Q3 2021 Inari Medical Inc Earnings Call
Good day, ladies and gentlemen, and welcome to Illinois Medical Inc. Third quarter 2021 earnings Conference call. At this time all participant lines are in a listen only mode. Later, we will conduct a question and answer session and instructions will be given at that time to ask a question you will need to press Star then one on your telephone.
A reminder, this call is being recorded if anyone should require operator assistance. Please press Star then zero I would now like to hand, the conference over to your host today.
Caroline corner of Westlake. Please go ahead.
Thank you operator, welcome to <unk> third quarter 2021 earnings call. Joining me on today's call are Bill Hoffmann, President and Chief Executive Officer, and Mitchell Chief Financial Officer. This call will include forward looking statements within the meaning.
The priority private Securities Litigation Reform Act of 1095, all statements made on this call that do not relate to matters of historical fact should be considered forward looking statements, including statements regarding the markets in which <unk> operates trends and expectations for products and technology trends and demands for <unk> products and <unk> expected financial performance.
<unk> position in the market and the impact of COVID-19 on <unk> operations and an RF customers operations. These statements are neither promises nor guarantees and involve known and unknown risks and uncertainties that could cause actual results performance or achievements to differ materially from any results performance or achievements expressed or implied by the forward looking statements.
Please review our most recent filings with the SEC, particularly the risk factors described in <unk> annual report on Form 10-K, and in <unk> quarterly report on Form 10-Q for the third quarter ended September 32021 for additional information.
Any forward looking statements provided during this call, including projections for future performance are based on management's expectations about today.
We undertake no obligation to update these statements except as required by applicable law.
<unk> press release with the third quarter 2021 results is available on <unk> website, Www Nardi medical Dot com under the investors section and includes additional details about <unk> financial results.
<unk> website also has the latest SEC filings, which you are encouraged to review a recording of today's call will be available on <unk> website by five PM Pacific time today.
Now I'd like to turn the call over to Bill for his comments and third quarter of 2021 business highlights.
Thank you Caroline and thank you everyone for joining us today, our third quarter was productive and successful and we again treated a record number of patients.
Our execution remains Chris.
All parts of our business and we continue to make significant progress on all five of our growth drivers.
We are excited to share additional detail about our performance.
But we would like to begin as usual with a patient story that might remind you have a wonderful impact our products and our people have on the lives of our patients.
A couple of months ago.
At the peak of the most recent COVID-19 surge in Houston, Texas, one of the hardest hit regions in the U S. A young woman presented to the emergency Department of a hospital near her home shortness of breath chest pain.
She was three weeks postpartum and soccer team she was struggling to take care for newborn.
Imaging tests revealed large blood clots, and bolster left and right loans.
The hospital was full of Covid patients and had no ICU beds available.
Thrombolytic therapy, which necessitates an ICU stay was the only treatment available. So this patient could not be treated she was sent home that evening on oral anti coagulants, which reduce the risk of developing new Clos, but do not eliminate existing costs.
The following day with worsening symptoms and now unable to climb the stairs to 10 for crying baby she called an ambulance, which took her to a different hospitals.
This hospital was equally overwhelmed with Covid patients and also had no ICU beds.
This hospital had been using an already devices for more than a year and art procedures do not require an ICU stay within.
Within just one hour of her arrival at the hospital Division had already removed the entire clot burden from both lungs using flow treatments.
Simpson's result for.
For vital signs returned to normal.
She was moved to our regular hospital bed and in less than two days she was home with a new base.
The profound effect on the life of this young mom is perhaps as obvious as it as beautiful as is the change in the trajectory of the life of her baby.
Although we learn of these patient outcomes.
It comes and stories like this on an almost daily basis now we remain mindful of their impact.
We'll always have the opportunity to pursue this mission and our life's work.
This story highlights some of the reasons, we continued to perform well and perhaps the most challenging operating environment of our lifetime and our procedures are safe effective fast easy to perform.
And required limited hospital resource.
This is even more important in the current environment significant shortages of staff hospital beds in ICU beds.
While COVID-19 might continue to wax and wane, we believe that these resource limitations will persist into 2022.
We believe our clinical and economic value proposition will continue to resonate through and well beyond the pandemic.
One final postscript to the story.
A physician who treated this patient shared the story with his peers and the administrators of the hospital first visited by this patient and I'm happy to report. They now are also using flow trigger.
I'd like now to turn our attention to our Q3 financial performance. Our revenue in Q3 was $72 $9 million up $34 2 million or <unk>, 88% from the same quarter last year and up $9 4 million or.
We're 15% from Q2.
Procedure growth was robust our physician customers performed approximately 6700 procedures, including a modest number of cases from Europe.
This procedure count is up from 5900 or about 14% from Q2.
We believe that coal that associated procedures represented about 11% of the total volume of procedures similar to 12% of Covid associated procedures, we saw during the previous surge in Q1.
Growth in those patients, whose ETE is not associated with Covid.
8%.
We see the ongoing abatement of Covid, we anticipate a tempering of the number of Covid associated procedures during Q4, regardless.
We expect to drive robust procedure growth within our core Tam as we have demonstrated throughout this pandemic.
Despite the continued questions about COVID-19 and.
And its impact on our business, we have made steady progress on all of our growth drivers and we have grown in every single quarter. Since the pandemic began in Q1 of 2020 in fact during the pandemic we've completed over 30000 procedures.
And nearly tripled our quarterly production of both cases in revenue we.
We added 500, new customer accounts.
Hired and trained over 100, new sales professionals developed our VP excellence program to drive deeper adoption created and execute our clot Warrior Academy online training and education platform, which has now reached over 4500 customers.
We enrolled over 800 patients into a flash and cloud registry published over 100 studies in peer reviewed journals initiated our flame trial to prospectively study flow treatment from massive p/e patients and announced the peerless randomized controlled trial for intermediate.
Risk PD patients withdrew seven new products obtained an important new clinical indications to expand our Tam and successfully launched all of our devices in Europe.
And while it has not been our goal we've accomplished all of this while maintaining positive cash flows from our operations.
We believe all of this suggests that our technology has tremendous impact on patients our value proposition resonates broadly and consistently and our team executes regardless of external circumstances, we remain focused on building our company for the long haul. We believe we can and will continue to execute effectively and grow aggressively.
I would now like to share with you more specific and recent progress we continue to make on all five of our growth drivers.
Our first growth driver is the.
The expansion of our sales organization to target new hospitals and physicians.
The size of our core Tam is large as you know and despite our continued growth we believe that only about 6% of all patients in the U S, who can and probably should benefit from our procedures were actually treated in Q3.
Our efforts to penetrate this market.
It will require a lot more sales professionals earlier. This year, we shared with you that we are targeting 180 to 200 territories by the end of the year, we remain on track to comfortably land and the high end of this range.
Our second growth driver is building awareness and driving deeper adoption at existing hospital customers.
A high percentage of our target PE and DVT patient populations are currently treated with anti coagulation alone.
Education and training of the <unk>.
Non interventional physicians, who are often responsible for treatment decisions for these patients is important and we continue to engage these physicians effectively.
We are also working with administrators.
Establishing systematic processes to identify and triage bpd patients consistently sort of ETE experts. The goal is to establish systems like those adopted for stroke and heart attack patients.
Altogether these efforts, which we have designated our BTB excellence program are yielding encouraging results.
More centers for example.
Establishing DTE coordinator position every quarter and penetration rates targeted centers are climbing we look forward to providing updates as we continue to execute the program.
Our third growth driver is to build upon our base of clinical evidence.
We have a lot to share on this topic.
Data from the first 500 patients enrolled into our Flash registry were presented at the TCT Conference last week.
This study already represents the largest ever prospective interventional datasets in the field of PD.
The data confirmed the best in class safety profile of Flotek for system impressive on table clinical improvement, while the median ICU stay remain zero day.
Perhaps more exciting as we are now reporting patient data out to six months, we believe the treatment with flow trigger fundamentally changes the natural course of this disease.
All cause mortality at all points of follow up.
As well as the rates of <unk>, and <unk>, which represent the terrible long term consequences for survivors of this disease are orders of magnitude better than those reported in the literature for <unk> patients treated with conservative medical management.
In a separate study recently published in a high impact peer reviewed journal, Dr Buckley and colleagues.
Reported the first ever comparison of PD patients treated with a thrombectomy device the flow trigger.
Patients treated with anti coagulation analytics the results are impressive.
<unk> treated with <unk> showed an 85% reduction in hospital mortality and a four day reduction in ICU stay. Finally, we are pleased to report that our peerless randomized controlled trial comparing flow treatment catheter directed thrombolysis remains on schedule. The protocol is complete.
This selection is underway and we expect first patient enrollment in Q1 of 2022.
Our fourth growth driver is to expand our product portfolio exciting developments here as well first low flavor has lived up to expectations. As a reminder flow saver is device used to simply return blood aspirated during a fluid treatment procedure to the patient, allowing virtually bloodless thrombectomy.
This is important because it enables the physician to wash as many times as necessary without concern for blood loss.
Estimated blood loss per procedure in fact is down by 80% even as the number of wishes per procedure has increased by 33% adoption has been brisk flow favorite has already been used in nearly 2500 procedures bloodless thrombectomy.
It's highly valuable for physicians and patients.
At the high performance bar.
For both existing and future competitiveness.
Next.
We received FDA clearance for.
When the clock schriever bolt in October the bold is a more aggressive country per system, which may allow us to treat older Clos and more advanced pvt.
In fact, it represents the first in a suite of products, we will bring to market over time to treat patients with post thrombotic syndrome, where PPS.
<unk> is a horrendous progressive condition that develops and about half of all untreated DVT patients and often result in venous leg ulcers.
At least 1 million patients in the United States right now with venous leg ulcers.
And Pts as the cause of about 60% of them.
We will have more to say about quadriga bold along with the remainder of our robust product pipeline over the coming quarters.
Our fifth and final growth driver is expansion.
Into adjacent and international markets.
The operating environment has stabilized across Europe, and we continue to make progress on launching this business. We have successfully established a commercial presence across all major European markets through a combination of direct team.
And third party distribution partnerships.
Enthusiasm feedback from physicians remain highly positive and we are seeing steady increases in our monthly case volumes. In addition to supporting and driving initial cases.
We are also gaining clarity and executing on longer term clinical and reimbursement strategies, we will need to help build out our European franchise beyond Europe, we're making progress on regulatory paths in both Japan and China.
Although the approval timelines remain years away.
We remain very optimistic about the longer term potential for our international business.
We believe that will not materially contribute in the immediate term.
Finally, I appreciate always the opportunity to close by reminding you that our work here is more important to us and justice.
We are committed to our mission.
We appreciate you, believing along with us an extraordinary possibilities and.
And we appreciate your continued support we are just getting started.
We believe we can and will grow sustainably and aggressively for many years to come with that I'd like to turn things over to Mitch.
Thank you Bill and good afternoon, everyone.
<unk> revenues for the third quarter of 2021 were $72 9 million compared to $63 5 million for the prior quarter and up $34 2 million or 88% for $38 7 million for the same period of the prior year compared.
Compared to Q3 of 2020, we have expanded our sales force opened new accounts and achieve deeper penetration of our products into existing accounts.
Revenue was split between our two products as follows 30% of our revenue was derived from the sale of <unk> products. During the third quarter of 2021, compared with 37% in the third quarter of 2020, and 70% was derived from the sale of <unk> during the third quarter of 2021 compared to 63% in the same period.
The prior year.
During Q3, the vast majority of our revenues came from procedures are stocking revenue was consistent with the level. We saw during Q2 of 2021 get to the broad acceptance of several of our new products, including the <unk>, which we introduced in Q3 of 2021, we expect our stocking revenue as a percent of total.
Revenue will moderate overtime.
Gross margin was 93% for the third quarter of 2021, compared with 91, 7% in the third quarter of 2020.
140 basis point decline was due primarily to a change in inventory management in anticipation of our facility move.
Operating expenses were $68 6 million in the third quarter of 2021.
Paired with $28 3 million for the same period in the prior year.
R&D expense was $12 5 million in the third quarter compared with $5 2 million in the same period of 2020.
Seven $3 million increase in R&D expense.
Primarily driven by an increase in head count as well as product development and clinical evidence development costs.
SG&A expense was $56 $1 million in the third quarter of 2021, compared with $23 1 million for the same period the prior year.
The $33 million increase was primarily due to personnel related expenses as a result of increased head count across the organization travel expenses and sales and marketing costs.
As a reminder, Q3's SG&A expense net loss and net loss per share included the impact of an $8 3 million onetime noncash stock based comp charge.
Net loss for the third quarter of 2021 with $2 8 million compared with net income of $6 5 million for the same period of the prior year.
The basic net loss per share for the third quarter of 2021 was <unk> <unk> based on the weighted average basic share count of $50 million.
Fully diluted share count as of the end of Q3 was $55 5 million.
This compares with a basic and fully diluted net income per share of <unk> 13, and <unk> 12.
Effectively and a weighted average basic and diluted share count of $48 3 million and $55 4 million respectively for the same period of the prior year.
I'd like to move on to a few balance sheet updates our cash of $81 2 million and investments of $87 4 million.
At the end of Q3, 2021 totaled $168 6 million compared to $164 2 million at the end of the fourth quarter of 2020, we.
We have not yet utilized $30 million revolving credit facility. Although we ended the third quarter with borrowing capacity under the credit line of approximately $28 2 million.
Our cash flows used in operating activities were $5 6 million in Q3 of 2021 compared to cash generated by operating activities of $7 3 million in Q2 of 2021 on a sequential comparison basis, our cash used during Q3 relates primarily to.
Investments in our new production and office facility.
I'll close my comments by addressing <unk> financial guidance, we are comfortable increasing our full year revenue guidance to 266, Q2 hundred $68 million up from our previous guidance of $250 million to $255 million.
With that I'd like to turn the call back to the moderator for questions.
Thank you.
Ask your question you will need to press Star then one on your telephone to withdraw your question. Please press the pound key please standby, while we compile the Q&A roster.
Okay.
Okay.
Our first question comes from the line of Cecilia furlong with Morgan Stanley. Your line is now open.
Great. Thank you for taking my questions Bill I wanted to start with sovereign and just see if you could provide a bit more commentary around what you've seen from an adoption standpoint today just in terms of procedures utilizing it and then as you look out for us as well just the ability for clothes, David to expand your U.
Inter basin, bringing physicians off the sidelines to tease floating vary due to concerns around blood loss.
Yes. So thanks, thanks, Cecilia good to talk with you.
<unk>.
As a quick aside here, we have joining me for questions and answers maybe even this question our chief operating officer drew hike.
Dr. Tom <unk>, who is our chief Medical officer. So so thanks for the question.
So first of all that the adoption had been brisk as we communicated in the.
In the prepared remarks.
It is.
The hospitals that already have flow favor. The percentage is very very high I would say almost all cases in almost all centers that have low favor if theyre doing more than one whoosh, they're probably using flow savings. So he is very very high rates of adoption.
The centers that don't have low favor on the books.
The hospital just yet.
<unk> not.
That is a function mostly of administrative challenges of going through value analysis committees, and so forth, but because it's part of the per procedure pricing. There's not an additional cost for these are purely administrative hurdles and we will get through them.
We do we do actually believe already that we've seen some people pick up.
Flow schriever.
Because the risk is lower right.
Potential for multiple washes with a much lower consequence for just missing is lower there is essentially no consequence for that so yes, we actually believe that.
This is not only exciting for our current user base, but that it is it is a driver of adoption.
Okay, Great and I wanted to ask you just on your comments around <unk>.
Extension, what you've seen in the quarter, but if you could talk a bit more about just your outlook today around both the clinical and reimbursement work needed to really open up some of those markets, especially in Europe over the next several years.
Yes.
Yes affiliates for hikes I can get started on that one so.
So not a whole lot to add beyond what you heard bill described in the prepared remarks.
Like what we're seeing so far in Europe.
Lots of positive momentum we've done cases now across most of the major European markets. We're doing cases every day now essentially the.
The monthly trends are positive incremental growth month after month.
And lots of enthusiastic feedback from the physician community, we are getting more clarity on the reimbursement and clinical work that we're going to need to do.
Market by market to really put ourselves in a position to drive broad adoption of both technologies in some cases that will look like dedicated clinical studies will need to do in some of those markets to submit that evidenced to the reimbursement authorities in gain broad based reimbursement. So those strategies are coming into view.
And some of those.
Markets, that's going to take us a number of quarters to complete that work in the meantime, we are going to be able to access and continue to access.
Opportunistically.
Our account level and regional level budgets, which will allow us to continue to do cases and expand the franchise even as we are.
Undertake that longer term reimbursement and clinical work that I described so.
So having said all that we still view this as a longer term growth driver for us.
And wouldn't anticipate international business being a material contributor to the overall commercial franchise.
It really for the foreseeable future. So we will continue to keep you posted on the progress but for now we like what we're seeing.
Great. Thank you for taking the questions.
Thank you. Our next question comes from the line of Larry <unk> with Wells Fargo. Your line is now open.
Hey, guys congrats on a nice quarter here, thanks for taking the questions.
Just I just wanted to start you guys, obviously had a great quarter, but I'm trying to understand the bridge from Q3 to Q4 implied in the guidance.
So maybe talk about stocking a little bit we estimated at about $12 5 million in Q3 is that closed and how should we think about whats implied in Q4, and Mitch I heard your comments on it moderating over time, but just comments on 2022 stocking would be helpful.
Just lastly, the Covid assumption for Q4, just the piece of the moving parts and stocking and Covid and anything else, we should understand on kind of the.
Implied 1% sequential growth in Q4, thanks sure not a problem Larry.
Stocking figure you quoted is really pretty much right.
Kind of that $12 $5 million range.
So I think thats something that we see as being.
Pretty consistent with where we were in Q2 on a percentage basis or percentage of total revenue that speaks to the really strong acceptance that we've had in the marketplace from the $2 24 in the 220 curve in the <unk> and some other the flow saver, obviously, which we just talked about with Cecilia.
From the 2022 point of view.
Made the comment about moderation in stocking revenue I think.
Moderation as sort of a term of art. Obviously, we are very excited about the product announcement memo sort of menu for 2022, who will get into that obviously in a lot more detail as we turn the page on the new year and.
We believe we will continue to have some strong acceptance by our customers of these new products that does generate some onetime technical upgrade revenue and but I think as the number of accounts grows and then basically the base of procedural revenue growth in the business to stocking revenue will inevitably fall as a percentage of total.
So I hope that helps a little bit in terms of our Q4 guidance I think youre kind of ourselves focusing in asking about that a little bit and maybe I can get this started.
Be more excited about that to be a part of it.
Yeah, I guess, the only thing I had there.
Larry.
The only other thing I would add Larry as we are.
I guess as frustrated as anybody with the waxing and waning of.
Of the pandemic and the Covid searches and the challenges that creates.
And so we're facing exactly the same sets of headwinds that everyone else faces with regard to staff shortages limitations hospital resources.
Procedure volumes are down in many hospitals forecast labs taken out all those challenges and yet.
We have been able to grow even if you eliminate completely.
If kobe did not cause DTE and we didn't see any sort of amplitude on those sorts of patients I think we'd be very pleased with an 8% growth sequentially from Q2 Q3.
Especially given all these challenges that everyone's facing and at some point here. We think the operating environment is going to return to some sort of normalcy and we think we can do even better anyway.
Full bandwidth and access so right now I think what you're seeing with with the coke the queue for implied guidance is.
Just we just want to make sure that we never ever Overpromise and we want to acknowledge also that the uncertainties that remain out there while at the same time acknowledging the fact that we do continue to execute into penetration of our <unk> very very effectively.
That's very helpful. Thanks Bill.
I mean, obviously you guys in September talked about transforming the company I can't remember exactly what you said, but I'm pretty sure you use or transform.
Which is obviously something we don't hear every day from a CEO.
So I guess my question my questions are how are you thinking about adjacencies.
Is this organic versus inorganic and.
When when are we going to learn more and do you have an analyst millionaire investor meeting set.
2022, and I might try this one more in if you left me.
<unk>.
You are already at seven or eight Larry So high now.
Okay, we get it completely so.
I'll see if I can get all of these and you remind me since I have edd, you'll have to remind me if I miss them, but I think the.
You are starting to see now.
Occasions of products. There is there is a bit of a track record now I think we've talked about seven ahead of this call seven new products and this one contributor Bowl is the first and what we believe a series of of products is really challenging disease state all clot, it's really not clouded scar tissue and eventually causes posted on Biotics sooner I think.
You'll see us.
Working on that market communicating a bit more in terms of numbers of patients very very large market.
And.
And our ability to address that market over time and again, it's a challenging disease states. So we'll see but that's that's the first and we believe there are several other new products that are coming down the line here you've been very olive you've been very patient with us we don't want to break any new news here, but again. These things. These these things are beginning to materialize now as you're seeing with <unk>.
Bold so there'll be a number of other adjacencies that we enter we're not going to talk at all about inorganic opportunities pro con when.
We're just not going to comment on those things for for obvious reasons.
Did I Miss any questions there Larry and so another one.
Analysts meeting for next year analysts meeting we are we're not quite ready to communicate a date, but we have we have shared with.
I think we've shared publicly that we do plan at some point in the first half of the year.
To do an analyst meeting so we're working on dates now and we will have some things to say about that shortly.
Just lastly on bold I just wanted to follow up what is the status of the launch how are these patients treated today.
Mitch bold.
Appropriate for them, thanks for taking the questions.
Yes, it's true I can get started on that one so we are in the early phases of what we call. The LMR either limited market release for bold, we got clearance here just at the end of October. So we're still in the early days, we've done I don't know dozen or so cases, so still very early.
And understanding how that product performs and some of these longer term patients that have these pts related.
<unk> in the longer term kind of scar as opposed to Clark.
Those patients today don't have great treatment options. That's why there is such a dramatic unmet need for that particular patient population.
They suffer from severe Pts many of them have ulcers and wounds that.
Our unhealed their quality of life is atrocious.
And they get kind of passed around the system without anyone being able to offer definitive treatment and that's exactly the unmet need that we've identified and what we hope we're going to be able to address over time clepsydra bold as you heard bill describe is really the first of what we envision as a system to try and help those patients. So still early days, we're just getting started.
The LMR and will keep everyone posted as we learn more about how that product is performing out in the market and these patients.
Thanks, Thanks for taking all the questions guys.
Our pleasure thanks, Larry.
Our next question comes from a line of Banff Atlantic with Canaccord. Your line is now open.
Hi, Sean for Pill Tonight, Thanks for taking our questions first.
First I just wanted to ask if you had any discussions regarding CMS are moving the MTBE for transferring his cash or a pulmonary embolus to me or any subsequent discussions of payers are administrator since that decision.
Yeah. So this is drew again.
I can give you some quick updates on the NCD good news there.
Two weeks ago.
M S announced publicly they were removing that and CD effective immediately.
So that NCD 240.6.
No longer exists.
It was never a particular overhang for our business more of a distraction really over the last couple of years, but nonetheless, we were pleased to see CMS respond to numerous physician societies in dozens and dozens of individual physicians that at all advocated for removing that NCD that stretched back to 1983.
We have proactively reached out to a handful of the private commercial payers.
That had reference to that NCD within their systems and updated them that has now been removed.
So all that has taken place over the last couple of weeks, but again it was not necessarily at all a headwind or an overhang for the business. So we haven't seen any impact commercially other than.
Clearing up that distraction, avoiding having to spend any time or additional bandwidth describing.
Describing it or talking about it.
Great Thanks that color.
And then can you also talk about by the way for continued penetration an existing accounts and perhaps how many accounts. They are only using folks who've are only use any pot traver. Thanks.
Yeah. So we're in about 1200 accounts active here in Q3. So we added a similar number of new accounts that you've seen us add on a quarterly basis.
That 1200 accounts over 60%.
Almost two thirds actually are using both technologies, which obviously means there's 30 some percent that are using only flow trooper or only caught schrieber, it's really a mix of pretty balanced mix those single technology accounts.
So that's the status is of Q4, we continue to make progress on pulling in.
Those second technologies into the.
Costs, where we have that opportunity.
And the vast majority of our case volume is coming from existing accounts from driving deeper penetration over 90% of our cases in the quarter came from those existing accounts. So that second growth driver that we talk about I think is increasingly important to driving the growth and that's exactly what we saw.
Here in Q3.
Great and then it gives a sneak annual one mark the Hh, you'll probably Vista field for size exited in the quarter.
Yes, I think we we communicated.
The prepared remarks.
That's the <unk> previously projected 180 to 200 territories by the end of the year that we were on pace to finish in the high end of that range. So I think we'll we'll leave it there without any.
Hopefully, it's okay to leave it there with adding further detail, but we've had no.
No.
It's always a challenge to hire and training on and try and on board, but we've had no COVID-19 related additional challenges.
Chris with the execution of our.
Hiring training and Onboarding program.
Great. Thank you for taking our questions. Thanks.
Hey, Shaun <unk>.
Thank you. Our next question comes from a line of Marie Tivo with T. Beattie Igene. Your line is not open.
Hi, Hi, 19 kind of started quarter and thanks for taking my question right.
I wanted to start here I guess, but the follow up on bold and just try to clarify.
A little bit about the design of the calf Curie.
Curious whether post symbiotic syndrome is included in the label.
And if so what the clinical data with sort of introduced.
To win that.
Yeah.
We can take to start with the area of the labeling.
Yeah, so that product. The design is really very similar in a lot of ways to the existing clock schrieber system and.
In the initial labeled indication here out of the gate mirrors, what we have in place for the clock schriever.
Kind of a core o'clock schriever product itself. So no big changes there overtime again, as we get more experience with the product and understand how it's performing.
We may decide to undertake some additional work to expand that labeling an update that labeling but that's the status is of where we are today.
Maria.
Provide a little political background about post thrombotic syndrome.
You can imagine patients who are under treated for deepness thrombosis may end up having scar tissue and occlusion of their veins due to poor fueling and these patients really have no options. They are the ones with swelling in their legs chronically non hewing venous ulcers and the ability to modify the tissue.
Remove tissue open up channels reduced the venous pressure.
Has resulted in healing of these.
Venus leg ulcers in patients that we've already treated so we're really excited to explore this new.
Market of patients that we hope to benefit, but I think we're quite early on in this experience.
Okay, that's great to hear I appreciate that color.
And then if I could ask here on.
Staffing shortages, we've been hearing across this quarter from several med Tech appears that staff shortages have led to kind of constraints on prestige doesn't I'm curious.
And what the impact was if any on a night that's corner.
Yes, Thanks, Maria I think the answer is it's really hard to measure so we hear anecdotally.
And for example that.
This hospital or that had to close down one of their labs are a couple of their labs are they have to close early and they are trying to manage.
Procedure volume from the Cath lab.
Pulling nurses from one place or another hiring.
Hiring traveling nurses, there's any number of anecdotal challenges and I suspect you've heard this from our other from some of our peers.
The the fact is however in or even in our core Tam we continued to grow pretty robustly and I think the the key here is that precede some procedures are getting done right and and I think our procedures carry a profile on our patient population carries a profile that is kind of a little bit higher than the.
Already a lot of our patient, especially the pay and pretty significant percentage of the DVT patients are not considered.
They're considered an emergency and so that's that's one part of the the second part of course is that our procedures of fast.
<unk> to perform then require limited hospital resource. So there's no icu's Davis required we believed pretty strongly in a lot of our hospitals their own metrics suggest these patients leave the hospital a little bit more quickly and I can't do that with the patient story that I shared.
Little earlier as well these are the sorts of procedures that are getting done based on characteristics of the patient high acuity setting emergent emergent type setting and the characteristics of the procedure just requiring a limited resource and I think secondary to all of that but but but important for.
For hospitals to continue to be.
Kind of financially burdened by that by the pandemic.
These these nobody's losing money on these procedures and I think that's an important component.
Okay that makes a lot of sense, one last quick housekeeping, one if I can sneak it in I heard the 6700 total procedures are so this quarter. If you have to split between D V TMP procedures.
The split.
And I think this is also in the queue from a revenue point of view the split was 70 30.
I talked about.
In any case for the quarter was 51% DVT and 49%.
Kind of different.
The waiting toward.
As always the waiting toward the.
Pte in terms of revenue.
Is primarily based on average average selling price is being a little higher than p/e as well as.
Devices that floats here is often used.
In DVT procedures and softening combination with soft country are so that's why it represents a little bit higher percentage of revenue then procedures.
Perfect I appreciate the time of night.
Thanks for next spring.
Thank you.
Last question comes from the line of Danielle and tell fee with STB delivering your line is now open.
Hi, guys Preah on for Danielle.
Congrats on a great quarter and thanks for taking my question.
Have one kind of a follow up from the last one just I.
I understand that that there's a higher mixed for flow traver and a quarter kind of related.
Asap.
Are you guys seen anything within the quarter.
And within the market.
From like a competitive dynamic or even colored related that's raising a higher awareness around P.
And then another follow up for me.
You would think that awareness Tom sure. So we've talked a lot about COVID-19 influencing the incidence of disease as well as perhaps being a headwind in many systematic ways, but one thing is certain the COVID-19 has done nothing but increase awareness about blood clots in general I would not say that.
There is a predilection for pulmonary embolism over DVT in terms of the awareness issue I think both of these are diseases associated with Covid and are now part of the common parlance.
Great. Thank you for that and just another one for me here it looks like procedures increased about mid single digits quarter over quarter X Covid impact is that the right way to think about it about the underlying growth or is there any seasonality factor and yet.
Yeah, So I think.
Heard Bill described in the prepared remarks, the procedure growth and our core Tam was 8% so even higher than the number you quoted so we liked what we saw we continue to execute we think crisply across the board and you are seeing that reflected in the core Tam.
All of those growth drivers that we discuss remain intact and we continue to make good progress across the board in each of them and I think taken together, that's what's contributing to the kind of growth that we're able to demonstrate in Q3 and I think it gives us some confidence heading into the end of the year.
Great. Thank you.
Thanks for asking express.
There are no further questions at this time.
Very good. Thank you thanks, everyone for joining us.
Ladies and gentlemen, this concludes today's conference call. Thank you for your participation you may now disconnect.
Yeah.
5% in the afternoon.
Yes.
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