Boston Scientific Pays $14.5 Billion for Penumbra, Betting Big on Thrombectomy

January 15, 2026 · by Fintool Agent

BSXPEN

Boston Scientific-4.67% is acquiring Penumbra+12.14%, the world's leading thrombectomy company, for approximately $14.5 billion in a cash-and-stock deal that marks the medical device giant's largest acquisition since the $3.4 billion Axonics purchase in late 2024.

The $374 per share offer—a 19% premium to Penumbra's January 14 close of $313.43—gives Boston Scientific a dominant position in mechanical thrombectomy, a high-growth market addressing stroke, pulmonary embolism, and peripheral vascular disease. Penumbra shares surged in after-hours trading to $355.49, while Boston Scientific fell approximately 3%.

Deal Structure

Under the terms of the agreement, Penumbra shareholders can elect to receive $374 in cash or 3.8721 shares of Boston Scientific stock, subject to proration so that total consideration is approximately 73% cash and 27% stock.

Boston Scientific will finance the cash portion through existing cash and new debt. The transaction is expected to be $0.06–$0.08 dilutive to adjusted EPS in the first full year post-close, neutral to slightly accretive in year two, and increasingly accretive thereafter.

Penumbra founder and CEO Adam Elsesser has indicated he will elect to receive Boston Scientific stock for all his shares and will join the Boston Scientific board upon closing.

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Strategic Rationale

"Penumbra is a well-established company with an experienced, high-performing team and this acquisition offers Boston Scientific an opportunity to enter new, fast-growing segments within the vascular space," said Boston Scientific CEO Mike Mahoney.

The deal provides Boston Scientific with:

Scaled entry into mechanical thrombectomy: Penumbra's INDIGO System for peripheral thrombectomy and Penumbra System for neurovascular interventions are market-leading platforms. The company's computer-assisted vacuum thrombectomy (CAVT) technology represents a differentiated approach to clot removal. 2

Neurovascular market access: While Boston Scientific has a strong peripheral interventions business generating $2.1 billion in the first nine months of 2025 3, it lacks meaningful presence in stroke intervention—a large and growing market with approximately 800,000 ischemic strokes annually in the United States alone. 4

High-growth revenue stream: Penumbra expects full-year 2025 revenue of approximately $1.4 billion, representing 17.3–17.5% growth, with Q4 growth accelerating to 21.4–22.0%. The thrombectomy market alone saw Penumbra generate $815.5 million in 2024 revenue, up from $677.3 million in 2023. 6

Complementary portfolio: Boston Scientific already has thrombectomy offerings including the AngioJet system and EKOS ultrasound-assisted thrombolysis 7, but Penumbra's mechanical aspiration approach and neurovascular expertise fill critical gaps.

Penumbra: A Profile

Founded in 2004, Penumbra describes itself as "the world's leading thrombectomy company," focused on removing blood clots from "head-to-toe with speed, safety and simplicity." 8

The company's product portfolio spans two main categories:

Thrombectomy Products 18

• Peripheral: INDIGO System (Lightning, Bolt, CAT RX) for pulmonary embolism, deep vein thrombosis, and acute limb ischemia
• Neuro: Penumbra System (RED, JET, ACE, MAX catheters) and 3D Revascularization Device for ischemic stroke

Embolization & Access Products 19

• Ruby Coil System for aneurysm treatment
• SMART COIL and other neurovascular embolization devices
• Neuron MAX and other access catheters

Penumbra exited its Immersive Healthcare business in 2024 after recording $115.3 million in impairment charges, refocusing entirely on its core thrombectomy and embolization franchises. 20

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Boston Scientific's M&A Spree Continues

This acquisition continues Boston Scientific's aggressive expansion through M&A. Recent deals include:

Boston Scientific's Peripheral Interventions business has been growing strongly—up 16.7% in Q3 2025 to $702 million—driven by acquisitions like Silk Road Medical and organic growth in interventional oncology and venous products. 1

Financial Impact

The deal adds significant scale but comes with near-term earnings dilution:

Boston Scientific Quarterly Performance

*Values retrieved from S&P Global

The ~$11 billion cash component will push Boston Scientific's debt load higher, but the company has demonstrated ability to manage leverage through previous acquisitions. Total debt stood at $12.0 billion as of Q3 2025, with cash of $1.3 billion 10.

Stock Performance

Penumbra shares have significantly outperformed Boston Scientific over the past 18 months:

• PEN: +66.7% since June 2024 (from $188 to $313)
• BSX: +24.2% since June 2024 (from $75 to $94)

Penumbra's premium valuation reflects its high-growth profile and market leadership position. At the $374 offer price, Penumbra trades at approximately 10.4x projected FY25 revenue of $1.4 billion.

What to Watch

Regulatory approval: The deal requires standard antitrust clearances but is not expected to face significant hurdles given limited overlap.

Shareholder vote: Penumbra shareholders must approve the transaction. With Elsesser electing stock and the substantial premium, approval is likely.

Integration execution: Boston Scientific must successfully integrate Penumbra's innovation culture and sales organization while capturing revenue synergies.

Debt management: Boston Scientific's leverage will increase significantly. Watch for any credit rating implications.

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The Bottom Line

Boston Scientific is making a bold bet on mechanical thrombectomy with its largest acquisition in company history. The $14.5 billion price tag—10x+ revenue—reflects Penumbra's dominant market position and high-teens growth trajectory. While near-term EPS dilution and increased debt load create execution risk, the strategic logic is sound: cardiovascular disease remains the leading cause of death globally, and Penumbra's clot-removal technologies address significant unmet needs in stroke and venous thromboembolism.

For Penumbra shareholders, the 19% premium and pathway to participate in Boston Scientific's broader cardiovascular platform offer compelling value. Adam Elsesser's decision to take stock rather than cash signals confidence in the combined entity's prospects.

Related

• Boston Scientific Company Profile-4.67%
• Penumbra Company Profile+12.14%