Penumbra: New Treatment Option for Stroke

Penumbra is a treatment option for people who have suffered a moderate to severe ischemic stroke (a stroke that occurs as a result of an obstruction in a blood vessel). Penumbra may be used when treatment with tissue plasminogen activator, or tPA (an intravenous clot-busting drug), is not recommended or in conjunction with tPA to achieve a higher efficacy. Penumbra can be used up to eight hours from the onset of stroke symptoms. The use of Penumbra also depends on the size and accessibility of the clot and the initial severity of the stroke.

First, a blood clot is located using cerebral angiography (brain catheterization) to image the blood vessels of the brain and the blood flowing through them. Cerebral angiography involves passing a catheter into a large artery in the groin and advancing the catheter up through the carotid artery that leads to the brain under X-ray guidance and monitors. A dye (contrast agent) is then injected into the carotid arteries, and X-ray is used to image the dye flowing through the blood vessels.

If a large clot is found, Penumbra may be used to try to remove part or all of the clot. The device is delivered into the brain through the catheter and moved through the blood vessels to the site of the clot. A “separator” is advanced through the catheter and then retracted to dislodge the clot. A suction device then grasps the clot for removal.