Volcano's Second Act

Launched in 2000, Volcano was a promising device start-up in what was seen at the time as one of the most exciting opportunities in cardiovascular medicine to come along in some time: vulnerable plaque. But the practical implications of vulnerable plaque have proved to be elusive, for both cardiologists and product companies. For one thing, while everyone agrees that vulnerable plaque is a fascinating concept, no one yet knows precisely what approach will work best, both in diagnosing the disease and treating it. . As the science of vulnerable plaque evolves, that evolution raises questions about the future relevance of a whole generation of tools to serve interventional cardiology. Thus, companies, like Volcano, that placed early bets on technology based on standard interventional cardiology tools, such as catheter- and guide wire-based devices, have had to hold somewhat contradictory thoughts in their mind at the same time: the benefits of conforming to existing approaches and methodologies in interventional cardiology and the likelihood that vulnerable plaque fundamentally changes certain basic assumptions of that specialty.