In July 2026, Dr. Justin Cappuzzo, became the first neurosurgeon in North Carolina to use Penumbra’s recently FDA-cleared Thunderbolt aspiration system to remove a clot causing an ischemic stroke. He was also the first physician in the world to use the technology through a transradial approach.

Thunderbolt represents the latest evolution in mechanical thrombectomy, a procedure used to restore blood flow by removing a clot from an artery in the brain. The system is designed to remove the clot through a catheter using computer-controlled, modulated aspiration rather than requiring the surgeon to manually pull the clot through the artery.

Throughout the procedure, the catheter provides continuous feedback about the interaction between its tip and the clot. Thunderbolt uses that information to adjust the force of suction in real time.

The goal is to remove more of the clot on the first attempt, reduce the number of passes through the artery, and restore blood flow sooner. Each of those advantages matters in stroke care, when every second counts.

“This technology is a powerful addition to our capabilities and is only the latest example of how our center provides southeastern North Carolina with world-renowned stroke care. Thanks to our advanced protocols, we are already removing clots faster than the national average, and this technology will allow us to be even more efficient in a situation where every minute counts to save brain cells.”

A transradial approach may support faster recovery

Cappuzzo performed the procedure through the radial artery rather than using the traditional transfemoral approach.

Although the access route does not change the goal of neurothrombectomy, it can meaningfully affect the patient’s experience after the procedure. Transradial access is associated with a lower risk of bleeding at the catheter insertion site. Patients may also experience less postprocedural pain and can sit up and walk sooner.

The transradial route is not appropriate for every patient. The neurointerventional team selects the access route based on the patient’s anatomy, clot location, and other clinical considerations.

Expanding advanced stroke care in coastal North Carolina

The introduction of Thunderbolt reinforces Novant Health Deloris P. Jordan Neurosciences Institute and Novant Health New Hanover Regional Medical Center as a leader in stroke care in southeastern North Carolina.

For referring and community physicians, the advance underscores the importance of directing patients with a suspected large-vessel occlusion into an established stroke system as quickly as possible. Access to advanced thrombectomy technology and neurointerventional expertise gives eligible patients another opportunity for faster reperfusion, fewer procedural passes and a less burdensome recovery close to home.

“Patients across the coast have access to world-class stroke care in Wilmington. There is an opportunity to save not only more lives, but to preserve healthy brain tissue and set patients up for the best recovery possible.”