Apparatus and methods for controlled clot aspiration

An aspiration thrombectomy system, comprising:

• an aspiration catheter;
• a vacuum source configured to provide negative pressure to the aspiration thrombectomy system;
• connection tubing configured to place the vacuum source and the aspiration catheter in fluid communication;
• one or more controllable valves configured to control a level of negative pressure provided by the vacuum source;
• one or more acoustic flow sensors configured to detect acoustic signals in the connection tubing or the aspiration catheter;
• and
• a controller configured to:
• receive, from one or more of the acoustic flow sensors, one or more first acoustic signals during a thrombectomy procedure;
• determine, based on the first acoustic signals, a current flow state in the connection tubing or the aspiration catheter;
• and
• operate, automatically in response to determining the current flow state based on the first acoustic signals, via one or more of the controllable valves, the aspiration thrombectomy system in a first operating mode of a plurality of operating modes comprising at least an extraction mode and a full vacuum mode.