Can Start-Ups Finish Up?

Abstract

In this issue of Circulation: Cardiovascular Quality and Outcomes , Xu et al present findings from a search of US patents related to bare-metal coronary stents in an effort to gain insight on how medical device innovation starts and how policies in the United States might help to promote more innovation.1 Of the 245 patents identified by their search strategy for the years 1984 to 1994, the authors report that the most frequently cited stent patents (their measure of patent importance to innovation headlined by the Palmaz and Gianturco patents) were from individual physician inventors working in academic medical centers and their small private companies. They also report a temporal trend that shows, in later years, more patents were granted to public companies. They concluded that policies aimed at supporting these entities might enhance and accelerate innovation because early innovation, in this case, was spurred by individual inventors with their small companies. Article see p 743 It is true that individual practitioners struggling with the challenges of everyday practice are an important source of new-device concepts that can possibly solve an unmet clinical need. However, the journey of successful innovation to maximized impact on public health requires that these early ideas (such as the original stiff, boxcar like tubular stent of Palmaz or the poorly scaffolding clam shell stent of Gianturco) need significant refinement through subsequent innovation (such as the later, industry-based Lau patent of the Multilink stent that …