Until just a few years ago, interventional cardiologists and circus aerialists appeared to share the same mindset: both considered working their respective wires with a net unthinkable, an approach driven in part by the same motivation—to exhibit a mastery of their craft. Cardiologists believed a clinician's technique should be sufficiently precise to avoid dislodging any potentially risky emboli during percutaneous transvascular coronary angioplasty (PTCA) or other interventional procedures. The chance that emboli would come loose and cause a stroke or heart attack was deemed largely an issue of technique; the greater the physician's skill, the lower the risk. Until recently, this issue was only theoretical because no protection devices existed. But fortunately for patients, that mindset changed with the development of a variety of embolic protection devices (EPDs) and the accompanying data from clinical trials supporting their advantages. Today even leading interventionalists acknowledge and are promoting the use of EPDs.
Not only has the mindset of interventionalists changed, but so too has the competitive landscape. Some industry executives had predicted that Medtronic Inc. 's acquisition last fall of EPD pioneer, PercuSurge Inc. , while signaling the promise of embolic protection devices, would also take the wind out of the sails of would-be competitors [See Deal]. (See "PercuSurge: Picking Up the Pieces,"IN VIVO, May 1999 [A#1999800110 and "Medtronic Scoops Up PercuSurge," IN VIVO, November 2000 [A#2000800218