CURRENT AND EMERGING U.S. MARKETS FOR MYOCARDIAL REVASCULARIZATION, REPAIR, AND REGENERATION PRODUCTS AND TECHNOLOGIES

348 Pages | 63 Exhibits | 2008 Analysis | Forecasts Through 2011

OVERVIEW:
Heart disease is the leading cause of death in the U.S., killing one person nearly every minute. Coronary heart disease--a group of disorders that result in a reduction in blood flow through the heart--affects more than 15.8 million people in the country, while heart failure has become the main reason that more than 5 million people endure 12 million to 15 million medical visits and 6.5 million to 7.0 million days spent in the hospital each year.

Current and emerging products enabling CABG and PCI myocardial revascularization procedures include automated anastomosis/anastomosis-assist devices, drug-eluting coronary stent systems, and drug-eluting PTCA balloon systems. Sales of these products--along with transmyocardial revascularization systems and anti-atherosclerosis biotherapy products for myocardial revascularization, as well as cell-based and device-based products for myocardial repair/regeneration--are projected to reach an estimated $4,126.5 million in the U.S. in the year 2011.

This dynamic, new report from Medtech Insight includes analyses of products, current and emerging markets, competitors, and opportunities in the fields of myocardial revascularization and repair/regeneration.

Covered topics in this report include anti-atherosclerosis biotherapy products; automated anastomosis/anastomosis-assist procedures and devices; bioabsorbable and biological material-carrying stent systems; cardiac structural support and modification technologies; cardiovascular phototherapy; cell-based and gene-based myocardial tissue repair/regeneration technologies; conventional, less-invasive, and transcatheter coronary artery bypass graft surgery; direct cardiac compression devices; drug-eluting coronary stent systems; drug-eluting PTCA balloon systems; endothelial progenitor cell capture antibody and antisense technologies; heart disease statistics; surgical ventricular restoration devices; therapeutic angiogenesis; and transmyocardial revascularization systems.

TABLE OF CONTENTS:
EXECUTIVE SUMMARY

i. Current and Emerging Markets for Selected Myocardial Revascularization Technologies and Products
	a. Facilitated Anastomosis Devices 
	b. Drug-Eluting Balloon Angioplasty Systems 
	c. Drug-Eluting Stent Systems 
	d. Transmyocardial Revascularization Systems 
	e. Atherosclerosis Management Biotherapy Products  
ii. Current and Emerging Markets for Selected Myocardial Repair/Regeneration Technologies and Products 
	a. Cell-Based Therapies for Myocardial Tissue Repair/Regeneration 
	b. Gene-Based Therapies for Myocardial Tissue Repair/Regeneration 
	c. Cardiac Structural Support/Modification Products 
iii. Combined Market for Selected Current and Emerging Myocardial Revascularization, Repair, and Regeneration Technologies and Products 
iv. Methodology 

Exhibit ES-1: Current and Emerging Myocardial Revascularization Products, Combined Market Forecast, 2007-2011 
Exhibit ES-2: Facilitated Anastomosis Devices Used in Coronary Artery Bypass Graft Surgery, Market Forecast, 2007-2011 
Exhibit ES-3: Drug-Eluting Balloon Angioplasty Systems for Treatment of In-Stent Restenosis, Market Forecast, 2007-2011 
Exhibit ES-4: Coronary Stent Systems, Market Forecast, 2007-2011 
Exhibit ES-5: Transmyocardial Revascularization Products, Market Forecast, 2007-2011 
Exhibit ES-6: Atherosclerosis Management Biotherapy Products, Market Forecast, 2007-2011 
Exhibit ES-7: Current and Emerging Myocardial Repair/Regeneration Products,  Combined Market Forecast, 2007-2011 
Exhibit ES-8: Cell-Based Myocardial Tissue Repair/Regeneration Products, Market Forecast, 2007-2011 
Exhibit ES-9: 2008, Selected Gene-Based Myocardial Tissue Repair/Regeneration  Approaches under Investigation 
Exhibit ES-10: Cardiac Support/Modification Devices, Market Forecast, 2007-2011 
Exhibit ES-11: Current and Emerging Myocardial Revascularization, Repair, and Regeneration Products, Combined Market Forecast, 2007-2011

1. HEART DISEASE/DISORDER OVERVIEW 

1.1 Heart Anatomy and Physiology 
	1.1.1 The Cardiac Conduction System 
	1.1.2 The Heart Valves 
1.2 Selected Heart Diseases/Disorders 
	1.2.1 Coronary Heart Disease 
		1.2.1.1 Atherosclerosis 
		1.2.1.2 Angina Pectoris 
		1.2.1.3 Myocardial Infarction 
	1.2.2 Hypertension 
		1.2.2.1 Systolic and Diastolic Pressures 
		1.2.2.2 Prehypertension 
	1.2.3 Cardiac Dysrhythmia 
		1.2.3.1 Bradycardia 
		1.2.3.2 Sick Sinus Syndrome 
		1.2.3.3 Heart Block 
		1.2.3.4 Atrial Fibrillation 
		1.2.3.5 Tachycardia 
		1.2.3.6 Ventricular Fibrillation 
	1.2.4 Cardiomyopathy 
		1.2.4.1 Dilated Cardiomyopathy 
		1.2.4.2 Hypertrophic Cardiomyopathy 
		1.2.4.3 Restrictive Cardiomyopathy 
	1.2.5 Heart Valve Disorders
		1.2.5.1 Valvular Stenosis 
		1.2.5.2 Valvular Regurgitation 
		1.2.5.3 Valve Prolapse 
	1.2.6 Heart Failure 
		1.2.6.1 Disease Development 
		1.2.6.2 Ejection Fraction Reduction 
		1.2.6.3 Classification/Staging Systems 

Exhibit 1-1: Cross-Section Diagram of the Heart 
Exhibit 1-2: Cross-Section Diagram of the Heart Valves 
Exhibit 1-3: Statistics for Selected Heart Disease Risk Factors 
Exhibit 1-4: Standard Angina Pectoris Classification
Exhibit 1-5: Angina Pectoris, Selected Statistics 
Exhibit 1-6: Myocardial Infarction, Selected Statistics 
Exhibit 1-7: 2007, Percentage of Adults Who Have Been Told They Have High Blood Pressure, by State 
Exhibit 1-8: Hypertension, Selected Statistics 
Exhibit 1-9: Cardiac Dysrhythmia, Selected Statistics 
Exhibit 1-10: Cardiomyopathy, Selected Statistics 
Exhibit 1-11: Heart Valve Disorders, Selected Statistics 
Exhibit 1-12: Summary, New York Heart Association Heart Failure Classification System 
Exhibit 1-13: Summary, American College of Cardiology/American Heart Association Heart Failure Staging System 
Exhibit 1-14: Heart Failure, Selected Statistics 

2. CURRENT AND EMERGING MYOCARDIAL REVASCULARIZATION TECHNOLOGIES 

2.1 Myocardial Revascularization Technologies 
	2.1.1 Coronary Artery Bypass Graft Surgery 
		2.1.1.1 Conventional Coronary Artery Bypass Graft Surgery 
		2.1.1.2 Less Invasive Coronary Artery Bypass Graft Surgery 
			2.1.1.2.1 Minimally Invasive Direct Coronary Artery Bypass 
			2.1.1.2.2 Off-Pump Coronary Artery Bypass 
			2.1.1.2.3 Port Access Coronary Artery Bypass 
			2.1.1.2.4 Hybrid Coronary Artery Bypass 
			2.1.1.2.5 Robotic-Assisted Coronary Artery Bypass 
		2.1.1.3  Transcatheter Coronary Artery Bypass Techniques 
			2.1.1.3.1 Ventriculo-Coronary Artery Bypass 
			2.2.1.3.2 In Situ Coronary Artery Bypass 
		2.1.1.4 Complications/Efficacy 
		2.1.1.5 Caseload Volumes Forecast 
	2.1.2 Facilitated Anastomosis 
		2.1.2.1 Benefits Compared to Conventional Suturing 
		2.1.2.2 Technologies 
		2.1.2.3 Procedure Volumes Forecast 
	2.1.3 Percutaneous Transluminal Coronary Angioplasty 
		2.1.3.1 Approaches 
		2.1.3.2 Applications 
		2.2.3.3 Complications/Efficacy 
		2.1.3.4 Caseload Volumes Forecast 
	2.1.4 Drug-Eluting Balloon Angioplasty 
		2.1.4.1 Clinical Experience with Drug-Eluting Balloons 
			2.1.4.1.1 Studies Involving the Paccocath Drug-Eluting Balloon 
			2.1.4.1.2 Studies Involving the SeQuent Please Drug-Eluting Balloon 
		2.1.4.2 Regulatory Outlook for Drug-Eluting Balloons 
		2.1.4.3 Caseload Volumes Forecast 
	2.1.5 Coronary Stenting 
		2.1.5.1 Stenting with Bare-Metal and Drug-Eluting Devices 
			2.1.5.1.1 Stent Materials 
				2.1.5.1.1.1 Stainless Steel 
				2.1.5.1.1.2 Nitinol 
				2.1.5.1.1.3 Tantalum 
				2.1.5.1.1.4 Cobalt-Chromium Alloys 
			2.1.5.1.2 Stent Coatings/Surfaces and Anti-Restenosis Agents 
				2.1.5.1.2.1 Sirolimus 
				2.1.5.1.2.2 Paclitaxel 
				2.1.5.1.2.3 Everolimus 
				2.1.5.1.2.4 Zotarolimus 
				2.2.5.1.2.5 Tacrolimus 
				2.1.5.1.2.6 Biolimus A9 
				2.1.5.1.2.7 Pimecrolimus 
		2.1.5.2 Stenting with Bioabsorbable Devices 
			2.1.5.2.1 The Igaki-Tamai Bioabsorbable Stent 
			2.1.5.2.2 The Absorbable Metal Stent 
			2.1.5.2.3 The REVA Bioabsorbable Stent 
			2.1.5.2.4 The Bioabsorbable Everolimus-Eluting Stent 
			2.1.5.2.5 Regulatory Outlook 
		2.1.5.3 Stenting with Biological Material-Carrying Devices 
			2.1.5.3.1 Endothelial Progenitor Cell Capture Antibodies 
			2.1.5.3.2 Antisense Agents 
		2.1.5.4 Stent Delivery
		2.1.5.5 Stent Deployment 
		2.1.5.6 Indications 
			2.1.5.6.1 Patients with Small Vessel Disease 
			2.1.5.6.2 Patients with Left Main Disease 
		2.1.5.7 Complications/Efficacy 
			2.1.5.7.1 Repeat Revascularization 
			2.1.5.7.2 Stent Thrombosis 
			2.1.5.7.3 Diabetes and Stenting 
			2.1.5.7.4 Stent-Associated ST-Segment Elevation Myocardial Infarction 
			2.1.5.7.5 Long Lesion Length and Restenosis 
		2.1.5.8 Caseload Volumes Forecast 
	2.1.6 Cardiovascular Phototherapy 
	2.1.7 Therapeutic Angiogenesis 
		2.1.7.1 Growth Factor-Based Therapy 
		2.1.2.2 Stem Cell-/Progenitor-Cell Based Therapy 
	2.1.8 Transmyocardial Revascularization 
		2.1.8.1 Laser-Based Transmyocardial Revascularization 
		2.1.8.2 Indications 
		2.1.8.3 Procedure Volumes Forecast 
2.2 Atherosclerosis Management Biotherapies 
	2.2.1 Pharmacological Approaches to Atherosclerosis Management 
	2.2.2 Caseload Volumes Forecast 

Exhibit 2-1: Advantages and Disadvantages of Conventional and Selected Minimally Invasive  Coronary Artery Bypass Techniques 
Exhibit 2-2: Advantages and Disadvantages of Selected Transcatheter Coronary Artery Bypass Techniques 
Exhibit 2-3: Coronary Artery Bypass Graft Surgery, Caseload Volumes Forecast, 2007-2011
Exhibit 2-4: Facilitated Anastomosis Performed in Conjunction with Coronary Artery Bypass Graft Surgery,  Procedure Volumes Forecast, 2007-2011 
Exhibit 2-5: Percutaneous Transluminal Coronary Angioplasty, Caseload Volumes Forecast, 2007-2011 
Exhibit 2-6: Pooled 24-Month Follow-Up Data for PACCOCATH-ISR I/II Trials
Exhibit 2-7: Six-Month Follow-Up Data for PEPCAD I-SVD Trial 
Exhibit 2-8: Six-Month Follow-Up Data for PEPCAD II-ISR Trial 
Exhibit 2-9: Drug-Eluting Balloon Angioplasty for In-Stent Restenosis, Caseload Volumes Forecast, 2007-2011 
Exhibit 2-10: 2008, Selected Anti-Restenosis Agents 
Exhibit 2-11: 2008, Selected Data from the PROGRESS-AMS and ABSORB Clinical Trials 
Exhibit 2-12: Coronary Stenting, Caseload Volumes Forecast, 2007-2011 
Exhibit 2-13: Growth Factor- and Stem Cell-Based Therapeutic Angiogenesis 
Exhibit 2-14: Transmyocardial Revascularization, Procedure Volumes Forecast, 2007-2011 
Exhibit 2-15: Atherosclerosis Management Biotherapies, Caseload Volumes Forecast, 2007-2011 

3. CURRENT AND EMERGING MYOCARDIAL  REPAIR/REGENERATION TECHNOLOGIES
 
3.1 Cell-Based Myocardial Tissue Repair/Regeneration Technologies 
	3.1.1 Graft Types 
	3.1.2 Cellular Therapy Administration 
	3.1.3 Clinical Experience 
	3.1.4 Procedure Volumes Forecast 
3.2 Gene-Based Myocardial Tissue Repair/Regeneration Technologies 
	3.2.1 Therapeutic Objectives 
	3.2.2 Therapeutic Approaches 
3.3 Cardiac Structural Support and Modification Technologies
	3.3.1 Direct Cardiac Compression 
	3.3.2 Myocardial Support and Remodeling 
	3.3.3 Surgical Ventricular Restoration 
	3.3.4 Procedure Volumes Forecast

Exhibit 3-1: Selected Types of Cells under Investigation for Myocardial Tissue Repair/Regeneration 
Exhibit 3-2: Cell-Based Myocardial Tissue Repair/Regeneration, Procedure Volumes Forecast, 2007-2011 
Exhibit 3-3: Cardiac Support/Modification, Procedure Volumes Forecast, 2007-2011 

4. CURRENT AND EMERGING MARKETS FOR SELECTED  MYOCARDIAL REVASCULARIZATION PRODUCTS 

4.1 Facilitated Anastomosis Devices 
	4.1.1 Products 
	4.1.2 Market Forecast 
	4.1.3 Competitors 
4.2 Drug-Eluting Balloon Angioplasty Systems 
	4.2.1 Products 
	4.2.2 Market Forecast 
	4.2.3 Competitors 
4.3 Drug-Eluting Stent Systems 
	4.3.1 Products 
	4.3.2 Market Forecast 
	4.3.3 Competitors 
4.4 Transmyocardial Revascularization Systems 
	4.4.1 Products 
	4.4.2 Market Forecast 
	4.4.3 Competitors 
4.5 Atherosclerosis Management Biotherapy Products 
	4.5.1 Products 
		4.5.1.1 High-Density Lipoprotein-Boosting Biotherapies 
		4.1.2.2 Inflammatory Process-Targeting Biotherapies 
	4.5.2 Market Forecast 
	4.5.3 Competitors 
4.6 Combined Myocardial Revascularization Products Market Forecast 

Exhibit 4-1: 2008, Selected Anastomosis Devices for Cardiac Applications 
Exhibit 4-2: Facilitated Anastomosis Devices Used in Coronary Artery Bypass Graft Surgery,  Market Forecast, 2007-2011 
Exhibit 4-3: 2007, Market for Facilitated Anastomosis Devices Used in Coronary Artery Bypass Graft Surgery, Share by Supplier 
Exhibit 4-4: Drug-Eluting Balloon Angioplasty Systems for Treatment of In-Stent Restenosis, Market Forecast, 2007-2011 
Exhibit 4-5: 2008, Selected Drug-Eluting Coronary Stents 
Exhibit 4-6: Coronary Stent Systems, Market Forecast, 2007-2011 
Exhibit 4-7: 2007, Drug-Eluting Coronary Stent Systems, Share by Supplier 
Exhibit 4-8: 2008, Selected Transmyocardial Revascularization Products 
Exhibit 4-9: Transmyocardial Revascularization Products, Market Forecast, 2007-2011 
Exhibit 4-10: 2007, Transmyocardial Revascularization Products,  Share by Supplier 
Exhibit 4-11: 2008, Selected Atherosclerosis Management Biotherapies 
Exhibit 4-12: Atherosclerosis Management Biotherapy Products, Market Forecast, 2007-2011 
Exhibit 4-13: Current and Emerging Myocardial Revascularization Products,  Combined Market Forecast, 2007-2011 

5. CURRENT AND EMERGING MARKETS FOR SELECTED MYOCARDIAL REPAIR/REGENERATION PRODUCTS 

5.1 Cell-Based Therapies for Myocardial Tissue Repair/Regeneration 
	5.1.1 Cell Types 
		5.1.1.1 Adipose-Derived Stem Cells 
		5.1.1.2 Skeletal Myoblasts 
		5.1.1.3 Human Adult Mesenchymal Stem Cells
		5.1.1.4 Human Embryonic Stem Cells 
		5.1.1.5 Parthenogenetic Stem Cells 
	5.1.2 Market Forecast
	5.1.3 Competitors 
5.2 Gene-Based Therapies for Myocardial Tissue Repair/Regeneration 
	5.2.1 Gene-Based Approaches under Investigation for the Enhancement of Myocardial Tissue Contractile Function and Prevention of Degenerative Ventricular Remodeling 
		5.2.1.1 AC6 Coding Gene 
		5.2.1.2 BARKct Coding Gene 
		5.2.1.3 SERCA2a and Phospholamban Coding Genes 
		5.2.1.4 S100A1 Coding Gene 
	5.2.2 Gene-Based Approaches under Investigation for the Regeneration of Myocardial Tissue
		5.2.2.1 Myocardin Transcription Factor
		5.2.2.2 p38 MAP Kinase 

	5.2.3 Market Analysis 
5.3 Cardiac Structural Support/Modification Products 
	5.3.1 Direct Cardiac Compression Devices 
	5.3.2 Myocardial Support and Remodeling Devices 
	5.3.3 Surgical Ventricular Restoration Devices 
	5.3.4 Market Forecast 
	5.3.5 Competitors 
5.4 Combined Myocardial Repair/Regeneration Products Market Forecast 

Exhibit 5-1: 2008, Selected Cell-Based Myocardial Tissue Repair/Regeneration Technologies in Development 
Exhibit 5-2: Cell-Based Myocardial Tissue Repair/Regeneration Products, Market Forecast, 2007-2011
Exhibit 5-3: 2008, Selected Gene-Based Myocardial Tissue Repair/Regeneration Approaches under Investigation
Exhibit 5-4: 2008, Selected Surgical Ventricular Restoration Devices 5-46
Exhibit 5-5: Cardiac Support/Modification Devices, Market Forecast, 2007-2011 
Exhibit 5-6: 2007, Cardiac Support/Modification Devices Market,  Share by Supplier 
Exhibit 5-7: Current and Emerging Myocardial Repair/Regeneration Products, Combined Market Forecast, 2007-2011 

6. COMPANY PROFILES 

6.1 Abbott Laboratories 
6.2 Advanced Cell Technology, Inc. 
6.3 Bioheart, Inc. 
6.4 BIOTRONIK GmbH & Company KG 
6.5 Boston Scientific Corporation 
6.6 B. Braun Melsungen AG 
6.7 Cardica, Inc.
6.8 Cardiogenesis Corporation 
6.9 Chase Medical, Inc. 
6.10 Cordis Corporation/Johnson & Johnson 
6.11 Cytori Therapeutics, Inc. 
6.12 Esperion Therapeutics, Inc. 
6.13 Geron Corporation 
6.14 GlaxoSmithKline PLC 
6.15 Medtronic, Inc.
6.16 Merck & Company, Inc. 
6.17 OrbusNeich 
6.18 Osiris Therapeutics, Inc. 
6.19 PLC Medical Systems, Inc. 
6.20 Roche Group 

APPENDIX:  COMPANY LISTING



COMPANIES COVERED:

  1. Abbott Laboratories
  2. Abbott Vascular
  3. Acorn Cardiovascular, Inc.
  4. Advanced Cell Technology, Inc.
  5. Angioblast Systems, Inc.
  6. AstraZeneca PLC
  7. AtheroGenics, Inc.
  8. ATS Medical
  9. AVANT Immunotherapeutics, Inc.
  10. AVI BioPharma, Inc.
  11. Bavaria Medizin Technologie GmbH
  12. Bioheart, Inc.
  13. Biosensors International Group LTD
  14. Biosense Webster, Inc.
  15. BIOTRONIK GmbH & Company KG
  16. Boston Scientific Corporation
  17. B. Braun Melsungen AG
  18. Bristol-Myers Squibb Company
  19. Cardica, Inc.
  20. CardioVascular BioTherapeutics, Inc.
  21. Cardiogenesis Corporation
  22. Cardium Therapeutics, Inc.
  23. Chase Medical, Inc.
  24. Celladon Corporation
  25. Cellartis AB
  26. Celldex Therapeutics, Inc.
  27. Cellerix SA
  28. Cellular Dynamics International, Inc.
  29. Cordis Corporation
  30. CordynaMic
  31. Cytori Therapeutics, Inc.
  32. deCODE Genetics
  33. DISA Vascular LTD
  34. Esperion Therapeutics, Inc.
  35. Eurocor GmbH
  36. Genzyme Corporation
  37. Geron Bio-Med LTD
  38. Geron Corporation
  39. GlaxoSmithKline PLC
  40. Human Genome Sciences, Inc.
  41. InSitu Technologies, Inc.
  42. International Stem Cell Corporation
  43. Intuitive Surgical, Inc.
  44. Johnson & Johnson
  45. MAQUET Cardiovascular
  46. Medtronic, Inc.
  47. Merck & Company, Inc.
  48. Mesoblast LTD
  49. MIV Therapeutics, Inc.
  50. MYOSIX SA
  51. Mytogen, Inc.
  52. Novadaq Technologies, Inc.
  53. Novare Surgical Systems, Inc.
  54. Novartis Pharmaceutical Corporation
  55. Novocell, Inc.
  56. OncoMed Pharmaceuticals, Inc.
  57. OrbusNeich
  58. Osiris Therapeutics, Inc.
  59. Paracor Medical, Inc.
  60. Pfizer, Inc.
  61. PLC Medical Systems, Inc.
  62. Relisys Medical Devices LTD
  63. REVA Medical, Inc.
  64. Roche Group
  65. Sahajanand Medical Technologies LTD
  66. sanofi-aventis
  67. Somanetics Corporation
  68. Sorin Biomedica
  69. SurModics, Inc.
  70. Targeted Genetics Corporation
  71. Terumo Corporation
  72. TissueGen, Inc.
  73. Tissue Genesis, Inc.
  74. Translumina GmbH
  75. Vascular Concepts Group
  76. Volcano Corporation
  77. Wyeth Pharmaceuticals
  78. XTENT, Inc.
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