Executive Summary

Q1 2025 delivered a clean beat: revenue $324.1M (+16.3% YoY; +2.7% QoQ) and non-GAAP diluted EPS $0.83, both above S&P Global consensus; U.S. thrombectomy revenue grew 25% to $187.9M, driving gross margin to 66.6% and adjusted EBITDA margin to 18.4% .
Management reiterated FY25 total revenue guidance $1.34–$1.36B and raised U.S. thrombectomy growth to 20–21% (from 19–20%), with plans for ≥100 bps gross margin expansion to >67% and operating margin of 13–14% .
Strategic narrative: CAVT-led share gains across VTE, arterial, and stroke; Ruby XL received early FDA clearance (launch targeted late Q2/early Q3), and Thunderbolt clinical data submitted to FDA; company manufactures 100% in U.S., limiting tariff risk and is on track for ≥70% GM by end-2026 .
International headwinds persist, particularly China (management removed ~$5M from 2025 forecast and sees continuing pressure in Q2), but strength in U.S. thrombectomy more than offsets .

What Went Well and What Went Wrong

What Went Well

Strong U.S. thrombectomy momentum: U.S. revenue +25% YoY to $187.9M; CEO highlighted 42% YoY growth in U.S. VTE, with conversions from anticoagulation/lytics and other platforms to CAVT (Flash 2.0, Bolt 12) .
Margin trajectory improving: gross margin expanded to 66.6% (+160 bps YoY) on favorable mix and productivity, and adjusted EBITDA margin reached 18.4% .
Pipeline execution: Early FDA clearance for Ruby XL (expedited inventory build; launch targeted late Q2/early Q3) and Thunderbolt clinical data submitted to FDA; management reiterated path to >70% GM by end-2026 .

What Went Wrong

International weakness: international revenue down 2.5% YoY (reported) in Q1; China declined $6.7M YoY and is expected to remain a headwind in Q2 .
Q2 gross margin headwind: CFO flagged 1-quarter expediting cost for Ruby XL, likely making Q2 GM similar to or slightly lower than Q1 before resuming sequential expansion in 2H25 .
Limited China contribution to 2025: management removed ~$5M from China from the FY plan given macro conditions (impact concentrated in Q2), requiring U.S. thrombectomy outperformance to offset .

Financial Results

Metric	Q3 2024	Q4 2024	Q1 2025
Revenue ($USD Millions)	$301.0	$315.5	$324.1
GAAP Diluted EPS ($USD)	$0.75	$0.86	$1.00
Non-GAAP Diluted EPS ($USD)	$0.85	$0.97	$0.83
Gross Margin (%)	66.5%	66.8%	66.6%
Adjusted EBITDA ($USD Millions)	$56.7	$63.7	$59.6
Adjusted EBITDA Margin (%)	18.8%	19.8%	18.4%
Operating Income ($USD Millions)	$35.4	$42.8	$40.4
Net Income ($USD Millions)	$29.5	$33.7	$39.2

Segment and Geography Breakdown (YoY)

Segment/Region	Q1 2024	Q1 2025
Thrombectomy Revenue ($USD Millions)	$187.7	$226.5 (+20.7%)
Embolization & Access Revenue ($USD Millions)	$91.0	$97.6 (+7.3%)
U.S. Thrombectomy ($USD Millions)	$150.3	$187.9 (+25.0%)
International Thrombectomy ($USD Millions)	$37.4	$38.7 (+3.3%)
U.S. Embolization & Access ($USD Millions)	$59.4	$69.0 (+16.2%)
International Embolization & Access ($USD Millions)	$31.6	$28.6 (−9.4%)
United States Total ($USD Millions)	$209.6	$256.9 (+22.5%)
International Total ($USD Millions)	$69.0	$67.3 (−2.5%)

KPIs

KPI	Q3 2024	Q4 2024	Q1 2025
U.S. Revenue Mix (%)	75.2%	78.6%	79.2%
Cash & Equivalents ($USD Millions)	$280.5	$324.4	$376.1
Adjusted EBITDA ($USD Millions)	$56.7	$63.7	$59.6
Net Debt	—	—	No debt (per CFO)

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Total Revenue	FY 2025	$1.34–$1.36B	$1.34–$1.36B	Maintained
U.S. Thrombectomy Growth	FY 2025	19–20% YoY	20–21% YoY	Raised
Gross Margin	FY 2025	≥100 bps expansion to >67%	≥100 bps expansion to >67%	Maintained
Operating Margin	FY 2025	13–14%	13–14%	Maintained
China Revenue Assumption	FY 2025	~$5M included in plan	Excluded given macro	Lowered

Earnings Call Themes & Trends

Topic	Previous Mentions (Q3 2024, Q4 2024)	Current Period (Q1 2025)	Trend
CAVT adoption & U.S. thrombectomy	U.S. thrombectomy +21% YoY (Q3) and +27% YoY (Q4) with VTE leadership	U.S. thrombectomy +25% YoY; U.S. VTE +42% YoY; conversions from lytics and other platforms	Accelerating
Stroke aspiration innovation	Strong aspiration portfolio; pipeline visibility (Q3/Q4)	RED 72 “Silver Label” launched; Thunderbolt clinical data submitted to FDA	Strengthening
Tariffs/macro & supply chain	International soft spots; China pressure (Q4)	100% U.S. manufacturing; ~75% U.S.-sourced components; active onshoring; China revenue excluded	Risk mitigated in U.S.; China down
Gross margin trajectory	GM ~66.5–66.8% with positive mix (Q3/Q4)	GM 66.6%; Q2 GM similar/slightly lower on Ruby XL expedite; back to sequential expansion in 2H	Upward path intact
Embolization portfolio	Modest growth in U.S.; intl pressure (Q3/Q4)	Ruby XL early FDA clearance; launch targeted late Q2/early Q3; focus on commercial team capacity	Improving setup
Manufacturing expansion	N/A	Costa Rica facility underway; provides flexibility vs tariffs and margin optimization by 2027	Long-term positive

Management Commentary

“In the first quarter, we generated total revenue of $324.1 million … U.S. thrombectomy revenue increased 25% year-over-year to $187.9 million, with our U.S. VTE franchise once again leading the business with total year-over-year growth of 42%.” – Adam Elsesser, CEO .
“Gross margin of 66.6% expanded 160 basis points … operating income of $40.4 million or 12.4% of revenue increased 550 basis points over the year ago period. We remain on track … to achieve a gross margin profile of over 70% by the end of 2026.” – Adam Elsesser .
“We currently manufacture 100% of our products in the United States … approximately 3/4 of our raw materials and components are currently sourced in the United States … engaged in … onshoring of certain materials.” – Adam Elsesser .
“FDA clearance of Ruby XL came earlier than we expected … expedited inventory build … market launch in either late Q2 or early Q3.” – Adam Elsesser .
“Regarding our THUNDER trial, in the first quarter of 2025, we submitted the clinical data to the FDA for review.” – Adam Elsesser .

Q&A Highlights

Growth drivers: Stroke grew above market; arterial contributions ramping (Bolt 7/6X), with VTE momentum across PE/DVT; share gains attributed to superior product performance rather than competitor disruption .
R&D and operating margin: Lower R&D reflects Immersive wind-down savings (~$10M per quarter, half in R&D), with continued investment in innovation; management keeps conservative stance on raising OM guidance early in the year .
China impact and FY25 guide: Consensus beat in Q1 (~$8–9M) vs removal of ~$5M China (mostly in Q2) implies net uplift, primarily from U.S. thrombectomy .
Ruby XL market: New larger coil for peripheral embolization; high physician interest; market sizing to follow initial clinical use .
Manufacturing & tariffs: Costa Rica plant offers flexibility—either margin optimization or international supply diversification depending on tariff backdrop; timeline toward 2027 .
New thrombolytic agent: Minimal near-term impact on thrombectomy demand; applicable to very distal strokes where aspiration catheters do not fit .
Pricing stance: Penumbra emphasized volume-led growth and is not raising prices broadly; Thunderbolt likely carries appropriate case pricing but aims to be competitive per case versus current multi-device approaches .

Estimates Context

Actual vs S&P Global Consensus (Q1 2025)

Metric	Consensus*	Actual	Surprise
Revenue ($USD Millions)	$315.7*	$324.1	+$8.4M; +2.7% – bold beat
Non-GAAP Diluted EPS ($USD)	$0.67*	$0.83	+$0.16; +24% – bold beat
EBITDA ($USD Millions)	$42.3*	$45.4*	+$3.1; +7% – beat (SPGI normalized)**

Values retrieved from S&P Global.
Bold beat/miss interpretation provided for investor context.
**Note: SPGI “EBITDA” reflects normalized methodology and may differ from company-reported adjusted EBITDA of $59.6M .

Key Takeaways for Investors

Strong U.S.-led beat with 25% thrombectomy growth and 42% VTE growth supports upward estimate revisions, particularly on U.S. thrombectomy trajectories for FY25 .
Guidance quality improved: U.S. thrombectomy raised to 20–21% while total revenue guide maintained despite China removal; signals confidence in core U.S. execution .
Near-term margin watch: Expect Q2 GM similar/slightly lower on Ruby XL expedite costs; plan for resumed sequential expansion in 2H25; maintain focus on mix and productivity .
Pipeline catalysts: Ruby XL (late Q2/early Q3 launch), Thunderbolt FDA review, and continued arterial innovation are set to reinforce competitive positioning and narrative strength .
Tariff/macro insulation: 100% U.S. manufacturing and onshoring strategy reduce tariff risk; Costa Rica build adds flexibility and optionality by 2027 .
International underweight remains a tactical benefit in current macro; U.S. now ~79% mix—keep positioning for sustained outperformance in U.S. thrombectomy .
Trading lens: Momentum in U.S. thrombectomy and credible path to >67% FY25 GM and 13–14% OM, paired with pipeline visibility, are likely positive stock catalysts; monitor Q2 gross margin and Thunderbolt regulatory updates .

Supporting Details and Cross-References

Q1 2025 headline metrics: revenue $324.1M; GM 66.6%; operating income $40.4M; net income $39.2M; adjusted EBITDA $59.6M; U.S. thrombectomy $187.9M .
Sequential revenue growth 2.7% in Q1 2025 (vs Q4 2024) driven by U.S. thrombectomy and EMEA, offset by China decline .
Prior quarters for trend: Q3 2024 revenue $301.0M; GM 66.5%; adjusted EBITDA $56.7M; non-GAAP EPS $0.85 . Q4 2024 revenue $315.5M; GM 66.8% (67.4% adjusted); adjusted EBITDA $63.7M; non-GAAP EPS $0.97 .
FY25 outlook reiterated/raised as above .

Penumbra Inc (PEN)·Q1 2025 Earnings Summary