Stryker Completes Seventh Acquisition of 2024 with Purchase of Neurointerventional Innovator Nico Corporation

Stryker, a global orthopedics giant, recently announced the completion of its acquisition of NICO Corporation, a leader in modern minimally invasive interventional technologies for neurosurgery. The financial terms of the deal were not disclosed.

Founded in Indiana, USA, in 2007, Nico provides minimally invasive treatment solutions for tumor and intracerebral hemorrhage (ICH) surgeries through its Minimally Invasive Parafascicular Surgery (MIPS) technique. The company offers two highly innovative neurointerventional products, BrainPath and Myriad, which have demonstrated significant efficacy in the treatment of intracerebral hemorrhage, cavernous malformations, primary brain tumors, and brain metastases.

This acquisition provides Nico with financial support and market opportunities, while also expanding Stryker’s leading position in the field of neurosurgery.

Nico’s focus on MIPS, an advanced neurosurgical technique that enables surgeons to reach the target area by bypassing or traversing the brain’s natural sulci through minimally invasive approaches, thereby reducing damage to healthy tissue. Based on this technology, Nico developed the BrainPath and Myriad systems.

BrainPath is an advanced device specifically designed for the BrainPath Minimally Invasive Procedure System (MIPS), offering navigable surgical pathways to subcortical spaces via trans-sulcal corridors. It minimizes damage to brain tissue during surgery, providing neurosurgeons with a safe and efficient operational platform. It is suitable for treating various neurological conditions, including primary and secondary tumors, vascular anomalies and malformations, intraventricular tumors, and cysts.

Myriad is an automated tool designed for precise resection, aspiration, and other procedures in neurosurgery, spinal surgery, and otolaryngology. In April 2024, Nico launched the third-generation Myriad product—the Spectra System—the first device in its class to combine handheld directional light with non-ablative, non-thermal resection. It enables safe, automated brain tumor resection and hematoma clearance, and features the ability to switch between white light and blue-light excitation to facilitate fluorescence-guided surgical resection. According to Nico’s official website, the Spectra System has recently received FDA approval and is registered with the UK Medicines and Healthcare products Regulatory Agency (MHRA) for sale and clinical use.

On April 11, The New England Journal of Medicine published the results of a clinical trial conducted by Emory University. The study demonstrated that early minimally invasive parafascicular surgery (MIPS) intervention using Nico’s BrainPath and Myriad technologies yielded superior therapeutic outcomes for intracerebral hemorrhage compared to current standard care—guideline-based medical management (MM). Specifically, the intervention reduced mortality rates and significantly shortened hospital stays.

Specifically, at 180 days, the utility-weighted modified Rankin Scale (UWmRS) score was 0.458 in the MIPS group versus 0.374 in the MM group. This difference indicated a 98.1% posterior probability of superiority for the MIPS group (95% confidence interval, 0.005 to 0.163). Furthermore, the 30-day mortality rate was lower in the MIPS group (9.3%) than in the MM group (18.1%). Additionally, the MIPS approach significantly reduced the length of stay (LOS) in the intensive care unit (ICU) by 2.8 days and shortened the hospital LOS by 3.1 days.

This acquisition also marks Stryker’s fifth in the neurointerventional field. Since acquiring Boston Scientific’s neurointerventional division for $1.5 billion in 2011, Stryker has rapidly grown into a global neurointerventional giant through frequent acquisitions.

Meanwhile, this is also Stryker'sThe seventh acquisition of 2024.

On July 30, Stryker announced its financial results for the second quarter of 2024, reporting quarterly net sales of $5.422 billion, an 8.5% year-over-year increase. Among these, the Medical Surgical and Neurotechnology business segment generated revenue of $3.117 billion, representing a 9% year-over-year growth.

Domestic Companies Form a Differentiated Competitive Landscape, and Neurointerventional Devices Enter Routine Centralized Procurement

Neurointerventional surgery is renowned for its minimal invasiveness, excellent efficacy, high efficiency, and significant development potential, having resolved many clinical challenges and earning acclaim as the [...] among interventional procedures.“The Crown Jewel,” particularly demonstrating significant advantages in the treatment of acute cardiovascular and cerebrovascular emergencies, enabling precise intervention within the golden time window and effectively reducing mortality and disability rates.

Taking stroke, a major indication for neurointerventional procedures, as an example, according to the "China Stroke Prevention and Treatment Report (According to the data from “2023,” there are 12.42 million prevalent cases of stroke among individuals aged 40 and above in China, ranking first globally, with a trend toward younger onset. Neurointerventional techniques have opened up new approaches and therapeutic pathways for cerebrovascular diseases such as stroke; however, due to the complex structure of cerebral blood vessels, these procedures impose high demands on physicians’ operational skills and surgical instruments.

The substantial patient demand, coupled with the relatively low penetration rate of cardiovascular and cerebrovascular treatments, will drive the continued growth of the neurointerventional market. According to research data from Frost & Sullivan,In 2023, China's neurointerventional market was valued at approximately RMB 14.3 billion and is projected to reach RMB 48.9 billion by 2030.

High-value consumables for neurointerventional procedures encompass five major categories: ischemic, hemorrhagic, stenosis, carotid artery, and vascular access devices. In terms of the competitive landscape, due to the complex cerebrovascular anatomy and high operational difficulty associated with neurointerventions, which impose significant technical barriers on medical devices, overseas giants such as Medtronic, Stryker, and Johnson & Johnson entered the market early and currently hold the vast majority of market share.

Amid the overarching trend of domestic substitution, Chinese enterprises have garnered significant attention in recent years, with leading companies such as MicroPort NeuroTech, Venus Medtech, Peijia Medical, and Sino Medical Sciences Technology gradually refining their strategic layouts.From the perspective of product pipeline layout, several domestic neurointerventional companies have basically achieved comprehensive coverage in the hemorrhagic, ischemic, stenosis, and access markets, while also establishing advantages in different niche segments.For instance, Mindray Medical and Jichuang Tongqiao hold a competitive edge in the ischemic stroke market, while MicroPort NeuroTech and Peijia Medical are more dominant in the hemorrhagic stroke market.

From the perspective of R&D pipelines, major domestic enterprises are consolidating their strengths while expanding their coverage to more markets.For example, Mindray Medical andEndovast's R&D pipeline is primarily focused on the stenosis and hemorrhage markets.；MicroPort NeuroTech’s products under development are focused onIschemia and Stenosis Market，Peijia Medical’s R&D pipeline is primarily focused on the ischemic market.

Ping An Securities Research: Currently, neurointerventional therapy in China is still in a relatively early stage, with an overall low localization rate. The market for hemorrhagic devices remains dominated by imports.However, domestically produced products are continuously breaking through to market entry, and coupled with the impact of centralized procurement on the market landscape, the momentum for domestic substitution is significant.

For example, Mindray Medical inThe 2024 interim performance report stated that over the next 18 months, the company expects to launch at least five blockbuster neurointerventional devices, including intracranial drug-coated balloon catheters for stenosis treatment (NMPA Innovative Medical Device designation), self-expanding drug-eluting stents, carotid artery stents, aneurysm embolization-assist stents for hemorrhagic stroke treatment (NMPA Innovative Medical Device designation), and flow diverters.

Meanwhile, enteringIn 2024, the neurointerventional field fully entered an era of normalized volume-based procurement.

On March 6, the Beijing-Tianjin-Hebei “3+N” Alliance announced the launch of volume-based procurement for neurointerventional coils. On March 19, the results of the centralized volume-based procurement for 28 categories of medical consumables under the Beijing-Tianjin-Hebei “3+N” Alliance were released, with guiding catheters, thrombectomy stents, and intracranial stents in the neurointerventional field all included in the procurement. The coverage extends to 10 provinces—Liaoning, Anhui, Yunnan, Guangxi, Jiangxi, Guizhou, Qinghai, Tibet, and Xinjiang Production and Construction Corps—as well as the Sanming Alliance.

In June, a consortium of seven top-tier Grade A tertiary hospitals, including the First Affiliated Hospital of Sun Yat-sen University in Guangzhou, launched procurement for three categories of products: transcatheter artificial aortic valve replacement systems, rechargeable implantable deep brain stimulation devices, and flow-diverting dense mesh stents, with a procurement cycle of one year.

On July 24, the Hebei Provincial Medical Insurance Bureau issued a notice stating that, to facilitate the centralized volume-based procurement of vascular interventional consumables led by Hebei Province, it has decided to conduct offline product presentations for six categories of vascular interventional consumables, including flow-diverting dense-mesh stents, embolization microspheres, neurointerventional balloon dilation catheters, thoracic aortic stents, arterial dilation balloons, and guiding catheters (for peripheral vascular intervention).

On August 29, the Anhui Provincial Pharmaceutical Centralized Procurement Platform released the “Anhui Province Centralized Volume-Based Procurement Document for Medical Consumables Including Intracranial Stents, Thrombectomy Stents, and Flow-Diverter Dense-Mesh Stents (Draft for Comments),” clearly stating that centralized volume-based procurement will be organized across the province for three categories of medical consumables: intracranial stents, thrombectomy stents, and flow-diverter dense-mesh stents.

With the advent of a concentrated launch period for domestically produced products, coupled with the stimulus of price reductions from centralized procurement, domestic manufacturers are entering a bonus period for seizing market share.