Cardiovascular The cardiovascular devices and equipment market has continued to go from strength to strength delivering innovative technologies continuously over the past 10-15 years. The market contains a spectrum of mature, growth and emerging technologies. The largest most mature segment is the cardiac rhythm management (CRM) market where incremental innovation in pacemaker technologies, compliments newer faster growing categories such as cardiac resynchronisation therapy (CRT) and implantable cardiac defibrillators (ICD). Innovation is underpinned by miniaturisation, MRI compatibility, wireless and remote monitoring functionality.
Trans-Aortic Valve Figure 1 - Cardiovascular Market
Segment TOTAL
In interventional cardiology and peripheral vascular segments, minimally invasive surgery (MIS) techniques such as balloon angioplasty (1980) have significantly expanded patient treatment options, replacing the need for invasive surgery for a majority of patients, leading to significantly improved patient outcomes at the same time as reducing treatment costs. Bare metal and drug eluting stents (2002) further improved the efficacy of these treatments, the later being the most transformative example of drug device convergence in the past decade and one where continued innovation will take the form of bioresorbable drug eluting stents in the next few years. One of the most recent addition to the vascular treatment offering has been trans-aortic valves (TAVI), where heart valves can be inserted using a balloon catheter instead of open heart surgery.
Cardiac Rhythm Management Pacemakers Implantable Cardioverter Defibrillator (ICD) Cardiac resynchronization therapy Interventional Cardiology Cardiac Catheters Coronary Stents Cardiac guide wires PFO Closure TAVI Peripheral Vascular Devices Peripheral vascular stents Synthetic surgical grafts Embolic protection device PTA balloon Aortic stent graft Inferior vena cava filter Peripheral guide wires Cardiac Surgery Heart Valves Cardiac Assist Devices Defibrilators Cardiac Monitor ECG IVUS
Global Market ($ Bln)
UK Market (ÂŁ Mill)
Growth CAGR (%)
35.85
515.39
8.4%
4.42 5.53 1.53
63.54 79.42 21.99
5.4% 6.8% 10.0%
1.45 2.08 0.51 0.11 0.34
20.77 29.94 7.33 1.59 4.89
12.0% 4.5% 12.0% 7.0% 23.0%
2.13 0.17 0.26 1.36 1.53 1.02 0.43
30.55 2.44 3.67 19.55 21.99 14.66 6.11
15.0% 7.0% 14.6% 0.0% 12.0% 8.0% 5.6%
0.77 0.85 8.93
11.00 12.22 128.30
0.0% 8.6% 9.9%
2.04 0.43
29.33 6.11
8.1% 11.0%
The application of other MIS therapies based upon technologies such as; grafts, coils, PFO closure, ablation techniques, embolic protection and vulnerable plaque treatments, as well as the convergence between new imaging and in-vitro diagnostic techniques, will serve as a platform for continued incremental and high impact innovation in the future. Recently both the CRM and interventional markets have encountered product safety and efficacy concerns where implantable defibrillator failures, pacemaker recalls and late stent restenosis, are prompting debates about the pace of product change as well as both the pre-market assessment and post market surveillance of these devices. This could serve to inhibit the rate of change and innovation uptake in cardiovascular markets, particularly in the short term. Transformative innovations are emerging in the convergence between traditional technologies and tissue and cell engineering e.g. stem cell therapies. Over time, the promise of bio-engineered organ replacements and cell therapeutics will fundamentally transform the technology profile of this market.