Continuous Enhanced Circulation Therapy (CECT) – Prevention of Deep Vein Thrombosis (DVT)

©Copyright, 2009

1 Continuous Enhanced Circulation Therapy (CECT)
1.1 Summary
Continuous enhanced circulation therapy (CECT) is a non-invasive blood circulation therapy used for the prevention of deep vein thrombosis by applying intermittent, sequential pressure to the patient’s leg in a systematic pattern, increasing the peak venous velocity (PVV) of venous blood flow and reducing the risk of clot formation. The AHA estimates that 1 out of every 1,000 Americans develops DVT each year. Continuous Enhanced Circulation Therapy (CECT) may provide superior DVT prevention compared with that provided by standard devices. Market size of portable size pneumatic compression device used for this therapy is estimated approximately $161 million worldwide in 2007. The market opportunity for the prevention of Deep Vein Thrombosis (DVT) is in excess of $2 billion per annum in the USA and Europe alone,
1.2 Background
Deep vein thrombosis (Throm-BO-sis), or DVT, is a blood clot that forms in a vein deep in the body. Blood clots occur when blood thickens and clumps together. Most deep vein blood clots occur in the lower leg or thigh. They also can occur in other parts of the body.
Any long period of immobility--such as being bedridden from illness, recovering from surgery, or sitting for extended periods while traveling--is a risk factor for DVT and pulmonary embolism, says the National Heart, Lung, and Blood Institute (NHLBI). DVT can also develop in other instances when the blood flow in the legs is restricted and slows down. Restricted flow may occur with certain types of cancer and cancer treatment, obesity, inherited clotting disorders, pregnancy, and damage to the veins following injury or orthopedic surgery. DVT may not cause any further problems, but possible complications include the following.
1.2.1.1 Pulmonary embolism
This is the most serious complication of DVT. A pulmonary embolism (PE) happens when a piece of the blood clot from a DVT breaks off and travels through the bloodstream to the lungs. In the lungs it can block a pulmonary artery. This can cause chest pain, shortness of breath or coughing up phlegm tinged with blood. In severe cases it can be fatal. PE can happen hours or even days after the DVT has formed, and may occur when there have been no obvious signs of a DVT. You should seek emergency medical treatment if you have symptoms of PE.
1.2.1.2 Post-thrombotic syndrome
This happens if DVT damages the valves in the deep veins, so that instead of flowing upwards, the blood pools in the lower leg. This can eventually lead to long-term pain, swelling and, in severe cases, ulcers on the leg.
1.2.1.3 Limb ischaemia
This is a rare complication that only happens in severe DVT. Because of the blood clot in the leg vein, the pressure in the vein can become very high. This can obstruct the blood flow through the arteries, so less oxygen is carried to the affected leg.
DVT is treated with medicines that thin the blood, interfere with the blood clotting process, and dissolve blood clots. Other treatments include filters to catch blood clots, compression stockings, compression pumps and continuous enhanced circulation therapy that prevent blood from pooling and clotting.
Figure 1: Deep Vein Thrombosis



1.3 Deep Vein Thrombosis Market Overview
Continuous enhanced circulation therapy system (CECT) provides the optimal hemo-dynamic profile by applying intermittent, sequential pressure to the patient’s leg in a systematic pattern, increasing the peak venous velocity (PVV) of venous blood flow and reducing the risk of clot formation. The system incorporates a family of pneumatic compression devices that are unique in the way they create pressure and apply it to the patient's limbs. This highly efficient mode of operation has enabled the creation of miniature (palm-sized), totally mobile, battery-operated compression devices with unique hemodynamic properties that can be used continuously in a wide range of indications.
Continuous enhanced circulation therapy (CECT) devices and Traditional Dynamic Compression Therapy devices collectively hold the 30% market share from physical compression devices. Total market for continuous enhanced circulation therapy (CECT) was estimated $64.4 million in 2007 and is expected to growth at a CAGR of 9 percent to reach $98 million in 2012.
Figure 2: Physical Compression Devices, Global Market Share, 2007


Figure 3: Continuous Enhanced Circulation Therapy (CECT) and Traditional Dynamic Compression Therapy Market, Revenue Analysis, Global, 2000 - 2012



1.4 Continuous Enhanced Circulation Therapy (CECT) Market Dynamics
1.4.1 Market Drivers
 Increasing aging population.
 Proven improved outcomes for patients.
 Miniaturization and portability allow for continuous therapy, without the restraints of needing proximity to a power outlet which thereby enables the usage of the system in the patient’s home away from the acute care/ clinic settings
 Advantage of earlier discharge in the HMO and Hospitals.
 Major savings in both direct and indirect costs especially in hospitals.
1.4.2 Market Restraints
 Lack of awareness among physicians of the advantages of continuous enhanced circulation therapy will continue to pose a challenge to the growth of this market.
 Advanced surgical procedures that ensure a speedier recovery could form an obstacle in the growth of the compression therapy market;
1.5 Competitive Scenario
Continuous enhanced circulation therapy (CECT) systems are directly competing with traditional dynamic compression therapy systems. Companies manufacturing traditional pneumatic compression pumps are focusing on new portable and technically advance non-invasive blood circulation units or dynamic compression units. The dynamic compression market is dominated by Kendall Healthcare (a division of Tyco Healthcare Group), Huntleigh healthcare (Getinge), Kinetic Concepts, ACI Medicals, Aircast, Juzo USA and Alba Health Products.
ActiveCare DVT is a world’s first continuous enhanced circulation therapy (CECT) device manufactured by Medical Compression System (DBN) Ltd based in Israel. ActiveCare DVT has advantages in terms of its size and portability over existing stationary pneumatic compression device. It does not requiring an external power source for operation. In the United States, the ActiveCare DVT® is priced at $1,500 and marketed by Hill-Rom.
1.6 Outlook and Implications
Continuous enhanced circulation therapy (CECT) systems translate into outstanding clinical results and major cost savings to the acute care facilities and HMOs. This market is primarily driven by rising physician awareness about this technique and growing acceptance levels. Continuous enhanced circulation therapy devices have significant advantages over traditional dynamic compression therapy systems. Increased prevalence of deep vein thrombosis and related disease conditions, the continuous enhanced circulation therapy (CECT) systems market is set to expand well into the future.

©Copyright, 2009
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