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Interventional Neurology – Improving outcome of neurovascular therapy

Tissue plasminogen activators (tPAs) are used for treatment of stroke, aneurysms, stenosis, and vascular malformations. A study published in the New England Journal of Medicine stated that Neurointerventional surgery in addition to IV-administered "clot-busting" tissue plasminogen activator (IV-tPA) therapy is more effective than administering IV-tPA alone for the treatment of stroke.

According to the Brain Aneurysm Foundation (BAF), brain aneurysm accounts for around 500,000 deaths each year. BAF estimates that aneurysm is predominant in the age group of 35–60 years. Moreover, globally around 15 million people suffer a stroke every year, as per stats released by the World Heart Federation. High incidence of stroke and brain aneurysm is contributing to increasing demand for interventional neurology devices. Furthermore, introduction of new techniques such as flow diverter and aspiration are propelling demand for interventional neurology devices. The global Interventional neurology market was valued at US$ 1,694.5 million in 2015 and is expected to expand at a CAGR of 5.3% during the forecast period (2016 – 2024).

Figure 1. Global Interventional Neurology Market Size and Forecast, US$ Million and Y-o-Y Growth (%), 2014-2024

Source: Coherent Market Insights Analysis (2017)

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Innovative neurointerventional devices to cannibalize conventional neurointerventional devices

Coiling is the conventional and more of a gold standard treatment technique for stroke. Increasing complexities in treating patients suffering from recurring stroke incidents is driving demand for advanced technological products. Neurointerventional devices such as Intrasaccular devices, stent retrievers, and flow diverters are expected to gain major traction during the forecast period (2016 – 2024). Intrasaccular devices are expected to be launched in the U.S. and Japan market by 2018. Realizing the benefits of stent retrievers, the American Heart Association and American Stroke Association have issued guidelines, recommending the use of stent retrievers along with tPA for treatment of stroke.

The American Heart Association (AHA) guidelines to treat acute ischemic stroke recommends deploying regional systems for stroke care. Deployment of stent retrievers is recommended at individual stroke centers or within hospitals for stroke care.

Penumbra 3D Revascularization Device (next-generation stroke-treatment device) proved more effective with Penumbra aspiration device according to the studies conducted by Penumbra, Inc. as compared to using the aspiration device alone.

Market players need to address demand-shift in devices and procedural techniques

The global Interventional neurology market is undergoing a demand-shift in terms of products and techniques to treat stroke and aneurysms. For instance, demand for bare platinum coils is growing at a rapid pace as compared to that for coated coils. This is mainly due to high costs of coated coils and their less improved clinical outcomes compared to bare platinum coils. The highly touted International Subarachnoid Aneurysm Trial (ISAT) demonstrated improved clinical outcomes with coils rather than clipping, which resulted in decline in the usage of clips in neurovascular surgery.

Strategic channel distribution agreements among manufacturers to bolster their regional reach

Codman Neuro entered into agreement with InNeuroCo, Inc. for the European distribution rights for intermediate catheters (ICs). Similarly, Covidien (now Medtronic) entered into an exclusive distribution agreement with Pulsar Vascular, Inc. to market and promote PulseRider in Europe, the Middle East, and Africa. PulseRider is a minimally invasive device intended for use (with embolic coils) for treatment of unruptured wide-neck intracranial aneurysms. Such strategic distribution partnership are helping market leaders to expand their global footprint.