Cerebral Endovascular Embolization Cases, Procedures Growth

In 2014, endovascular embolization techniques were employed in approximately 90.5 thousand cerebral aneurysm and AVM repair procedures worldwide, of which aneurysm targeting interventions accounted for about 89.2%, with the rest contributed by AVMs hemoisolation.

During the forecast period, the total global volume of transcatheter neurovascular embolization procedures is projected to grow 4% per annum to an estimated 109.9 thousand interventions in the year 2019. The largest absolute and relative gains in cerebral embolization procedure volumes are expected in the largest Asian-Pacific states (mostly China) and the Rest-of-the-World, where low relative usage of endovascular techniques (30-35% versus 65-75% in the U.S. and Europe) will continue to support their increasing penetration of clinical practices and serve as the primary locomotive of growth in the corresponding global product market.

Largely mature U.S. and West European market geographies are likely to register considerably more modest advances in cerebral embolization procedure volumes.  Below is compared the growth rates to 2019 for cerebral endovascular embolization in the major Asia-Pacific countries (Japan, India, and China) to the same in Western Europe.

Screen Shot 2015-10-05 at 9.41.24 AM

Source: MedMarket Diligence, LLC; Report #C310, “Emerging Global Market for Neurointerventional Technologies in Stroke, 2014-2019”.

 

Clinical procedure trends in the management of acute stroke

The scope of FDA-approved medical and interventional modalities commonly employed in preventive management of stroke includes oral anticoagulation, antiplatelet, and lipid-lowering drug therapies, cerebral aneurysm and AVM repair surgery, carotid endarterectomy, stereotactic radiosurgery, as well as endovascular embolization of intracranial aneurysms and AVMs, carotid artery stenting with embolic protection, left atrial appendage closure, along with rarely used and likely to be abandoned intracranial stenting.

In contrast to causes-oriented therapies used in stroke prevention, therapeutic modalities employed in the emergent management of acute stroke are focused almost exclusively on patients’ cardiopulmonary and hemodynamic support and ad hoc containment of dangerous complications and corresponding brain damage associated with stroke.

Among the life-threatening complications that commonly accompany acute cerebral hemorrhage or ischemia are cerebral edema; hydrocephalus; brain stem compression; vasospasm and pulmonary embolism.

Management of the aforementioned acute complications relies on a few proven treatment regimens, including (but not limited to):

  • medical therapy and catheter-based ventricular drainage of cerebrospinal fluid to control intracerebral pressure in patients at risk of edema, hydrocephalus or brain stem compression;
  • hypertensive hypervolemic hemodilution (or “triple-H” therapy) to treat ischemic neurological deficit from vasospasm following subarachnoid hemorrhage;
  • subcutaneous anticoagulation (with heparins or heparinoids) for prophylaxis of pulmonary embolism (which accounts for approximately 10% of deaths following stroke); and
  • elective hypothermia for temporary salvaging brain cells from necrosis due to hemorrhagic trauma or acute ischemia (although the latter technique has not been proven efficacious in clinical trials and was not endorsed in the latest, 2007 versions of the AHA hemorrhagic and ischemic stroke guidelines).

The currently available curative treatment options for acute stroke are limited to intravenous t-PA therapy (which has about 30% efficacy and is indicated for a very narrow cohort of eligible ischemic stroke patients only), investigational intra-arterial thrombolytic therapy, transcatheter cerebral thrombectomy (in patients who did not qualify for or failed t-PA therapy), and emergency craniotomy-based or endoscopic removal of stroke-related hematoma (which carries a 50% to 80% risk of mortality and is reserved for rapidly deteriorating young patients with large lobar hemorrhages).

Screen Shot 2015-10-04 at 3.11.46 PM
Source Report #C310

The rehabilitation phase of stroke management relies on general physiotherapeutic techniques commonly used in patients with various physical and neurological disabilities. Prophylactics of recurrent cerebrovascular events in stroke survivors employs medical and interventional regimens referred to in the overview of primary and secondary stroke prevention.

At right are the key metrics in the management of acute stroke in the U.S., Western Europe, Asia/Pacific and the rest of the world, as detailed in the MedMarket Diligence report #C310.

Procedures in the management of acute stroke are detailed in the MedMarket Diligence report #C310, with current/forecast procedure volumes for carotid artery stenting, embolization of cerebral aneurysm & AVM, left atrial appendage closure, and cerebral thrombectomy.

Screen Shot 2015-10-04 at 3.20.41 PM

Source Report #C310

 

 

The Spine Market in China, India, & Japan, 2011-2021

The rise and growth of the spinal fusion market within China and India within the Asia Pacific region has been rapid and dramatic and reflects the spectacular growth in the economies of the emerging markets of the Asia Pacific region. It is predicted that the rise in these markets will have been so dramatic that by 2020 the Asia Pacific region will have outgrown the North American market and will have become the largest regional market.

Screen Shot 2015-10-04 at 12.16.54 PM

Source: Report #M540

Screen Shot 2015-10-04 at 11.16.39 AM

Source: Report #M540

Report: Worldwide Wound Management, Forecast to 2024

Pending Report Announcement

Worldwide Wound Management, Forecast to 2024:
Established and Emerging Products, Technologies and Markets
in the Americas, Europe, Asia/Pacific and Rest of World
· 350 pages · 200 Exhibits · 75 Company Profiles · Report #S251 · November/December 2015
(Click for full report description)

Price: $4,250 (print or PDF; add $200 for both).
Pre-publication $1,000 discount.
Site/Global License also available.

Order online or send us your order form.

This report will detail the complete range of products and technologies used in wound management and wound care, from dressings, bandages, hydrogels, tissue engineered products, physical treatments and others. The report will detail current clinical and technology developments in the worldwide market providing a current assessment of products in development and on the market; market size and forecast; competitor market shares; 75-100 competitor profiles; and an assessment of the market opportunity for current and hopeful competitors.

The report will provide full year (actual) 2014 market size and share data, with forecast market data to 2024, for the Americas (with detail for U.S., Rest of North America and Latin America), Europe (with detail for United Kingdom, Germany, France, Spain, Italy, and Rest of Europe), Asia/Pacific (with detail for Japan, Korea, and Rest of Asia/Pacific) and Rest of World.

This report will detail the current and projected market for wound management products, including dressings, closure devices, debridement, pharmacological products, tissue engineered products and others. Emphasis will be placed on advanced and leading edge developments (i.e., those approaching wound management from novel perspective) such as growth factors, stem cells, gene therapy and other approaches, while baseline data (current and forecast market size and current competitor market shares per country) will be provided for established segments — multiple dressings types (film, foam, alginate, antibacterial, non-adherent), hydrogels, hydrocolloids, pharmaceuticals, and physical treatments. The report will detail the clinical and technology developments underlying the clinical practice and market development in wound care market, with data on products in development and on the market; market size and forecast; competitor market shares; competitor profiles; and market opportunity. Separate size, growth and competitor data are presented for the U.S., rest of North America, Latin America, leading western European countries (specifically, United Kingdom, Germany, France, Italy, Spain), rest of Europe, Japan, Korea, rest of Asia/Pacific, and the Rest of World category. The report’s company profiles will assess leading and key emerging companies regarding current/projected products, technologies and positions in the advanced wound care market.

TABLE OF CONTENTS
EXECUTiVE SUMMARY
SECTION 1: INDUSTRY BACKGROUND
1.1. Industry Structure
1.2. A Complex Industry
1.3. Historical Perspective and Technology Breakthroughs
1.4. Wound Management Trends
1.4.1. Surgical Wounds
1.4.2. Traumatic Wounds
1.4.3. Burns
1.4.4. Chronic Wounds
1.5. Market Dynamics
SECTION 2: CLINICAL BACKGROUND AND CASELOAD
2.1. Background
2.2. Skin Anatomy: A Summary
2.3. Types of Wounds
2.3.1. Classification
2.3.1.1. Wagner Classification System
2.3.1.2. By Severity
2.3.1.3. By Morphology
2.3.1.4. By Etiology
2.3.1.5. Color Classification
2.3.2. Surgical Wounds
2.3.3. Traumatic Wounds
2.3.4. Burns
2.3.4.1. Debridement
2.3.4.2. Grafting
2.3.5. Pressure Ulcers
2.3.5.1. Ulcer Classification
2.3.5.2. Hospital-Acquired Ulcers
2.3.6. Venous Ulcers
2.3.7. Arterial Ulcers
2.3.8. Diabetic Ulcers
2.3.8.1. Prevalence
2.3.8.2. Stages of Diabetic Ulcers
2.3.8.3. Treatment
2.3.8.4. Amputations
2.3.8.5. Novel treatment for Diabetic Foot Ulcers
2.4. Wound Healing Physiology
2.4.1. Inflammatory Phase
2.4.2. Proliferative Phase
2.4.3. Angiogenesis
2.4.4. Maturation Phase
2.5. Factors Affecting Wound Healing
2.5.1. Extrinsic Factors
2.5.1.1. Mechanical Stress
2.5.1.2. Debris
2.5.1.3. Temperature
2.5.1.4. Desiccation and Maceration
2.5.1.5. Infection
2.5.1.6. Chemical Stress
2.5.1.7. Medication
2.5.1.8. Other Extrinsic Factors
2.5.2. Intrinsic Factors
2.5.2.1. Health Status
2.5.2.1.1. Acquired Immune Deficiency Syndrome
2.5.2.2. Age Factors
2.5.2.3. Body Build
2.5.2.4. Nutritional Status
2.6. Major Treatment Categories and Regimens
2.7. Incidence of Treatments, Growth Rates and Trends
SECTION 3: PRODUCTS, TECHNOLOGIES AND MARKETS
3.1. Background
3.2. Traditional Wound Care Products
3.2.1. Adhesive Dressings
3.2.1.1. Market and Competitive Activity
3.2.2. Gauze
3.2.2.1. Market and Competitive Activity
3.2.3. Non-Adherent Dressings
3.2.3.1. Market and Competitive Activity
3.3. Interactive Wound Healing Products
3.3.1. Film Dressings
3.3.1.1. Overview
3.3.1.2. Leading Products and Other Product Examples
3.3.1.3. Market and Competitive Activity
3.3.2. Foam Dressings
3.3.2.1. Overview
3.3.2.2. Leading Products and Other Product Examples
3.3.2.3. Market and Competitive Activity
3.3.3. Hydrogels
3.3.3.1. Overview
3.3.3.2. Leading Products and Other Product Examples
3.3.3.3. Market and Competitive Activity
3.4. Bioactive Wound Healing Products
3.4.1. Hydrocolloids
3.4.1.1. Overview
3.4.1.2. Leading Products and Other Product Examples
3.4.1.3. Market and Competitive Activity
3.4.2. Alginate Dressings
3.4.2.1. Overview
3.4.2.2. Market and Competitive Activity
3.4.2.3. Leading Products and Other Product Examples
3.4.3. Antimicrobial Dressings
3.4.3.1. Overview
3.4.3.2. Leading Products and Other Product Examples
3.4.3.3. Market and Competitive Activity
3.5. Biologics
3.5.1. Overview
3.5.2. Bioengineered Skin & Skin Substitutes
3.5.3. Market and Competitive Activity
3.6. Wound Care Devices
3.6.1. Negative Pressure Devices
3.6.1.1. Overview
3.6.1.2. Leading Products and Other Product Examples
3.6.1.3. Market and Competitive Activity
3.6.2. Ultrasound Devices
3.6.2.1. Overview
3.6.2.2. Leading Products and Other Product Examples
3.6.2.3. Market and Competitive Activity
3.6.3. Electrical Stimulation Devices
3.6.3.1. Overview
3.6.3.2. Pulsed Electromagnetic Therapy (PEMF)
3.7. Emerging Wound Therapy Technologies
3.7.1. Growth Factors: Introduction
3.7.2. Growth Factor Nomenclature
3.7.3. Developments in Growth Factors
3.7.4. Market and Competitive Activity
SECTION 4: COUNTRY MARKET FORECAST 2014-2024
4.1. Global Overview
4.2. Market Estimates
4.2.1. Global Market for Traditional Adhesive Dressings
4.2.2. Global Market for Traditional Gauze Dressings
4.2.3. Global Market for Non-Adherent Dressings
4.2.4. Global Market for Film Dressings
4.2.5. Global Market for Foam Dressings
4.2.6. Global Market for Hydrogel Dressings
4.2.7. Global Market for Hydrocolloid Dressings
4.2.8. Global Market for Alginate Dressings
4.2.9. Global Market for Antimicrobial Dressings
4.2.10. Global Market for Negative Pressure Wound Therapy
4.2.11. Global Market for Bioengineered Skin & Skin Substitutes
4.2.12. Global Market for Wound Care Growth Factors
4.3. Market Potential
4.4. Leading Companies in the Wound Management Market
4.5. Competitor Market Shares by Product
4.5.1. Market Shares by Country for Traditional Adhesive Dressings
4.5.1.1. United States
4.5.1.2. Rest of North America
4.5.1.3. Latin America
4.5.1.4. EU
4.5.1.4.1. United Kingdom
4.5.1.4.2. Germany
4.5.1.4.3. France
4.5.1.4.4. Italy
4.5.1.4.5. Spain
4.5.1.4.6. Rest of EU
4.5.1.5. Asia Pacific
4.5.1.5.1. Japan
4.5.1.5.2. Korea
4.5.1.5.3. Rest of Asia Pacific
4.5.1.6. Rest of World
4.5.2. Market Shares by Country for Traditional Gauze Dressings
4.5.2.1. United States
4.5.2.2. Rest of North America
4.5.2.3. Latin America
4.5.2.4. EU
4.5.2.4.1. United Kingdom
4.5.2.4.2. Germany
4.5.2.4.3. France
4.5.2.4.4. Italy
4.5.2.4.5. Spain
4.5.2.4.6. Rest of EU
4.5.2.5. Asia Pacific
4.5.2.5.1. Japan
4.5.2.5.2. Korea
4.5.2.5.3. Rest of Asia Pacific
4.5.2.6. Rest of World
4.5.3. Market Shares by Country for Non-Adherent Dressings
4.5.3.1. United States
4.5.3.2. Rest of North America
4.5.3.3. Latin America
4.5.3.4. EU
4.5.3.4.1. United Kingdom
4.5.3.4.2. Germany
4.5.3.4.3. France
4.5.3.4.4. Italy
4.5.3.4.5. Spain
4.5.3.4.6. Rest of EU
4.5.3.5. Asia Pacific
4.5.3.5.1. Japan
4.5.3.5.2. Korea
4.5.3.5.3. Rest of Asia Pacific
4.5.3.6. Rest of World
4.5.4. Market Shares by Country for Film Dressings
4.5.4.1. United States
4.5.4.2. Rest of North America
4.5.4.3. Latin America
4.5.4.4. EU
4.5.4.4.1. United Kingdom
4.5.4.4.2. Germany
4.5.4.4.3. France
4.5.4.4.4. Italy
4.5.4.4.5. Spain
4.5.4.4.6. Rest of EU
4.5.4.5. Asia Pacific
4.5.4.5.1. Japan
4.5.4.5.2. Korea
4.5.4.5.3. Rest of Asia Pacific
4.5.4.6. Rest of World
4.5.5. Market Shares by Country for Foam Dressings
4.5.5.1. United States
4.5.5.2. Rest of North America
4.5.5.3. Latin America
4.5.5.4. EU
4.5.5.4.1. United Kingdom
4.5.5.4.2. Germany
4.5.5.4.3. France
4.5.5.4.4. Italy
4.5.5.4.5. Spain
4.5.5.4.6. Rest of EU
4.5.5.5. Asia Pacific
4.5.5.5.1. Japan
4.5.5.5.2. Korea
4.5.5.5.3. Rest of Asia Pacific
4.5.5.6. Rest of World
4.5.6. Market Shares by Country for Hydrogel Dressings
4.5.6.1. United States
4.5.6.2. Rest of North America
4.5.6.3. Latin America
4.5.6.4. EU
4.5.6.4.1. United Kingdom
4.5.6.4.2. Germany
4.5.6.4.3. France
4.5.6.4.4. Italy
4.5.6.4.5. Spain
4.5.6.4.6. Rest of EU
4.5.6.5. Asia Pacific
4.5.6.5.1. Japan
4.5.6.5.2. Korea
4.5.6.5.3. Rest of Asia Pacific
4.5.6.6. Rest of World
4.5.7. Market Shares by Country for Hydrocolloid Dressings
4.5.7.1. United States
4.5.7.2. Rest of North America
4.5.7.3. Latin America
4.5.7.4. EU
4.5.7.4.1. United Kingdom
4.5.7.4.2. Germany
4.5.7.4.3. France
4.5.7.4.4. Italy
4.5.7.4.5. Spain
4.5.7.4.6. Rest of EU
4.5.7.5. Asia Pacific
4.5.7.5.1. Japan
4.5.7.5.2. Korea
4.5.7.5.3. Rest of Asia Pacific
4.5.7.6. Rest of World
4.5.8. Market Shares by Country for Alginate Dressings
4.5.8.1. United States
4.5.8.2. Rest of North America
4.5.8.3. Latin America
4.5.8.4. EU
4.5.8.4.1. United Kingdom
4.5.8.4.2. Germany
4.5.8.4.3. France
4.5.8.4.4. Italy
4.5.8.4.5. Spain
4.5.8.4.6. Rest of EU
4.5.8.5. Asia Pacific
4.5.8.5.1. Japan
4.5.8.5.2. Korea
4.5.8.5.3. Rest of Asia Pacific
4.5.8.6. Rest of World
4.5.9. Market Shares by Country for Antimicrobial Dressings
4.5.9.1. United States
4.5.9.2. Rest of North America
4.5.9.3. Latin America
4.5.9.4. EU
4.5.9.4.1. United Kingdom
4.5.9.4.2. Germany
4.5.9.4.3. France
4.5.9.4.4. Italy
4.5.9.4.5. Spain
4.5.9.4.6. Rest of EU
4.5.9.5. Asia Pacific
4.5.9.5.1. Japan
4.5.9.5.2. Korea
4.5.9.5.3. Rest of Asia Pacific
4.5.9.6. Rest of World
4.5.10. Market Shares by Country for Negative Pressure Wound Therapy
4.5.10.1. United States
4.5.10.2. Rest of North America
4.5.10.3. Latin America
4.5.10.4. EU
4.5.10.4.1. United Kingdom
4.5.10.4.2. Germany
4.5.10.4.3. France
4.5.10.4.4. Italy
4.5.10.4.5. Spain
4.5.10.4.6. Rest of EU
4.5.10.5. Asia Pacific
4.5.10.5.1. Japan
4.5.10.5.2. Korea
4.5.10.5.3. Rest of Asia Pacific
4.5.10.6. Rest of World
4.5.11. Market Shares by Country for Bioengineered Skin & Skin Substitutes
4.5.11.1. United States
4.5.11.2. Rest of North America
4.5.11.3. Latin America
4.5.11.4. EU
4.5.11.4.1. United Kingdom
4.5.11.4.2. Germany
4.5.11.4.3. France
4.5.11.4.4. Italy
4.5.11.4.5. Spain
4.5.11.4.6. Rest of EU
4.5.11.5. Asia Pacific
4.5.11.5.1. Japan
4.5.11.5.2. Korea
4.5.11.5.3. Rest of Asia Pacific
4.5.11.6. Rest of World
4.5.12. Market Shares by Country for Wound Care Growth Factors
4.5.12.1. United States
4.5.12.2. Rest of North America
4.5.12.3. Latin America
4.5.12.4. EU
4.5.12.4.1. United Kingdom
4.5.12.4.2. Germany
4.5.12.4.3. France
4.5.12.4.4. Italy
4.5.12.4.5. Spain
4.5.12.4.6. Rest of EU
4.5.12.5. Asia Pacific
4.5.12.5.1. Japan
4.5.12.5.2. Korea
4.5.12.5.3. Rest of Asia Pacific
4.5.12.6. Rest of World
4.6. Regional and Country Market Sizes
4.7. Americas
4.7.1. United States
4.7.1.1. USA Market for Traditional Adhesive Dressings
4.7.1.2. USA Market for Traditional Gauze Dressings
4.7.1.3. USA Market for Non-Adherent Dressings
4.7.1.4. USA Market for Film Dressings
4.7.1.5. USA Market for Foam Dressings
4.7.1.6. USA Market for Hydrogel Dressings
4.7.1.7. USA Market for Hydrocolloid Dressings
4.7.1.8. USA Market for Alginate Dressings
4.7.1.9. USA Market for Antimicrobial Dressings
4.7.1.10. USA Market for Negative Pressure Wound Therapy
4.7.1.11. USA Market for Bioengineered Skin & Skin Substitutes
4.7.1.12. USA Market for Wound Care Growth Factors
4.7.2. Rest of North America
4.7.2.1. Rest of North America Market for Traditional Adhesive Dressings
4.7.2.2. Rest of North America Market for Traditional Gauze Dressings
4.7.2.3. Rest of North America Market for Non-Adherent Dressings
4.7.2.4. Rest of North America Market for Film Dressings
4.7.2.5. Rest of North America Market for Foam Dressings
4.7.2.6. Rest of North America Market for Hydrogel Dressings
4.7.2.7. Rest of North America Market for Hydrocolloid Dressings
4.7.2.8. Rest of North America Market for Alginate Dressings
4.7.2.9. Rest of North America Market for Antimicrobial Dressings
4.7.2.10. Rest of North America Market for Negative Pressure Wound Therapy
4.7.2.11. Rest of North America Market for Bioengineered Skin and Skin Substitutes
4.7.2.12. Rest of North America Market for Wound Care Growth Factors
4.7.3. Latin America
4.7.3.1. Latin America Market for Traditional Adhesive Dressings
4.7.3.2. Latin America Market for Traditional Gauze Dressings
4.7.3.3. Latin America Market for Non-Adherent Dressings
4.7.3.4. Latin America Market for Film Dressings
4.7.3.5. Latin America Market for Foam Dressings
4.7.3.6. Latin America Market for Hydrogel Dressings
4.7.3.7. Latin America Market for Hydrocolloid Dressings
4.7.3.8. Latin America Market for Alginate Dressings
4.7.3.9. Latin America Market for Antimicrobial Dressings
4.7.3.10. Latin America Market for Negative Pressure Wound Therapy Devices
4.7.3.11. Latin America Market for Bioengineered Skin and Skin Substitutes
4.7.3.12. Latin America Market for Wound Care Growth Factors
4.8. European Union
4.8.1. United Kingdom
4.8.1.1. UK Market for Traditional Adhesive Dressings
4.8.1.2. UK Market for Traditional Gauze Dressings
4.8.1.3. UK Market for Non-Adherent Dressings
4.8.1.4. UK Market for Film Dressings
4.8.1.5. UK Market for Foam Dressings
4.8.1.6. UK Market for Hydrogel Dressings
4.8.1.7. UK Market for Hydrocolloid Dressings
4.8.1.8. UK Market for Alginate Dressings
4.8.1.9. UK Market for Antimicrobial Dressings
4.8.1.10. UK Market for Negative Pressure Wound Therapy Devices
4.8.1.11. UK Market Bioengineered Skin and Skin Substitutes
4.8.1.12. United Kingdom Market for Wound Care Growth Factors
4.8.2. Germany
4.8.2.1. Germany Market for Traditional Adhesive Dressings
4.8.2.2. Germany Market for Traditional Gauze Dressings
4.8.2.3. Germany Market for Non-Adherent Dressings
4.8.2.4. Germany Market for Film Dressings
4.8.2.5. Germany Market for Foam Dressings
4.8.2.6. Germany Market for Hydrogel Dressings
4.8.2.7. Germany Market for Hydrocolloid Dressings
4.8.2.8. Germany Market for Alginate Dressings
4.8.2.9. Germany Market for Antimicrobial Dressings
4.8.2.10. Germany Market for Negative Pressure Wound Therapy Devices
4.8.2.11. Germany Market for Bioengineered Skin and Skin Substitutes
4.8.2.12. Germany Market for Wound Care Growth Factors
4.8.3. France
4.8.3.1. France Market for Traditional Adhesive Dressings
4.8.3.2. France Market for Traditional Gauze Dressings
4.8.3.3. France Market for Non-Adherent Dressings
4.8.3.4. France Market for Film Dressings
4.8.3.5. France Market for Foam Dressings
4.8.3.6. France Market for Hydrogel Dressings
4.8.3.7. France Market for Hydrocolloid Dressings
4.8.3.8. France Market for Alginate Dressings
4.8.3.9. France Market for Antimicrobial Dressings
4.8.3.10. France Market for Negative Pressure Wound Therapy Devices
4.8.3.11. France Market for Bioengineered Skin and Skin Substitutes
4.8.3.12. France Market for Wound Care Growth Factors
4.8.4. Italy
4.8.4.1. Italy Market for Traditional Adhesive Dressings
4.8.4.2. Italy Market for Traditional Gauze Dressings
4.8.4.3. Italy Market for Non-Adherent Dressings
4.8.4.4. Italy Market for Film Dressings
4.8.4.5. Italy Market for Foam Dressings
4.8.4.6. Italy Market for Hydrogel Dressings
4.8.4.7. Italy Market for Hydrocolloid Dressings
4.8.4.8. Italy Market for Alginate Dressings
4.8.4.9. Italy Market for Antimicrobial Dressings
4.8.4.10. Italy Market for Negative Pressure Wound Therapy Devices
4.8.4.11. Italy Market for Bioengineered Skin and Skin Substitutes
4.8.4.12. Italy Market for Wound Care Growth Factors
4.8.5. Spain
4.8.5.1. Spain Market for Traditional Adhesive Dressings
4.8.5.2. Spain Market for Traditional Gauze Dressings
4.8.5.3. Spain Market for Non-Adherent Dressings
4.8.5.4. Spain Market for Film Dressings
4.8.5.5. Spain Market for Foam Dressings
4.8.5.6. Spain Market for Hydrogel Dressings
4.8.5.7. Spain Market for Hydrocolloid Dressings
4.8.5.8. Spain Market for Alginate Dressings
4.8.5.9. Spain Market for Antimicrobial Dressings
4.8.5.10. Spain Market for Negative Pressure Wound Therapy Devices
4.8.5.11. Spain Market for Bioengineered Skin and Skin Substitutes
4.8.5.12. Spain Market for Wound Care Growth Factors
4.8.6. Rest of Europe
4.8.6.1. Rest of Europe Market for Traditional Adhesive Dressings
4.8.6.2. Rest of Europe Market for Traditional Gauze Dressings
4.8.6.3. Rest of Europe Market for Non-Adherent Dressings
4.8.6.4. Rest of Europe Market for Film Dressings
4.8.6.5. Rest of Europe Market for Foam Dressings
4.8.6.6. Rest of Europe Market for Hydrogel Dressings
4.8.6.7. Rest of Europe Market for Hydrocolloid Dressings
4.8.6.8. Rest of Europe Market for Alginate Dressings
4.8.6.9. Rest of Europe Market for Antimicrobial Dressings
4.8.6.10. Rest of Europe Market for Negative Pressure Wound Therapy Devices
4.8.6.11. Rest of Europe Market for Bioengineered Skin and Skin Substitutes
4.8.6.12. Rest of Europe Market for Wound Care Growth Factors
4.9. Asia/Pacific
4.9.1. Japan
4.9.1.1. Japan Market for Traditional Adhesive Dressings
4.9.1.2. Japan Market for Traditional Gauze Dressings
4.9.1.3. Japan Market for Non-Adherent Dressings
4.9.1.4. Japan Market for Film Dressings
4.9.1.5. Japan Market for Foam Dressings
4.9.1.6. Japan Market for Hydrogel Dressings
4.9.1.7. Japan Market for Hydrocolloid Dressings
4.9.1.8. Japan Market for Alginate Dressings
4.9.1.9. Japan Market for Antimicrobial Dressings
4.9.1.10. Japan Market for Negative Pressure Wound Therapy Devices
4.9.1.11. Japan Market for Bioengineered Skin and Skin Substitutes
4.9.1.12. Japan Market for Wound Care Growth Factors
4.9.2. Korea
4.9.2.1. Korea Market for Traditional Adhesive Dressings
4.9.2.2. Korea Market for Traditional Gauze Dressings
4.9.2.3. Korea Market for Non-Adherent Dressings
4.9.2.4. Korea Market for Film Dressings
4.9.2.5. Korea Market for Foam Dressings
4.9.2.6. Korea Market for Hydrogel Dressings
4.9.2.7. Korea Market for Hydrocolloid Dressings
4.9.2.8. Korea Market for Alginate Dressings
4.9.2.9. Korea Market for Antimicrobial Dressings
4.9.2.10. Korea Market for Negative Pressure Wound Therapy Devices
4.9.2.11. Korea Market for Bioengineered Skin and Skin Substitutes
4.9.2.12. Korea Market for Wound Care Growth Factors
4.9.3. Rest of Asia/Pacific
4.9.3.1. Rest of Asia/Pacific Market for Traditional Adhesive Dressings
4.9.3.2. Rest of Asia/Pacific Market for Traditional Gauze Dressings
4.9.3.3. Rest of Asia/Pacific Market for Non-Adherent Dressings
4.9.3.4. Rest of Asia/Pacific Market for Film Dressings
4.9.3.5. Rest of Asia/Pacific Market for Foam Dressings
4.9.3.6. Rest of Asia/Pacific Market for Hydrogel Dressings
4.9.3.7. Rest of Asia/Pacific Market for Hydrocolloid Dressings
4.9.3.8. Rest of Asia/Pacific Market for Alginate Dressings
4.9.3.9. Rest of Asia/Pacific Market for Antimicrobial Dressings
4.9.3.10. Rest of Asia/Pacific Market for Negative Pressure Wound Therapy Devices
4.9.3.11. Rest of Asia/Pacific Market for Bioengineered Skin and Skin Substitutes
4.9.3.12. Rest of Asia/Pacific Market for Wound Care Growth Factors
4.9.4. Rest of World
4.9.4.1. Rest of World Market for Traditional Adhesive Dressings
4.9.4.2. Rest of World Market for Traditional Gauze Dressings
4.9.4.3. Rest of World Market for Non-Adherent Dressings
4.9.4.4. Rest of World Market for Film Dressings
4.9.4.5. Rest of World Market for Foam Dressings
4.9.4.6. Rest of World Market for Hydrogel Dressings
4.9.4.7. Rest of World Market for Hydrocolloid Dressings
4.9.4.8. Rest of World Market for Alginate Dressings
4.9.4.9. Rest of World Market for Antimicrobial Dressings
4.9.4.10. Rest of World Market for Negative Pressure Wound Therapy Devices
4.9.4.11. Rest of World Market for Bioengineered Skin and Skin Substitutes
4.9.4.12. Rest of World Market for Wound Care Growth Factors
SECTION 5: COMPANY PROFILES (preliminary, subject to change)
5.1. 3M Health Care
5.2. ACell
5.3. AcryMed Inc.
5.4. Agennix Incorporated
5.5. AGT Sciences Ltd
5.6. Altrika Ltd
5.7. Anika Therapeutics
5.8. Argentum Medical
5.9. Avita Medical
5.10. B. Braun Melsungen AG
5.11. Biopharm GmbH
5.12. Biotime, Inc.
5.13. BSN Medical GmbH
5.14. Cardium Therapeutics
5.15. CliniMed Limited
5.16. Coloplast Group
5.17. Covalon Technologies, Ltd.
5.18. ConvaTec Inc.
5.19. Cook Biotech, Inc.
5.20. Covidien
5.21. Cytogenix
5.22. Cytomedix
5.23. Derma Sciences, Inc.
5.24. DeRoyal Industries Inc.
5.25. Diapulse Corporation of America
5.26. Eqalix, Inc.
5.27. Euroderm AG
5.28. Gentell Inc
5.29. Geritrex Corp.
5.30. Hartmann Group
5.31. Hollister Incorporated
5.32. Imbed Biosciences, Inc.
5.33. Integra LifeSciences, Inc.
5.34. Kendall (Covidien)
5.35. Kinetic Concepts, Inc. (Acelity)
5.36. Kuros Biosurgery AG
5.37. Laboratoires Urgo
5.38. LifeCell Corporation (Acelity)
5.39. Lohmann & Rauscher International GmbH and Co. KG
5.40. Macrocure
5.41. Medline Industries
5.42. Microban International Ltd.
5.43. MicroVas Technologies, Inc
5.44. Mölnlycke Health Care AB
5.45. NovaBay Pharmaceuticals
5.46. Oculus Innovative Sciences
5.47. Organogenesis Inc
5.48. Osiris Therapeutics
5.49. Perry Baromedical
5.50. RXi Pharmaceuticals
5.51. SafeBlood Technologies
5.52. Sanofi Biosurgery (formerly Genzyme Biosurgery)
5.53. SANUWAVE Health, Inc.
5.54. Shire Regenerative Medicine
5.55. Smith & Nephew plc
5.56. Soluble Solutions, LLC
5.57. Spiracur, Inc.
5.58. Systagenix, Inc. (Acelity)
5.59. TEI Biosciences
5.60. Tissue Regeneration Technologies, LLC
5.61. UDL Laboratories
5.62. Uluru, Inc.
5.63. Vomaris Innovations, Inc.

APPENDIX: COMPANY DIRECTORY


Worldwide Wound Management, Forecast to 2024:
Established and Emerging Products, Technologies and Markets
in the Americas, Europe, Asia/Pacific and Rest of World
· 350 pages · 200 Exhibits · 75 Company Profiles · Report #S251 · October 2015
(Click for full report description)

Price: $4,250 (print or PDF; add $200 for both).
Pre-publication $1,000 discount.
Site/Global License also available.

Order online or send us your order form.

 

Management of Acute Stroke

strokeStroke is a life-threatening medical condition characterized by a sudden catastrophic breakdown in the brain-supporting cerebrovascular system and blood supply, which, in many instances, is followed by an irreversible injury to the brain cells and severe neurological impairment or death.

Notwithstanding a remarkable progress in medical science and technology and associated improvements in clinical practices, stroke continues to constitute the major public health problem in the U.S. and overseas. According to the World Health Organization (WHO), OECD, and governments’ data, approximately 12.0 million to 13.0 million people worldwide suffered a stroke in 2014, of which roughly 75% represented first attacks and 25% were qualified as recurrent attacks. Based on the same sources, almost 3.5 million acute stroke episodes result in death within one year globally, which makes it the third most common cause of death, behind diseases of the heart and cancer.

Stroke is also a leading cause of serious and lasting disability and long-term institutionalized care.

Screen Shot 2015-10-01 at 11.04.21 AM

Source: MedMarket Diligence, LLC; Report #C310.

Management of Stroke
Therapeutic management of stroke encompasses a broad scope of prophylactic, palliative and curative treatment modalities that are typically employed in some combinations during the preventive, acute and rehabilitation phases of stroke-related care delivery.

Historically, prevention has been universally regarded as the best form of medicine for dealing with any disease. This old wisdom is especially true in management of acute stroke, which represents a catastrophic event with a largely predetermined clinical progression and outcome that stem from the patient’s preexisting pathologies and can be only marginally altered with available emergent therapies.

Presently, the commonly accepted strategy of primary and secondary stroke prevention is focused on elimination or remedying of the modifiable risk factors that have been shown to create a general predisposition or directly contribute to the onset of acute cerebral ischemia or/and hemorrhage.

Within the context of general population, this strategy is targeting alleviation of certain lifestyle risk factors (such as smoking, obesity, physical inactivity, excessive alcohol consumption, drug abuse, high-fat diet etc.), which could contribute to the development of cardiovascular and other pathologies associated with increased propensity to stroke.

In patient caseloads with preexisting medical conditions (AFib, mechanical prosthetic valves, recent AMI, stoke or TIA, hypertension, diabetes, etc.) which are characterized by a high risk of adverse vascular events potentially leading to stroke, preventive strategy is focused on reducing such risks via a strict control and monitoring of corresponding hemostatic and hemodynamic parameters.

Finally, in persons with diagnosed cerebrovascular pathologies (high grade carotid stenosis, intracranial aneurysms and AVMs) the first line preventive therapy involves their repair or eradication, when technically possible.

The scope of FDA-approved medical and interventional modalities commonly employed in preventive management of stroke includes oral anticoagulation, antiplatelet, and lipid-lowering drug therapies, cerebral aneurysm and AVM repair surgery, carotid endarterectomy, stereotactic radiosurgery, as well as endovascular embolization of intracranial aneurysms and AVMs, carotid artery stenting with embolic protection, left atrial appendage closure, along with  rarely used and likely to be abandoned intracranial stenting.

In contrast to causes-oriented therapies used in stroke prevention, therapeutic modalities employed in the emergent management of acute stroke are focused almost exclusively on patients’ cardiopulmonary and hemodynamic support and ad hoc containment of dangerous  complications and corresponding brain damage associated with stroke.

Among the life-threatening complications that commonly accompany acute cerebral hemorrhage or ischemia are cerebral edema; hydrocephalus; brain stem compression; vasospasm and pulmonary embolism.

Management of the acute complications of stroke relies on a few proven treatment regimens, including (but not limited to):

  • medical therapy and catheter-based ventricular drainage of cerebrospinal fluid to control intracerebral pressure in patients at risk of edema, hydrocephalus or brain stem compression;
  • hypertensive hypervolemic hemodilution (or “triple-H” therapy) to treat ischemic neurological deficit from vasospasm following subarachnoid hemorrhage;
  • subcutaneous anticoagulation (with heparins or heparinoids) for prophylaxis of pulmonary embolism (which accounts for approximately 10% of deaths following stroke); and
  • elective hypothermia for temporary salvaging brain cells from necrosis due to hemorrhagic trauma or acute ischemia (although the latter technique has not been proven efficacious in clinical trials and was not endorsed in the latest, 2007 versions of the AHA hemorrhagic and ischemic stroke guidelines).

The currently available curative treatment options for acute stroke are limited to intravenous t-PA therapy (which has about 30% efficacy and is indicated for a very narrow cohort of eligible ischemic stroke patients only), investigational intra-arterial thrombolytic therapy, transcatheter cerebral thrombectomy (in patients who did not qualify for or failed t-PA therapy), and emergency craniotomy-based or endoscopic removal of stroke-related hematoma (which carries a 50% to 80% risk of mortality and is reserved for rapidly deteriorating young patients with large lobar hemorrhages).

Rehabilitation phase of stroke management relies on general physiotherapeutic techniques commonly used in patients with various physical and neurological disabilities. Prophylactics of recurrent cerebrovascular events in stroke survivors employs medical and interventional regimens referred to in the overview of primary and secondary stroke prevention.


The above is excerpted from, “Emerging Global Market for Neurointerventional Technologies in Stroke, 2014-2019“, published September 2015. For details, see link.

 

Neurointerventional Treatments for Acute Stroke

Stroke is a life-threatening medical condition characterized by a sudden catastrophic breakdown in the brain-supporting cerebrovascular system and blood supply, which, in many instances, is followed by an irreversible injury to the brain cells and severe neurological impairment or death.

Notwithstanding the remarkable progress in medical science and technology and associated improvements in clinical practices, stroke continues to constitute the major public health problem in the U.S. and overseas. According to the World Health Organization (WHO), OECD, and governments’ data, approximately 14 million to 16 million people worldwide  suffered a stroke in 2014, of which roughly 75% of the cases (10.5 – 12.0 million) represented first attacks and 25% (or 3.5 to 4.0 million cases) were qualified as recurrent attacks. Based on the same sources, about 5 million acute stroke episodes result in death within one year globally, which makes it the third most common cause of death, behind diseases of the heart and cancer.

Stroke is also a leading cause of serious and lasting disability and long-term institutionalized care.

Acute stroke – also known as “cerebrovascular accident” – represents a catastrophic manifestation of accumulated circulatory disorders that affect the vasculature of the brain. The two major subdivision of stroke are ischemia or lack of blood and oxygen supply typically resulting from occlusion of cerebral arteries, and hemorrhage or leakage of blood outside the normal cerebral vessel conduit. Both types of stroke cause necrosis of certain groups of brain cells, which leads to irreversible impairment of various neurological functions in about 22% to 25% of patients and death within one year in another 20% to 25% of stroke caseloads.

Acute stroke is managed by a broad scope of prophylactic, palliative and curative treatment regimens that are typically employed in some combinations during the preventive, acute and rehabilitation phases of stroke-related care delivery.

Treatments for acute stroke are the subject of the MedMarket Diligence report #C310, “Emerging Global Market for Neurointerventional Technologies in Stroke, 2014-2019” (see details)

Although sales are low now, one of the fast(er) growing areas in the neurointerventional management of stroke is technologies to provide closure of the left atrial appendage, a vestige of the embryonic left atrium which, for patients with atrial fibrillation, can result in the formation of blood clots in the relatively stagnant pooled blood in the appendage.

Currently, only the Watchman LAA Closure System is approved in the U.S. for left atrial appendage closure, but sales are now projected to grow at 13% annually through 2019. Consequently, the make-up of the market will change considerably from 2014 to 2019:

Screen Shot 2015-09-30 at 6.32.21 PM Screen Shot 2015-09-30 at 6.32.40 PM

Source: MedMarket Diligence, LLC; Report #C310 (published September 2015).

Coverage in 2015 global spine surgery technology report

The MedMarket Diligence report, “Global Market For Medical Device Technologies in Spine Surgery, 2014-2021” (link), is a detailed market and technology assessment and forecast of the products and technologies in the management of diseases and disorders of the spine. The report describes the diseases and disorders of the spine, characterizing the patient populations, their current clinical management, and trends in clinical management as new techniques and technologies are expected to be developed and emerge. The report details the currently available products and technologies, and the manufacturers offering them. The report details the products and technologies under development and markets for each in spine surgery. The report provides the current and forecast market to 2021, by region/country, of procedures and manufacturer revenues.

Technologies covered:

  • Cervical implants
  • Thoracolumbar implants
  • Minimally invasive implants
  • Non-fusion implants
  • Orthobiologics

Geographic market detail:

  • North America — United States, Canada
  • Europe — Germany, France, Spain, Italy, United Kingdom
  • Asia/Pacific — Japan, India, China
  • Central and Latin America
  • Rest of World

Selected (published report includes over 100 companies) list of companies included in the report:

  • Accel Spine
  • Advanced Spine Fixation Systems Inc
  • Aesculap
  • Alphatec Spine (Scient’x Groupe S.A.)
  • Apollo
  • Argomedical AG
  • Baumer S.A.
  • Beijing Montagne Medical Device Co.
  • Biedermann Motech GmbH & Co. KG
  • Biomatlante
  • Biotech GmbH
  • Biotechni
  • BIOTEK – Chetan Meditech Pvt. Ltd
  • Bonovo Orthopedics Inc
  • coLigne AG
  • DePuy Synthes
  • Dieter Marquardt Medizintechnik GmbH
  • ESKA Implants AG
  • Exactech Spine
  • Gerraspine AG
  • Globus Medical
  • Graftys
  • Integra LifeSciences
  • Japan Medical Dynamic Marketing (MDM) INC
  • K2M
  • Kyocera Medical Corporation
  • LDR Medical
  • Medicrea
  • Medtronic Spinal and Biologics
  • Medyssey Spine Ltd (Zimmer)
  • Nakashima Medical Co. Ltd
  • Norer Medical Group (Xinrong Best Medical Instrument Co. Limited)
  • NuVasive
  • Onur MEDiKAL San. Ve Tic Ltd. Sti.
  • Orthopaedic & Spine Development
  • Osteotech
  • Seohancare co. ltd
  • Solco Biomedical
  • Sozhou Kangli
  • Spineart
  • Spinelab Ltd.
  • Stryker Spine
  • Surgival-Grupo Cosias
  • Ulrich GmbH & Co.KG
  • Wright Medical Technology
  • Zimmer Biomet

For complete details on this report, including ordering online, see link.

Technology advances in spine surgery

Manufacturers, clinicians and others focusing on technology advancement in spine surgery are not developing radical innovations, but are making enough incremental improvements in a number of ways that result in growth in the industry.  Most improvements fall into a number of categories:

Screen Shot 2015-09-14 at 7.29.36 AMNew materials technologies: Historically, spinal fusion instrumentation was fabricated from metallic biomaterials, including stainless steel and titanium alloy, because of their strength and fatigue resistance. However, one key drawback of these metallic implants is incompatibility with diagnostic imaging, including MRI and CT scans, which are crucial for visualizing changes to the spinal cord and vital soft tissue structures of the spine. To overcome these issues a variety of new materials such as biocompatible carbon fiber-reinforced (CFR) thermoplastic materials and implantable polyetheretherketone (PEEK) polymers were examined as an alternative to the traditional materials. In addition to biocompatibility, biostability and compatibility with diagnostic imaging, these advanced thermoplastic polymers provide a range of mechanical properties that are well suited to the demanding environment of spinal implants.

Implantable PEEK polymers are available today in an array of formulations, ranging from unfilled grades with varying molecular weight, to image-contrast and carbon fiber-reinforced grades. The first implantable unfilled PEEK polymer–PEEK-OPTIMA was pioneered in 1999 by United Kingdom-based Invibio Biomaterial Solutions. Introduced by Invibio in 2007 to provide controlled visibility through X-ray, CT and MRI technologies, image-contrast grades offer tailored opacity that allows for easier post-operative device placement verification by surgeons and clear assessment of the healing site. Also launched by Invibio in 2007, carbon fiber-reinforced (CFR) grades provide significantly increased strength and stiffness as well as a modulus similar to that of cortical bone.

The CD HORIZON LEGACY PEEK Rod from Medtronic Sofamor Danek and the EXPEDIUM™ PEEK Rod System from DePuy Spine, Inc., are examples, in which these polyetheretherketone (PEEK) polymers are radiolucent and have the ability to reduce scatter and artifact from CT and MRI images. [Picture source: MRI scan via Shutterstock]

Screen Shot 2015-09-14 at 7.24.36 AMComputer aided fixation of spinal implants: A number of proprietary techniques are being developed that provide computer or robotic alignment for the placement of spinal implants. Current research ensures that further developments will occur resulting in more extensive use of computer aided fixation. [Picture source: NIH]

 

percutaneous spineMinimally invasive spine surgery: Manufacturers have development technologies in percutaneous and endoscopic approaches to spine surgery that are having (and will continue to have) a significant impact on patients, clinical practice and the market for spine products.  It is producing all the expected benefits of less invasiveness — less traumatic surgery results in shorter recovery times and better outcomes and opens up spine surgery to more elderly, infirm and other patients for whom traditional spine surgery would be contraindicated. [Image: Handbook of Minimally Invasive and Percutaneous Spine Surgery; allamericanspeakers.com]

 

Screen Shot 2015-09-14 at 7.19.47 AMVariable axis screw systems: A variable axis screw system is a pedicular screw system that features a variable-axis head, which offers a ±25 degrees of angulation. The system also offers a pre-contoured rod. The contoured rod, along with the angulation available in the screw head, alleviates the need for rod contouring. The screw also features a pre-assembled head and double lead thread. The pre-assembled head reduces the steps required for construct assembly and the double lead thread increase the speed of screw insertion and construct assembly so that the overall operative time can be shortened. [Picture source: DePuy Synthes]

Products, technologies, markets, companies and opportunities in the spine surgery industry are the focus of the MedMarket Diligence Report #M540, “Global Market for Medical Device Technologies in Spine Surgery, 2014-2021: Established and Emerging Products, Technologies and Markets in the Americas, Europe, Asia/Pacific and Rest of World.” The next five purchasers of this report (any option) will receive a 25% discount off the published price online by entering the coupon code “spinepricectomy”.

 

The Future (Ours) is in China for Medtech

The importance of China in the global economy became apparent this week, with the ups and downs of its economic state tripping the hair trigger that financial markets have for the huge nation’s growth market.

But in hard terms, what does that mean? As an example, look at spine surgery technology and compare the forecasted growth in sales in China not against the much lower U.S. market but against other high-growth Asia-Pacific markets such as India and Japan. Below is the balance of spine surgery technology sales (encompassing cervical fusion, thoracolumbar implants, minimally invasive spinal fusion, interbody fusion, and orthobiologics) for 2014 and forecasted for 2021 for China, India, and Japan.

Spine Surgery Sales by Country, 2014 & 2021

Screen Shot 2015-09-02 at 2.15.28 PM

Source: MedMarket Diligence, LLC; Report #M540

The relative growth of the market in China is apparent in the change of pie slice sizes, but in hard numbers, Japan’s annual sales in 2021 will be $243 million higher than they were in 2014, but by comparison, China’s 2021 spine surgery sales will be $536 million higher than in 2014.

It is evident that China has made great advances in the quality and quantity of research work and in the development of its medical industry and the provision of healthcare in China. According to the International Monetary Fund, the gross domestic product of China was over $8,230 billion in 2012, making China’s economy the second largest economy in the world. China’s life sciences markets have shown particularly aggressive growth in absolute terms, with sales of the country’s reagents and analytical laboratory instruments showing annual growth in the 15% to 20% range. The Chinese pharmaceutical market is growing at 13.1% through 2020 (Source: McKinsey) and projected growth in the in vitro diagnostics market in China is at 10%.

The overall size and growth in China’s medtech market, including spine surgery, demands a business strategy to gain sales there, since no other market worldwide is expected to drive so much new revenue.

 

 

Global Growth in Spine Surgery

Spine surgery is a relatively mature market — all segments of the spine can be treated, significant share has been garnered by a few major companies, and there are no radically new technologies disrupting current market positions. Yet, trends in the patient population, the active innovation by all companies (see further, below, on market shares per region), the fact that it remains an invasive procedure (even the best minimally invasive approaches have room for improvement), and the accelerating migration of advanced spine technologies to developing non-U.S. markets are all reasons why this “mature” market is anything but stagnant.

Success in applying minimally invasive approaches to spine fusion has opened up procedure volumes for more patients, resulting in the fastest growing area of spine fusion sales. Fusion devices are strong worldwide, with the non-U.S. markets lagging in volumes, but growing at markedly faster rates.

Below is illustrated the segment growth rates for major geographic regions.

Screen Shot 2015-08-27 at 8.39.15 AM

Source: MedMarket Diligence, LLC; Report #M540

The result of the faster non-U.S. growth is that the dominance of U.S. spine surgery markets will decline over the next decade. Below is the change in the share of the global spine surgery market represented by each reach from 2014. For example,  the U.S. market will lose 6% of the global market between 2014 and 2021, while Asia-Pacific will gain roughly 5%.

Screen Shot 2015-08-27 at 7.46.20 AM

Source: MedMarket Diligence, LLC; Report #M540

A two-tier market

The big players (Medtronic, DePuy, Stryker, Zimmer-Biomet) cumulatively control a large swath of the spine surgery market, yet many millions of dollars streams to hungry and innovative smaller spine companies. For example, below is the distribution of market shares for cervical fusion globally.

cervical fusion mkt shares by region

Source: MedMarket Diligence, LLC; Report #M540