Hi!
I am not a cardiologist either but the argument for IVUS and IVUS+stent are based on a series of issues which are both clinical and cost-related. First, the clinical data supporting the use of IVUS in conjunction with Angioplasty with or without stents is very compelling indeed. I don't have the mega-trial data in front of me but the rate of reduction in re-stenosis was very significant indeed. Add to that the practical ability, using Cardiometrics technology, to see, post stent deployment, whether there is leakage around the stent, and the clinical arguments are very compelling. On the cost front, reduced re-stenosis and better stent placement reduce the overall cost of the cath lab to the hospital (reduced repeat procedures). Dr Jeffrey Moses of Lennox Hill in New York (a leading interventional Doc), told me that he has calculated that in his (extremely skilled) hands, he has estimated that his Hospital saves about $300 per procedure despite the additional time it takes due to the ivus part and the increased cost due to the cost of the catheter itself.
You will find many skilled Cardiologists who will question the need for IVUS. However, you should think about the number of run of the mill cardiologists for whom IVUS maymake the difference between a clean procedure and messy repeats.
Indeed the world does not need a new stent!!! However, ESON was unable to do a deal with one of the stent companies (still possible though) and, for the most part, a stent is a stent is a stent. As long as their stent is a reasonably good one (and I have not had the time to check this out yet!) the combination with the baloon and the IVUS catheter is a powerful one because it takes away the complaint that it takes too long to carry out the additional IVUS checks. On the cost front, the battle is more of a Hospital Administrator related battle which can be won with the compelling trial results that have been published.
Finally, by freeing itself of Cordis, the company will finally be able to give IVUS a real chance in the market which JNJ, with its Stent problems, was unable to do.
Good Luck everyone |
