The U.S. drug-eluting stent market just got a little more crowded. Medtronic (NYSE: MDT) announced late last week that the FDA had approved its Endeavor stent for marketing in the U.S.

The Endeavor joins Johnson & Johnson's (NYSE: JNJ) Cypher and Boston Scientific's (NYSE: BSX) Taxus as the only stents approved here in the States. Medtronic has already been competing with both of them overseas.

Medtronic won't be competing against just the entrenched duo; it's also going up against the stents' bare-metal cousins, as well as alternative procedures like bypass surgery. The drug-oozing variety is still dealing with bad publicity from a study in 2006 that said they weren't safe (the percentage of stent procedures using drug-eluting stents is down to 62% from 88% in mid-2006). Even with the plethora of competition, now seems like a pretty good time to get in, since the drug-eluting stent market appears to be stabilizing.

Assuming the FDA stays consistent with its review timing, the three-month time frame from Medtronic's advisory panel meeting to approval means that Abbott Laboratories (NYSE: ABT) should expect to hear about its approval about mid-March, based on its November positive committee meeting.

I'm not sure that being a few months behind is ultimately going to hurt Abbott that much. In my opinion, it has the best clinical-trial data, so it seems that the battle will come down to whether cardiologists will pick the stent with promising clinical-trial data or the one they have real-life experience with.

That could leave Medtronic as the odd man out in the foursome. Then again, the Endeavor stent has sold well in Europe, so maybe Medtronic's sales force will endeavor here as well.

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