect repairs and valvular interventions (or 6.6% of the total);
  • close to 931 thousand acute stroke prophylaxis and treatment procedures (contributing 6.2% of the total);
  • over 374 thousand abdominal and thoracic aortic aneurysm endovascular and surgical repairs (or 2.5% of the total); and
  • almost 254 thousand placements of temporary and permanent mechanical cardiac support devices in bridge to recovery, bridge to transplant, and destination therapy indications (accounting for about 1.7% of total procedure volume).

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CABG: Coronary artery bypass graft; PCI: Percutaneous coronary intervention; AAA: Abdominal aortic aneurysm; TAA: Thoracic abdominal aneurysm; CVI: Chronic venous insufficiency; DVT: Deep vein thrombosis; PE: Pulmonary embolectomy.

Source: MedMarket Diligence, LLC; Report #C500, “Global Dynamics of Surgical and Interventional Cardiovascular Procedures, 2015-2022.” (To request report excerpts, click here.)

Global Dynamics of Surgical and Interventional Cardiovascular Procedures, 2015-2022

Publishing June 2016:
Global Dynamics of Surgical and Interventional Cardiovascular Procedures, 2015-2022

This is a global report from MedMarket Diligence detailing from 2015 to 2022 the volume of interventional and surgical cardiovascular procedures, including open heart, peripheral vascular, cerebrovascular and all associated endovascular interventions.

Table of Contents

Executive Summary

Section 1: Common Acute and Chronic Cardiovascular Conditions Targeted by Surgical and Transcatheter Interventions

1.1     Ischemic Heart Disease

1.1.1     Angina Pectoris
1.1.2     Acute Myocardial Infarction
1.1.3     Incidence, Prevalence, Established Treatment Modalities

1.2     Heart Failure

1.2.1     Incidence, Prevalence, Established Treatment Modalities

1.3     Peripheral Artery Disease

1.3.1     Critical Limb Ischemia
1.3.2     Incidence, Prevalence, Established Treatment Modalities
1.3.3     Aortic Aneurysm
1.3.4     Incidence, Prevalence, Established Treatment Modalities

1.4     Peripheral Venous Disorders

1.4.1     Deep Venous Thrombosis and Pulmonary Embolism
1.4.2     Chronic Venous Insufficiency and Varicose Veins
1.4.3     Incidence, Prevalence, Established Treatment Modalities

1.5     Cerebrovascular Disorders

1.5.1     Cerebrovascular Occlusions and Acute Ischemic Stroke
1.5.2     Cerebral Aneurysm & AVM and Hemorrhagic Stroke
1.5.3     Incidence, Prevalence, Established Treatment Modalities

1.6     Structural Heart Disorders

1.6.1     Congenital Heart Defects

1.6.1.1     Incidence, Prevalence, Established Treatment Modalities

1.6.2     Valvular Disorders

1.6.2.1     Incidence, Prevalence, Established Treatment Modalities

1.7     Cardiac Rhythm Disorders

1.7.1     Bradycardia
1.7.2     Tachycardia

1.7.2.1     Atrial Fibrillation

1.7.3     Incidence, Prevalence, Established Treatment Modalities

Section 2: Current and Projected Volumes of Therapeutic Interventional and Surgical Cardiovascular Procedures

2.1    Coronary Artery Revascularization

2.1.1    Coronary Artery Bypass Graft Surgery

2.1.1.1    Utilization Trends and Procedure Volumes

2.1.2    Percutaneous Coronary Interventions

2.1.2.1    Coronary Angioplasty and Stenting

2.1.2.1.1 Utilization Trends and Procedure Volumes

2.1.2.2    CoronaryMechanical and Laser Atherectomy

2.1.2.2.1 Utilization Trends and Procedure Volumes

2.1.2.3    Mechanical Thrombectomy

2.1.2.3.1 Utilization Trends and Procedure Volumes

2.2    Acute and Chronic Heart Failure Management

2.2.1    Ventricular Assist Device Placement

2.2.1.1    Utilization Trends and Procedure Volumes

2.2.2    Total Artificial Heart Implantation

2.2.2.1    Utilization Trends and Procedure Volumes

2.2.3    Donor Heart Transplantation

2.2.3.1    Utilization Trends and Procedure Volumes

2.3    Peripheral Artery Revascularization

2.3.1    Lower Extremity Arterial Bypass Surgery

2.3.1.1    Utilization Trends and Procedure Volumes

2.3.2     Percutaneous Transcatheter Interventions

2.3.2.1    Angioplasty and Stenting

2.3.2.1.1 PTA and Bare Metal Stenting
2.3.2.1.2 PTA and Drug-Eluting Stenting
2.3.2.1.3 PTA with Drug-Coated Balloons
2.3.2.1.4 Utilization Trends and Procedure Volumes

2.3.2.2    Mechanical and Laser Atherectomy

2.3.2.2.1 Utilization Trends and Procedure Volumes

2.3.2.3    Catheter-Directed Thrombolysis and Thrombectomy

2.3.2.3.1 Utilization Trends and Procedure Volumes

2.4    Aortic Aneurysm Repair

2.4.1    Surgical AAA and TAA Repair
2.4.2    Endovascular AAA and TAA Repaire
2.4.3    Utilization Trends and Procedure Volumes

2.5    DVT and CVI Management

2.5.1    Vena Cava Filter Placement

2.5.1.1    Utilization Trends and Procedure Volumes

2.5.2    Endovenous Ablation

2.5.2.1    Utilization Trends and Procedure Volumes

2.5.3    Venous Revascularization

2.5.3.1    Mechanical Thrombectomy
2.5.3.2    Venous Angioplasty and Stenting
2.5.3.2     Utilization Trends and Procedure Volumes

2.6    Acute Stroke Prophylaxis and Treatment

2.6.1    Carotid Artery Stenosis Management

2.6.1.1    Carotid Endarterectomy
2.6.1.2    Carotid Artery Stenting
2.6.1.3    Utilization Trends and Procedure Volumes

2.6.2    Cerebral Thrombectomy

2.6.2.1    Utilization Trends and Procedure Volumes

2.6.3    Cerebral Aneurysm and AVM Repair

2.6.3.1    Cerebral Aneurysm and AVM Surgical Clipping
2.6.3.2    Cerebral Aneurysm and AVM Coiling & Flow Diversion
2.6.3.3    Utilization Trends and Procedure Volumes

2.7    Treatment of Structural Heart Disorders

2.7.1     Congenital Heart Defect Repair

2.7.1.1    Utilization Trends and Procedure Volumes

2.7.2    Heart Valve Repair and Replacement

2.7.2.1    Heart Valve Repair and Replacement Surgery
2.7.2.2    Utilization Trends and Procedure Volumes
2.7.2.3    Transcatheter Valve Repair and Replacement
2.7.2.4    Utilization Trends and Procedure Volumes

2.8    Cardiac Rhythm Management

2.8.1    Implantable Pulse Generator-Based Therapy

2.8.1.1    Pacemaker Implantation
2.8.1.2    Implantable Cardioverter Defibrillator Placement
2.8.1.3    Cardiac Resynchronization Therapy Device Placement
2.8.1.4    Utilization Trends and Procedure Volumes

2.8.2    Arrhythmia Ablation Therapy

2.8.2.1    Standard SVT Ablation
2.8.2.2    Utilization Trends and Procedure Volumes
2.8.2.3    AFib Ablation

2.8.2.3.1 Surgical AFib Ablation
2.8.2.3.2 Transcatheter AFib Ablation
2.8.2.3.3 Utilization Trends and Procedure Volumes

Section 3: Country Healthcare Profiles

3.1    United States and Other Americas

3.1.1    United States
3.1.2    Brazil
3.1.3    Canada
3.1.4    Mexico

3.2    Largest West European States

3.2.1    France
3.2.2    Germany
3.2.3    Italy
3.2.4    Spain
3.2.5    United Kingdom

3.3    Major Asian States

3.3.1    China
3.3.2    India
3.3.3    Japan


Global Dynamics of Surgical and Interventional Cardiovascular Procedures, 2015-2022
June 2016
Price:  $3,950 (print or PDF; add $200 for both).  Site/Global License also available.
For immediate download, order online or fax your order form.  Site/Global License also available.

 Questions? >> reports@mediligence.com.

 

 

Cardiovascular Disorders Applicable for Stent Implantation

Cardiovascular disease includes high blood pressure, coronary heart disease (myocardial infarction, angina pectoris), heart failure, stroke, and congenital cardiovascular defects. Roughly 80 million Americans have one or more of these types of heart disease. Of those, more than 38 million are greater than 60 years of age.

Cardiovascular disease is the leading cause of death worldwide and is responsible for 35% (864,480) of all deaths in the United States and 30% (17.5 million) of all deaths globally. The exhibit shows the rates of death attributed to cardiovascular disease and coronary heart disease. For men ages 35–74, the United States ranks sixteenth in cardiovascular deaths; for women ages 35–74, the United States ranks thirteenth. 

 

International Death Rates Per 100,000 Population
for Total Cardiovascular Disease and Coronary Heart Disease for the Top 20 Countries
 
Men, ages 35–74
 
Country

CVD Deaths

CHD Deaths

Russian Federation (2002)

1,555.2

835.0

Bulgaria (2004)

915.6

273.3

Romania (2004)

770.0

314.3

Hungary (2005)

709.7

384.7

Poland (2005)

517.3

201.3

Czech Republic (2005)

454.7

224.8

China, Rural (1999)

413.4

64.3

Argentina (2001)

405.9

119.8

China, Urban (1999)

389.0

105.7

Colombia (1999)

331.3

168.2

Scotland (2004)

327.3

220.6

Finland (2005)

311.2

193.9

Greece (2004)

306.7

164.8

Belgium (1997)

289.3

143.0

Denmark (2001)

285.7

141.8

United States (2005)

283.3

169.4

Northern Ireland (2004)

281.7

194.4

New Zealand (2001)

273.6

181.2

Germany (2004)

270.8

142.2

England/Wales (2004)

262.8

168.9
 
Women, ages 35–74
 
Country

CVD Deaths

CHD Deaths

Russian Federation (2002)

659.2

288.1

Bulgaria (2004)

434.6

100.4

Romania (2004)

403.1

134.3

Hungary (2005)

291.1

118.1

China, Rural (1999)

279.3

40.9

China, Urban (1999)

273.4

71.1

Colombia (1999)

229.9

94.7

Poland (2005)

201.8

59.6

Czech Republic (2005)

200.0

82.3

Argentina (2001)

174.2

35.2

Mexico (2001)

166.0

69.0

Scotland (2004)

153.9

80.6

United States (2005)

145.3

69.6

New Zealand (2001)

135.2

74.9

Northern Ireland (2004)

129.2

66.0

Denmark (2001)

127.3

51.0

Belgium (1997)

126.4

44.0

Greece (2004)

125.5

43.1

Portugal (2003)

123.2

35.0

England/Wales (2004)

117.0

55.4
 
Note: Data shown is most recent year available, revised 2008
 
Sources: The World Health Organization, NCHS, and NHLBI
 

The above is an excerpt from MedMarket Diligence report #C245, "Worldwide Market for Drug-Eluting, Bare and Other Coronary Stents, 2008-2017." April 2009

 

Medical technology defies definition

In a prior post, I sought to explore the shifting nature of the medical industry, from clearly defined categories of devices, drugs and diagnostics to a spectrum of products that defy categorization into any one category and instead frequently qualify as multiple.

…Competition in the medical product industry has long since changed from being defined as those products performing a similar, albeit narrowly-defined function, like when the angioplasty manufacturer could reasonably consider his/her competitors to be all other manufacturers of devices that produce catheter-based recanalization of the atherosclerotic lumen. It is a myopic angioplasty manufacturer who does not now also consider atherectomy, transmyocardial laser revascularization, bare metal stents, drug-eluting stents, and traditional/open, MIDCAB (and similar) or even percutaneous coronary artery bypass graft, as well as the classes of drugs and other non-device approaches to produce non-surgical reversal of atherosclerosis….

Gauging the state of technology development in the recent past and the present, the trend toward less demarcation between medical product categories continues unabated, not just for treatment of ischemic heart disease, but for other diseases and disorders. Advances in technology enable this, while the customer — healthcare systems, third party payers and, increasingly, patients — are demanding this.

There nonetheless remain certain aspects of select diseases and disorders that sustain preference if not dominance by one class of medical products.  The spine, playing as it does such a physical, structural, functional role, demands solutions that are device-intensive (e.g., discs, cages), however much bone growth factors, bone graft substitutes and other non-device products are moving in. Cancer treatment, aside from surgical intervention, remains largely a drug-intensive effort, although "drug" continues to be redefined to include moieties that are clearly biotech in nature.

I continue to think about ischemic disease in particular because it represents a sort of microcosm of medtech development. Physicians like to view treatment in terms of "gold standards" or the current state of the art, but as ischemic heart disease (and many other diseases) have shown, the goal line keeps changing as new technologies advance the quality of life, clinical outcome, cost of care and other criteria that determine value of innovations in the market.  Ischemia can be addressed from so many different perspectives that it has become a lightening rod for development efforts.  

Ultimately, I am thrilled at bearing witness to the evolution of technology development.  At the same time, however, I must empathize with. and work hard to come to the aid of, my medtech clients who must continually look to the bigger picture to ensure that their products and technologies remain relevant, lest the trend suddenly make them obsolete.

 

 

 

 

New medtech startups, identified by name

As I am occasionally known to do, I am providing the list of actual company names recently identified (October 2008) as medtech startups (and included in the Medtech Startups Database).  See below:

  • Tissue Fusion, LLC (laser devices to "weld" biological tissues together for wound closures)
  • Applied Catheter Technologies, Inc. (drug-coated urinary and other catheters and stents that are designed to prevent or treat scar tissue)
  • Cleveland Heart, Inc. (artificial heart technologies)
  • Perfusion Solutions, Inc. (heart pumps)
  • Congruent Medical Technologies, Inc. (compliant balloon technologies)
  • NeoChord, Inc. (device for mitral valve repair without need for sternotomy)
  • Akebia Therapeutics, Inc. (pharmaceutical treatments for ischemia and vascular disease, focused on peripheral artery disease)
  • Svelte Medical Systems, Inc. (non-polymeric drug eluting stent)
  • DiabetiTec LLC (device technology in diabetes management)
  • Loma Vista Medical, Inc. (medical device inflatables, including devices for biological navigation such as in support of colonoscopy and other endoscopy)
  • TransCorp Medical, Inc. (minimally invasive products for motion-preserving spine surgery)
  • Osseon Therapeutics, Inc. (minimally invasive treatment of vertebral compression fractures)
  • Sapheon, Inc. (minimally invasive treatments for removing varicose veins)
  • Lutonix, Inc. (drug-coated angioplasty for coronary and peripheral applications)
  • Carmat SAS (fully implantable artificial heart)

Most of these are pretty darn new, but some have just come out of stealth (whether they realize it or not), since I identified them. I used to do this more often — giving company name details in forums like this blog — but cut back when I was told I was giving away too much of the store.  However, in the interests of those recently begun following us on Twitter (http://twitter.com/medmarket), I wanted to once again give up a few more of these details.

Medtech startup formations economically immune?

There is certainly the possibility (despite my doubts) that the current economic slowdown in global markets will have major effects on the medical technology industry. One simply cannot deny that there is simply less VC or other cash floating around that might be put to medtech investment. And maybe, as has occurred in the past (e.g., in the post dotcom bubble era), investment that does take place will move further downstream, away from the speculative risk of very early startups. In hindsight, it is easy to see such trends and developments.

But looking forward, it is difficult to see significantly diminished demand for the promise of medical technology development. Companies continue to be founded at a strikingly active pace.

The Medtech Startups Database, from MedMarket Diligence, has over the past half dozen years accumulated the data on nearly 900 new medtech companies under two years old — a remarkable pace of entrepreneurship.  In the very recent activity in company formation, here are a samping of the technologies these companies are pursuing:

  • Laser devices to “weld” biological tissues together for wound closures.
  • Drug-coated urinary and other catheters and stents that are designed to prevent or treat scar tissue.
  • Artificial heart technologies.
  • Heart pumps.
  • Compliant balloon technologies.
  • Device for mitral valve repair without need for sternotomy.
  • Pharmaceutical treatments for ischemia and vascular disease, focused on peripheral artery disease.
  • Non-polymeric drug eluting stent
  • Device technology in diabetes management.
  • Medical device inflatables, including devices for biological navigation such as in support of colonoscopy and other endoscopy.
  • Minimally-invasive products for motion-preserving spine surgery.
  • Minimally invasive treatment of vertebral compression fractures.
  • Minimally invasive treatments for removing varicose veins.
  • Drug-coated angioplasty for coronary and peripheral applications

 


Medtech Startups Database described here. See pending and recent MedMarket Diligence reports: Sealants, Glues Wound Closure (coming in December), Ablation Technologies,  and Spine Surgery.