The newer approaching to repairing these aneurysms is on the illustrations on the left. It’s a catheter based therapy, where through a catheter we have a device that basically realigns the inside, the aorta from the inside out. And basically what we want to do is take the blood flow off of that aneurysm and prevent it from a rupture and now we can do that through a catheter based therapy.In the United States, about 60% of the EVAR procedures are now done catheter based like you see on the left whereas 40% open repair. And I’ll talk to you about the limitations with EVAR today and how that’s likely to change in the years ahead. This is the current market for Endovascular grafts, what we call intra-renal or devices below the renal arteries. The importance of that, I’ll make more clear as we go through this. It’s a $1 billion market. Different growth rates in different market segments in the US, it’s growing 6% to 8% in Europe, closer to 5% to 6% in the outside. And the other more emerging markets closer to 10% to 12%. Blended growth rate of around 8% globally, that’s procedure growth, you can see the average selling prices. These are expensive devices. We have a rep for a clinical specialist in every procedure, so it’s a high touch clinically sophisticated type of an implant. Primary physician that does these is vascular surgeons, also some interventional cardiologists and some cardiac and cardiovascular physicians as well. This is the competitive landscape, what’s unique about these devices is the evolution, really all of the devices over on the right, the three proximal fixation that was kind of the earlier, the first generation devices. They are grafts with stents basically stone to them. They are implanted through a catheter and deployed and then at the top, there are I don’t have a pointer, but there is, hooks or barbs that attach and anchor into the vessel valve. And that’s what holds the device in place, just below the renal arteries which you can see coming off of this middle picture with Medtronic.
So, these stents that you see right here, they attach and then, the limbs are added to the device from the bottom. So, it’s a top down type of a device. The limitation with that type of an approach is if you lose your purchase and the aortic neck and you slip, then the device is no longer excluding the aneurysm and that’s a type (ph) mode we call a migration.You can also get Endoleaks in this aneurysm picture you see here in the center. Sometimes you can get leaks from the top, sometimes from the bottom and actually even from the sides or side branches. So, you could effectively exclude an aneurysm but still get an Endoleak and I’ll talk about how we address that later. Our device is the furnished (ph) over on the left and you can see it’s very different. And instead of using hooks and barbs to attach ourselves into the aortic valve, we actually set the device right on that saddle, where the aorta splits off and goes down into your legs that’s our fixation. So, we don’t fix mechanically per say, but we actually set and using the patients on anatomy. And of course there is nowhere for the device to go. So, migration is not a failure mode with this device. Early on, yet that being a very intuitive approach obviously, the device has always go very clinical – good clinical results which I’ll show you in a minute. But it was a more difficult system to use. So, early in the company’s evolution, it had a limited range of sizes in a more cumbersome delivery system and that’s what we’ve really worked on over the last few years. Made the device a lot easier to use, built out the range or sizes, so it’s no longer kind of a hard to use niche product. Now it’s just as easy to use as the other devices and to treat a wide range of patients. Read the rest of this transcript for free on seekingalpha.com