Among the various neurointerventional devices that have been developed for challenging indications, such as intracranial aneurysms and acute ischemic stroke (AIS), flow diverters and stent retrievers have shown particular promise as viable treatment alternatives, although they have yet to prove their long-term effectiveness, says an analyst with research and consulting firm GlobalData.

Priya Madhavan, MS, GlobalData's Analyst covering Medical Devices, states that following the success of stent-based technologies in the interventional cardiology and endovascular therapy fields, flow diverters, such as the Pipeline Embolization Device, and stent retrievers, including Solitaire, have attracted attention from the neurointerventional community.

Madhavan says: “Flow diversion techniques can be employed to treat complex intracranial aneurysms, including wide-neck, large and giant aneurysms, which remain difficult to treat due to high recanalization and recurrence rates. Flow diversion devices aim to reduce the need for inserting multiple coils and using stent- and balloon-assisted devices.

“However, while this is a promising technique for otherwise untreatable aneurysms, we do not believe that the technology will replace embolic coils. We predict the flow diverter market to reach revenues of $200 million by 2020, which is more than two-fold lower than the embolic coil market.”

Meanwhile, the development of novel mechanical thrombectomy devices, such as stent retrievers, has been fuelled by the limitations of intravenous thrombolysis with recombinant tissue plasminogen activator.

Stent retrievers provide a one-step technique for device deployment and clot retrieval, which increases ease of use and patient safety. With the development of innovative stent-retriever technologies, market sales of mechanical thrombectomy devices, such as the MERCI clot retrieval system, have decreased significantly. GlobalData forecasts the stent retriever market to achieve revenues of over $50 million by 2020 and gain the largest share in the mechanical thrombectomy devices arena.

Madhavan concludes: “Despite the enthusiasm elicited by these stent-based devices, we have a long way to go before they become the standard treatment for neurovascular applications, as we first need to see long-term, robust data demonstrating their clinical effectiveness. Performance and quality standards also need to be established and treatment costs reduced, to enable widespread adoption of these devices in the future.”