Q4 2021 Penumbra Inc Earnings Call
Good afternoon, My name is Chris and I'll be your conference operator today.
At this time I'd like to welcome everyone to Penumbra is fourth quarter and year end 2021 conference call.
All lines have been placed on mute to prevent any background noise.
After the Speakers' remarks, there will be a question and answer session.
If you would like to ask a question. During this time simply press star followed by the number one on your telephone keypad.
If you would like to withdraw your question. Please press star one again.
I would like to introduce MS Jee Hamlyn Harris Investor Relations for Penumbra, Ms. Hamlyn Harris you May begin your conference.
Thank you operator, and thank you all for joining us on today's call to discuss <unk> earnings release for the fourth quarter and year end.
2021 copy of the press release and financial tables, which includes the GAAP to non-GAAP reconciliation can be viewed under the investors tab on our company website at Www Dot.
Dot com joining.
During the course of this conference call. The company will make forward looking statements. Please refer to the safe Harbor provisions of the private Securities Litigation Reform Act is 1995.
Statements regarding our financial performance commercialization clinical trials regulatory status quality compliance and business trends.
Actual results could differ materially from those stated or implied by our forward looking statements due to certain baseline.
Including those referenced in our 10-K.
The year ended December 31, 2021, which is scheduled to be filed with the SEC on February 22 2020.
As a result, we caution you against placing undue reliance on these forward looking statements and we encourage you to review our periodic filings with the SEC, including the 10-K previously mentioned for a more complete discussion of these factors and other risks.
Our future results or the market price about stock, including but not limited to the COVID-19 pandemic on our business.
And those of operations and financial condition.
<unk> disclaims any duty to update or revise our forward looking statements as a result of new information future events developments or otherwise.
On this call certain financial measures are presented on a non.
non-GAAP basis, a reconciliation of GAAP to non-GAAP financial measures is provided in the press release.
We anticipate the prepared comments on today's call will run approximately 20 minutes I didn't answer him as chairman and CEO provide a business update Maggie Yuen, our Chief Financial Officer will then discuss our financial results for the fourth quarter and full year and Jason Ellis, Our executive Vice President of strategy will discuss our 2022 that was that I would.
Like to China, a nickel to Adam Elsa.
Thank you Keith good afternoon, everybody and thank you for joining the numbers fourth quarter and year end 2021 conference call.
Our total revenues for the fourth quarter $204 million a year over year increase of 22, 2% as reported and 23% in constant currency.
And a seven 3% sequential increase from the third quarter.
For the full year 2000, 2021, our total annual revenues were $747 6 million, which represented growth of 33, 4% over full year 2020.
In the fourth quarter, we achieved record revenue in both our neuro and vascular businesses.
Also we started making progress towards our goal of building a safe and secure health care platform using immersive computing to help a significant number of patients.
The early part of this first quarter of 2022, we navigated the same macro challenges that every company in our field to see including severe staffing issues, particularly in hospitals supply constraints rising inflation.
Other COVID-19 related challenges that said, our team is stronger than ever and able to take on the important work necessary to help the millions of patients that reside within the six large underpenetrated markets, we're serving.
During the last two years of the pandemic the number team delivered several new paradigm changing products to our physician customers and we continue to invest significantly in new innovation within each of these markets as well as in production to ensure a steady supply chain as possible. These.
Investments matter to the long term growth and profitability for our business.
We're also excited about several new important products, we expect to bring to our customers within neuro and vascular and immersive healthcare later this year.
Now I'd like to spend a few minutes discussing our team's execution during the fourth quarter.
Let's start with vascular.
We reported global vascular growth of 34% year over year to $113 6 million in the fourth quarter as we saw strong performances from both our thrombectomy and embolization franchises.
Our vascular team has an enormous amount of work to do over the next several years as the opportunities for growth in both of these franchises are significant.
This quarter the demand for our vascular embolization products.
Celebrated following the prior Covid wave growing 13% sequentially.
Which took a lot of our teams attention.
We also increased our revenue both sequentially and year over year in all four vascular thrombectomy segments.
Hi, DVT coronary A&P and are in great position each going forward.
In just the past few years, we have launched paradigm changing technology into all four of the Underpenetrated markets within which there are over 1 million patients we can help.
Each year, nearly 90% of whom are not yet treated and single session therapy.
On the venous side and DVT PE.
We saw an accelerating number of patients treated with our lightning 12 technology.
Through the second half of 2021.
Notably the highest number of new physician customers adopted lightning 12.
Fourth quarter, not only do we see a long runway of continued growth ahead with this technology. We also have new innovation expected late this year for <unk> patients.
Similarly, we continue to expand our leadership position with.
With lightning seven the <unk>.
The option of which has been robust since its launch in the second quarter.
Lightning <unk> changed the paradigm in the treatment of the ally and we also have plans to augment this paradigm late this year as well with additional products and build on our proprietary computer aided innovation.
On the coronary thrombectomy side, we presented positive clinical data from the Chita study in November at the TCT Conference.
These data drove increasing awareness of the utility of cat Rx for patients with coronary lesions with high thrombus burden.
We saw accelerating revenue from our coronary business in the fourth quarter and we believe we are in the early stages of growth in this market.
The positive trends that underlie our strong growth in both vascular thrombectomy and embolization are a testament to our unique products strong commercial team and clinical focus our best in class vascular team added more new <unk> customers in the past four quarters than any similar stretch.
In our history.
Including a record number of new customers added in Q4.
Further going forward the team is working with more positions within our existing accounts to bring our technology to them. This is important given that they serve all three specialties in this field interventional cardiologists interventional radiologists.
Vascular surgeons.
Many of whom do procedures and more than one area. We are well positioned as we have invested significantly over the past few years to prepare our commercial team to meet the needs of physicians and all three specialties with continued innovation and clinical focus, including new and relevant clinical.
Studies in DVT.
And Pete.
Let me now turn to our neuro business in the fall.
Quarter, we recorded the fastest sequential growth in nearly three years, excluding the initial COVID-19 quarter as our neuro business expanded six 8% over the third quarter of 2021 and accelerated to 13, 3% growth year over year to $94 million.
Led by our stroke franchise.
Coming off last quarter's 17% sequential increase in our U S stroke business the momentum with the Red Catheters continued driving 11% sequential growth in the fourth quarter.
The Red catheter unit volume has already eclipsed the peak for our previous generation products set in 2019 before the pandemic and recall.
We had 72 has become our best selling product for large vessel strokes.
62 has exceeded all expectations.
Not only is red 60, twos use utility utilization and distal aspiration being robust the product is being adopted at a much higher rate than anticipated large vessel occlusions as a primary treatment as well in large part because it is the best tracking catheter on the market.
We believe catheter track ability will become an even more important tree as we move into the new paradigm in this market in the future.
As you look into 2022 and beyond the Red portfolio was very important for two reasons first we think red will continue to drive strong growth and share gains for our stroke business not just in the U S. But also in Europe , Japan and other geographies in which we are we'll be launching these products.
Second Red sets the stage for Thunderbolt, which is our most significant innovation in stroke to date.
We're even more confident in our decision to conduct a trial in the U S. For Thunderbolt. We expect this trial will demonstrate the profound benefit of thumb Thunderbolt, which could change the paradigm in stroke intervention by significantly enhancing the speed and completeness of clot removal.
We are also well positioned in neuro access and embolization more than year. After U S. Launch, we are still seeing increasing adoption of BMX 96, and access with additional innovation slated for later this year. Likewise, we are seeing a renewed interest in our larger neuro coil PMT, which represents a unique and <unk>.
Important product line for some of the most challenging and utilization cases.
Turning now to our <unk> healthcare business, we have made significant progress in the work necessary to build the first platform for virtual reality and healthcare.
To build this platform our work in 2022 is focused on three important areas.
First we are making significant progress innovating on the technical side of building. This platform both in terms of hardware and software.
Second we have begun important conversations with some of the leading companies across more than a dozen healthcare channels within which there are more than 15 billion patients who can benefit.
Lastly, we are exploring dozens of partnerships with third party companies, who could eventually become very large sources applicable content for patients on our platform.
Moving finally to our international business, we made significant progress in the fourth quarter.
Growing revenue, 19% on a year over year basis.
The upcoming launches in several international markets of our Red Catheters and Lightning technology.
With continued expansion of our business in China, and Japan, we are well positioned for strong growth in our international business going forward.
I would now like to turn the call over to Maggie to go over our financial results for the quarter.
Thank you Adam good afternoon, everyone today, I'll discuss our financial results for the fourth quarter and full year of 2021.
Financial results on this call for revenue and gross margin on a GAAP basis, while operating expenses, including research and development and SG&A and operating income.
GAAP basis, which excludes non recurring and one time expenses.
Cancellation of GAAP to non-GAAP financial measures is provided in our posted press release.
For the first quarter ended December 31, 2021, our total revenues were $204 million an increase.
<unk> of 22, 2% reported and 23% in constant currency compared to the fourth quarter of 2020 and sequential growth of seven 3% over the third quarter of 2021.
Our geographic mix of sales in the quarter were 78% U S 29, 2% International U S and international reported growth of 23, 7% and 18, 8% respectively compared to the same period in 2020.
Moving to revenue by franchise revenue from our vascular business grew to $113 6 million in the fourth quarter of 2021, an increase of 34% reported or 31, 1% in constant currency compared to the same period last year.
Compared to prior quarter revenue from our vascular business grew by seven 7% driven by growth across the U S and our international regions in both peripheral embolization and some back to new products.
Revenue from our neuro business was $94 million in the fourth quarter of 2021, an increase of 13, 3% reported and 14, 1% in constant currency compared to the same period, a year ago with strong growth in U S New home Thrombectomy and international Neuro access.
Yes.
Gross margin in the fourth quarter of 2021 was 61, 5% compared to 56, 5% in first quarter of 2020, and 63, 1% compared to last quarter.
The fourth quarter of 2020 included negative 900 basis point impact associated with product returns.
Fourth quarter 2021, gross margin was lower than last quarters into inflation, including labor rate adjustments and higher logistic costs as well as some product and regional mix impact.
Our accelerated investment in fixed cost labor and capacity and manufacturing capabilities. In 2021 has allowed us to navigate labor shortages and supply change change disruptions.
Looking forward, while these investments and inflation impacts will continue to be a headwind to gross margin, we could see a margin expansion opportunities in the second half of the year.
Now on to our operating expenses.
In the quarter, we had nonrecurring research and development milestones and onetime expenses associated with <unk> acquisition and amortization of acquired intangible assets of $42 6 million.
Which was within the range of $35 million $245 million that I previously shared on the last call.
As such the following fourth quarter financial metrics will represent non-GAAP financial results, which exclude the impact from these non recurring and one time expenses.
In the fourth quarter of 2021, our total operating expenses were $123 million or 63% of revenue compared to $96 $1 million or 57, 6% of revenue for the same quarter a year ago.
Research and development expenses for Q4, 2021 were $19 4 million compared.
Compared to $19 $5 million in Q4 2020.
SG&A expenses for Q4, 2021 were $103 $5 million compared to $76 6 million for Q4 2020.
The increase in operating expenses reflect an increase in head count higher travel and in person activities and investment in growth opportunities.
We had operating income in the quarter up $2 5 million compared to operating loss of $1 7 million for the same quarter a year ago.
I will now summarize our full year performance.
For the full year of 2021, and total revenue for the year was $747 $6 million, which.
Presents an increase of 33, 4% reported and 32, 6% in constant currency compared to full year 2020.
Our geographic mix of sales in the year or 76% U S and 29, 4% International.
<unk> International reported growth of 31, 9% and 37, 3%, respectively compared to a year ago.
Revenue from our vascular business for the full year of 2021 was $408 9 million.
An increase of 52, 7% reported and 52, 3% in constant currency.
Revenue from our neuro business for the full year of 2021 was $338 7 million an increase of 15, 7% reported and 14, 6% in constant currency.
Our gross margin for the year was 63, 6% of revenue compared to 68% of revenue for the full year 2020.
Excluding the 2021 impact from the nonrecurring research and development milestones, one time expenses associated with <unk> acquisition, and amortization of acquired intangibles and sense of $42 $6 million that I previously discussed at the 2020 and nonrecurring expense associated with the development and product.
Launch of Lightning 12 of $27 million that we discussed last year, we had non operating non-GAAP operating income for the full year of $35 million compared to a non-GAAP operating loss of $18 $3 million for 2020.
Turning to cash flow and balance sheet accounts receivable increased by $13 9 million and net inventories increased by $5 $2 million compared to third quarter of 2021.
Working capital levels and was consistent with volume trends. We ended the fourth quarter of 2021 with $254 $9 million in cash and cash equivalents in marketable securities and no debt.
And now I would like to turn the call over to Jason to discuss our 2022 guidance.
Thank you Maggie and good afternoon everybody.
We're introducing revenue guidance for full year 2022 in the range of $860 million to $875 million, representing 15% to 17% growth over full year 2021 revenue of $747 $6 million the short term macro.
Challenges to which Adam referred in his remarks were a factor in the first several weeks of this quarter as seen by other companies in our field looking forward, we expect to launch new important products that will contribute to our neuro and vascular businesses towards the latter part of this year.
In sum, we expect strong sequential revenue growth and also expect our quarterly revenue growth versus year ago periods to accelerate as we move through 2022, starting within the guidance growth range at the lower end and exiting towards the higher end overall consistent with our approach to setting guide.
In the past our 2022 revenue guidance represents our current views on our markets timing of new product launches and other relevant inputs I will now turn the call back to Adam for closing remarks.
Thank you, Jason Maggie and cheap.
I would like to conclude our prepared remarks today with two key points.
First our number is in one of the strongest position it has ever been.
We have six large underpenetrated markets World class technology, and more innovation on the way.
We acknowledge from past experience.
But the work ahead as hard and will take time, but the benefit to patients of opening up these new large markets is incredibly strong and our team is committed to these challenges.
Second I'd like to end today by applauding, our physician customers, the nurses and technicians administrators and the entire staff in their hospitals.
Obviously the work they've done throughout the pandemic is amazing however, we understand that in the past month and a half with the severe steps staffing shortages and hospitals has tested even was strongest.
All of our fatigue with pandemic has not made it easier.
I want you all to know that we admire your dedication compassion and of course, just plain hard work.
Thank you for what you've done in I hope the months ahead bring a return to a more normalized schedule. Thank you now.
Now thank you for your attention on the call today, and we'd like to open the call to questions. Operator. Please go ahead.
Thank you.
A reminder, if you'd like to ask a question. Please press Star then one on your telephone keypad.
Our first question is from Robbie Marcus with Jpmorgan. Your line is open.
Great. Thanks for taking my question and congrats on a good quarter.
Thank you.
Adam.
You mentioned new product launches in 2022 O I lost track of how many times you said it but a lot.
And both stroke and vascular and neuro.
Neuro and vascular I was hoping you could give us a little bit of.
Color around the impact.
The magnitude of these launches and a little finer point on on when in the year, we might start to see that.
Yes.
Great question, let me without.
Giving away things that that it's premature to give away for obvious reasons.
Let me see.
Sort of calibrate.
Calibrate.
What we've talked about.
In neuro.
They talked about Thunderbolt, we're going to do a trial.
Says, we have other things coming in the rest of that portfolio.
So I want that to be understood. We're excited about constantly innovating in the other parts of our business as well as in stroke and the vascular side it really comes down to.
The way, we've always thought about our businesses, which is we continue to think about this space is that we're in and how to make the products better and better and better.
And we are very excited about some of the innovation that's coming we think it will make the procedures, particularly in <unk> to be easier faster more complete.
That's the goal to move this deal to the point, where physicians can look at these patients that have clot, whether it's on the arterial side DVT and PE and even in the coronary and just say, let's just take it out.
And that has to think about it as some bigger.
Question around trade offs. So that's been our quest for many years.
These innovations fit within that very very well.
Okay.
Great.
And just a quick follow up Adam you had the Cheetah study.
Late last year and in coronary.
You're growing really well and vascular how should we think about the impact of coronary in any size of what it was in the quarter and how to think about it going into 2022 would be helpful.
<unk>.
Yeah, So we haven't quantified.
The the dollar per se other than to say the first.
And most obvious starting point is.
The physicians that are still using manual aspiration in light of the Cheetah data that seems like the first obvious starting point given how good that data was.
And really in comparison.
So that's folks who are already believing that aspiration is necessary in those patients.
And then after that of course will move to the next group room.
You may want to use aspiration, but had been reluctant.
Looked at the trended data and believe that it is compelling.
We believe in and other customers fleet.
To answer the other part of your question obviously.
We really had a part of a quarter.
With the Cheetah data out there wasn't a full quarter, but theres no question that it had an.
An impact we did if you just were to look at the change from the beginning to the end there was a change.
But we expect that to continue throughout the year.
Thanks, a lot.
Of course, thank you.
Our next question is from Larry <unk> with Wells Fargo. Your line is open.
Hey, guys. Thanks for taking the question.
Two for me.
Hey, Adam two for me one on Thunderbolt, one odd real.
Adam we've done a bunch of checks on Thunderbolt and doctors seem pretty excited about the concept.
So my questions are what changed to lead you to do a study before approval any color on the trial design.
Long do you think it will take to do the trial and file it wasn't clear from your comments earlier too.
If you are including that in the 2022 launches and I had one follow up.
Okay.
Mike. This question so let me try that again.
The mall.
And hopefully get the gist of it.
So we've been working with the FDA.
Obviously, I'm not yet prepared to lay out the exact trial design.
The specific timing.
But as I've said.
In the past and I want to very clearly reiterate this is we are really a good position right now in stroke and the Red series is doing really well and it's obviously a foundational part of using Thunderbolt and so the ability to continue to bring that technology throughout this year.
To our customers I think is an important part of the strategy.
And then when the trial is over and again as soon as I can give you a more direct estimate on the timing will bring doing that.
To the to the table as well.
But even without that and again.
I'm incredibly excited about the work our team has done with that product.
We have a lot of really strong runway with the Red series and the reaction continues to be.
Pretty extraordinary so I think we are.
I think pretty clearly alluded to.
Really really strong position with our stroke franchise when you add thunderbolt.
Top of that which is not really included in this year's expectations.
It just makes it even better.
You said you had about.
Yes.
So thunderbolt is not included in the 2022 launches does that is that what you just said.
That's right.
Okay. Thank you and then on real Adam any any metrics you can share with us on the progress to.
To date, you haven't shared anything on placements or anything like that and what's the guidance assume for real in 2022, thanks for taking the questions.
Yes, so we we are not focusing on.
Real as a big.
A big source of revenue in 2022.
So that's.
That's just not part of.
The way, we're thinking about that business in the next year or so.
Our focus is on building the platform itself and then working to.
<unk> had the conversations with the folks in the channel who would be using.
The real system for their patients as well as the third party.
<unk>.
One our hosted on the platform. So we're going to try to do as best we can and really we'll look to do this in the second half of the year.
Start to give some updates when we can.
About how those conversations are going both with that.
The users of the product in the third party developers and that really is the best way to measure of whether we're doing this.
The way we had anticipated.
So again not focusing on the.
The short term revenue as much as using this year as I think we've said a couple of times as a building block to build this really first ever.
Platform.
And immersive healthcare.
Thank you Adam.
Of course, thank you.
Our next question is from Bill <unk> with Canaccord. Your line is open.
Great. Thanks, Good evening two questions. So first is just on guidance as we think about the first quarter and the level of impact.
<unk> is having on a lot of folks just.
How should we think about it is this something where.
It has significant impact to January and so we're looking at a flattish quarter up or down.
How should we really think about Q1 is my first question.
Yes, let me I'll give you sort of a quick.
Sort of larger thoughts.
Jason can give more specifics to the second part of the question.
We called it out as you know we've done I think a really.
Pretty good job in our company navigating COVID-19 over the last couple of years.
And.
There is no question that.
This round in January , particularly in the first part of January .
Staffing issues, particularly were very different.
Said that before and that that was true.
Yes.
They just werent people.
Cable to be working at the same levels that is necessary that being said we.
That's the field resolved.
<unk> is very strong.
But I'll, let I'll, let Jason address the specifics to this.
This quarter.
Yes, Bill Thanks for the question and so we had an extraordinarily.
Strong fourth quarter record quarter, if not for that record I would expect that the <unk>.
First quarter would also would have been a record quarter. So.
We expect that sequentially from the first to the fourth quarter, we will see sequential growth and accelerating year over year growth in the first quarter, given what Adam talked about with respect to those first several weeks we would expect.
The quarter in the first quarter to be down sequentially, and then accelerating thereafter.
Great. Thanks, Thanks for that and then just a bigger picture thought I mean vascular has gone very well for you.
We've seen a lot of other players starting to I up this vertical whether it be through acquisitions or new product launches.
Philosophically, how do you think about this.
As we move forward.
It's almost like we're going from a two to three player.
Market to all of a sudden this is going to get pretty crowded over the next 12 months to 24 months.
Yeah, So first of all.
I'll start with the most obvious.
Important to say I am really actually quite happy to see more and more people.
Even in this space carries budget.
Wanting to help.
Related to a huge number of patients.
Better technology and better treatment than they have been getting so the validation that comes from other companies getting into this space I think is really important and I think it will help.
Speed up the adoption of single section there.
So that's important as it relates to our ability to.
Stay ahead, and keep innovating and coke compete.
We have done this for a while as you know we've done it in stroke for many many years and.
Given where we are we're starting at a totally different spot with lightning than we did before in stroke.
And we think we can even go further than that as I alluded to.
In my prepared remarks and in the questions. So.
I think we're in a really good spot we know the technologies that are that are out there.
Feel good about.
Where we are.
And I think we as a company will stay.
In a really good place that being said.
Again.
It's great to see the attention being given to these patients.
I think that only helps us.
Okay.
Our next question comes from Margaret Kaczor with William Blair. Your line is open.
Hi, everyone. This is Brandon on for Margaret Thanks for taking the question I wanted to focus first Brian .
Hey, guys just on the guidance.
Last year you had.
In 2021, you had really outperformed the original guidance you gave.
I can appreciate that Covid, maybe limited the visibility you have but it seems like.
Last year, you had a little bit of a conservative guide and outperformed and then.
Adam you had used the word accelerate a lot in the prepared remarks, so as we're moving into the next year I'm just curious how youre thinking about how you framed up the 22 revenue guidance.
Maybe compared to how you did it in 'twenty one.
What that could mean for potential upside as we move through the year.
Yes.
Let me start with.
So reiterating how we think about guidance.
We try to do guidance.
<unk> guidance in the most accurate form possible. So we take everything we know almost a year out from the end of it and <unk>.
I think a pretty good job of planning and figuring out.
How things are going to go including new products and so on.
And Thats, how we did the guidance at the beginning of 2021 and that's how we're doing it now obviously we were fortunate in 2021.
And we did outperform that.
It would be premature.
Look back a year from where we are today and discussed that but I think it's the same exact metrics that we've used in the past as Jason do you want to add anything yes, Brian and thanks for the question, maybe just a little bit of context, obviously 2020.
Revenue was impacted for everybody by Covid right.
And 2021, a little less so.
The increase in revenue.
On a dollar amount term in 2021.
It was well over $100 million.
Notwithstanding.
<unk> a great 2021, we are expecting too.
And even the low point of your guidance over $100 million of incremental dollar of revenue.
And as we've talked about we have innovation about which we are excited.
For both the neuro and vascular businesses as well as what we expected immersive healthcare.
That.
We have not included to some extent in this guidance, including Thunderbolt as Adam mentioned, Jennifer earlier question. So we feel really good about where the business is and where the guidance is but as Adam mentioned that factors in.
The contribution that we expect from those products that we anticipate having throughout the year.
Okay. Thanks, and then.
We talked a little bit about international product launches coming up can you maybe right size us on which of your latest products like the Red and Lightning catheters are launch international already in.
Which one.
Which countries might be coming throughout the year. When we can expect those and just remind us where I think your international your.
Our direct internationally and where those products might be most impactful in the next call. It 12 months.
Yes, well, let's start with the Red series and then maybe focus on lightning. So red is at this point with a few small countries.
Really.
Coming from the U S. Obviously the.
Two large.
Non U S markets.
Our Europe .
In Japan.
I did make those comments that debt that is there for future international growth.
And potentially.
Towards the back half of this year.
And then lightning.
Again with the exception of some smaller countries, primarily the U S. Today.
It will be available.
Sooner.
Europe , then the Red series.
Yes.
We are excited about that there is some navigation around reimbursement.
In some of those countries.
And it is not yet in Japan.
But again excited to eventually bring to bear as well.
Yeah.
Thank you.
Yes. Thank you thanks, Brian .
Our next question is from.
Citigroup Your line is open.
Hi, This is Anthony on for Joanne. Thank you for taking our question.
Just a quick one the model.
Milestone related to Thunderbolt interest with some more.
The detail around what that was unrelated to or what those milestones are.
Yes, so it's.
There was a an understanding with.
The person, who helped invent and work on that product.
That once we got through a certain.
Milestone with working with the FDA.
We would make this payment that's the last payment of.
The only payment there is.
Again, very similar to what happened with lightning.
A couple of years ago, I think if you go back and you can look at it forget the exact quarter, but we did something very similar so.
It's like that.
Thanks.
Yes of course, thank you.
Again, if you would like to ask a question. Please press Star then one on your telephone keypad.
Our next question is from David Ross, Scott with Truest Securities. Your line is open.
Hey, guys. Thanks for taking the question and congrats on the strong end to the year.
I wanted to start on I guess guidance for full year 2022 I guess, how are you thinking about some of the growth in each of these different segments, where I know that north during back to me had a recall in the early part of 2021.
Several of our easy easier for all come back to me had some structural tailwind for them in that segment.
We pull forward into 2022, so I guess when you think about each of those segments.
How are each of those playing into that overall growth guidance. You gave for 2023 and should we be thinking about whether or not theres any strength or acceleration specifically within each of those segments.
Yes, it's a great question so the.
<unk>.
We look at our business is in.
We are talking about it I think shows that we have.
Six large underpenetrated markets five in the interventional space that are going to drive our growth. This year, obviously immersive healthcare is more an investment for future growth and hopefully in.
A few years, we'll be talking a lot about that driving growth, but in the short term.
Looking at the five areas in interventional that that are Underpenetrated and then.
The six being the court the embolization business in peripheral that is continuing to grow. It's just not really underpenetrated. We just continue to do well and take share all of them matter to our company's success.
Nope that we've made that pretty clear we're investing in all of them. We all have.
In each one of them sort of World class technology, right now whether it's in stroke.
Coronary with <unk>.
<unk> achieved a data obviously in PE and DVT and on the arterial side. So it really isn't we're not looking at any particular, one they might slightly vary quarter by quarter based on.
The way certain conversations go with sales reps.
And hospitals, but it really is all of those that are going to drive our growth.
This year and into the future and then hopefully add.
The other large market and immersive healthcare on top of it.
Again not to belabor it.
All of it is part of our success, Jason if you want to add to that yeah.
The only thing I'd add David is we're on really strong footing.
Both neuro and vascular businesses, so those five interventional markets that Adam referred to.
Four of them as you know are on the vascular side and then <unk>.
Roke on the on the neuro side.
They are all going to contribute to our growth.
In 2022, and even beyond 2022 in a significant way, but obviously the numbers are just <unk>.
Four of them in vascular and one of them on the neuro side.
For 2022 something to consider.
Okay Thats helpful. Adam you mentioned that the.
<unk> catheters at a clip or clips the peak sales in 2019 from prior catheter line.
I guess, what do you think has been the biggest driver of that and then when you think about that kind of in the context of market share versus.
Market growth versus overall share recapture I guess, how should we think about those.
In the context of just the overall strength of bright serious catheter since that launch. Thank you.
Yes.
Great question, So I think.
For us in 2021.
A lot of that.
Growth came from.
Market share.
There was some growth.
In the market, we think but again as I've talked about in the past so much of that work is.
Yet to really Reengage everyone's ready everyone wants to wave after wave last year sort of kept people from doing some of the work necessary. So with a little luck, we'll see that change in 'twenty.
'twenty two.
And I know from talking to customers there.
There's a lot of interest and want to see it grow they want to see more people treated but a lot of our gain happen through share.
In 2021.
And I think that will be true.
Going forward as well I think there's more share to keep gaining.
Why the first part of the question is why or what caused that.
These are just really extraordinary tools the red series as some of the best work we've ever done.
Terribly proud of our R&D.
R&D team and the innovation that they brought to it especially given the circumstances.
The following 2020.
Couldnt be prouder than that that is a incredibly important product again, it's not only important to date by itself, but it is foundational for.
The future.
Given that it is part of it would be used with thunderbolt after that.
In this study and after the study.
Okay.
There are no further questions at this time Ms Hamlyn Harris.
Okay.
Thank you operator on behalf of our management team. Thank you all again for joining us today NCL interesting.
Look forward to updating you on our first quarter call.
This concludes today's conference call you may now disconnect.
Please wait the conference will begin shortly.
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