Summary of Penumbra (NYSE:PEN) 2025 Conference Call on Storm PE Company and Industry - **Company**: Penumbra, Inc. - **Industry**: Medical Devices, specifically focusing on treatments for pulmonary embolism (PE) Core Points and Arguments 1. **Introduction of Storm PE Trial**: The Storm PE trial is a landmark study that compares mechanical thrombectomy (CABT) using the Lightning Flash System by Penumbra against anticoagulation alone for treating intermediate high-risk pulmonary embolism patients [2][12][19] 2. **Significance of the Trial**: This is the first randomized trial in over a decade that evaluates endovascular therapy against anticoagulation, establishing the efficacy of mechanical thrombectomy in reducing strain on the heart [7][12] 3. **Primary Endpoint**: The primary endpoint was the right ventricle to left ventricle (RV to LV) ratio, which showed a significant reduction in the CABT group (78% achieved a therapeutic effect) compared to the anticoagulation group (52%) [11][12] 4. **Safety Profile**: The safety endpoints were comparable between the CABT and anticoagulation groups, with two major adverse events in the CABT group and four in the anticoagulation group, indicating a favorable safety profile for the CABT procedure [11][12] 5. **Patient Screening and Enrollment**: Out of 767 screened patients, only 100 were randomized, highlighting a rigorous screening process to ensure well-matched groups for the trial [15][16][18] 6. **Market Opportunity**: The prevalence of intermediate high-risk pulmonary embolism in the U.S. is estimated to be between 15% and 25% of all PE cases, translating to tens of thousands of potential patients who could benefit from this new treatment [18][19] 7. **Guideline Changes**: The trial provides foundational evidence that could lead to changes in treatment guidelines, moving away from the traditional approach of waiting for patient deterioration before considering intervention [19][20][28] 8. **Future Data and Publications**: Additional functional and quality of life data will be shared in future meetings, which are expected to further support the adoption of CABT [12][27][35] 9. **Education and Awareness**: There is a need for widespread education among healthcare providers, including non-interventionalists, to ensure the new treatment is adopted effectively [35][36][44] 10. **Cost-Effectiveness**: Preliminary health economic evaluations suggest that the CABT procedure may lead to long-term cost savings by reducing hospital readmissions and improving patient outcomes [56][57] Other Important but Possibly Overlooked Content 1. **Screening Ratio**: The screening ratio of 1:7 is considered excellent for a cardiovascular trial, indicating a high-quality selection process [15][17][22] 2. **Quality of Anticoagulation**: The trial achieved a high rate of full-dose anticoagulation (80% at 48 hours), which is significantly better than typical real-world scenarios [71][72] 3. **Multidisciplinary Approach**: The trial was conducted in collaboration with the PERT Consortium, emphasizing the importance of a multidisciplinary team in managing PE [35][60] 4. **Potential Class Effect**: The safety profile of the CABT procedure may set a new standard for mechanical thrombectomy devices, influencing future device development and adoption [52][55] 5. **Patient Cohort**: The trial focused on a specific cohort of intermediate high-risk patients, which may limit the generalizability of the results to other patient populations [78][81]