Aortic stent grafts are most commonly used to reinforce a weak spot in an artery, which is known as an aneurysm. The stent grafts are designed to seal tightly with the patients native artery above and below the aneurysm, and are used to treat abdominal aortic aneurysms as well as thoracic aortic aneurysms.

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Aortic aneurysms, as opposed to aneurysms found elsewhere in the body, are potentially very serious, as a burst aorta results in massive internal bleeding that can be fatal unless treated rapidly by an experienced emergency medical team. Since their introduction in patients in 1991, aortic stent graft devices have gained wide acceptance and availability, with their adoption fueled in great part by advances in stent-graft design and by a variety of devices for various anatomic features. Over time, these devices have gained traction for use in patients with ruptured aneurysms because they are minimally invasive and have shorter recovery times.

This report focuses on the aortic stent graft implant market for abdominal and thoracic aneurysms.

The abdominal aortic market comprises about 80-90% of the market, with the niche market being the thoracic one.

The thoracic aneurysm repair market is still a young market where there is a strong pipeline of products from both the large manufacturers and small emerging players. For most manufacturers, following the successful launch of an AAA product, the thoracic stent graft segment presents the opportunity with the most unmet needs for pursuit.

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The 10MM are covered and forecast in this report, which provides the unmet needs, future adoption, and Compound Annual Growth Rates (CAGRs) in both the abdominal stent graft and thoracic stent graft markets. Global Data analysis demonstrates this market to be a young and growing market, subject to rapid technological development and with much room for product adoption. The global aortic stent grafts market is determined for the 10 countries with insight into the competitive landscape, the marketed and pipeline products, the current and emerging players and market analysis.

The report identifies the unmet needs in the market while providing an understanding of physicians perceptions and decision-making processes in using and evaluating the adoption of the stent graft.

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What Physicians Think quotes provide a unique insight into how healthcare professionals are reacting to events within the industry, and what their responses could mean for industry strategists. In this report you will understand the perceptions of leading Vascular Surgeons from around the world. This information is essential for all strategic decision makers in every organization allowing them to act on high quality information.

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1 Table of Contents 8

1.1 List of Tables 15

1.2 List of Figures 21

2 Introduction 23

2.1 Catalyst 24

2.2 Related Reports 25

2.3 Upcoming Related Reports 25

3 Industry Overview 26

3.1 Overview 26

3.2 Indications 27

3.2.1 Aortic Abdominal Aneurysm 27

3.2.2 Thoracic Aortic Aneurysm 28

3.2.3 Aortic Dissection 29

3.3 Clinical Outcomes 30

3.3.1 Lifestyle Changes 31

3.3.2 Medication 32

3.3.3 Open Surgery 32

3.3.4 Endovascular Repair 33

3.4 Procedure Trends 35

3.4.1 Global 35

3.4.2 US 38

3.4.3 EU 40

3.4.4 Asia-Pacific 42

3.4.5 South America 45

3.5 Market Access 47

3.5.1 Adoption 49

3.5.2 Regulation 56

3.5.3 Reimbursement 62

3.6 Regulatory Issues/Recalls 75

3.6.1 Anaconda Back on the Market in March 2014 after a Voluntary Recall of Anaconda by Vascutek 75

3.6.2 Terminated FDA’s Class II Recall of TriVascular’s Ovation Prime in April 2014 75

3.7 Mergers, Deals, and Acquisitions 75

3.7.1 Medtronic Acquires Covidien 75

3.7.2 TriVascular Launches $100m Initial Public Offering 76

3.7.3 Lombard Medical Pursues US Initial Public Offering 76

3.7.4 TriVascular Raises $40m in Series E Financing 76

3.7.5 LifeTech Scientific Creates Partnership with Medtronic 76

3.7.6 LeMaitre Vascular Terminates Distribution Agreement with Endologix 77

3.7.7 Jotec Enters Licensing Agreement with Hydromer 77

3.7.8 Endologix Public Offering of Notes 77

3.7.9 Aptus Endosystems Secures Financing 77

3.7.10 Altura Medical Secures Financing 77

3.7.11 Endologix Acquires Nellix Endovascular 78

3.8 Economic Impact 78

3.8.1 Economic Impact of Aneurysms 78

3.8.2 Treatment Costs of Aortic Aneurysms 79

4 Unmet Needs 81

4.1 Addressing the Complications 81

4.1.1 Endoleaks 81

4.1.2 Ischemic Complications 82

4.1.3 Limb Thrombosis 83

4.1.4 Infection 83

4.1.5 Paraplegia in Thoracic Aortic Aneurysm 83

4.2 The Seal and Landing Zone 84

4.3 Short Neck 85

4.4 Cost Containment 86

4.5 More Low Profile Systems 87

4.6 Customized Fenestrated Stent Grafts 88

4.7 Multi-Branch Stent Grafts 89

4.8 Thoracic Endovascular Aneurysm Repair Unmet Needs 90

4.9 Long-Term Clinical Data 91

5 Market Opportunity Analysis 92

5.1 Emerging Markets 92

5.2 Thoracic Aortic Disease Market 93

5.3 Addition of Physician Training Programs 94

5.4 Disruptive Technologies 95

5.5 Minimally Invasive Trend 96

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