EVAR Market: Challenges, Innovation and Growth

Article preview from Medtech Insight - April  01, 2011

Endovascular aortic aneurysm repair procedures account for the majority of abdominal aortic aneurysm repairs performed in the US, and total worldwide revenues from aortic endograft systems now exceed $1 billion per year. Many believe that continuing improvements in endograft technology will drive EVAR penetration to 90% or beyond within the next five to 10 years. However, before that milestone is reached, the field must address a number of lingering concerns about long-term endograft stability and viability, and endograft systems will need to evolve to encompass a wider range of patients with challenging anatomy, including small or tortuous access vessels, short or highly angulated aortic necks, and aneurysms that lie close to the renal arteries.

EVAR Market: Challenges, Innovation and Growth

Article preview from Medtech Insight - April  01, 2011

The field of endovascular aortic aneurysm repair (EVAR) has evolved considerably in the two decades since Juan Parodi, MD, and colleagues performed the first EVAR procedure in Argentina back in 1990. After a somewhat rocky start, exemplified by the well-publicized problems with early endograft designs, physicians and manufacturers have worked together diligently to address many of the considerable challenges inherent in placing and maintaining endovascular devices in the inconstant and often hostile aortic anatomy. As a result of this effort, EVAR has evolved into a procedure that is now considered the new standard of care for managing patients with abdominal aortic aneurysms (AAAs). Moreover, ongoing advances in endovascular technologies for repairing thoracic aortic aneurysms (TAAs), although a much smaller market than AAA repair, have created an important less-invasive alternative to risky open surgery in the technically challenging TAA patient population as well.

Today, EVAR procedures account for the majority (over 60%) of AAA repairs performed in the US, and total worldwide revenues from aortic endograft systems now exceed $1 billion per year. Many believe that continuing improvements in endograft technology will drive EVAR penetration to 90% or beyond within the next five to 10 years. However, before that milestone is reached, the field must address a number of lingering concerns about long-term endograft stability and viability, and endograft systems will need to evolve to encompass a wider range of patients with challenging anatomy, including small or tortuous access vessels, short or highly angulated aortic necks, and aneurysms that lie close to the renal arteries.

The ongoing evolution in endovascular therapy for aortic disease has fueled a growing device market, valued at over $1.2 billion worldwide in 2010 (for both AAA and TAA devices) and expected to grow to $1.7 billion by 2015. AAA devices account for the majority of this total, generating about $900 million in sales in 2010, the majority in the US.

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