Penumbra Begins FORWARD Study of Red Perfusion Catheter Portfolio in Distal Acute Ischemic Stroke Management

July 7, 2026—Penumbra, Inc. announced the initiation of its FORWARD study, which will collect safety and efficacy data on mechanical thrombectomy in the management of acute ischemic stroke with distal occlusions. The first patient in the study was treated by Keith Woodward, MD, neurointerventional radiologist at Vista Radiology in Knoxville, Tennessee.

According to Penumbra, FORWARD is an international, multicenter, prospective study of functional outcomes in real-world treatment and revascularization of nondominant and distal M2 occlusions. The study will enroll up to 250 patients at approximately 40 sites.

The objective of the study is to evaluate Penumbra’s Red reperfusion catheter portfolio to address M2 occlusions.

The company portfolio includes the Thunderbolt CAVT platform that delivers modulated aspiration for acute ischemic stroke. Thunderbolt recently received CE Mark approval and FDA clearance.

The study will include patients treated with medical management alone and those treated with mechanical thrombectomy and medical management.

Nitin Goyal, MD, and Alex Spiotta, MD, are Coprincipal Investigators of the FORWARD study.

“Distal occlusions are among the more difficult strokes to treat as medical interventions for patients in this population have historically provided limited benefit,” commented Dr. Goyal in Penumbra’s press release. “FORWARD is a prospective study designed to evaluate whether that paradigm can change. Mechanical thrombectomy has an established safety profile and a strong track record in treating large vessel occlusions.”

Dr. Goyal further stated, “With the latest advancements designed for navigating deeper into the brain, the FORWARD study aims to determine whether these same benefits can extend to distal occlusions and help pave the way for an important treatment option for a patient population that has limited choices.”

Dr. Spiotta added, “Enrolling the first patient in FORWARD is an important milestone in understanding the true impact of mechanical thrombectomy on distal occlusions. We have already seen how mechanical thrombectomy can positively benefit patients with acute ischemic stroke by rapidly restoring blood flow to the brain and improve patient outcomes. The results of this study will help inform physicians on treatment selection for stroke patients with M2 occlusions, potentially supporting wider adoption of mechanical thrombectomy for this challenging condition.”