SIR 2026: Nationwide Analysis Finds CAVT Associated with Shorter Hospital and ICU Stays, and Lower Readmissions in ALI

A new nationwide retrospective study analysing more than 9,000 lower extremity acute limb ischemia (ALI) patient records found that Computer Assisted Vacuum Thrombectomy (CAVT™) is associated with a significant reduction in hospital resource usage compared to open embolectomy (OE). The researchers found that CAVT was associated with reduced 30-day mortality, shorter hospital and ICU stays, lower need for post-procedure ICU and step-down care, fewer readmissions, and more discharges to home. The data was presented by Dr. Brian Schiro, MD, of the Miami Cardiac and Vascular Institute, at the SIR Annual Scientific Meeting on April 13th in Toronto.

ALI affects as many as 259,000 Americans per year and is associated with significant in-hospital mortality between 9% and 12%.^1,2 ALI patients also face short- and long-term complications, including in hospital amputation rates as high as 6% to 9%,² and a low five-year amputation-free survival rate of 36.7%, according to one study.³ If an underlying lesion is involved and not treated, ALI caused by thrombosis may have a recurrence rate of 43%.¹ Lower extremity amputations are associated with additional resource utilization costs of $110,000 per patient.^4,i

“These findings show that CAVT represents a potential shift in ALI management nationwide,” said Dr. Schiro. “By reducing ICU utilization, shortening hospital stays, and getting patients back home faster with fewer readmissions, CAVT may help ease both the clinical and economic burden of a disease that carries high mortality, amputation risk, and cost.”

Dr. Schiro and his colleagues used the Premier Healthcare Database to identify adults 40 years and older who underwent inpatient therapy for lower extremity ALI using associated procedure codes between January 2021 and June 2024. Multivariable regression models adjusted for patient and hospital factors and reported odds ratios (OR) and length of stay ratios (LOSR) with 95% confidence intervals (CIs).⁵

After adjustment, CAVT was associated with:⁵

Shorter hospital and ICU stays

• 35% reduction in mean length of stay (2.33 days less) (LOSR 0.65, 95% CI 0.62-0.68; p< 0.001).
• 41% reduction in mean post-procedure length of stay (2.27 days less) (LOSR 0.59, 95% CI 0.56-0.62; p< 0.001).
• Shorter mean ICU stays by 0.66 days when admitted (LOSR 0.77, 95% CI 0.71-0.84; p< 0.001), though there was no difference in overall ICU admissions between groups.
•  27% lower odds of post procedure ICU admissions (OR 0.73, 95% CI .63-0.85; p< 0.001) and shortened mean post procedure ICU duration by 0.79 days (LOSR 0.71, 95% CI 0.64-0.80; p< 0.001).
• 0.35 ICU days saved per patient (p<0.0001), accounting for ICU admission probability.

Reduced need for step-down care and lower readmissions

• 50% lower odds of step-down unit use (OR 0.50, 95% CI 0.43-0.58; p<0.001).
• 39% lower mortality rate within the 30-day follow-up period (OR 0.61, 95% CI 0.38-0.99, p=0.047), though in-hospital mortality did not differ during index admission.
• 28% lower odds of 30-day all cause readmissions (OR 0.72, 95% CI 0.60-0.87, p<0.001), and 41% lower 30-day ALI related readmissions (OR 0.59, 95% CI 0.47-0.74, p<0.001).
• Over three times the odds of being discharged to home (OR 3.09, 95% CI 2.67-3.58, p< 0.001.

For a condition where time, resources, and outcomes are tightly linked, this large-scale real-world analysis underscores the growing importance of minimally invasive therapies in delivering more efficient, patient-centered vascular care.

Learn more about Penumbra’s CAVT technology.

Important Safety Information

Additional information about Penumbra’s products can be located on Penumbra’s website at https://www.penumbrainc.com/products/peripheral-thrombectomy-cavt/. 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. 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 ©2026 Penumbra, Inc. All rights reserved. CAVT, is a registered trademark or trademark of Penumbra, Inc. in the USA and other countries.

<sup>1. Acute Limb Ischemia (ALI) U.S. Incidence and Market for Removal of Thrombi and Emboli. The Sage Group. 2019.
2. Jarosinski M, Kennedy JN, Khamzina Y, et al. Percutaneous thrombectomy for acute limb ischemia is associated with equivalent limb and mortality outcomes compared with open thrombectomy. J Vasc Surg. 2024 May;79(5):1151-1162.e3. doi:10.1016/j.jvs.2024.01.014
3. Howard DPJ, Banerjee A, Fairhead JF, Hands L, Silver LE, Rothwell PM. Population-Based Study of Incidence, Risk Factors, Outcome, and Prognosis of Ischemic Peripheral Arterial Events. Circulation. 2015;132(19):1805-1815. doi:https://doi.org/10.1161/circulationaha.115.016424
4. Smith R. The hidden costs of amputations. Wound Care Advantage. Published April 4, 2023. Accessed April 17, 2026. https://www.thewca.com/blog/the-hidden-costs-of-amputations.
5. Arko F, Chaer R, Harris L, et al. Resource utilization differences between aspiration thrombectomy and open embolectomy in lower extremity acute limb ischemia: a U.S. nationwide cohort study. Presented at: Society of Interventional Radiology Annual Scientific Meeting (SIR 2026); April 2026; Toronto, ON, Canada.
i. The resource utilization cost of a lower extremity amputation includes the amputation procedure, therapy, and prosthetics.</sup>