4 things to know about our acquisition of Silk Road Medical

As the president of the Vascular group in the Peripheral Interventions business, Cat Jennings oversees the development of minimally invasive treatments for conditions that affect the blood vessels, such as peripheral artery disease (PAD), and diseases of the veins, like deep vein thrombosis.

"Our mission is to be the best peripheral company in the world, and for the world," says Jennings.

One of the most recent ways Jennings's team is working toward this ambitious goal is through the acquisition of Silk Road Medical. She explains how this development will enable Boston Scientific to reach even more of the millions of people at risk of stroke around the world each year.

What is Silk Road Medical known for?

To me, the Silk Road Medical story is really the story of stroke prevention.

Carotid artery disease affects approximately four million patients in the U.S., with 400,000 new cases diagnosed each year, and is one of the leading causes of stroke.ⁱ This condition is caused when plaque builds up in the carotid arteries in the neck and a stroke can occur if this buildup stops blood flow or plaque fragments travel to the brain.

Treatment options for people with carotid artery disease historically include optimal medical therapy, open surgery (carotid endarterectomy) and transfemoral carotid artery stenting, in which a stent is delivered from the femoral artery in the groin through the abdomen and up to the carotid artery.

Seeing the opportunity to uniquely combine the best aspects of these procedures, Silk Road Medical developed a procedure called transcarotid artery revascularization, or TCAR. In a TCAR procedure, a vascular surgeon places a small stent directly into the carotid artery through a small incision in the neck. What's unique about TCAR is that blood flow is temporarily reversed during the procedure so any bits of plaque that may break off are diverted away from the brain, where they could otherwise cause a stroke.

The procedure is less invasive than open surgery, which may require general anesthesia and can be too risky for some patients. Additionally, the TCAR procedure allows for direct access to the carotid arteries, while the transfemoral approach requires entering the body from the groin. That's a hard path with a lot of anatomy to get through, including the arch of the aorta in the chest, making it a more complicated option.

TCAR has among the lowest reported stroke rate of any carotid intervention, making this a wonderful technology for us to bring into our portfolio alongside our other minimally invasive therapies.ⁱⁱ

How do you feel it's a good match for Boston Scientific?

This acquisition and the TCAR technology allow us to better serve patients because TCAR is much less invasive than the current standard of care surgical procedure, and the results are just as good.

It also allows us to provide a better solution for physicians with faster, more predictable procedures.

And it's better for the health care system, because TCAR leads to shorter hospital stays, and may lead to fewer complications.ⁱⁱⁱ

What plans do you have for the growth of TCAR in the years to come?

First, we want to build on the momentum that Silk Road Medical has built in the United States, relying on their unique expertise around the TCAR procedure.

There's also a huge opportunity to take this product to other regions around the world. There are so many patients who may benefit from this therapy that don't have access to it, and with the strength of Boston Scientific, we're going to be able to bring that technology to them.

What drives you to keep creating new solutions for patients with vascular conditions, whether through the development of new technologies or through acquisitions like this one?

I've been at Boston Scientific for 20 years. In every level of the organization, I'm surrounded by incredible people who are passionate about the products we develop. I'm proud of all that we've accomplished but realize there's so much work to do to help bring even better solutions to physicians and their patients, and that's what gets me excited about not just the last 20 years, but what the next 20 years hold.

i Weerd M Stroke 2010; Modus Health Group for 2022 Vascularweb.org; Virani, Salim, et al. "Heart Disease and Stroke Statistics-2020 Update." American Heart Association, 3 Mar. 2020.

ii Kashyap VS, Schneider PA, FotehM, MotaganahalliR, Shah R, Eckstein HH, Henao S, LaMuragliaG, Stoner MC, Melton J, Massop D, Hanover T, Titus J, Moore WS, Rodríguez-Carvajal R, Malas MB, Arko FR 3rd, Pierce D, Anain P, Oskin T; ROADSTER 2 Investigators*. Early Outcomes in the ROADSTER 2 Study of TranscarotidArtery Revascularization in Patients WithSignificant Carotid Artery Disease. Stroke. 2020 Sep;51(9):2620-2629. doi: 10.1161/STROKEAHA.120.030550. Epub2020 Aug 19. PMID: 32811386.

iiiJ Am Heart Assoc. 2022;11:e024964. DOI: 10.1161/JAHA.121.024964