Peripheral CTO Market to Hit US$ 18.05 Billion by 2031 - North America Leads With 43% Share as Medtronic, Boston Scientific & Cardinal Health Dominate; OCT-Guided & Drug-Eluting Innovations Accelerate 5.3% CAGR

Leander, Texas and Paris, France - Dec 09, 2025
According to DataM Intelligence, the global peripheral CTO market reached US$ 12.02 billion in 2023 and is expected to reach US$ 18.05 million by 2031, growing at a CAGR of 5.3% from 2024 to 2031. This steady growth is propelled by rising prevalence of peripheral artery disease (PAD), increasing geriatric population, growing adoption of advanced crossing and re-entry devices, surging demand for revascularization procedures, product launches and approvals in interventional cardiology, technological advancements in optical coherence tomography (OCT)-guided catheters and drug-eluting scaffolds, and research on steerable microcatheters to improve procedural success rates and reduce complications.

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Report Details:
• No. of Pages: 180
• Forecast Period: 2024-2031
• Market Size (Base Year 2023): $12.02 Billion
• Market Size (Forecast Year 2031): $18.05 Billion
• Compound Annual Growth Rate: 5.3%
• Regions Covered: Global

United States Recent Developments:
✅ Simpsons Interventions received FDA's breakthrough device designation for the Acolyte Image Guided Crossing and Re-Entry Catheter System in April 2024, enabling real-time OCT visualization for guidewire placement in PAD revascularization and aligning with enhanced procedural accuracy.
✅ Abbott received FDA approval for the Esprit BTK System, a drug-eluting scaffold for chronic limb-threatening ischemia (CLTI), certified for US vascular centers and reporting 32% adoption in below-the-knee applications.
✅ Avinger, Inc. announced the full commercial launch of the Pantheris LV image-guided directional atherectomy system in August 2024, focusing on OCT-integrated atherectomy and supported by NIH grants for CTO efficacy studies.

Europe Recent Developments:
✅ Becton Dickinson and Company initiated a clinical trial for its investigational vascular-covered stent in PAD patients in March 2024, compliant with EU MDR standards and integrated into multicenter protocols across Europe for outflow obstruction management.
✅ Bentley launched the BeBack crossing catheter for heavily calcified lesions in May 2023, driven by CE approvals and achieving 26% growth in interventional radiology applications.
✅ Royal Philips announced the first implant of the Duo Venous Stent System in June 2024 across European centers, aligning with EU vascular directives and partnerships with regional endovascular suites.

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Competitive Landscape
Competition is centered on OCT-guided crossing devices, re-entry catheters, drug-eluting technologies, and partnerships with vascular intervention centers across developed and emerging markets:

1. Medtronic Plc dominates the market with 24.7% global market share, supported by an extensive CTO crossing and support catheter portfolio and proven reliability in PAD and CLTI care.
2. Boston Scientific Corporation holds 20.3% share, driven by advanced atherectomy and balloon systems and global interventional distribution channels.
3. Cardinal Health captures 17.1% share, known for precision-engineered guidewires and expansion across North America and Europe.
4. Koninklijke Philips N.V. maintains 14.5% share, focused on next-gen imaging-integrated stents with OCT innovations.
5. Cook Medical Incorporated secures 12.2% share, excelling in re-entry devices with strong adoption in Europe.
6. Becton, Dickinson and Company holds 10.4% share, driven by its flagship covered stent technology and presence in vascular centers across EMEA.
7. Baylis Medical Company accounts for 8.9% share, specializing in radiofrequency wires and cost-efficient microcatheters.
8. Terumo Corporation represents 7.6% share, advancing penetration across Asian clinics with durable support systems.

✦ Emerging / Upcoming Players - Fastest Growth Segment
New contenders are gaining traction through AI-assisted navigation, bioresorbable scaffolds, and minimally invasive microcatheter designs:
9. Avinger Inc. (U.S.) - Emerging share: 3.2%, expanding through OCT-guided atherectomy systems for calcified CTOs.
10. Soundbite Medical Solutions (U.S.) - Emerging share: 2.9%, seeing strong adoption in North America with sonic-based crossing tools.
11. Simpsons Interventions (U.S.) - Emerging share: 2.5%, developing real-time imaging analytics for re-entry procedures.
12. Asahi Intecc Co., Ltd. (Japan) - Emerging share: 2.2%, supplying next-gen hydrophilic wires to facilities across APAC.

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Segmentation Analysis
By Product Type
• Crossing CTO Devices represents the largest segment with 48% revenue share in 2023, projected to grow at 5.6% CAGR, valued for specialized guidewire navigation, OCT integration, versatility in calcified lesions, effective performance in revascularization, and widespread adoption in interventional suites requiring precise luminal access across global centers. Re-Entry Devices shows steady growth with 52% revenue share in 2023, expected to grow at 5.0% CAGR, preferred for subintimal recanalization efficiency, cost-effective deployment, and uses in complex PAD with moderate complication profiles.

By End-User
• Hospitals commands the largest share with 70% revenue share in 2023, growing at 5.4% CAGR, driven by high PAD case incidence, urbanization in cath labs, growing demand for advanced imaging tools, essential need for multidisciplinary interventions, and rising awareness across specialized vascular units and ICUs. Ambulatory Surgical Centers shows robust growth with 30% revenue share in 2023, expanding at 5.1% CAGR, valued for outpatient CTO treatments and procedural scalability.

By Application
• Lower Extremity CTO leads the market with 65% revenue share in 2023, growing at 5.5% CAGR, driven by advanced endovascular facilities, urbanization in CLTI management, growing R&D for device innovations, essential role in limb salvage procedures, and rising insurance coverage across public and private sectors.
Upper Extremity CTO shows accelerated growth with 35% revenue share in 2023, expected to grow at 5.0% CAGR, preferred for targeted revascularization and cost efficiencies.

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Regional Analysis:
» North America holds the largest market share with 43% revenue share in 2023, driven by high prevalence of PAD and diabetes-related CTOs, advanced interventional adoption, stringent FDA regulations, and substantial R&D investments across the United States and Canada.

» Asia-Pacific emerges as the fastest-growing region, projected to expand at 6.0% CAGR through 2031, fueled by rising geriatric populations, increasing lifestyle-related vascular diseases, massive healthcare infrastructure expansions, growing awareness programs, and affordable device access across China, India, and Southeast Asian countries.

Market Trends & Drivers
The Peripheral Chronic Total Occlusion Market is experiencing steady growth driven by PAD surges, geriatric health priorities, device innovation advancements, and regulatory adaptations for breakthrough designations. Key trends include the development of OCT-guided and sonic-assisted crossing catheters, growth of drug-eluting re-entry systems, advancement in bioresorbable scaffolds, expansion of outpatient endovascular techniques, and increasing focus on AI for procedural planning and limb preservation. The epidemiological evolution, technological innovation, and revascularization requirements are significantly contributing to market growth.

Contact Us:
Sai Kiran
DataM Intelligence 4market Research LLP
Phone: +1 877-441-4866
Email: Sai.k@datamintelligence.com

About DataM Intelligence
DataM Intelligence is a renowned provider of market research, delivering deep insights through pricing analysis, market share breakdowns, and competitive intelligence. The company specialises in strategic reports that guide businesses in high-growth sectors such as medical devices and vascular innovations.
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This release was published on openPR.