Lately, the intravascular imaging catheter and pressure guidewire markets have been attracting the majority of attention in the interventional cardiology (IC) device world. As concerns about overstenting plague the market, these catheters and guidewires represent one of the few remaining areas of growth. But there might be one more area worth considering: chronic total occlusion (CTO) treatment.

CTOs which are cases where plaque blocks more than 99% of the vessel have traditionally been treated using bypass surgery rather than minimally invasive techniques such as stenting. Percutaneous coronary interventions (PCIs) for CTOs are considered highly risky and beyond the scope of expertise of your average cardiologist. However, things might be turning around now. More studies are showing that PCIs are becoming an effective treatment method for CTOs, largely as a result of major leaps ahead in drug-eluting stent (DES) technology as well as the development of guidewires and microcatheters that make CTOs easier to cross safely. And let's face it: PCIs are cheaper on the health care system compared to a full-on bypass surgery, and budgetary pressures are something that cardiologists are more than familiar with.

Major IC device manufacturers have embraced CTO technology as one of the last frontiers in the IC world. At the recent American College of Cardiology (ACC) conference, a lot of the spotlight was on CTO-PCI, as the procedure is referred to in the industry. For example, Abbott was showcasing its FDA approval for CTO crossing for its HT Progress and Pilot guidewires as well as its NC Trek balloon. Volcano has also recently announced FDA approval for its Valet microcatheter, designed to be used in CTO treatments. Boston Scientific recently acquired BridgePoint Medical, which has focused on devices designed for CTO treatment.
So overall, the IC device market is still slowing, yes. But I think as this post and our earlier post prove, there are definitely still growth opportunities if you're looking in the right places.

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