Angioplasty Catheters: A Staple in Interventional Cardiology

December 10, 2019
Nick Talamantes

Angioplasty catheters remain an essential tool in the interventional cardiologist’s toolkit for the treatment of severe cardiovascular disease.

Cardiovascular disease (CVD) is a serious problem in the US that affects nearly half (48%) of all adults.[1] The statistics are overwhelming with approximately 120 million adults in the US living with CVD. Furthermore, heart disease is the leading cause of death in the US, claiming nearly 700,000 lives every year.[2] While the burden of CVD is significant, advances in pharmaceuticals and medical devices resulted in a substantial decline in CVD-related deaths in the last two decades. According to the American Heart Association, from 2006 to 2016 the age-adjusted death rate attributable to CVD fell 18.6%.[3] The ability to target CVD in its early stages, as well as treat the disease in its severest stages has undoubtedly saved and prolonged many lives.

The modern era interventional cardiology began in the 1960s and 1970s thanks in large part to the cumulative efforts of American vascular radiologist Charles Dotter and German cardiologist Andreas Gruentzig. Angioplasty techniques and technologies have continued to advance since the first angioplasty procedures were performed over half a century ago. The most recent evolution in angioplasty technology is the drug-coated balloon (DCB catheter), which entered the US and European markets within the last five years. In that time, DCBs have amassed a substantial amount of clinical evidence demonstrating their superiority to plain old balloon angioplasty (POBA) catheters.[4][5][6]

There are many factors contributing to the continued stability of the US angioplasty catheters market. However, some headwinds are anticipated to slow adoption of newer angioplasty technologies.

The Forecast

In 2018, Jaunt estimates that the US market for angioplasty catheters was valued at $713.6 million. It is projected that total sales attributable to angioplasty catheters will increase at a compound annual growth rate (CAGR) of 0.9% during the forecast period (2018-23). By 2023, sales of angioplasty catheters are anticipated to reach $747.8 million.

The angioplasty catheters market can be segmented into four product types: DCB, POBA, cutting, and scoring balloon catheters. POBA catheters accounted for the largest share (~52%) of US angioplasty catheter sales in 2018. DCB catheter sales will steadily increase, encroaching on POBA catheter sales. Table 1 presents the 2018 breakdown by product type for angioplasty catheters.

Table 1: Angioplasty Catheters, Share by Catheter Type, 2018

Drivers and Limiters of Growth

Perhaps the largest factor driving growth of angioplasty catheter sales is the growing burden of CVD in the US. Behavioral risk factors (e.g. poor diet, obesity, decreased physical activity) linked to the development of CVD are on the rise. In addition to controllable risk factors, Americans are getting older. Elderly adults are at an elevated risk of developing chronic diseases, such as CVD. Angioplasty procedure volumes continue to steadily, albeit slowly, increase – ensuring a need for balloon catheters.

A significant blow to growth of catheter unit sales was dealt when the transitional pass-through (TPT) payment for DCBs expired in January 2018. The expiration of the additional reimbursement means that the cost of DCBs are now packaged into payments for interventional procedures using angioplasty catheters.[7] As a result of this, POBA and DCB catheters are now reimbursed at the same rate, despite significant differences in the average sale prices for these devices (~$100 vs. ~$1,000). The reimbursement cut is anticipated to negatively impact unit sales of DCBs – particularly in cost-sensitive facilities.

Unfortunately, Americans aren’t getting any healthier. Risk factors strongly associated with the development of CVD continue to rise in the US. Minimally invasive solutions will remain a critical aspect to the management of the most severe forms of CVD for the foreseeable future. New technologies, such as DCBs, are helping to halt further disease progression, alleviate symptoms, and reduce costly repeat revascularizations.

For further information on the angioplasty catheters market, please contact Jaunt at intelligence@jauntup.com.

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Jaunt LLC is a management consulting firm focused on new and emerging medical markets. They solve product-market-fit problems by partnering with companies and investors to define market opportunities and to successfully bridge the gap between technology and its customer. Located in Mesa, AZ, Jaunt services clients across the country. For additional information visit JauntUp.com.


[1] https://www.heart.org/en/news/2019/01/31/cardiovascular-diseases-affect-nearly-half-of-american-adults-statistics-show

[2] https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

[3] https://ahajournals.org/doi/full/10.1161/CIR.0000000000000659

[4] https://www.cochrane.org/CD012510/PVD_drug-eluting-balloon-angioplasty-versus-uncoated-balloon-angioplasty-stenosis-stents-lower-limb

[5] https://www.ncbi.nlm.nih.gov/pubmed/27539695

[6] https://vascularnews.com/pooled-analysis-dcbs-angioplasty/

[7] https://evtoday.com/news/cms-transitional-pass-through-payment-for-drug-coated-balloon-reimbursement-expires

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