Global Peripheral Chronic Total Occlusion (CTO) Market Size, Share, Industry, Forecast, and Outlook (2024-2031)

Overview

The global peripheral CTO market reached US$ 12.02 billion in 2023 and is expected to reach US$ 18.05 million by 2031, growing at a CAGR of 5.3% during the forecast period 2024-2031.

A peripheral chronic total occlusion (CTO) is a blockage in a peripheral artery that is caused by a buildup of plaque over time. CTOs are a type of peripheral artery disease (PAD) and can be challenging to treat with endovascular techniques.  Chronic total occlusions (CTO) are important anatomic variants for interventional cardiologists. Peripheral arteries, which supply blood through the legs along with other arteries outside the heart, are affected by this disorder. This reduced blood flow can cause pain, ulcers that remain unhealed, and in severe instances, even limb loss. 

Specialized medical instruments called peripheral CTO devices are intended to treat chronic complete occlusions of peripheral arteries. Assisting to travel through or around the occlusion and restoring blood flow are devices such as atherectomy systems, crossing catheters, guidewires, and re-entry devices. These gadgets' technological improvements have increased success rates by providing more precision, flexibility, and support during difficult procedures.

Scope

Market Dynamics: Drivers

Increasing technological advancements

The increasing technological advancements propel the market growth. For instance, in April 2024, Simpsons Interventions, a California-based healthcare technology company, received the FDA’s breakthrough device designation for its Acolyte Image Guided Crossing and Re-Entry Catheter System.  The new device is designed to help interventional cardiologists treat patients with coronary chronic total occlusions (CTOs) who do not respond to medical therapy. It delivers real-time optical coherence tomography (OCT) visualization that helps with the guidance and placement of guidewires during revascularization procedures.

CTOs occur when patients develop 100% stenosis in a coronary artery. Crossing the CTO can provide certain challenges for interventional specialists—any complications may require the care team to shift to coronary artery bypass graft surgery (CABG). According to Simpsons Interventions, their device’s real-time OCT capabilities improve cardiologist performance and reduce the risk of patients requiring CABG. There are many technological advancements in recent times that act as a driving factor for the peripheral CTO market.

Restraints

Factors such as the complexity of procedures, high costs associated with the treatment and devices,  shortage of skilled professionals, and stringent regulatory requirements for the approval of new treatments are expected to hamper the market.

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Segment Analysis

The peripheral CTO market is segmented based on device type, end-user, and region.

The segment crossing CTO device accounted for approximately 48.3% of the peripheral CTO market share

The crossing CTO device segment is expected to hold the largest market share over the forecast period. In this segment, the technological advancements and rising funds for private manufacturers for device development would drive this market. A crossing CTO device is a tool used to navigate through a chronic total occlusion (CTO) to deliver guidewires and treat peripheral arterial disease (PAD).

For instance, in May 2023, Bentley, a global leader in the endovascular treatment for aortic and peripheral vascular disease, announced their first product launch in the United States with the BeBack crossing catheter designed for the treatment of heavily calcified lesions. The BeBack catheter is designed for steering through Chronic Total Occlusions (CTO), which often is the most challenging part when treating heavily calcified lesions. The catheter is available in an 80 and 120-cm catheter in both a 2.9F and 4F size. The device makes use of a steerable and in-length adjustable Nitinol needle, which is used for crossing and targeted re-entry purposes.

Geographical Analysis

North America accounted for approximately 42.6% of the peripheral CTO market share 

North America region is expected to hold the largest market share over the forecast period. The technological advancements, and growing awareness among people, in this region, help to propel the market. 

For instance, in March 2024, Becton Dickinson and Company started a clinical trial of its investigational vascular-covered stent in people with peripheral arterial disease (PAD). The study is enrolling 315 patients to evaluate the safety and effectiveness of the self-expanding nitinol implant with a fluoropolymer coating. Becton Dickinson and Company's single-arm clinical trial recently enrolled its first patient at a site in Iowa. The site is one of up to 40 that BD plans to activate across the U.S., Europe, Australia, and New Zealand as it works to enroll PAD patients and track them for 36 months.

Moreover, in April 2024, Abbott received FDA approval for its latest drug-eluting scaffold, designed to help reopen arteries in the legs that have become clogged below the knee. The Esprit BTK System aims to treat the most severe form of peripheral artery disease, a condition known as chronic limb-threatening ischemia, or CLTI, where hampered blood flow can lead to foot or lower leg amputations.

Market Segmentation

By Device Type

• Crossing CTO Device
• Truepath
• Viance Device
• Re-Entry Device
• Centercross CTO Device
• Prodigy
• Crosslock
• Others 

By End-User

• Hospitals
• Ambulatory Surgical Centers
• Others

By Region

• North America 
  • U.S.
  • Canada
  • Mexico 
• Europe
  • Germany
  • U.K.
  • France
  • Spain
  • Italy
  • Rest of Europe 
• South America
  • Brazil
  • Argentina
  • Rest of South America 
• Asia-Pacific
  • China
  • India
  • Japan
  • South Korea
  • Rest of Asia-Pacific 
• Middle East and Africa

Competitive Landscape

The major global players in the peripheral CTO market include Medtronic, Boston Scientific Corporation, Avinger Inc., Cardinal Health, Koninklijke Philips N.V, Cook Medical Incorporated, Becton, Dickinson and Company, Baylis Medical Company, Soundbite Medical Solution, Terumo Corporation among others.

Key Developments

• In August 2024, Avinger, Inc. announced the full commercial launch of the Pantheris LV image-guided directional atherectomy system. Avinger's proprietary technology incorporates an onboard image-guidance system to allow physicians to see inside the artery during an atherectomy or CTO-crossing procedure by using an imaging modality called optical coherence tomography, or OCT. During the procedure, high-resolution intravascular OCT images are displayed on Avinger's Lightbox console in real time to guide therapy.
• In June 2024, Royal Philips announced the first implant of the Duo Venous Stent System, an implantable medical device indicated to treat symptomatic venous outflow obstruction in patients with chronic venous insufficiency (CVI), following premarket approval (PMA) from the U.S. Food and Drug Association (FDA).

Why Purchase the Report?

• To visualize the peripheral CTO market segmentation based on device type, end-user, and region, as well as understand key commercial assets and players.
• Identify commercial opportunities by analyzing trends and co-development
• Excel data sheet with numerous data points of peripheral CTO market level with all segments.
• PDF report consists of a comprehensive analysis after exhaustive qualitative interviews and an in-depth study.
• Product mapping is available in Excel consisting of key products of all the major players.

The peripheral CTO market report would provide approximately 51 tables, 54 figures, and 181 Pages.

Target Audience 2024

• Manufacturers/ Buyers
• Industry Investors/Investment Bankers
• Research Professionals
• Emerging Companies