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Penumbra, Inc. designs, develops, manufactures, and markets medical devices in the United States and internationally. The company operates through two segments, Ventricular Assistive (VAD) Systems Group and Neurovascular Intervention Devices Group. As of December 31, 2006, its VAD Systems Group segment sold cardiovascular support systems comprising left ventricular assist devices; tissue heart pumps; heart assist blood pumps; ventricular assist blood pumps; and centrifugal blood pumps to hospitals and distributors in the United States and internationally. The Neurovascular Intervention Devices Group segment produces balloon angioplasty catheters and tools for treatment of vascular stenosis; electrosurgical pads for endovascular surgical procedures; ultrasound imaging products for carotid artery disease screening and diagnostic applications; and instruments for neurovascular surgery. In addition, this segment provides maintenance service contracts under which customers can lease equipment to replace their long-term commitments with capital equipment ownership. The company markets its products directly to physicians in the United States through in-person sales visits by its representatives.