Stents Branch Out and Return to Their Start-Up Roots

While innovation in interventional cardiology has historically come from small companies, industry consolidation and a flattening of technology has, in recent years, given the edge to large suppliers, which now all but dominate the field. Drug-eluting stents, which require huge resource expenditures, seem to epitomize this shift of interventional cardiology to a big-company game. But in at least one highly promising area--bifurcated lesions--small companies continue to have the edge in developing a device to effectively treat this significant unmet clinical need. Encouraging for these smaller companies is the fact that the critical technology hurdle in treating bifurcations is primarily mechanical, not biological, enabling new approaches that can potentially complement, not compete against, drug-coated stents.