Drug-coated balloons will be used more often in treating periperal artery disease in the U.S. at the expense of standard angioplasty and peripheral stents.
|The IN.PACT Admiral drug-coated balloon is inflated and inserted into the blocked artery|
U.S. physicians will increasingly adopt drug-coated balloons to treat peripheral artery disease at the expense of percutaneous transluminal angioplasty and peripheral stents, according to a survey conducted by RBC Capital Markets.
The survey involved 50 vascular surgeons, interventional cardiologists and interventional radiologists. Those physicians said that in 2017, use of drug-coated balloons would represent about 22% of the cases treatment from 12% currently.
"This is incrementally positive for Medtronic and Bard, since they are the only two players currently in the DCB market, with Admiral and Lutonix, respectively," wrote Glenn Novarro, an analyst with RBC Capital Markets, in a research note last week.
Other than Medtronic and Bard, Spectranetics is also expected to gain share. That company has developed the Stellarex DCB that is approved in Europe, but not in the U.S.
Drug coated balloons are coated externally with the drug paclitaxel that has the potential to help prevent the arteries from being blocked again after the procedure. During the procedure, the blocked artery is first partially opened with a traditional angioplasty balloon sans the drug. Thereafter, DCB is used to fully open the narrowed portion of the artery. This allows the drug to be applied to the artery wall.
In the RBC survey, physicians responded that Medtronic's DCB — IN.PACT Admiral — holds a slight edge over Bard's DCB - Lutonix - in terms of share. Admiral commands 52% and Lutonix 48%.
That is not surprising given that Admiral has shown that it is clinically more effective than Lutonix in treating peripheral artery disease.
The Admiral balloon had lower repeat procedures required to improve blood flow - called clinically-driven target lesion revascularization rate - of just 9.1% of total patients compared with the much higher CD-TLR of 28.3% of patients who underwent standard balloon angioplasty. In other words 91% of patients treated with Medtronic's DCB didn't have to undergo a repeat procedure - known freedom from TLR - whereas it was 82% for C.R. Bard's Lutonix DCB at two years.
The primary patency rate which shows restoration of blood flow through the treated artery was 78.9% in the Medtronic DCB group, compared to only 50.1% in the group that underwent angioplasty without any balloons. C.R. Bard's Lutonix DCB had a primary patency rate of 58.6%.
Not surprisingly, the physicians surveyed responed that they believe Medtronic will gain a 2 percentage points annually in their practices.
Arundhati Parmar is senior editor at MD+DI. Reach her at [email protected] and on Twitter @aparmarbb
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