Endovascular Today: How Science-Based Aspiration Principles Inform Effective Stroke Care

A recent issue of Endovascular Today includes an article sponsored by Penumbra on the importance of Science-Based Aspiration (S-BAT) principles in stroke care. S-BAT is a framework at the root of all of Penumbra’s neuro thrombectomy devices. It is built on four core principles that guide effective aspiration:

• Physics: Recognizing energy flows and what actually occurs when catheter meets clot.
• Vessel Sizing: Understanding average vessel sizing and the optimal catheter-to-vessel ratio for effective aspiration.
• Flow Control: Evaluating the consequences of excessively restricting blood flow during a thrombectomy procedure.
• Time: Analyzing procedure time in relation to patient outcomes, and key opportunities to reduce time.

“Physics and vessel sizing help maximize pressure differentials, enhancing aspiration performance. Flow control and time address the risks of consequences of excessively restricting blood flow for prolonged periods during a thrombectomy. Recent research suggests that use of these principles together can help improve patient outcomes,” the authors write.¹

“In aspiration we’re driving clot removal by creating a large pressure differential between the arterial blood pressure and the pump. The key variables that affect removal are pressure differential, catheter radius, fluid viscosity, and catheter length,” said Dave Barry, Engineer Emeritus at Penumbra.

“Choosing a large diameter catheter is an obvious choice to increase the chance of successful thrombectomy,” Barry explains. “As the catheter to vessel diameter ratio approaches 1:1, the arterial pressure is reduced and eventually blocked. This results in a decrease in the pressure differential offsetting any benefit gained by the larger catheter. The optimal system is maximizing catheter diameter while maintaining the pressure differential,” he said.

The article also describes the CANADAPT approach to thrombectomy — a specific method for performing A Direct Aspiration First-Pass Technique (ADAPT) — which draws upon on core S-BAT principles to enhance procedural success. The stepwise technique that characterizes CANADAPT is effective because it maximizes the pressure differential between the vacuum inside the catheter and the systolic arterial pressure in the vessel. This is effective because high pressure always flows toward low pressure, creating a “push” effect that facilitates clot ingestion.¹

Choosing an appropriately sized catheter for a given vessel is key to the effectiveness of CANADAPT. Using a proportionally larger catheter risks a reduction in pressure differential due to inhibition of systolic flow, while using a proportionally smaller catheter risks a reduction in ingestion rate. An appropriately sized catheter is one that will maximize the effect of systolic pressure while maintaining adequate surface area for efficient clot ingestion. The article also explores the relationship between procedure speed and functional outcomes.

These S-BAT principles are at the heart of the product development process for Penumbra, resulting in aspiration catheters that are thoughtfully designed to maximize speed and efficacy in stroke management.

Three case studies appear alongside the article to detail Penumbra products in action, including:

• Left M1 occlusion addressed with RED™ 72 Reperfusion Catheter with SENDit™ Technology | Ryan Hebert, MD | Neurosurgery | Yale New Haven Hospital²
• Left M2 occlusion addressed with RED 43 Reperfusion Catheter | Jeff Beecher, DO | Neurological Surgery | Novant Health New Hanover Regional Medical Center³
• Left distal M1 occlusion addressed with RED 72 Reperfusion Catheter | Victor Szeder, MD, PhD, MSc, FSVIN | Interventional Neuroradiology | UCLA⁴

See the full article in Endovascular Today.

For more on science-based aspiration, see the S-BAT Info Center.

Important Safety Information

The clinical results presented herein are for informational purposes only, and may not be predictive for all patients. Individual results may vary depending on patient-specific attributes and other factors. Product availability varies by country. Caution: Federal (USA) law restricts these devices to sale by or on the order of a physician. Prior to use, please refer to Instructions for Use (IFU) for complete product indications, contraindications, warnings, precautions, potential adverse events, and detailed instructions for use. For the complete Penumbra IFU Summary Statements, visit: peninc.info/risk. Please contact your local Penumbra representative for more information.

Copyright ©2025 Penumbra, Inc. All rights reserved. RED and SENDit are registered trademarks or trademarks of Penumbra, Inc. in the USA and other countries. All other trademarks are the property of their respective owners.

<sup>1. Hebert R, Beecher J, Szeder V. Science-Based Aspiration Thrombectomy (S-BAT) Principles Inform Effective Stroke Care. Endovasc Today. June 2025. Available at: https://evtoday.com/articles/2025-june/science-based-aspiration-thrombectomy-s-bat-principles-inform-effective-stroke-care. Accessed September 17, 2025.
2. Disclosures: Consultant to Penumbra.
3. Disclosures: Consultant to Penumbra, Providence Medical, Aesculap Surgical Equipment, Medtronic, Viz.ai, and Balt.
4. Disclosures: Consultant to Medtronic, Penumbra, and Wallaby.</sup>