The recognition of pharyngeal electrical stimulation (PES) as a valuable treatment for dysphagia, or difficulty swallowing, following a stroke marks a significant advancement in patient care. This acknowledgment comes from the American Stroke Association (ASA), an offshoot of the American Heart Association (AHA). In their latest guidelines, released on January 26, 2026, the ASA emphasizes PES's role as a beneficial intervention aimed at alleviating dysphagia symptoms and minimizing the risks associated with aspiration.
These guidelines are particularly crucial for patients who have suffered a severe stroke and experience dysphagia that necessitates interventions such as tracheotomy and mechanical ventilation. The ASA highlights that administering PES after these patients have been weaned off ventilators can effectively lessen the severity of swallowing difficulties, lower the aspiration risk, and accelerate the decannulation process.
One notable device in this space is the Phagenyx PES system, developed by the UK-based company Phagenesis. This innovative system addresses the neurological aspects of swallowing coordination through the application of low electric currents to the throat nerves via a catheter inserted through the nose. Phagenyx received de novo clearance from the US Food and Drug Administration (FDA) in October 2022 and obtained a CE mark in Europe in 2012, later achieving compliance under the European Union’s Medical Device Regulation in August 2024. It stands out as the only commercial PES treatment available for patients within both the US and European markets.
In a recent funding round in March 2024, Phagenesis successfully secured $42 million to bolster its commercialization efforts in the United States while simultaneously expanding its reach in Europe. The CEO of Phagenesis, Chad Hoskins, expressed gratitude for the ASA's endorsement, which he believes underscores the importance of Phagenyx in enhancing outcomes for stroke survivors. He noted that incorporating PES into standard care not only improves patient recovery but also simplifies processes for healthcare providers.
Research shows that approximately 46.6% of stroke survivors face difficulties in swallowing, a condition that is unfortunately common yet often inadequately addressed. Historically, standard care has revolved around monitoring, rehabilitative therapies, and dietary adjustments. Alarmingly, studies reveal that nearly half of all stroke patients continue to experience dysphagia six months post-stroke, significantly increasing their vulnerability to pneumonia and mortality.
Dr. Alex Choi, a professor of neurosurgery and neurology at the University of Texas Health Science Center at Houston, pointed out the long-standing lack of effective therapeutic options for dysphagia despite its widespread impact. He stated, "The addition of PES to the guidelines indicates that we finally possess a validated treatment option that can be seamlessly integrated into routine stroke management."
The field of neuromodulation devices is rapidly evolving, with applications extending beyond dysphagia to include conditions such as incontinence, migraines, and depression. According to analysis by GlobalData, the global market for neuromodulation devices is anticipated to expand at a compound annual growth rate (CAGR) of 6.7%, reaching an estimated value of $12.9 billion by 2034, up from $6.35 billion in 2024.
