Boston Scientific's (NYSE:BSX) second quarter looked like a rerun of its first quarter. Sales were down just a hair, about 2%, but the company was able to cut costs -- especially sales, general, and administrative -- enough to increase operating income by 8%. Net income on a GAAP basis, though, fell by 15%, primarily thanks to a loss-on-sale of non-strategic investments.

Investors are rightfully growing weary of Boston Scientific's ability to cut expenses on flat sales, and they sent the stock down 11% yesterday.

On the revenue side, it was a tale of two distinct classes of medical devices headed in opposite directions. Cardiac rhythm management saw sales increase 10% year over year. However, St. Jude Medical (NYSE:STJ) grew that part of its business by 20% this quarter.

In the other direction, worldwide sales of drug-eluting stents slipped by more than 12% this quarter as Medtronic (NYSE:MDT) continued to push into the U.S. market. Boston Scientific claims to have lost five points of market share in the States. It did see a drop of 30% in domestic stent sales. For comparison, Johnson & Johnson (NYSE:JNJ) said it had lost seven points of market share. On the other hand, Boston Scientific's international stent sales increased by 10%.

Of course, that's going to change even more, since a fourth player was approved earlier this month. Abbott Labs (NYSE:ABT) has already begun selling its Xience V stent. Under the terms of the Guidant breakup deal, Boston Scientific gets to sell that stent under the brand name Promus. Boston Scientific's gross margin will be smaller than that of its current offering -- Taxus Express2 -- because it has to share the profit with Abbott. However, some profit is better than no profit. Boston Scientific is continuing to fight for market share, hoping to get its Taxus Liberte stent approved for sale this quarter.

The new, leaner Boston Scientific is looking pretty good, but it's going to have to show that it can bulk up revenue a little before investors will have confidence in the stock again.

Fool contributor Brian Orelli, Ph.D., doesn't own shares of any company mentioned in this article. Johnson & Johnson is a Motley Fool Income Investor recommendation. The Fool's disclosure policy bulks up by printing itself in 72-point font.