Evolving Your Capital Strategy as You Grow
Interview with Efemoral Medical CEO Christopher Haig
Key Learnings From Chris' Experience
Match technology to a problem the market can’t yet solve — and protect it early. Efemoral redirected bioresorbable scaffold technology from the coronary space to peripheral arterial disease, where outcomes were inconsistent and physicians were open to new solutions. By proving feasibility, refining the design, and building a strong global patent portfolio, the company created both clinical relevance and a defensible market position.
In clinical trials, prioritize patient follow-up, not just enrollment speed. Efemoral chose Australia and New Zealand over traditional European pathways not only for regulatory fit, but also because patient compliance in these regions ensures the long-term data their device requires — a factor just as critical as enrollment timelines.
Treat each funding stage as preparation for the next. Angel capital can launch a company, but reaching later fundraising rounds — and attracting institutional investors — requires disciplined governance, clear milestones, and organized data. Use the early stage to build credibility and generate proof points so that when larger capital is needed, you’re already operating at the standard institutional investors expect.
Perhaps the most valuable thing you can do as a medtech entrepreneur is see things that aren't there yet — and convince everyone else to see them too.
"That's a characteristic of very successful entrepreneurs — being able to get people rallying around a vision of the future that doesn't exist yet," says Christopher Haig, co-founder and CEO of Efemoral Medical.
Chris likens it to Steve Jobs’s “reality distortion field,” that magnetic conviction that can make bold ideas feel inevitable. Over nearly three decades in interventional cardiology — from his early days at ACS/Guidant through commercial leadership roles at Abbott Vascular — this mindset proved essential.
In 2017, former Abbott colleague Dr. Lewis Schwartz approached Chris with bioresorbable scaffold technology that had been applied in coronary use.
While the technology was effective, it didn’t achieve commercial success because there were already several effective treatment options, including drug-eluting stents, which had success rates of 90–95% in coronary arteries. In peripheral applications, however, physicians lacked viable long-term options that avoided the need for permanent implants.
“If you have the same disease in your leg, the outcomes from stenting or ballooning are just not very good,” Chris explains. “The need for reintervention with peripheral disease is much higher.”
Today, Efemoral’s multi-segment bioresorbable scaffold system has been implanted in 36 patients across Australia and New Zealand, with zero complications and no reinterventions at six months.
Guest
CEO of Efemoral Medical
Christopher is the co-founder and CEO of Efemoral Medical, leading development of its bioresorbable scaffold technology for peripheral arterial disease. He has over 25 years of experience in cardiovascular devices, holding leadership roles at strategics including Guidant Corporation and Abbott Vascular, and driving growth at startups such as Calypso Medical and QT Vascular, where he built commercial infrastructure and launched multiple products ahead of its $55 million IPO.
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How To Identify a "Large Unmet Need" — And What To Do Next
“Large unmet need” isn’t a throwaway line for investor decks — it’s a filter that shapes the entire trajectory of a company. Choose the wrong problem, and you can spend years building something elegant that the market doesn’t truly need.
The Efemoral team saw this contrast clearly when comparing coronary and peripheral interventions. Coronary stenting is a success story with consistent and durable results. Peripheral arterial disease, on the other hand, remains unpredictable: reinterventions are common, and physicians cycle through balloons, stents, drug-coated devices, and atherectomy tools — none of them reliably outperforming the others. In markets like this, clinicians are more willing to try something new because the status quo does not deliver consistently.
In Efemoral’s early days, the focus was on proving feasibility quickly: assembling a trusted group of engineers, drawing on lessons learned from earlier scaffold programs, and moving through bench tests and animal studies to refine the concept.
The design that emerged — a series of short, independent scaffolds crimped side by side on a single balloon — addressed the strength-versus-flexibility trade-off that had limited previous peripheral stenting approaches.
While the technical solution mattered, Chris was equally focused on protecting it. Efemoral now holds 20 issued patents across major markets, including the U.S., Europe, China, India, and Japan, creating a defensive moat around its approach. “I remember when we got our first patent — it felt like it would never come,” Chris says. “But over time, those filings became a real asset. They protect the device and give partners and investors confidence that we can defend our position in the market.”
For Chris, the choice to focus on peripheral disease was as much a strategic decision as a technical one. “You need to develop something for an unmet clinical need — a large unmet clinical need,” he says. The payoff is twofold: investors can see the market potential from the outset, and physicians are actively seeking a better solution. Efemoral’s eight-year journey underscores the point: significant unmet needs can justify the long timelines, capital demands, and regulatory lift of breakthrough devices — and they give a new technology the space to prove itself without having to unseat a near-perfect incumbent.
How To Leverage Geography as Clinical Data Advantage
Choosing where to run a first-in-human study can be as strategic as the device design itself. For Efemoral, the decision to launch in Australia and New Zealand was about more than finding a favorable regulatory pathway — it was about securing the right ecosystem to generate high-quality, long-term data.
Chris weighed three factors: regulatory feasibility, investigator quality, and patient compliance. Europe, once the default for U.S. medtech startups, had become less appealing after changes to its medical device directives, which tightened requirements even for pre-commercial products. “There’s been some changes…governing not just commercialized, but pre-commercial products,” Chris notes.
Australia and New Zealand offered a stronger mix. Both countries have world-class investigators and operate in English, eliminating translation hurdles. Just as important, patients there tend to take trial commitments seriously — a critical advantage for Efemoral’s bioresorbable scaffold, which requires long-term follow-up to prove durability. Chris notes that in some regions, patients who feel fine after treatment often skip follow-up visits, making it difficult to collect complete datasets. In Australia and New Zealand, however, trial teams consistently see patients return as scheduled, even months later, enabling reliable imaging and outcome tracking. “Even if they’re implanted with our device and they feel good, they still come back for their follow-up,” Chris says.
That commitment has paid off. Efemoral tracks not only clinical outcomes but also visual evidence through scheduled angiography and intravascular imaging. The result: among the 36 patients enrolled so far, none have required reintervention, and no restenosis or complications have been reported. Recent participants now have more than six months of follow-up — a key milestone for regulatory submissions and eventual commercialization.
From Angels to Sophisticated Rounds: How to Win Over Institutional Capital
Efemoral’s fundraising journey shows how capital strategy must evolve in step with technical milestones. Over its first years, the company raised more than $10 million in equity from individual angel investors, supplemented by a model that worked well initially but won’t meet the scale of future needs.
The Angel Stage Reality
Early-stage funding involved managing dozens of one-on-one relationships, with individual checks typically ranging from $25,000 to $100,000. “It’s very labor-intensive because you’re sometimes getting checks of $25,000,” Chris recalls. “There’s a lot of discussions you have to have and a lot of documents going back and forth.”
Patience was essential, particularly for the ambiguous “I’ll get back to you” responses. “The hardest is neither a no nor a yes,” Chris says. Explicit rejections proved more useful than indefinite delays, allowing him to focus on engaged prospects.
The approach succeeded primarily due to Chris’ extensive network. Investors who had worked with him or co-founder Lou Schwartz before already trusted them, and physician investors added powerful credibility. “The fact that we have physicians investing in us is a strong signal that a knowledgeable person is willing to put some risk capital into this company,” Chris notes.
That credibility was reinforced through consistent progress updates. In the angel stage, every technical win — from early animal data to positive safety signals and first-in-human milestones — became a tool for building momentum. Sharing these results kept current investors engaged and opened doors to new ones. “It’s the steady stream of proof points that convinces others to follow,” Chris says.
Preparing for Institutional Capital
“Our capital needs are going to be much larger,” Chris says, noting that pre-clinical studies conducted under Good Laboratory Practice (GLP) standards — along with the rigorous quality and documentation requirements that FDA mandates for non-clinical safety testing — are particularly costly.
The next phase will require institutional investors, including venture capital, family offices, and strategics. The leap isn’t just about bigger checks; it’s about being ready for their standards, too, which could include even tighter governance and more stringent financial oversight.
Preparing for that shift can feel daunting, but Chris cautions founders not to get distracted by surface-level concerns. Founders can often overestimate the weight of cap table aesthetics, focusing too much on assembling a specific type of investor to achieve a clean cap table. Having raised funds from many angel investors instead of name-brand VCs hasn’t been a barrier for Efemoral. “Eventually, I think what will speak loudest is the quality of your data,” Chris says.
Building Strategic Relationships Early
Chris applies the same long-term thinking to M&A planning. The key is to start years before you’re ready to sell. “You should get to know them…build a relationship among many people,” he says, noting that large strategics often have multiple entry points — business units, venture arms, technical teams.
This breadth is essential because personnel changes are inevitable. “People in strategics, they change jobs. Maybe they were a leader in one area and they switched to another area, maybe they leave the company,” Chris says.
Understanding a strategic’s priorities allows founders to position their technology within that vision — and sometimes reshape it. “Try to understand what their strategy is, what they’re looking for, but also be able to differentiate your device, why you think it’s relevant for their portfolio,” Chris explains. “If you’re really good, you can shift their perspective into thinking about the world as you see it.”
In both fundraising and strategic engagement, Chris cautions against waiting until capital is nearly gone or a sale is imminent, which erodes leverage. Equally risky is overpromising in ways that damage credibility — yet underselling your vision can be just as limiting. The challenge is to strike the right balance, start early, and keep building relationships long before you need them.
For Chris, those long-term relationships — just like the technology itself — began with seeing something that wasn’t there yet, and having the patience and persistence to make others see it too.
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