TL/DR –
The intravascular lithotripsy (IVL) market is growing as medical device companies develop systems for calcified coronary and peripheral lesions; however, uneven hospital adoption is a barrier to this growth. Coronary IVL use in the US increased to 7.8% of percutaneous coronary interventions in late 2022, up from 0% in 2021, while overall calcium modification use rose to 16% from 11.1% over the same period. Despite this increase, adoption of IVL technology varies widely, with hospitals determining the technology’s role based on workflow, consistency between operators, purchasing decisions, and how IVL systems fit within existing cath lab portfolios.
Atherectomy Usage Drops as Intravascular Lithotripsy Market Expands
Despite uneven hospital adoption, the intravascular lithotripsy (IVL) market is experiencing growth. Medical-device companies are innovating systems for calcified coronary and peripheral lesions, reveals GlobalData.
Uptick in Coronary IVL Use in the US
Coronary IVL use in the US experienced a surge to 7.8% of percutaneous coronary interventions (PCIs) in late 2022, from 0% in 2021. This is based on an analysis of 2.7 million PCIs in the CathPCI Registry. Simultaneously, overall calcium modification use saw an increase to 16% from 11.1%, while atherectomy use dipped to 4.4% from 5.4%.
IVL Enhancing Patient Treatment Pool
“IVL is broadening the scope of patients who receive treatment. It does not merely shift share between devices,” notes Ashley Clarke, Senior Medical Analyst at GlobalData. IVL is finding use alongside atherectomy and specialty balloons rather than replacing them. Hospitals will likely determine the technology’s role based on workflow suitability, operator consistency, purchase decisions, and how IVL systems blend with existing cath lab portfolios.
Rising Competition in the IVL Market
As companies create systems with higher pulse counts, varying energy platforms, and lesser equipment requirements, competition intensifies. IVL will likely follow a path similar to interventional cardiology’s multi-faceted approach to treating calcified lesions. Factors that will shape IVL’s utilization and purchasing include workflow fit, the capacity to standardize outcomes across operators, and the technology’s compatibility with existing cath lab portfolios.
Growth Opportunity for IVL Companies in the Peripheral Segment
IVL companies could find their next growth opportunity in the peripheral segment, even though outcomes data is still under development. For successful adoption, companies must combine clinical evidence with training and implementation support, especially in peripheral artery disease, where hospital workflows can differ. Clarke indicates that companies providing credible evidence along with training and implementation support are more likely to secure lasting adoption, particularly in sectors where workflows may be more variable.
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