Neuroendovascular devices for treating hemorrhagic and ischemic stroke, while investigational, are gaining attention because of technology advances, intriguing anecdotal evidence of efficacy in a field in which previous drug therapies haven't worked, and positive but controversial emerging clinical data. Companies are pursuing neuro applications of endovascular devices, but despite lots of noise, clinical challenges and uncertain market potential restrain many from investing heavily in the field.

UK investigators' recent decision to call an early halt to enrollment in a major study comparing neurosurgical clipping to endovascular coil treatment of ruptured cerebral aneurysms may signal a significant change of practice habits in a critical area of neurology. The findings, if they're as good as they appear to be, could do to surgical clipping and endovascular coils what the BENESTENT trials of the early 1990s did to promote stenting over balloon angioplasty in patients with coronary artery disease.

While other medical device start-ups are turning away from international distribution, ev3, a new endovascular roll-up founded by a number of former SciMed executives, is preaching the value and importance of an international sales effort and are inviting other device companies to join them.