CoAxia's New Path in Stroke

Article preview reprinted from IN VIVO - February 2009

If the 1990s was the decade of the heart, this was supposed to be the decade of the brain. But the tremendous market for stroke device companies has never quite materialized in part because stroke treatment is so elusive.

CoAxia's New Path in Stroke

Article preview reprinted from IN VIVO - February 2009

If the 1990s was the decade of the heart, this was supposed to be the decade of the brain. Having made important technology advances in many areas of cardiovascular medicine and having built enormous business franchises around them, big device companies and small were supposed to be turning their attention to the brain, and specifically stroke, as an area of tremendous opportunity, both clinically and commercially.

Indeed, stroke promised to be an area every bit as large, in terms of both clinical value and financial opportunity, as cardiovascular, with huge unmet clinical needs and technology challenges that, in some cases, follow cardiovascular devices, in others, not. But as we near the second decade of the 21st century, it's pretty clear that stroke has come nowhere near realizing the potential that many saw a decade ago. While there have been novel technologies and some solid successes, stroke has yet to become a device industry subsegment to challenge even interventional cardiology, let alone all of cardiovascular devices.

There are a number of reasons—perhaps most fundamentally, stroke is a much more difficult condition to treat than, say, restenosis, with shorter treatment windows and less obvious standards of care. In turn, that difficulty leads to challenges in areas such as regulatory approval, clinical trials—as the number of failed stroke trials, in both drugs and devices, testifies to compellingly—and, ultimately, market adoption. Thus, notwithstanding the success scattered here and there, there has yet to emerge a large company with a multi-billion-dollar franchise in stroke, while among smaller start-ups, the recent shutting down of Seattle-based Northstar Neuroscience Inc. offers a kind of confirming note to the stroke opportunity, with many industry insiders nodding their heads understandingly.

Still, stroke's enormous potential helps explain why so many start-ups and their investors continue to embrace the opportunity. To succeed, however, may mean taking different paths and unconventional strategies, strategies that differ from those we've seen in the past. At least that's the approach taken by Minneapolis-based CoAxia Inc., developers of a novel re-perfusion device, as it pursues a technology fundamentally different from the kind of clot removers and coils, filters, and nets that have been the staple of stroke start-ups; a clinical and regulatory path that aims to establish the kind of clinical efficacy that most stroke companies stop short of; and a market adoption route that looks beyond the traditional core market of interventional neuroradiologists.

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Companies mentioned in this article:

Boston Scientific Corp.

CoAxia Inc.

Concentric Medical Inc.

Northstar Neuroscience Inc.

ev3 Inc.


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