STXS - DB report pulled off Yahoo (cannot verify accuracy)
Deutche Bank/Alex Brown Report (3 Ratings) 27-Sep-07 10:20 am
here's the full report:
Stereotaxis (Buy, CP: $13.21, TP: $16.00, STXS.OQ, Tao Levy)
Hospital Supplies & Medical Devices
Remote navigation: the latest on Niobe and Sensei
We recently touched base with a leading electrophysiologist at The Cleveland
Clinic who has significant experience with both the Stereotaxis Niobe system and Hansen Medical's (HNSN, not rated) Sensei (post FDA approval). THE VIEW ON NIOBE: At Cleveland Clinic, the Niobe is being used virtually 100% of the time and there is discussion that the hospital could purchase two
additional systems when the institution completes the construction of a new cardiac building. Previously, we had heard that they were interested in one more, but
the idea that they might purchase two bodes well for the future utility of the system. The major criticism he has of the technology is the lack of an irrigated catheter, which should be forthcoming by the end of 2007
or early 2008. His experience with an irrigated magnetic catheter in a pig model yielded very positive results with improved maneuverability versus the 8mm and 4mm catheters, which bodes well for Stereotaxis down the road. THE VIEW ON SENSEI: Regarding the Sensei, we learned of several issues which have surfaced including several adverse events. The biggest difficulty appears to be that the system does not handle well in the right atrium where atrial tachycardia
and atrial flutter post AFib are treated. The issue may be related to the mechanics of the catheter which prevent it from maneuvering well in that region of the heart (or could be related to a learning curve). In addition, there have been problems related to vascular injury in the retroperitoneal space, an area of the abdominal cavity, caused by the large sheath (14F) and resulted in patient bleeding. In one case, the procedure had to be stopped. In addition, the Intellisense feature,
which allows a clinician to know the amount of pressure being placed on the cardiac wall, does not seem to be overly reliable and not that frequently used. For example, if the ablation catheter is not perpendicular, the reading
may be incorrect. Unfortunately, in some cases, it is difficult for the operator to know whether the catheter is perpendicular. At the Cleveland Clinic, they use an ultrasound catheter with the Sensei in every procedure in
order to see the position of the catheter on the tissue to further determine the amount of pressure on the cardiac wall; however, in some cases even with the ultrasound catheter, this cannot be determined. Given these issues, we believe that upon wider spread use of the Sensei, it is possible that adverse events increase rapidly, especially when used by less skilled electrophysiologists than found at Cleveland Clinic. BOTTOM LINE: While we do not believe the initial difficulties experienced on Hansen's Sensei to benefit Stereotaxis' business near-term, longer-term, unless they are resolved, will be a net positive for STXS, especially upon FDA approval of the irrigated catheter (4Q07/1Q08). |
