Author(s):

Matthew Runnalls
Darren Navarro
Stephanie LaBelle

Introduction:

Millennium Research Group’s new survey investigates the changing dynamics of the venous intervention market with a specific focus on the treatment of acute deep vein thrombosis (DVT) and obstructive chronic deep vein disease with venous stents. The survey shows that physicians are becoming increasingly aware of and involved in the treatment of the venous system. Many challenges remain in terms of treating both acute and chronic disease, however, including the need to generate greater awareness among primary care physicians, accumulate better clinical data, and develop improved devices.

Scope:

What Questions Will Physician Forum Help You Answer?

• Which patient groups are most likely receiving aggressive DVT treatment and which underserved groups represent the greatest opportunity?
• Where are chronic venous disease patients being referred to and what factors are influencing referral patterns for DVT treatments?
• What are the future prospects for venous stenting? What is the current market size?
• How do different treatment options compare on factors that are important to effective DVT treatment?

Key Sections: The following is an overview of the structure of the publication. The full publication contains 81 slides.

• Commercial Context
  • Clinical Environment – Venous Disease, Venous Thromboembolism Patient Populations, Recent Events
  • Commercial Impact Analysis – DVT Treatment, Venous Stent Market
• Methodology
  • Survey Design
  • The Specialists – Regional Distribution, General Demographics, Venous Disease
  • The Referrers – Regional Distribution, General Demographics
• DVT Interventions
  • DVT Disease Overview – Primary Causes, Chronic Venous Disease
  • Treatment Algorithm for DVT Patients
  • DVT Clinical Practice – Physician Guidelines, Candidates for Intervention, Contraindications to Pharmacotherapy, Patient Referral Streams, Limiters of DVT Treatment, Key Limiters of DVT Treatment, Undertreated Patients
  • DVT Therapeutics – Prophylactic Treatment, First-Line Treatment, Second-Line Treatment, Choosing a Treatment Option, Treatment Comparisons, Familiarity with Pharmacomechanical Thrombectomy
• Chronic Deep Vein Disease (CDVD)
  • CDVD – Background
  • CDVD Major Topics
  • CDVD Overview – Patient Volumes, Growth Drivers, Volumes by Disease, Specialist Roles in Disease, Obstruction Prevalence, Degree of Obstruction
  • CDVD Clinical Practice – Imaging Modalities, Intravascular Ultrasound Usage, Referral Patterns, Treatment Limiters, Venous Stenting, Stenting Indications, Stent Brands and Sizes, Venous Stent Market Shares, Anatomical Placement, Factors in Stent Design
• Referring Physicians
  • Symptomatic Venous Disease Patient Volumes
  • Factors Influencing CDVD Diagnosis
  • Venous Disease Volumes
  • Venous Obstruction and Reflux
  • First-Line Treatment Options
  • Patient Referrals to a Specialist
  • Treatment Options for Referred Patients
  • Clinical Improvement among Referred Patients
  • Factors Driving Venous Stenting
  • Clinical Improvement among Venous Stenting Patients
  • Venous Stenting Awareness

Methodology: This study investigates the increasing use of endovascular venous interventions to treat both acute and chronic venous disease. Participants in all groups are located throughout the US and completed the survey between July 27 and August 11, 2010. Respondents were recruited through Millennium Research Group’s proprietary in-house databases. Respondents were invited to participate through e-mail, and the survey was administered online.

The study includes two separate surveys, referred to as the specialists and the referrers:

• The specialists (n = 98):
  • Core segment (n = 88):
    • 26 cardiothoracic surgeons
    • 22 interventional cardiologists
    • 21 vascular surgeons
    • 19 interventional radiologists
  • Additional stenting respondents (n = 10):
    • 1 cardiothoracic surgeon
    • 4 interventional cardiologists
    • 2 vascular surgeons
    • 3 interventional radiologists
• The referrers (n = 78):
  • Core segment (n = 78):
    • 43 general practitioners/family practitioners
    • 25 emergency medicine physicians
    • 10 internists