Boston Scientific strengthened its product portfolio with two acquisitions in the past quarter. Boston has completed its acquisition of Advanced Stent Technologies (AST) for an initial payment of $120 million payable in Boston Scientific stock, plus the possibility of future contingent payments. AST has been developing stent and stent delivery systems specifically designed to address the anatomical needs of coronary artery disease in bifurcated vessels. A significant percentage of coronary artery disease, as much as 30%, occurs when a single bifurcates into two vessels. Bifurcations have been difficult to treat with conventional stents since those stents are designed to support a single cylinder, not a cylinder with an offshoot in the middle.
Interventional cardiologists have tried a number of techniques to modify existing stents in an effort to get them to conform to the anatomy of a bifurcation. Historically, the outcomes for treating bifurcations, with bare-metal and drug-eluting stents, have been less successful than those for standard lesions.
AST has experimented with several different stent designs and over time has developed a design called the Petal. This design incorporates stent features at both ends with the Petal feature in the middle. The Petal bifurcation stent is designed to expand into the side branch, permitting blood to flow into both branches of the bifurcation and providing support at the branch. When combined with Boston Scientific's paclitaxel-eluting stent technology, the Petal device will also deliver drugs to the bifurcated vessel, which should also improve outcomes.
Separately, Boston has acquired TriVascular, Inc., exercising an exclusive option to acquire the company obtained in December 2002. Terms of the acquisition were not disclosed.
TriVascular's innovative AAA stent-graft design reduces the size of the TriVascular device by replacing much of the metal stent assembly with a polymer that is injected into channels within the stent-graft during the procedure. The resulting device can be delivered into the patient through a narrower delivery system. These characteristics are intended to provide a treatment option for a broad range of patients, including those patients with unusual anatomies such as those who harbor narrow blood vessels and atypical sized aortic necks. These types of patients typically are not candidates for currently available stent-grafts. TriVascular successfully completed its first human implant of its AAA stent-graft in 2002 and clinical experience to date on 78 patients has shown promising results in Phase I studies. The US Phase II pivotal trial is planned to begin this year, and commercialisation within the US is expected in 2008. CE mark is also expected this year. In addition, TriVascular is in the early stages of developing a thoracic aortic stent-graft, built on the same platform as the AAA stent-graft.
The market for AAA stent-grafts was approximately $370 million in 2004. However, market evolution and penetration has been limited. Of the 1.7 million patients in the US estimated to have aortic aneurysmal disease, only 360,000 patients (21%) are diagnosed and just 60,000 (3.5%) receive some form of treatment. Many believe the market could triple by 2008 with the introduction of a device that offers less-invasive placement and the improved durability required to decrease the incidence of re-intervention.
Non-surgical endovascular stent-grafts currently account for approximately one third of all aortic repair procedures performed. With the recent acquisition, Boston plans to increase its share in the overall market for AAA devices.
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