On September 17, 2024, Boston Scientific (NYSE: BSX) announced,Completed the acquisition of Silk Road Medical (Nasdaq: SILK),Total price approximately USD 1.18 billion(Approximately 8.4 billion RMB)。
Silk Road Medical is a medical device company that performs minimally invasive surgeries—Transcarotid Artery Revascularization (TCAR), pioneered a new approach to stroke prevention and carotid artery disease treatment.
# Executive Evaluation
Cat Jennings, President of Boston Scientific's Vascular and Peripheral Interventions Division, said:
"Upon the completion of this acquisition, Boston Scientific will provide more doctors and their patients with the innovative TCAR platform through extensive commercial coverage, thereby strengthening our vascular technology solutions. The integration of the TCAR platform into our product portfolio means that we can offer new treatment options for patients with carotid artery disease, reducing stroke risk and improving patient outcomes."”
The acquisition price is $27.5 per share, with an equity value of approximately $1.18 billion.According to Silk Road Medical's forecast, its net revenue in 2024 will reach approximately $194-$198 million, representing a 10%-12% increase over the previous fiscal year.
Boston Scientific Corporation expects that this transaction will not have a significant impact on its adjusted earnings per share (EPS) for 2024 and 2025, with growth expected thereafter. Under U.S. Generally Accepted Accounting Principles (GAAP), the impact of the transaction is expected to be more dilutive due to amortization expenses and acquisition-related net charges.
# Expand Product Portfolio
What Boston Scientific is eyeing is the development of Silk Road MedicalTCAR (Transcarotid Artery Revascularization) ProcedureAnd products inTreatment of Carotid Artery DiseaseAndPrevent StrokeSuperiority.
Transcarotid Artery Revascularization (TCAR)Existing Treatment Options for Carotid Artery Disease IncludeCarotid Endarterectomy (hereinafter referred to asCEA）AndTranscarotid Stent Angioplasty(hereinafter referred to as CAS)。But in the results of multiple randomized trials,CEA AndCAS Within 30 days after treatmentSerious adverse reactions may occur., the effect is not entirely satisfactory.TCAR is an alternative to CEA and CAS.Clinical studies have shown that, compared to CEA,TCAR canReduce the risk of early complications and mortality, as well as the long-term risk of stroke。▲Animation Demonstrating How TCAR Works (Source: Company's Official Website)TCAR began inA small incision slightly above the collarbone in the neck, also known as carotid access, The incision is located below the carotid artery stenosis and most of the cranial nerves, usingTranscarotid Access PuncturePlace the catheter into the carotid artery;At the same time, locate the femoral vein in the groin, insert a catheter through puncture, and connect the two puncture sites via an external tube.Then, the proximal end of the target carotid artery is clamped. Due to the high pressure in the carotid artery and low pressure in the groin vein, blood will flow directly from the distal end of the carotid artery out of the body, pass through the external thrombus filter, and enter the groin vein.Establish a temporary blood reflux system in vitro, allowing blood to flow from the brain toward the heart within the target carotid artery.(Exactly opposite to the direction of blood flow in the natural state).
ENROUTE®Transcarotid Stent SystemIn March 2024, Silk Road Medical announced inUnited StatesFirst to LaunchConical EnRoute Transcarotid Stent System,Applicable toPatients at High Risk and Standard Risk for Adverse Events in Carotid Endarterectomy。▲ENROUTE®Transcarotid Protection and Stent System(Source: Company's official website)
Working Principle
- 035'' Support Guidewire, Dilator, and Uber-Flex™ Arterial Sheath Combination Design, Used ForMinimally Invasive Vascular Access。
Angled-tip Uber-Flex™ Arterial SheathMaintain the intraluminal position of interventional devices, successfully placing the device and optimizing the preparation for blood reflux;External Plug and Hub Eye Design with Suturing GroovesEnsure the stability of the sheath.。
ExtendedInterventional Device Working Channel, allowing the ergonomic design for transcarotid access to be separated from the image intensifier.
The ENROUTE™ Transcarotid Stent Delivery System, with a length of 57cm, canRapid and easy stent delivery。
Dynamic Flow ControllerAdjusting Reverse Blood Flow, and integrates a 200μ filter, capable of capturing embolic debris.
Percutaneous Vein Return SheathComplete the circuit and return the filtered blood to the patient.。
ENROUTE®Transcarotid Retrograde Flow Thrombectomy Protection DeviceENROUTE®ThroughCarotid Artery Reverse Flow Thrombectomy Protection DeviceBy reversing blood flow out of the brain，Prevent thrombus fragments from flowing to the brain during carotid artery revascularization。The filter in the flow controller collects fragments of various sizes, and the filtered blood returns through the sheath in the femoral vein.Flow reversal can redirect embolic debris that may cause strokes away from the brain, while stent support stabilizes plaque and prevents embolization, therebyReduce the long-term risk of stroke, while also decreasing the likelihood of intraoperative complications or even death.Industry analysts believe that although Boston Scientific currently does not have a TCAR product,Existing resources can be utilized in the future.ImproveTCAR Penetration Rate in the United States, which is also beneficial for launching new products and introducing them toChinaAndEmerging markets such as JapanDilation.Current CEARemains the main method for treating carotid artery stenosis。
However, by meeting the criteria provided by CEA for cerebral protection and reducing the risk of 30-day and long-term stroke,At the same time, it provides minimally invasive methods within blood vessels.TCAR may become a treatmentCarotid Artery DiseasePreferred Solution。
It is estimated that there were 433,000 new cases of carotid artery disease in the United States in 2021, with the potential market size for TCAR products in the United States being approximately$3.1 billion annually (approximately 22.32 billion RMB).▲TCAR Development Trends (Source: Company Official Website)
As of the end of 2023, the United States had conductedMore than 85,000 casesTCAR surgery is rapidly replacing two other traditional procedures.And the products sold by Silk Road Medical are currentlyThe only one available on the marketEquipment for TCAR Surgery。
TCAR Product Portfolio AnnuallyThe total potential market opportunity in the United States is approximately$3.1 billion。Outside the United StatesThe global market also has potential$2.3 billionMarket Opportunity. Therefore,The addressable market size for Silk Road Medical is over 5 billion US dollars.Silk Road Medical Founded in March 2007,PioneeredTransCarotid Artery Revascularization (TCAR), a minimally invasive and safe method for treating carotid artery disease, effectively preventing strokes.Products includeENROUTE Transcarotid Retrograde Flow Protection Device, ENROUTE Transcarotid Stent System, and ENROUTE Transcarotid Peripheral Access Kit, etc.。
Signing Distribution Agreements with Japan's Medico Hirata and China's Genesis MedTech Group Following Approval of the Company’s ENROUTE Stent and ENROUTE Neuroprotection System.
2024In the first quarter, Silk Road Medical reported revenue of$48.5 million (approximately RMB 350 million), an increase of 21% compared to the same period last year.
However, operating costsIncreased by 16%, reaching 51.4 million US dollars, leading toQuarterly net loss was $14.1 million.This time, reaching an agreement with Boston Scientific for the acquisition may well be a win-win choice.# About Boston Scientific
Boston Scientific (NYSE: BSX) was founded in 1979 and is a global leading medical technology company.Boston Scientific established its China headquarters in Shanghai in 1997., currently inBeijing, Guangzhou, Chengdu, Hong Kong, TaipeiHas branches.The core business scope of the company coversCardiac Intervention, Cardiac Rhythm Management, Atrial Fibrillation Management, Peripheral Intervention, Oncology Intervention, Endoscopic Intervention, Respiratory Intervention, Urology and Neuromodulationetc.Following the tradition of being an innovation leader, Boston Scientific is committed to becoming a medical technology company that meets the needs of doctors and patients, demonstrates innovative vitality, and commands respect by providing high-quality medical products and services in prevention, diagnosis, and treatment.
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