Managing to a Successful Acquisition

Dan Rose is a returning guest to Medsider and the former CEO of LimFlow, which was recently acquired by Inari. Dan’s roots trace back to Virginia, but he has been working in various medtech enterprises in Europe since 1999, accumulating a tremendous amount of experience across both large strategics and early-stage ventures. 

Starting in 2003, Dan worked at Medtronic for three years, with three different business units, and in five different countries. This was followed by his stint at Medtronic Europe, where he took on the position of head of marketing during the heyday of drug-eluting stents. He then joined the implantable pump company Sequana Medical in Zurich as CCO, followed by a role as the Head of Commercial for Direct Flow Medical. Under his leadership, Direct Flow Medical notably generated about $30 million in just two years. In 2016, he took the helm at LimFlow and guided the company’s path for seven years until its acquisition by Inari in late 2023.  

LimFlow was founded to address a major issue: blockages in leg arteries – a significant problem for people living with peripheral artery disease (PAD). The obstruction of blood flow can progress into a more severe condition known as Chronic Limb-Threatening Ischemia (CLTI), an extremely challenging disease where patients experience escalating leg pain and chronic foot ulcers. The blocked blood flow to the foot may eventually lead to lower limb amputations – roughly 100,000 to 120,000 occur annually in the US alone – and is associated with a high morbidity and mortality rate. 

The LimFlow device, in simple terms, introduces a less invasive way to treat CLTI. Arteries take blood from the heart to the tissue, and veins take deoxygenated blood from the tissue back to the heart. Instead of trying to open the blocked artery, LimFlow cleverly reroutes blood flow through a nearby vein – which, unlike arteries, are typically unaffected by atherosclerosis. The LimFlow procedure involves connecting arteries and veins together using wires and catheters. Then, a covered stent is placed into the vein to redirect blood flow in the reverse direction. 

Through this method, LimFlow effectively restores blood flow in the legs, facilitating the healing of the foot and averting the need for amputation. It offers a ray of hope to people suffering from CLTI and secured FDA approval in September of 2023, shortly before LimFlow's acquisition by Inari. 

Today, LimFlow is poised for a new chapter. Dan says, “From our perspective of culture, market development, and infrastructure, Inari was a beautiful landing place for LimFlow.” Under Inari’s umbrella, LimFlow is set to become a dedicated business unit, capitalizing on Inari’s strengths: commercialization and therapy development. 

Key Learnings From Dan’s Experience

• Vet your potential investors carefully and consider how their involvement will impact your business operations, especially if there are multiple parties involved. Limit their influence on decision-making to maintain flexibility and control over your company's direction. 

• In the early development phases, design for the average user to maximize adoption rates. Always iterate towards simplicity and be prepared to pivot accordingly. Don't focus solely on cutting-edge features or only cater to experts. And don't hold onto complex elements or features simply because they were part of the original plan. 

• Understanding the reimbursement landscape and how your technology fits into that is crucial to progress your conversations with VCs. Research potential investors to ensure that they have the capacity to invest and that their interests match your company's focus. Pursue those who can infuse substantial capital, streamlining your fundraising process.