Great Aspirations: New Mechanical Approaches to Treating Pulmonary Embolism

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Pulmonary embolisms are managed by blood thinners, anticoagulants, and thrombolytic drugs, which cannot always resolve the problem and entail their own risks for bleeding complications. In a market with few widely used treatment options, start-ups Althea Medical, Akura Medical, and Magneto Thrombectomy are giving surgeons new minimally invasive tools to remove clots more effectively than ever.

Pulmonary embolism (PE) and stroke have much in common. They both involve blood clots being lodged in problematic areas, and both can be treated with drugs or surgeries ranging in degree of invasiveness. Where the two indications differ is in the adoption of various techniques to destroy or extract clots. While clinicians use mechanical thrombectomy, stenting, open surgery, and thrombolytic drugs such as tissue plasminogen activator (tPA) to treat stroke, some 90% of PE patients only receive heparin, a blood thinner, as their primary treatment. Though heparin and similar drugs are effective at stopping the formation of new clots and preventing existing ones from accumulating mass, they cannot ensure the breakdown of the often larger, older, and denser clots present in cases of PE.

To address the unmet need, namely patients with advanced PE who require urgent intervention, large device manufacturers including Abbott and Boston Scientific, along with newer entities like Inari Medical and Penumbra, have brought forth their own solutions. Inari, in particular, has garnered attention with the success of its oversubscribed IPO in May 2020, which Bloomberg called the best first-day performance of any of the 74 IPOs so far that year. Inari went public after two years of commercial operation in the PE and deep vein thrombosis (DVT) spaces, reporting $84.9 million in revenue and turning a net loss of $10.2 million into a net income of $4.1 million during that period. On the heels of Inari’s success with drug-free, catheter-based mechanical thrombectomy, there has been a growing interest in the category, beginning with leveraged technologies originally aimed at stroke and paving the way for novel PE-dedicated applications from Althea Medical, Akura Medical, and Magneto Thrombectomy Solutions.


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