Penumbra System: ACE68 / JET 7 / JET 7 Xtra Flex
Penumbra, Inc. (Alameda, CA)
System Overview The latest generation of the Penumbra System features the ACE Reperfusion Catheters, HiFlow Aspiration Tubing, the 3D Revascularization Device, and Pump MAX aspiration pump and accessories. The system represents the original ADAPT platform.
Level: Level 1
System Overview The latest generation of the Penumbra System features the ACE Reperfusion Catheters, HiFlow Aspiration Tubing, the 3D Revascularization Device, and Pump MAX aspiration pump and accessories. The system represents the original ADAPT platform. Launched in 2016, the ACE68 Reperfusion Catheter offers outstanding trackability and enables even greater aspiration power for clot removal through its large 0.068" lumen.
Lightning Technology: Computer-Assisted Aspiration The Penumbra ENGINE/Lightning pump adds a clot-detection algorithm to the aspiration platform. The aspiration catheter connects to a vacuum pump (the Penumbra Engine), which generates suction through negative pressure (approximately 98.2 kPa); the vacuum exerted on the thrombus is controlled by the aspiration tubing, which has a microprocessor running dual clot detection algorithms. Lightning Flash, cleared by the FDA in January 2023, features dual clot detection algorithms: one detects clot based on pressure differentiation, while the other detects flow characteristics. Composed of a stainless-steel, laser-cut hypotube, the Lightning catheter offers 1:1 torqueability and an atraumatic design. The combination of improved catheter technology and computer-aided clot detection sets the Lightning System apart as a significant advance in the mechanical thrombectomy space.
Catheter Matrix Catheter
ID
Primary Target
ACE68
0.068"
ICA / M1
JET 7 / JET 7 Xtra Flex
0.072"
Proximal LVO, maximum aspiration
ACE64
0.064"
M2 / transitional
3MAX
0.035"
Distal MeVO
PROMISE Study (ACE68 / ACE64) The PROMISE study analyzed the safety and effectiveness of the Penumbra System with the ACE68 and ACE64 reperfusion catheters in aspiration thrombectomy of stroke using ADAPT. PROMISE was a prospective study enrolling 204 patients with intracranial anterior circulation LVO ischemic stroke in 20 centers from February 2016 to May 2017, with initial treatment within 6 hours of symptom onset. A final revascularization mTICI 2b-3 was achieved in 96.5% (194/201) of patients, per investigator assessment. “ADAPT as a frontline approach demonstrated excellent results in both revascularization rates and clinical outcomes,” with the study indicating that stroke revascularization with aspiration is safer and more effective with ACE68 and ACE64 than ever before.
JET 7 in ICA-T Occlusions All patients treated with a Direct Aspiration first-Pass Technique (ADAPT) using the JET 7 “Standard Tip” Penumbra Reperfusion catheter for acute T-ICA occlusion were retrospectively included, with baseline data, puncture to recanalization time, number of attempts, switch rate, and successful recanalization rate assessed. First-attempt successful recanalization (eTICI ≥ 2b) was obtained in 90.5% of cases.
ADAPT Deployment Sequence Track catheter over microcatheter + wire to proximal clot face Remove inner members; connect to aspiration source; engage clot If flow returns, slowly withdraw under continuous aspiration If clot is “corked” (no flow return), withdraw catheter + clot as a unit en bloc If two passes fail, escalate to stent retriever combined (Solumbra) technique
Technical Tip
“Catheter won’t track the last centimetre” is the most common ADAPT failure. Advance over an intermediate-stiffness microcatheter (e.g., a 0.027") and a stiffer wire, and use a “ledgereducing” coaxial step-up rather than forcing the tip. ──────────────────────────────────────────────────
Curated external education for the Aspiration Catheters family. Media is provided for reference under fair-use/educational terms and credited to its source; it supplements the printed Atlas.
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Chapter 2
Aspiration and Reperfusion Catheters
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Overview
Level: Level 1
System Overview The latest generation of the Penumbra System features the ACE Reperfusion Catheters, HiFlow Aspiration Tubing, the 3D Revascularization Device, and Pump MAX aspiration pump and accessories. The system represents the original ADAPT platform. Launched in 2016, the ACE68 Reperfusion Catheter offers outstanding trackability and enables even greater aspiration power for clot removal through its large 0.068" lumen.
Lightning Technology: Computer-Assisted Aspiration The Penumbra ENGINE/Lightning pump adds a clot-detection algorithm to the aspiration platform. The aspiration catheter connects to a vacuum pump (the Penumbra Engine), which generates suction through negative pressure (approximately 98.2 kPa); the vacuum exerted on the thrombus is controlled by the aspiration tubing, which has a microprocessor running dual clot detection algorithms. Lightning Flash, cleared by the FDA in January 2023, features dual clot detection algorithms: one detects clot based on pressure differentiation, while the other detects flow characteristics. Composed of a stainless-steel, laser-cut hypotube, the Lightning catheter offers 1:1 torqueability and an atraumatic design. The combination of improved catheter technology and computer-aided clot detection sets the Lightning System apart as a significant advance in the mechanical thrombectomy space.
Catheter Matrix Catheter
ID
Primary Target
ACE68
0.068"
ICA / M1
JET 7 / JET 7 Xtra Flex
0.072"
Proximal LVO, maximum aspiration
ACE64
0.064"
M2 / transitional
3MAX
0.035"
Distal MeVO
PROMISE Study (ACE68 / ACE64) The PROMISE study analyzed the safety and effectiveness of the Penumbra System with the ACE68 and ACE64 reperfusion catheters in aspiration thrombectomy of stroke using ADAPT. PROMISE was a prospective study enrolling 204 patients with intracranial anterior circulation LVO ischemic stroke in 20 centers from February 2016 to May 2017, with initial treatment within 6 hours of symptom onset. A final revascularization mTICI 2b-3 was achieved in 96.5% (194/201) of patients, per investigator assessment. “ADAPT as a frontline approach demonstrated excellent results in both revascularization rates and clinical outcomes,” with the study indicating that stroke revascularization with aspiration is safer and more effective with ACE68 and ACE64 than ever before.
JET 7 in ICA-T Occlusions All patients treated with a Direct Aspiration first-Pass Technique (ADAPT) using the JET 7 “Standard Tip” Penumbra Reperfusion catheter for acute T-ICA occlusion were retrospectively included, with baseline data, puncture to recanalization time, number of attempts, switch rate, and successful recanalization rate assessed. First-attempt successful recanalization (eTICI ≥ 2b) was obtained in 90.5% of cases.
ADAPT Deployment Sequence Track catheter over microcatheter + wire to proximal clot face Remove inner members; connect to aspiration source; engage clot If flow returns, slowly withdraw under continuous aspiration If clot is “corked” (no flow return), withdraw catheter + clot as a unit en bloc If two passes fail, escalate to stent retriever combined (Solumbra) technique
Deployment
Technical Tip
“Catheter won’t track the last centimetre” is the most common ADAPT failure. Advance over an intermediate-stiffness microcatheter (e.g., a 0.027") and a stiffer wire, and use a “ledgereducing” coaxial step-up rather than forcing the tip. ──────────────────────────────────────────────────
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