First Patient Enrolled in Penumbra's FORWARD Study Evaluating Mechanical Thrombectomy and Computer Assisted Vacuum Thrombectomy for Distal Acute Ischemic Stroke

ALAMEDA, Calif.,July 7, 2026/PRNewswire/ --Penumbra, Inc. (NYSE:PEN), the world's leading thrombectomy company, announced the initiation of its FORWARD study, an international, real world prospective, multi-center study. The study will collect safety and efficacy data on mechanical thrombectomy, including computer assisted vacuum thrombectomy (CAVT™) and modulated aspiration, in the management of acute ischemic stroke with distal occlusions. The first patient was treated by Keith Woodward, M.D., neurointerventional radiologist at Vista Radiology in Knoxville, Tenn.

"Distal occlusions are among the more difficult strokes to treat as medical interventions for patients in this population have historically provided limited benefit," said Nitin Goyal, M.D., co-principal investigator of FORWARD and endovascular neurologist at Semmes-Murphey Neurologic and Spine Institute in Memphis, Tenn. "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. 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."

"Distal occlusions are among the more difficult strokes to treat as medical interventions for patients in this population have historically provided limited benefit," said Nitin Goyal, M.D., co-principal investigator of FORWARD and endovascular neurologist at Semmes-Murphey Neurologic and Spine Institute in Memphis, Tenn. "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. 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."

FORWARD (FunctionalOutcomes inReal‑World TreatmentandRevascularization of Non-dominant and Distal M2 Occlusions) will enroll up to 250 participants at approximately 40 sites. The objective of the study is to evaluate Penumbra's market-leading RED reperfusion catheter portfolio, which includes THUNDERBOLT, the first CAVT platform to deliver modulated aspiration for acute ischemic stroke, to address M2 occlusions. The study will include patients treated with medical management alone and those treated with mechanical thrombectomy and medical management.

"Enrolling the first patient in FORWARD is an important milestone in understanding the true impact of mechanical thrombectomy on distal occlusions," said Alex Spiotta, M.D., co-principal investigator of FORWARD and chief of the neurosurgery department and director of neuroendovascular surgery at the Medical University of South Carolina. "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."

Stroke remains the third leading cause of death and disability globally, with approximately 11.9 million new cases in 2021 and about 94 million people living with its long-term effects.1Distal vessel occlusions account for roughly 25-40 percent of acute ischemic strokes2,3and studies estimate M2 occlusions occur in about 3-7% of acute ischemic stroke,4,5or approximately 21,000-66,000 M2 strokes annually.6

"FORWARD will deepen the medical community's understanding of how mechanical thrombectomy, specifically our latest catheter and CAVT technology, can more effectively address the complexity of M2 stroke," said James F. Benenati, M.D., FSIR, chief medical officer at Penumbra. "Penumbra's commitment to clinical research offers more insight into how our innovations translate to real-world patient outcomes, reinforcing our mission to develop the most meaningful treatment options for challenging medical conditions."

THUNDERBOLT recently received CE Mark and FDA clearance. It introduces modulated aspiration to Penumbra's neuro thrombectomy portfolio, offering advanced CAVT technology designed to detect, fatigue, and completely ingest clot at the site of the occlusion.

About PenumbraPenumbra, Inc., the world's leading thrombectomy company, is focused on developing the most innovative technologies for challenging medical conditions such as ischemic stroke, venous thromboembolism such as pulmonary embolism, and acute limb ischemia. Our broad portfolio, which includes computer assisted vacuum thrombectomy (CAVT), centers on removing blood clots from head-to-toe with speed, safety and simplicity. By pioneering these innovations, we support healthcare providers, hospitals and clinics in more than 100 countries, working to improve patient outcomes and quality of life. For more information, visitwww.penumbrainc.comand connect onInstagram,LinkedInandX.

Important Safety InformationAdditional information about Penumbra's products can be located on Penumbra's website athttps://www.penumbrainc.com/providers. Caution: Federal (USA) law restricts these devices to sale by or on the order of a physician. Prior to use, please refer to the Instructions for Use (IFU) for complete product indications, contraindications, warnings, precautions, potential adverse events, and detailed instructions for use. Please visitwww.peninc.info/riskfor the complete IFU Summary Statements.

Forward-Looking StatementsExcept for historical information, certain statements in this press release are forward-looking in nature and are subject to risks, uncertainties and assumptions about us. Our business and operations are subject to a variety of risks and uncertainties and, consequently, actual results may differ materially from those projected by any forward-looking statements. Factors that could cause actual results to differ from those projected include, but are not limited to: the risk that the pending acquisition by Boston Scientific Corporation will not be completed in the expected timeframe or at all, including the risk that required regulatory approvals will not be obtained; potential adverse effects to our business during the pendency of the acquisition, such as employee departures or diversion of management's attention from our business; failure to sustain or grow profitability or generate positive cash flows; failure to effectively introduce and market new products; delays in product introductions; significant competition; inability to further penetrate our current customer base, expand our user base and increase the frequency of use of our products by our customers; inability to achieve or maintain satisfactory pricing and margins; manufacturing difficulties; permanent write-downs or write-offs of our inventory or other assets; product defects or failures; unfavorable outcomes in clinical trials; inability to maintain our culture as we grow; fluctuations in foreign currency exchange rates; potential adverse regulatory actions; and the potential impact of any acquisitions, mergers, dispositions, joint ventures or investments we may make. These risks and uncertainties, as well as others, are discussed in greater detail in our filings with the Securities and Exchange Commission, including our Annual Report on Form 10-K for the year ended December 31, 2025, which we filed on February 25, 2026. There may be additional risks of which we are not presently aware or that we currently believe are immaterial which could have an adverse impact on our business. Any forward-looking statements are based on our current expectations, estimates and assumptions regarding future events and are applicable only as of the dates of such statements. We make no commitment to revise or update any forward-looking statements in order to reflect events or circumstances that may change.

• GBD 2021 Stroke Risk Factor Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol. Oct 2024;23(10):973-1003. doi:10.1016/s1474-4422(24)00369-7

• Ospel JM, Nguyen TN, Jadhav AP, et al. Endovascular Treatment of Medium Vessel Occlusion Stroke. Stroke. Mar 2024;55(3):769-778. doi:10.1161/strokeaha.123.036942

• Saver JL, Chapot R, Agid R, et al. Thrombectomy for Distal, Medium Vessel Occlusions: A Consensus Statement on Present Knowledge and Promising Directions. Stroke. Sep 2020;51(9):2872-2884. doi:10.1161/strokeaha.120.028956

• Rai AT, Domico JR, Buseman C, et al. A population-based incidence of M2 strokes indicates potential expansion of large vessel occlusions amenable to endovascular therapy. J Neurointerv Surg. Jun 2018;10(6):510-515. doi:10.1136/neurintsurg-2017-013371

• Duloquin G, Graber M, Garnier L, et al. Incidence of Acute Ischemic Stroke With Visible Arterial Occlusion: A Population-Based Study (Dijon Stroke Registry). Stroke. Jul 2020;51(7):2122-2130. doi:10.1161/strokeaha.120.029949

• Rai AT, Link PS, Domico JR. Updated estimates of large and medium vessel strokes, mechanical thrombectomy trends, and future projections indicate a relative flattening of the growth curve but highlight opportunities for expanding endovascular stroke care. J Neurointerv Surg. Dec 21 2023;15(e3):e349-e355. doi:10.1136/jnis-2022-019777