The Financial Times recently reported that Johnson & Johnson (J&J) is considering the sale of Cerenovus, its neurovascular division. This aligns with a broader industry trend where companies are shifting toward high-growth, high-margin markets, and focusing resources on areas with higher perceived growth potential.

The neurovascular market, estimated at $4.2bn in 2024 by GlobalData, is becoming increasingly specialised and competitive. Major players such as Stryker, Medtronic, and Terumo control about 68% of the global neurovascular market, making it challenging for mid-sized companies such as Cerenovus to scale effectively. J&J’s acquisitions of Abiomed for $16.6bn, Shockwave Medical for $13.1bn, and V-Wave for $1.7bn highlight a commitment to the cardiovascular interventions sector, which is expected to outpace the neurovascular market.

The success of neurovascular interventions relies on rapid device application, as effective treatment must occur within minutes to hours of symptom onset. This time constraint limits market growth despite the rising demand for stroke treatment. To succeed in this market, companies must go beyond technological innovation. As stroke care evolves, improving treatment protocols, accelerating the adoption of new devices, and expanding access to life-saving interventions are critical. A multi-pronged approach is key to growing the neurovascular market, shifting toward faster, more efficient solutions to meet increasing demand. While larger, more established players with significant market share are likely to lead these innovations, this dynamic also creates opportunities for disruptive competitors to tap into underdeveloped market segments.

J&J’s potential exit from the neurovascular market follows a trend among medtech leaders such as Medtronic and Stryker, which have refocused on high-growth markets. Medtronic divested its patient monitoring and respiratory businesses to concentrate on core markets, while Stryker expanded through acquisitions in digital surgery and neurovascular care. J&J’s potential move reflects a similar strategy to strengthen its position in cardiovascular care.

While this shift could provide short-term financial benefits, it risks limiting J&J’s ability to capitalise on the growing demand for advanced stroke care. Medtronic, Stryker, and Terumo have successfully invested in both the cardiovascular and neurovascular markets. Terumo strengthened its neurovascular portfolio with the 2016 acquisition of Sequent Medical and its innovative WEB aneurysm treatment device. While the cardiovascular market remains Terumo’s primary revenue driver, its ongoing investment in the neurovascular market has enabled it to capture new growth opportunities and monopolise the emerging intrasaccular flow device sector.

With the ageing population and rising stroke rates, health systems are increasingly prioritizing stroke interventions and expanding access to thrombectomy procedures. Additionally, AI is transforming stroke care, improving detection and triage. These developments make neurovascular care an attractive long-term opportunity for companies investing in these advancements.

Ultimately, J&J’s potential exit could provide short-term financial gains, but it may forfeit long-term growth in the evolving neurovascular sector. As J&J shifts resources to cardiovascular care, competitors such as Medtronic, Stryker, and Terumo may strengthen their foothold in neurovascular care, shaping the future of stroke care.