Neurovascular Intervention Devices Global Market estimated to be worth $4.2 billion by 2027
Neurovascular Intervention is a specialized field of neuroscience, which involves the treatment of neurological disorders like intracranial aneurysm, ischemic stroke, arteriovenous malformation and carotid stenosis and others by performing minimally invasive procedures. Cerebral aneurysm also called as intracranial aneurysm is a disorder wherein a weak or thin spot on a blood vessel in the brain bulges out and fills with blood which then exerts pressure on the nerves or surrounding brain tissues and may lead to leak or rupture. Ischemic stroke a disorder of blockage or occlusion of cerebral arteries due to blood clots or fatty deposits in the case of atherosclerosis and thereby interrupts the blood flow to the brain. The arteriovenous malformation (AVM), a disorder characterized by an abnormal tangle of vessels in the brain in which one or more arteries are directly connected to one or more veins. The carotid stenosis is caused due to plaque (abnormal thickening of the artery wall) deposits in the carotid arteries present on both the left and right side of the neck and intracranial stenosis is caused due to abnormal plaque deposition within the brain arteries. According to the Center for Disease Control and Prevention (CDC), about 140,000 Americans die due to stroke (the fifth leading cause of death in the U.S.) i.e. 1 out of every 20 deaths. The annual incidence of AVM in the United States is 1.34 per 100,000 people and about 12% of the AVM are estimated to be clinically symptomatic. The worldwide prevalence of cerebral aneurysm is estimated to be 3.2% with a mean age of 50 with a gender ratio of 1:1. Globally, in 2020, approximately 58 million people are leaving with carotid stenosis aged between 30 – 79 years. Some of the causes for carotid stenosis are age (65-75 years), high blood pressure and hypertension.
In modern medicine, minimally invasive interventions are considered as the cornerstone and in this regard over the past decade, there is a gradual shift from complex open surgery to minimally invasive image-guided interventions having lesser complications, better outcomes and lower cost. Such interventions are also being implemented in treating neurovascular diseases. The minimally invasive procedures for neurovascular interventions include artificial embolization, stenting and mechanical thrombectomy. Artificial Embolization devices like coils, liquid embolics, flow diverters and flow disruptors are used to treat intracranial aneurysm and arteriovenous malformations. Stenting procedure is done to treat carotid stenosis, intracranial aneurysm and intracranial stenosis with products like carotid stents and intracranial stents which are implanted into the artery. Neurovascular thrombectomy is a mechanical endovascular treatment done to remove blood clots present in the brain which leads to stroke. Thrombectomy devices are stent retrievers and aspiration devices. Some of the support devices used during coil embolization, stenting and thrombectomy devices are microcatheters, balloon catheters, guidewires, and neurovascular sheath.
According to IQ4I Analysis, Neurovascular Intervention devices global market is expected to reach $4,167.4 million by 2027 growing at a high single digit CAGR from 2020 to 2027. Some of the factors driving the market are increase in incidence and prevalence of neurovascular diseases like cerebral aneurysm, stroke, arteriovenous malformations, and increase in the aging population, technological advancement, acquisitions and favourable reimbursements. Rise in the number of product recalls, lack of skilled professionals, adverse effects of product implant are restraining the growth of the market. The stringent regulatory process and alternative treatments that include surgical clipping, pharmaceutical drugs and stem cell therapies are some of the threats to the market.
Neurovascular Intervention Devices global market is classified based on products, applications and geography. The products segment is further categorized into four sub-segments i.e., Artificial embolization devices (coils, liquid embolics, flow diverter, flow disruptor and others such as embolic spheres and vascular plugs), stents (intracranial and carotid stents), thrombectomy device (stent retriever and aspiration device) and support devices (microcatheter, and others such as guidewires, balloon catheters and sheaths). Artificial embolization device segment holds the largest share in 2020 and is projected to grow at a low single digit CAGR from 2020 to 2027. Among artificial embolization devices, coils segment accounts for the largest revenue in 2020 and it is expected to grow at a low single digit from 2020 to 2027. The Flow Diverter segment is the fastest-growing segment and is projected to grow at a high single digit CAGR from 2020 to 2027 due to increased safety, less recurrence, less radiation exposure, lower cost and shorter recovery time.
Further, based on the type of coil, the bare metal coil segment accounted for the largest revenue in 2020 and coated coils are expected to grow at a low single digit CAGR from 2020 to 2027. The thrombectomy device segment is the fastest-growing segment and is projected to grow at a high single digit CAGR from 2020 to 2027 due to increase in ischemic stroke procedures, technological advancements in stent retrievers and aspiration devices. Under the thrombectomy devices, stent retriever segment contributed to the largest revenue in 2020 and is expected to grow at a high single digit CAGR from 2020 to 2027.
Based on the application, the Neurovascular Intervention Devices global market is segmented into intracranial aneurysm, ischemic stroke, arteriovenous malformation and others. Among application, the intracranial aneurysm segment accounted for the largest share in 2020 and is projected to grow at a low single digit CAGR from 2020 to 2027, due to the increase in incidence and prevalence of intracranial aneurysm and increase in aging population. The Ischemic stroke segment is the fastest-growing segment and is projected to grow at a high single digit CAGR from 2020 to 2027 due to increase in product regulatory approvals for stent retrievers, increase in ischemic stroke patients and procedures, technological advancement in stent retriever and aspiration devices.
The neurovascular intervention market by region is segmented as North America, Europe, Asia-Pacific and the Rest of the world. North America accounts for the largest revenue in 2020 and it is expected to grow at a low single digit CAGR from 2020 to 2027 due to adoption of the technological advancements, increasing incidences of neurovascular diseases, increasing demand for minimally invasive procedures, favorable reimbursements, product launches, skilled personnel and strong product pipeline. The Asia-Pacific region is the fastest-growing region with a high single digit CAGR from 2020 to 2027 due to increasing healthcare awareness, rapid economic growth, large patient pool, reduced cost of neurovascular intervention devices and increase in aging population are creating demand for neurovascular intervention devices in this geography.
Considering the attractiveness of the neurovascular intervention market, several venture capitalists are aggressively investing. Globally, funding is more concentrated on product developments, approvals and also execution of go-to-market strategies. For instance, in August 2020, Wallaby Medical (China) which has its R&D centre in the U.S. has raised more than $20.0 million and the funding will be used for the development of its innovative stroke solution portfolio and regulatory approvals. In addition to external investments, several companies are investing in their R&D activities to develop innovative products. For instance, Silk Road Medical Inc (U.S.) has invested ~19.2% of the total revenue during 2020 (Q2) in R&D, and Balt Extrusion (France) every year is investing ~10.0% of its total revenue in R&D.
According to IQ4I analysis, the average number of coils used per embolization procedure is estimated to be xx units (ASP - $xx). The average number of stent retrievers and aspiration devices used per ischemic stroke procedure is estimated to be xx (ASP - $xx) and xx ($xx) respectively. Globally, the total number of aspiration devices used is estimated to be xx in 2020 and is expected to grow at a low double digit CAGR from 2020 to 2027.
Neurovascular intervention market has a huge opportunity for existing players and new entrants. According to IQ4I analysis, it is estimated that in the U.S. 6.5 million people have unruptured brain aneurysm and the incidence of ruptured aneurysm is about 10 in every 100,000 people per year. Currently, xx intracranial aneurysm procedures are performed in the U.S. annually indicating a penetration rate of xx% with an opportunity of xx% in the market. Globally, ~xx intracranial aneurysm procedures are performed per year and the numbers of procedures are increasing due to the advantage of endovascular coiling over surgical clipping. Similarly, in the U.S. there are about 700,000 people who are living with stroke and about 87% of all strokes are ischemic strokes. Approximately, xx procedures are performed by using stent retrievers and xx procedures are performed by using aspiration devices every year in the U.S. indicating penetration of xx% with an opportunity of xx%.
Some of the companies are coming up with technological advancements to maintain their leadership status in the neurovascular intervention market. For instance, a U.K. based company called Anaconda Biomed has developed a thrombectomy system consisting of a delivery catheter, a funnel-shaped aspiration catheter, and a stent retriever and when used the funnel self-expands and confirms it’s direct to the artery up to 5 mm. The device is also designed to locally arrest flow and thrombus extraction without fragmentation.
The neurovascular intervention companies mainly focus on expansion, new product launches, and acquisitions to be competent and gain access to new technologies both in existing and new market areas. For instance, the currently marketed clot retrievers have an issue with respect to exerting pressure on the vessel which lead to further complications like vessel damage. In this regard, Rapid Medical (Israel) received CE mark approval for its Tigertriever XL stentrievers in July 2020, which is a fully visible clot retriever, and a self-adjustable device used for the treatment of ischemic stroke and the device can retrieve large clots. The Tigertriever XL features a length of 53 mm and an adjustable diameter that can conform to any vessel diameter up to 9 mm. It is delivered via a standard microcatheter with an internal diameter of 0.021 inches. Another added advantage is the presence of mesh which is radiopaque for better visibility inside the vessels and eliminates the need for long-term antiplatelet therapy as required in the case of stent implantation.
Stryker Corporation launched its flow diverter Surpass Evolve Flow Diverter in August 2020 in the U.S. following FDA approval and the device is made up of cobalt-chromium and platinum tungsten braided which is self-expandable and is used for the treatment of wide-neck and fusiform intracranial aneurysms. The same device was launched in Europe in 2019. It is the 64-wire cobalt-chromium flow diverter and the device has the ability to excellent flow diversion and highly flexible implant enhanced vessel wall contact as compared to traditional 48-wire flow diverters.
The Neurovascular Intervention Devices market is consolidated with the top 7 players occupying major share of the market. Some of the major players in the market include Stryker Corporation (U.S.), Medtronic Plc (Ireland), Penumbra, Inc. (U.S.), Terumo Corporation (Micro Vention, Japan), Johnson & Johnson (U.S.), Balt Extrusion (France), Abbott Laboratories (U.S.), Boston Scientific Corporation (U.S.), Silk Road Medical Inc. (U.S.), Microport Scientific Corporation (China), and Acandis GmbH (Germany).