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At TCT, Cardiology Companies Invade Neurology's Turf

Having gradually chipped away at the patient base of surgeons, where are interventional cardiologists to go next? One answer: neurology. At this year's TCT meeting, two new areas of stroke prevention were discussed as potential growth opportunities. The first area is PFO closure: 25% of people in the general population have a congenital heart wall defect that is associated with cryptogenic stroke. In the other, left atrial appendage occlusion, to eliminate a pouch in the heart that can collect clots that cause stroke in patients with atrial fibrillation.

It is certainly one of interventional cardiology's most striking successes that, over the past decade or so, it has grown in large measure by slowly stealing away patients from cardiac surgeons. Despite stellar clinical success of their own in coronary artery bypass grafting (CABG) surgery, surgeons have watched as interventionalists have extended their domain, moving beyond single vessels to multi-vessel disease. And, armed with a host of new tools and ever more sophisticated techniques, interventionalists now seem ready to tackle cases—in tortuous lesions or total chronic occlusions, for example—long been thought to be the exclusive province of surgeons.

But interventional cardiology's success has created challenges of its own: having gradually chipped away at the patient base of surgeons,...

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