COURAGE Trial: Bad News Again for Stents at ACC, Or Is It?
For the second year in a row, results from a clinical trial announced at the annual American College of Cardiology (ACC) conference appeared to be bad news for coronary stents. The outcomes from the COURAGE trial, announced at this year's ACC meeting in New Orleans at the end of March, found that angioplasty with stenting did not reduce the risk of major adverse cardiovascular events when added to optimal medical therapy.
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In the world of medical devices, there are companies that begin by developing one thing and wind up doing something altogether different. But few have taken the kind of path that Volcano has. Once a high-flying dynamo with dreams of striking it big in vulnerable plaque, Volcano has seen those dreams all but disappear. But instead of crashing to earth Icarus-like, Volcano is soaring, this time on the back of the unlikeliest of technologies, intravascular ultrasound (IVUS), and a business built on a number of opportunistic commercial moves made while still forging ahead in vulnerable plaque. Volcano's new vision: that of a therapy-guidance leader, a "theranostic company," that helps physicians understand whom, how, and when best to treat.
A few companies with the foresight, even during the heyday of drug-eluting stents, to begin developing drug-eluting balloons are well-positioned to capture one of the next enormous growth markets in cardiology, according to "Current and Emerging US Markets for Myocardial Revascularization, Repair, and Regeneration Products and Technologies," a report recently published by the Medtech Insight division of FDC-Windhover.
The real story that came out of this year's Transcatheter Cardiovascular Therapeutics (TCT) meeting held in October in Washington, DC, is not the news per se regarding specific clinical trial results or new device technologies. Instead, it is the story behind the news. Interventional cardiology has been built on the back of evidence-based medicine. That methodology, however, has come under attack in the last year.