Q2 2024 Penumbra Inc Earnings Call

Good afternoon. My name is Aaron and I will be your conference operator for today. At this time, I would like to welcome everybody to Penumbra's second quarter 2024 conference call. All lines have been placed on mute to prevent any background noise.

Operator: At this time, I would like to welcome everybody to Penumbra's second quarter 2024 conference call. All lines have been placed on mute to prevent any background noise.

Operator: At this time, I would like to welcome everybody to Penumbra's second quarter 2024 conference call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question-and-answer session. And 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, hit star followed by the number one again. Thank you.

Operator: After the speaker's remarks, there will be a question and answer session, and 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, hit star followed by the number one again. Thank you. With that, I would like to introduce Ms. Cecilia Furlong, Business Development and Investor Relations for Penumbra. Ms. Furlong, you may begin your conversation.

After the speaker's remarks, there will be a question and answer session, and 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, hit star followed by the number one again. Thank you.

Cecilia Furlong: With that, I would like to introduce Miss Cecilia Furlong. Miss Cecilia Furlong, Business Development Investor Relations for Penumbra. Miss Furlong, you may begin your conference.

Speaker Change: With that, I would like to introduce Ms. Cecilia Furlong, Business Development and Investor Relations for Penumbra. Ms. Furlong, you may begin your conference.

Cecilia Furlong: Thank you, operator, and thank you all for joining us on today's call to discuss Penumbra's earnings release for the second quarter of 2024. A copy of the press release and financial tables, which includes a gap to non-gap reconciliation, can be viewed under the investors tab on our company website at www.penumbrainc.com. During the course of this conference call, the company will make forward-looking statements, pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, including 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 a forward-looking statement due to certain risks and uncertainties, including those referenced in our 10-K for the year end of December 31, 2023, filed with the SEC.

Operator: Thank you operator and thank you all for joining us on today's call to discuss Penumbra's earnings release for the second quarter of 2024. A copy of the press release and financial tables which includes a gap to non-gap reconciliation can be viewed under the investors tab on our company website at www.penumbrainc.com, During the course of this conference call, the company will make forward-looking statements pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, including statements regarding our financial performance, commercialization, clinical trials, regulatory status, quality, compliance, and business trends.

Cecilia Furlong: Thank you, operator, and thank you all for joining us on today's call to discuss Penumbra's earnings release for the second quarter of 2024.

Speaker Change: A copy of the press release and financial tables, which includes a gap to non-gap reconciliation, can be viewed under the Investors tab on our company website at www.penumbrainc.com.

Operator: Actual results could differ materially from those stated or implied by our forward-looking statements due to certain risks and uncertainties, including those referenced in our 10-K for the year ended December 31, 2023, filed with the SEC. 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 $10K previously mentioned, for a more complete discussion of these factors and other risks that may affect our future results or the market price of our stocks. Penumbra disclaims any duty to update or revise its forward-looking statements as a result of new information, future events, developments, or otherwise.

Speaker Change: During the course of this conference call, the company will make forward-looking statements pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995.

Speaker Change: including statements regarding our financial performance, commercialization, clinical trials, regulatory status, quality, compliance, and business trends.

Speaker Change: Actual results could differ materially from those stated or implied by our forward-looking statements due to certain risks and uncertainties, including those referenced in our 10-K for the year ended December 31, 2023, filed with the SEC.

Cecilia Furlong: As a result, we caution you against placing undue reliance on the 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 that may affect our future results or the market price of our stock.

Speaker Change: 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.

Cecilia Furlong: A number just claims any duty to update or revise our forward-looking statements as a result of new information, future events, developments, or otherwise. On this call, financial results for revenue are presented on a GAAP basis, while gross margin, operating expenses, operating income, and adjusted EBITDA are presented on a non-GAAP basis. The corresponding gap measures and a reconciliation of gap to non-gap financial measures are provided in our posted press release. Non-GAAP gross margin, operating expenses and operating income exclude amortization of acquired intangible assets in the second quarter of 2024 and 2023, and an impairment of our immersive healthcare business in the second quarter of 2024.

Speaker Change: That may affect our future results or the market price of our stock.

Speaker Change: Penumbra disclaims any duty to update or revise our forward-looking statements as a result of new information, future events, developments, or otherwise.

Cecilia Furlong: On this call, financial results for revenue are presented on a gap basis, while gross margin, operating expenses, operating income, and adjusted EBITDA are presented on a non-gap basis. The corresponding GAAP measures and a reconciliation of GAAP to non-GAAP financial measures are provided in our posted press release. Non-GAAP gross margin, operating expenses, and operating income exclude amortization of acquired intangible assets in the second quarter of 2024 and 2023 and an impairment of our immersive health care business in the second quarter of 2024. Adjusted EBITDA excludes impairment expenses, stock compensation expense, depreciation and amortization, benefit from income taxes, and interest income expenses.

Speaker Change: On this call, financial results for revenue are presented on a GAAP basis, while gross margin, operating expenses, operating income, and adjusted EBITDA are presented on a non-GAAP basis.

Speaker Change: The corresponding GAAP measures and a reconciliation of GAAP to non-GAAP financial measures are provided in our posted press release.

Speaker Change: non-GAAP gross margin, operating expenses, and operating income exclude amortization of acquired intangible assets in the second quarter of 2024 and 2023, and an impairment of our immersive healthcare business in the second quarter of 2024.

Cecilia Furlong: Adjusted EBITDA excludes impairment expenses, soft compensation expense, depreciation, and amortization, benefit from income taxes and interest income expenses.

Speaker Change: Adjusted EBITDA excludes impairment expenses, stock compensation expense, depreciation and amortization, benefit from income taxes, and interest income expenses.

Adam Elsesser: Adam Elfesser, the Numbers chairman and CEO, will provide a business update.

Cecilia Furlong: Adam Elsesser, Penumbra's Chairman and CEO, will provide a business update. Maggie Yuen, our Chief Financial Officer, will then discuss our financial results for the second quarter of 2024. And Jason Mills, our Executive Vice President of Strategy, will discuss our updated 2024 guidance. With that, I would like to turn the call over to Adam Elsesser. Thank you, Cecilia.

Adam Elsesser: Adam Elsesser, Penumbra's Chairman and CEO , will provide a business update. Maggie Yuen, our Chief Financial Officer, will then discuss our financial results for the second quarter of 2024. And Jason Mills, our Executive Vice President of Strategy, will discuss our updated 2024 guidance.

Maggie Yuan: Maggie Yuan, our Chief Financial Officer, will then discuss our financial results for the second quarter of 2024.

Jason Mills: And Jason Mills, our Executive Vice President of Strategy, will discuss our updated 2024 guidance.

Adam Elsesser: With that, I would like to turn the call over to Adam Elfesser. Thank you, Cecilia. Good afternoon.

Adam Elsesser: Thank you for joining Penumbra's second quarter 2024 conference call. Our total revenue for the second quarter was $299.4 million, a year-over-year increase of 14.5% as reported and 14.7% on a constant currency basis. Our US thrombectomy revenue grew 25% compared to the same quarter a year ago to $153.7 million and 29.8% year-over-year in the first half of 2024, driven by our CAVT products in VTE and arteriole. Our international thrombectomy revenue was $49.8 million, growing 26% year over year.

Adam Elsesser: With that, I would like to turn the call over to Adam Elsesser.

Adam Elsesser: Thank you for joining the number second quarter of 2024 conference call. A total revenue for the second quarter was $299.4 million, a year-over-year increase of 14.5% is reported and 14.7% on a constant currency basis. Our U.S. Thrombectomy revenue grew 25% compared to the same quarter a year ago to $153.7 million, and 29.8% year-over-year in the first half of 2024, driven by our CAVT products in VTE and arterial. Our international thrombectomy revenue was $49.8 million, growing 26% year-over-year. On a worldwide basis, total thrombectomy revenue was $203.5 million, growing 25% year-over-year. Our global embolization and access revenue declined slightly year-over-year to $95.9 million, but improved sequentially by 5% driven by our U.S.

Adam Elsesser: Thank you, Cecilia. Good afternoon. Thank you for joining Penumbra's second quarter 2024 conference call.

Maggie S. Yuen: Our total revenue for the second quarter was $299.4 million, a year-over-year increase of 14.5% as reported, and 14.7% on a constant currency basis.

Maggie S. Yuen: Our U.S. thrombectomy revenue grew 25%.

Maggie S. Yuen: compared to the same quarter a year ago to $153.7 million and 29.8% year-over-year in the first half of 2024, driven by our CAVT products in VTE and arterial.

Maggie S. Yuen: Our international thrombectomy revenue was $49.8 million, growing 26% year-over-year. On a worldwide basis, total thrombectomy revenue was $203.5 million, growing 25% year-over-year.

Adam Elsesser: On a worldwide basis, total thrombectomy revenue was $203.5 million, growing 25% year over year. Our global embolization and access revenue declined slightly year over year to $95.9 million, but improved sequentially by 5%, driven by our U.S. business, which grew 9% sequentially and 1% year over year to $64.5 million. This strong sequential growth in the US was due to our sales team responding to the first quarter competitive launch. Non-GAAP gross margins expanded to 65.5%, up 170 basis points year over year.

Maggie S. Yuen: Our global embolization and access revenue declined slightly year over year to $95.9 million, but improved sequentially by 5%.

Adam Elsesser: business, which grew 9% sequentially and 1% year-over-year to $64.5 million. This strong sequential growth in the U.S. was due to our sales team responding to the first quarter competitive launches. Non-GAAP gross margins expanded to 65.5%, up 170 basis points year-over-year. Non-GAP operating income in the second quarter was $31.7 million, representing 10.6% of revenue, increasing 280 basis points over the same period a year ago and 370 basis points improvement sequentially. We continue to see a path to gross margins over 70% over the next 21 to 27 months, and we expect operating margin expansion to outpace gross margin expansion for the foreseeable future.

Maggie S. Yuen: driven by our U.S. business, which grew 9% sequentially and 1% year-over-year to $64.5 million. This strong sequential growth in the U.S. was due to our sales team responding to the first quarter competitive launches.

Maggie S. Yuen: non-GAAP gross margins expanded to 65.5%, up 170 basis points year-over-year. non-GAAP operating income in the second quarter was $31.7 million.

Adam Elsesser: Non-GAAP operating income in the second quarter was $31.7 million, representing 10.6% of revenue, increasing 280 basis points over the same period a year ago and 370 basis points of improvement sequentially. We continue to see a path to gross margins over 70% over the next 21 to 27 months, and we expect operating margin expansion to outpace gross margin expansion for the foreseeable future. Clinically significant clot burden in the arteries and veins of the body and the brain is still one of the most undertreated acute issues in healthcare today.

Maggie S. Yuen: representing 10.6% of revenue, increasing 280 basis points over the same period a year ago and 370 basis points improvement sequentially.

Maggie S. Yuen: We continue to see a path to gross margins over 70% over the next 21 to 27 months, and we expect operating margin expansion to outpace gross margin expansion for the foreseeable future.

Adam Elsesser: Clinically significant clot burden in the arteries and veins of the body and the brain is still one of the most under-treated acute issues in healthcare today. For 20 years, Penumbra has innovated and innovated our thrombectomy products to make them effective in removing clot in the safest, fastest, and simplest way possible. With the launch of CABT last year, we can now say that our products are the safest and most effective in removing blood clots compared to other mechanical systems and other modalities. Therefore, Penumbra is in a period of transformation. From a company solely innovating and treating the patients that were deemed treatable to a company that has a genuine responsibility over the next five plus years to reach the majority of the 125 million annual thrombectomy patients in the United States.

Speaker Change: Clinically significant clot burden in the arteries and veins of the body and the brain is still one of the most undertreated acute issues in health care today.

Adam Elsesser: For 20 years, Penumbra has innovated and innovated our thrombectomy products to make them effective in removing clots in the safest, fastest, and simplest way possible. With the launch of CAVT last year, we can now say that our products are the safest and most effective in removing blood clots compared to other mechanical systems and other modalities. Therefore, Penumbra is in a period of transformation, from a company solely innovating and treating the patients that were deemed treatable to a company that has a genuine responsibility over the next five plus years to reach the majority of the 125 million annual thrombectomy patients in the United States.

Speaker Change: For 20 years, Penumbra has innovated and innovated our thrombectomy products.

Speaker Change: to make them effective in removing clot in the safest, fastest, and simplest way possible.

Speaker Change: With the launch of CABT last year, we can now say that our products are the safest and most effective in removing blood clots compared to other mechanical systems and other modalities.

Speaker Change: Therefore, Penumbra is in a period of transformation.

Speaker Change: From a company solely innovating and treating the patients that were deemed treatable, to a company that has a genuine responsibility over the next five plus years to reach the majority of the 125 million annual thrombectomy patients in the United States.

Adam Elsesser: Meanwhile, we are multiple years into the process of building toward a similarly unique opportunity in international markets with the work we are doing in reimbursement, clinical ovens, and commercial expansion.

Adam Elsesser: Meanwhile, we are multiple years into the process of building toward a similarly unique opportunity in international markets with the work we are doing in reimbursement, clinical evidence, and commercial expansion. Now, let's focus on what specifically happened in the second quarter and how we see the next several quarters. Starting with our vascular business, we had our first available Flash 2.0 units in late April, which was later than we had hoped, but the initial cases showed that it was worth waiting for for experienced users of Flash 1.0.

Speaker Change: Meanwhile, we are multiple years into the process of building toward a similarly unique opportunity in our international markets with the work we are doing in reimbursement, clinical opens, and commercial expansion.

Adam Elsesser: Now, let's focus on what specifically happened in the second quarter and how we see the next several quarters. We had our first available Flash 2.0 units in late April, which was later than we had hoped, but the initial cases showed that it was worth waiting for. For experienced users of Flash 1.0, the reaction to Flash 2.0 has been positive, but more that it is a very good iterative product. For new first-time users of Flash, Flash 2.0 generated an extreme change in the future. The feedback starts with excitement that the speed of the cases was much faster than their current cases, with a much safer profile.

Speaker Change: Now let's focus on what specifically happened in the second quarter and how we see the next several quarters.

Speaker Change: Starting with our vascular business, we had our first available flash 2.0 units in late April , which was later than we had hoped, but the initial cases showed that it was worth waiting for.

Adam Elsesser: The reaction to Flash 2.0 has been positive, but more that it is a very good iterative product for new, first-time users of Flash. It generated an extremely positive reaction. The feedback starts with excitement, that the speed of the cases was much faster than their current cases with a much safer profile, less worry about cardiac decompensation because of the smaller catheter used. No need to deal with returning potentially compromised blood and clinically very acceptable blood loss that had the benefit of being contained in our pump canister and not uncontained in the room.

Speaker Change: For experienced users of Flash 1.0, the reaction to Flash 2.0 has been positive, but more that it is a very good iterative product.

Speaker Change: For new first-time users of Flash, Flash 2.0 generated an extremely positive reaction.

Speaker Change: The feedback starts with excitement.

Speaker Change: that the speed of the cases was much faster than their current cases.

Adam Elsesser: Less worry about cardiac decompensation because of the smaller catheter used. No need to deal with returning potentially compromised blood and clinically very acceptable blood loss that had the benefit of being contained in our pump canister and not uncontained in the world. This feedback, particularly on the issue of returning compromised blood, was highlighted at a recent San Diego VTE Summit, citing data from extensive testing, the growing body of evidence, and existing guidelines. Physicians are starting to become aware of this issue, and, not surprisingly, this issue is likely going to be discussed at upcoming medical conferences where experts will continue to educate on the known risks.

Speaker Change: with a much safer profile.

Speaker Change: Less worry about cardiac decompensation because of the smaller catheter used. No need to deal with returning potentially compromised blood.

Speaker Change: clinically very acceptable blood loss that had the benefit of being contained in our pump canister and not uncontained in the room.

Adam Elsesser: This feedback, particularly on the issue of returning compromised blood, was highlighted at a recent San Diego VTE summit, citing data from extensive testing, the growing body of evidence, and existing guidelines. Physicians are starting to become aware of this issue. And not surprisingly, this issue is likely going to be discussed at upcoming medical conferences where experts will continue to educate on the known risks of returning potentially compromised blood. Given the feedback we are getting from Flash 2.0, we have seen particularly competitive tactics in the second half of the quarter in VTE.

Speaker Change: This feedback, particularly on the issue of returning compromised blood, was highlighted at a recent San Diego VTE summit, citing data from extensive testing, the growing body of evidence, and existing guidelines.

Speaker Change: Physicians are starting to become aware of this issue and not surprisingly this issue is likely going to be discussed at upcoming medical conferences where experts will continue to educate on the known risks of returning potentially compromised blood.

Speaker Change: Given the feedback we are getting from Flash 2.0, we have seen particularly competitive tactics in the second half of the quarter in VTE.

Adam Elsesser: In the second half of the quarter in VTE, I want to stress that we are no strangers to competition and we are motivated to compete, particularly when the feedback on our products is that they are the best for patients. Our experience of competing over 17 years against some of the best companies in Medtech has shown that physicians ultimately choose the best product. This work is important and exciting. However, it takes time and does not happen in a straight line quarter to quarter. We saw the same dynamic in the stroke market years ago when that mark was equally under-penetrated and growing at a similar pace.

Adam Elsesser: I want to stress that we are no strangers to competition, and we are motivated to compete, particularly when the feedback on our products is that they are the best for patients. Our experience of competing for 17 years against some of the best companies in medtech has shown that physicians ultimately choose the best product. This work is important and exciting. However, it takes time and does not happen in a straight line, quarter to quarter.

Speaker Change: I want to stress that we are no strangers to competition, and we are motivated to compete, particularly when the feedback on our products is that they are the best for patients.

Speaker Change: Our experience of competing over 17 years against some of the best companies in medtech has shown that physicians ultimately choose the best product.

Speaker Change: This work is important and exciting. However, it takes time and does not happen in a straight line quarter to quarter. We saw the same dynamic in the stroke market years ago when that market was equally underpenetrated and growing at a similar pace.

Adam Elsesser: We saw the same dynamic in the stroke market years ago when that market was equally underpenetrated and growing at a similar pace. Penumbra emerged as the clear leader, and we continue to expand our position today. With Flash 2.0, we gained significant share in VTE and Q2, growing within our stated guidance, and we expect to continue to do so in the second half of the year and beyond. Our arterial business, led by Lightning Bolt in the U.S., also continues to perform extremely well. The technology we call modulated aspiration and Lightning Bolt continues to remove blood clots very easily compared to prior modality, and Q2.

Adam Elsesser: The number emerged as the clear leader, and we continue to expand our position today. With Flash 2.0, we gain significant share in VTE and Q2, growing within our stated guidance range, and we expect to continue to do so in the second half of the year and beyond. Our arterial business led by Lightning Bolt in the US also continues to perform extremely well. The technology we call modulated aspiration and lightning bolt continues to remove blood clot very easily compared to prior modalities. In Q2, our US arterial business grew year-over-year significantly above our stated guidance range. The 12-month stride study results were also recently published in the Journal of Vascular Surgery, showing higher target limb salvage rates at one year of 88.5% versus historical literature rates for CDT and open surgery, which are as low as 57% and 65%, respectively.

Speaker Change: Penumbra emerged as the clear leader, and we continue to expand our position today. With Flash 2.0, we gained significant share in VTE and Q2, growing within our stated guidance range.

Speaker Change: And we expect to continue to do so in the second half of the year and beyond.

Speaker Change: Our arterial business.

Speaker Change: led by Lightning Bolt in the U.S. also continues to perform extremely well. The technology we call Modulated Aspiration and Lightning Bolt continues to remove blood clot very easily compared to prior modalities.

Adam Elsesser: Our US arterial business grew year over year, significantly above our stated guidance range. The 12-month stride study results were also recently published in the Journal of Vascular Surgery showing higher target limb salvage rates at one year of 88.5% versus historical literature rates for CDT and open surgery, which are as low as 57% and 65%, respectively. This continues to make the case for an endovascular first approach to arterial thrombus removal and is reflected in the strength of our growing arterial pathway.

Speaker Change: In Q2, our U.S. arterial business grew year over year, significantly above our stated guidance range.

Speaker Change: The 12-month STRIDE study results were also recently published in the Journal of Vascular Surgery showing higher target limb salvage rates.

Speaker Change: at one year of 88.5% versus historical literature rates for CDT and open surgery, which are as low as 57% and 65% respectively.

Adam Elsesser: actively. This continues to make the case for an endovascular first approach to arterial trombus removal and is reflected in the strength of our growing arterial business. Moving to our neurovascular business, we saw another good quarter with our US road business growing 19% year over year. Our neural access business also saw good momentum, including the launch of our Midway access catheters. Just last week, at the Society of Interventional Surgery, Neuro Interventional Surgery meeting in Colorado Springs, Dr. David Firella, one of the principal investigators of the Thunder Study, highlighted Thunderbolt in a late-breaking session, showing a few case examples of how easily Thunderbolt removes clot.

Speaker Change: This continues to make the case for an endovascular first approach to arterial thrombus removal and is reflected in the strength of our growing arterial business.

Adam Elsesser: Moving to our neurovascular business, we saw another good quarter with our US stroke business growing 19% year over year. Our neuro access business also saw good momentum, including the launch of our midway access catheter. Just last week at the Society of Interventional Surgery's Neuro-Interventional Surgery meeting in Colorado Springs, Dr. David Fiorella, one of the principal investigators of the THUNDER Study, highlighted Thunderbolt in a late-breaking session, showing a few case examples of how easily it removes clots.

Speaker Change: Moving to our neurovascular business, we saw another good quarter with our US stroke business growing 19% year-over-year. Our neuro access business also saw good momentum, including the launch of our midway access catheters.

Speaker Change: Just last week at the Society of Neurointerventional Surgery meeting in Colorado Springs, Dr. David Fiorella, one of the principal investigators of the THUNDER study,

Speaker Change: highlighted Thunderbolt in a late breaking session showing a few case examples of how easily Thunderbolt removes clot.

Adam Elsesser: This success puts us in a strong position as we focus on completing the Thunder Study and prepare to bring Thunderbolt to the market. Finally, we are encouraged to hear a lot of conversations among physicians regarding making sure that the right size catheters are used for stroke cases so it's not to stretch an artery with an oversized catheter.

Adam Elsesser: This success puts us in a strong position as we focus on completing the Thunder Study and preparing to bring Thunderbolt to the market. Finally, we are encouraged to hear a lot of conversations among physicians regarding making sure that the right size catheters are used for stroke cases so as not to stretch an artery with an oversized catheter.

Speaker Change: This success puts us in a strong position as we focus on completing the Thunder Study and prepare to bring Thunderbolt to the market.

Speaker Change: Finally, we are encouraged to hear a lot of conversations among physicians regarding making sure that the right size catheters are used for stroke cases so as not to stretch an artery with an oversized catheter.

Adam Elsesser: Now I'd like to spend a few minutes discussing our comprehensive market access initiatives, which I think are very important to both near term and long term as we develop these under penetrated thrombectomy markets. Over the past 12 months, we have spent significant time and effort, both internally and with an excellent team of third-party analytical partners, engaging in generating evidence from large third-party hospital data sets to better understand how CABT performs versus other therapies, including anti-coagulation alone, across a wide range of metrics. Our rigor has resulted in the completion of studies in PE and DVT that we believe set a high bar for data quality and independence.

Adam Elsesser: Now I'd like to spend a few minutes discussing our Comprehensive Market Access Initiative, which I think is very important both near-term and long-term as we develop these under-penetrated thrombectomy models. Over the past 12 months, we have spent significant time and effort both internally and with an excellent team of third-party analytical partners engaged in generating evidence from large third-party hospital datasets to better understand how CAVT performs versus other therapies, including anticoagulant alone, across a wide range of metrics.

Speaker Change: Now, I'd like to spend a few minutes discussing our comprehensive market access initiatives, which I think are very important to both near-term and long-term as we develop these underpenetrated thrombectomy markets.

Speaker Change: Over the past 12 months, we have spent significant time and effort both internally and with an excellent team of third-party analytical partners.

Speaker Change: engaged in generating evidence from large third-party hospital data sets to better understand how CAVT performs versus other therapies including anticoagulation alone across a wide range of metrics.

Adam Elsesser: Our rigor has resulted in the completion of studies in PE and DVT that we believe set a high bar for data quality and independence, as we hope and expect. CAVT outperforms other advanced therapies across a wide range of parameters related to hospital efficiency and cost, but most importantly, procedural effectiveness and safety, because of our persistent and rapid innovation cycle. We expect this growing relative outperformance to be reflected in the evidence that we will generate continuously from this point forward. We also plan to generate similar high-quality data sets across every vascular bed and patient population we serve with CAVT.

Speaker Change: Our rigor has resulted in the completion of studies in PE and DVT that we believe set a high bar for data quality and independence.

Adam Elsesser: As we hope and expect, CABT outperforms other advanced therapies across a wide range of parameters related to hospital efficiency and cost, but most importantly, procedural effectiveness and safety. Because of our persistent and rapid innovation cycles, we expect this growing relative outperformance to be reflected in the evidence that we will generate continuously from this point forward. We also plan to generate similar high quality data sets across every vascular bed and patient population we serve with CABT. We've recently started the process of discussing the results of these high quality studies with some of the largest hospital systems in the US and supporting these partners in whatever ways are appropriate to offer CABT to a growing number of patients that could benefit from access to this technology.

Speaker Change: As we hoped and expected, CAVT outperforms other advanced therapies across a wide range of parameters related to hospital efficiency and cost, but most importantly, procedural effectiveness and safety.

Speaker Change: Because of our persistent and rapid innovation cycles, we expect this growing relative outperformance to be reflected in the evidence that we will generate continuously from this point forward.

Speaker Change: We also plan to generate similar high-quality datasets across every vascular bed and patient population we serve with CAVT.

Adam Elsesser: We've recently started the process of discussing the results of these high-quality studies with some of the largest hospital systems in the US and supporting these partners in whatever ways are appropriate to offer CAVT to a growing number of patients that could benefit from access to this technology. We very much look forward to communicating these results to our partners and the physician community at large in the months and years ahead. Now, I'd like to give an update on our immersive health care.

Speaker Change: We've recently started the process of discussing the results of these high-quality studies with some of the largest hospital systems in the U.S. and supporting these partners in whatever ways are appropriate to offer CAVT to a growing number of patients that could benefit from access to this technology.

Adam Elsesser: We very much look forward to communicating these results to our partners and the physician community at large in the months and years ahead.

Speaker Change: We very much look forward to communicating these results to our partners and the physician community at large in the months and years ahead.

Adam Elsesser: Now I'd like to give an update on our immersive healthcare business. We have developed an extraordinary set of products that have shown to greatly benefit. patients. I could not be prouder of our amazing immersive healthcare team. Even with this confidence in the long-term benefit and likely success of our immersive healthcare platform and technology, our current focus needs to be on helping as many patients as possible in our interventional business, particularly in this critical moment where we believe our CAVT technology can help most patients who need to come back to me.

Speaker Change: Now I'd like to give an update on our immersive health care business.

Adam Elsesser: We have developed an extraordinary set of products that have shown to greatly benefit. I could not be prouder of our amazing immersive healthcare team, even with this confidence in the long-term benefit and likely success of our immersive healthcare platform and technology. Our current focus needs to be on helping as many patients as possible in our interventional business, particularly in this critical moment, where we believe our CAVT technology can help most patients who need thrombectomy. Therefore, we have begun to explore alternative avenues for the immersive health care business. Because of that decision, we are taking a one-time, non-cash accounting charge.

Speaker Change: We have developed an extraordinary set of products that have shown to greatly benefit patients.

Speaker Change: I could not be prouder of our amazing immersive health care team.

Speaker Change: Even with this confidence in the long-term benefit and likely success of our immersive health care platform and technology, our current focus needs to be

Speaker Change: on helping as many patients as possible in our interventional business.

Speaker Change: particularly in this critical moment where we believe our CAVT technology can help most patients who need thrombectomy.

Adam Elsesser: Therefore, we have begun to explore alternative avenues for the immersive healthcare business. Because of that decision, we are taking a one-time non-cash accounting charge. As we explore these alternatives, we expect to reduce our ongoing operating expenses, thereby further increasing our operating margin and cash flow trajectory going forward. This strategic move allows us to focus 100% of our time, energy, and resources to help as many patients as possible while increasing our company's profitability.

Speaker Change: Therefore, we have begun to explore alternative avenues for the immersive healthcare business.

Speaker Change: Because of that decision, we are taking a one-time, non-cash accounting charge.

Adam Elsesser: As we explore these alternatives, we expect to reduce our ongoing operating expenses, thereby further increasing our operating margin and cash flow trajectory going forward. This strategic move allows us to focus 100% of our time, energy, and resources to help as many patients as possible while increasing our company's profitability. I know many of you have come to expect me to be very confident about the future of our business, but my confidence is grounded in what I and our team are seeing every day in the field.

Speaker Change: As we explore these alternatives, we expect to reduce our ongoing operating expenses, thereby further increasing our operating margin and cash flow trajectory going forward. This strategic move allows us to focus 100 percent of our time, energy, and resources

Speaker Change: to help as many patients as possible while increasing our company's profitability.

Adam Elsesser: I know many of you have come to expect me to be very confident about the future of our business, but my confidence is grounded in what I and our team are seeing every day in the field. The three new CAVT products that we expect to launch over the next nine months should augment our strong position as we enter and move through 2025. We are also confident about both market growth and our market share trends in VTE, arterial, and stroke in the United States next year. Obviously, having the best products is a key factor, but our confidence is further voided by our expansive market access work and our strong commercial footprint.

Speaker Change: I know many of you have come to expect me to be very confident about the future of our business.

Speaker Change: But my confidence is grounded in what I and our team are seeing every day in the field.

Adam Elsesser: The three new CAVT products that we expect to launch over the next nine months should augment our strong position as we enter and move through 2025. We're also confident about both market growth and our market share trends in VTE, arterial, and stroke in the United States next year. Obviously, having the best products is a key factor, but our confidence is further buoyed by our extensive market access work and our strong commercial footprint. We're also not.

Speaker Change: The three new CAVT products that we expect to launch over the next nine months should augment our strong position as we enter and move through 2025.

Speaker Change: We are also confident about both market growth and our market share trends in VTE, arterial, and stroke in the United States next year.

Speaker Change: Obviously having the best products is a key factor, but our confidence is further buoyed by our expansive market access work and our strong commercial footprint.

Adam Elsesser: We also will not have the same difficult year-over-year growth challenges in 2025 in key international markets, namely China and Europe, that we are facing throughout 2024. And we expect the launch of Flash 2.0 and Lightning Bolt 7 in Europe late this year to have a more pronounced impact on our international growth next year.

Adam Elsesser: We also will not have the same difficult year-over-year growth challenges in 2025 in key international markets, namely China and Europe, that we are facing throughout 2024. And we expect the launch of Flash 2.0 and Lightning Bolt 7 in Europe late this year to have a more pronounced impact on our international growth next year. That being said, we have traditionally set revenue guidance in line with our best assessment of what we can achieve.

Speaker Change: We're also not...

Speaker Change: We also will not have the same difficult year-over-year growth challenges in 2025 in key international markets, namely China and Europe , that we are facing throughout 2024.

Speaker Change: And we expect the launch of Flash 2.0 and Lightning Bolt 7 in Europe late this year to have a more pronounced impact on our international growth next year.

Adam Elsesser: That being said, we have traditionally set revenue guidance in line with our best assessment of what we can achieve. Going forward, our guidance will reflect a comfortable level of conservatism.

Speaker Change: That being said, we have traditionally set revenue guidance in line with our best assessment of what we can achieve.

Adam Elsesser: Going forward, our guidance will reflect a comfortable level of conservatism. Jason will discuss this updated guidance at the end of our prepared remarks. For now, I will say that we see very favorable prospects for our business for the remainder of this year. And in 2025, we have the benefit of the new product launch, continued share gains, and the abatement of the transient headwinds impacting 2024. I now turn the call over to Maggie to go over our financial results for the second quarter of 2024. Thank you, Adam. Good afternoon, everyone.

Speaker Change: Going forward, our guidance will reflect a comfortable level of conservatism.

Adam Elsesser: Jason will discuss this updated guidance at the end of our prepared remarks. For now, I will say that we see very favorable prospects for our business for the remainder of this year. And in 2025, we have the benefit of new product launches, continued share gains, and the abatement of the transient headwinds impacting 2024.

Speaker Change: Jason will discuss this updated guidance at the end of our prepared remarks. For now I will say that we see very favorable prospects for our business for the remainder of this year and in 2025 we have the benefit

Jason: of new product launches, continued share gains, and the abatement of the transient headwinds impacting 2024.

Maggie Yuan: I now turn the call over to Maggie to go over our financial results for the second quarter of 2024. Thank you, Adam. Good afternoon, everyone. Today, I will discuss the financial results for the second quarter of 2024. The financial results on this call for revenue are on the GAAP bases where our growth margin, operating expenses, and operating income are on the non-GAAP basis.

Jason: I now turn the call over to Maggie to go over our financial results for the second quarter of 2024.

Maggie S. Yuen: Today, I will discuss the financial results for the second quarter of 2024. Financial results on this call for revenue are on a GAAP basis, while gross margin, operating expenses, and operating income are on a non-GAAP basis. GAAP measures and our reconciliation of GAAP to non-GAAP financial measures are provided in a posted press release.

Maggie: Thank you, Adam. Good afternoon, everyone. Today, I will discuss the financial results for the second quarter of 2024.

Maggie: Financial results on this call for revenue are on a GAAP basis, while gross margin, operating expenses, and operating income are on a non-GAAP basis. The corresponding GAAP measures and our reconciliation of GAAP to non-GAAP financial measures are provided in our posted press release.

Maggie Yuan: We want to get measures, and our reconciliation of gap to non-gap financial measures are provided in opposite press release. For the second quarter and the June 30, of 2024, our total revenues were $299.4 million. In case of 14.5% reported and 14.7% in constant currency compared to the second quarter of 2023. Our geographic mix of sales for the second quarter of 2024 was 72.9% US and 27.1% international. Our US region reported growth of 16.8% driven by 24.9% growth from Vectomy franchise. Our international region increased 8.7% reported and 9.4% in constant currency, driven by growth in overall from Vectomy revenue, partially offset by decline in embolization and access franchise in several regions.

Maggie S. Yuen: For the second quarter and June 30th, 2024, our total revenues were $299.4 million, an increase of 14.5% reported and 14.7% in constant currency compared to the second quarter of 2023. Our geographic mix of sales for the second quarter of 2024 was 72.9% U.S. and 27.1% international. Our U.S. region reported growth of 16.8%, driven by 24.9% growth in our thrombectomy franchise. Our international regions increased 8.7% reported and 9.4% in constant currency, primarily driven by growth in overall thrombectomy revenue, partially offset by declines in embolization and excess franchise in several regions.

Maggie: For the second quarter end of June 30th, 2024, our total revenues were $299.4 million, an increase of 14.5% reported and 14.7% in constant currency compared to the second quarter of 2023.

Maggie: Our geographic mix of sales for the second quarter of 2024 was 72.9% U.S. and 27.1% international.

Maggie: Our U.S. region reported growth of 16.8%, driven by 24.9% growth in our thrombectomy franchise.

Maggie: Our international regions increase 8.7% reported and 9.4% in constant currency, primarily driven by growth in overall thrombectomy revenue, partially offset by decline in embolization and excess franchise in several regions.

Maggie Yuan: The sequential growth in our total revenues of 7.4% was primarily driven by an increase in our global from Vectomy revenue of $15.8 million or 8.4%. Moving to revenue by products, revenue from global from Vectomy business grew to $203.5 million in the second quarter of 2024. An increase of 25.2% reported and 25.4% in constant currency compared to the same period last year. Our US growth of 24.9% driven by volume growth in new accounts since last year and our international growth of 26.2% compared to the same period last year reflect continuous strong momentum in CABT products. Revenue from embolization and access business was $95.9 million in the second quarter of 2024 at the client of 3.1% reported and 3% in constant currency.

Maggie S. Yuen: The sequential growth in our total revenues of 7.4% was primarily driven by an increase in our global thrombectomy revenue of $15.8 million, or 8.4%. Moving to revenue by product, revenue from the global thrombectomy business grew to $203.5 million in the second quarter of 2024, an increase of 25.2% reported and 25.4% in cost and currency compared to the same period last year. Our U.S. growth of 24.9% driven by volume growth in newer accounts since last year and our international growth of 26.2% compared to the same period last year reflect continuous strong momentum in CAVT products.

Maggie: The sequential growth in our total revenues of 7.4% was primarily driven by an increase in our global thrombectomy revenue of $15.8 million or 8.4%.

Maggie: Moving to revenue by products.

Maggie: Revenue from global thrombectomy business grew to $203.5 million in the second quarter of 2024, an increase of 25.2% reported and 25.4% in cost and currency compared to the same period last year.

Maggie: Our U.S. growth of 24.9%, driven by volume growth in newer accounts, since last year. And our international growth of 26.2%, compared to the same period last year, reflect continuous strong momentum in CAVT products.

Maggie S. Yuen: Revenue from embolization and excess business was $95.9 million in the second quarter of 2024, a decline of 3.1% reported and 3% in constant currency, primarily driven by an overall decline in international regions, as we indicated at the beginning of the year. Non-GAAP gross margin operating expenses and operating income exclude amortization of acquired intangible assets of $2.4 million in the second quarter of 2024 and 2023, respectively, and a $110.3 million impairment of our immersive healthcare business in the second quarter of 2024. Adjusted EBITDA excludes impairment expenses of $110.3 million and stock compensation, depreciation, and amortization.

Maggie: Revenue from embolization and excess business was 95.9 million dollars in the second quarter of 2024, a decline of 3.1% reported and 3% in constant currency.

Maggie Yuan: I'm merely driven by an overall decline in international regions, as we indicated at the beginning of the year. Non-Get gross margin, operating expenses, and operating income exclude amortization of a quiet intangible asset of $2.4 million in the second quarter of 2024 and 2023, respectively. And a $110.3 million in payment of our immersive healthcare business in the second quarter of 2024. Adjusted EBITDA excludes the impairment expenses of $110.3 million and stock compensation, depreciation and amortization benefits from income taxes and interest income expenses of $3.8 million. Gross margin for the second quarter of 2024 is 65.5% compared to 63.8% for the second quarter of 2023.

Maggie: Primarily driven by an overall decline in international regions, as we indicated at the beginning of the year.

Maggie: Nodgap gross margin operating expenses and operating income exclude amortization of acquired intangible assets of $2.4 million in the second quarter of 2024 and 2023, respectively.

Maggie: and a $110.3 million impairment of our immersive healthcare business in the second quarter of 2024.

Maggie: Adjusted EBITDA excludes the impairment expenses of $110.3 million and stock compensation, depreciation, and amortization. Benefit from income taxes and interest income expenses of $3.8 million.

Maggie S. Yuen: Benefit from income taxes and interest income expenses of $3.8 million. Gross margin for the second quarter of 2024 was 65.5% compared to 63.8% for the second quarter of 2023. We delivered 170 basis point improvements driven by favorable thrombectomy product mix across all regions and productivity improvements. We expect steady improvements in the second half of the year and are on track to deliver 100 to 150 basis points of gross margin expansion in 2024. Total operating expense for the quarter was $164.5 million, or 54.9% of revenue, compared to $146.6 million, or 56.1% of revenue for the same quarter last year.

Maggie: Gross margin for the second quarter of 2024 is 65.5% compared to 63.8% for the second quarter of 2023. We delivered 170 basis point improvements driven by favorable thrombectomy product mix across all regions and productivity improvements.

Maggie Yuan: We delivered 170 basis point improvements driven by favorable from back to me product makes across all regions and productivity improvements. We expect steady improvements in the second half of the year and on track to deliver 100 to 150 basis point gross margin expansion in 2024. Total operating expense for the quarter was $164.5 million or 54.9% of revenue compared to $146.6 million or 56.1% of revenue for the same quarter last year. Our research and development expenses for Q2 2024 were $24.9 million compared to $21.5 million for Q2 2023. S-GNA expenses for Q2 2024 were $139.6 million, or 46.6% of revenue, compared to $125.1 million, or 47.8% of revenue for Q2 2023.

Maggie: We expect steady improvements in the second half of the year and are on track to deliver 100 to 150 basis point gross margin expansion in 2024.

Maggie: Total operating expense for the quarter was $164.5 million, or 54.9% of revenue, compared to $146.6 million, or 56.1% of revenue for the same quarter last year.

Maggie S. Yuen: Our research and development expenses for Q2 2024 were $24.9 million compared to $21.5 million for Q2 2023. SG&A expenses for Q2 2024 were $139.6 million, or 46.6% of revenue, compared to $125.1 million, or 47.8% of revenue, for Q2 2023. We recorded operating income of $31.7 million, or 10.6% of revenue, in the second quarter of 2024, compared to operating income of $20.3 million, or 7.8% of revenue, for the same period last year.

Maggie: Our research and development expenses for Q2 2024 were $24.9 million compared to $21.5 million for Q2 2023.

Maggie: SG&A expenses for Q2 2024 were $139.6 million or 46.6% of revenue compared to $125.1 million or 47.8% of revenue for Q2 2023.

Maggie Yuan: We recorded operating income of $31.7 million, or 10.6% of revenue, in the second quarter of 2024 compared to an operating income of $20.3 million, or 7.8% of revenue, for the same period last year. As Adam discussed in a strategic move for immersive healthcare, we expect to reduce over $20 million in ongoing operating expense and save over $20 million in cash over the next 12 months. This will contribute to our operating margin expansion in 2025. We posted adjusted EBITDA of $46.3 million or 15.5% of total revenue compared to 14.6% in the second quarter of last year.

Maggie: We recorded operating income of $31.7 million or 10.6% of revenue in the second quarter of 2024, compared to an operating income of $20.3 million or 7.8% of revenue for the same period last year.

Maggie S. Yuen: As Adam discussed in our strategic move for immersive healthcare, we expect to reduce over $20 million in ongoing operating expenses and save over $20 million in cash over the next 12 months. This will contribute to our operating margin expansion in 2025. We posted adjusted EBITDA of $46.3 million, or 15.5% of total revenue, compared to 14.6% in the second quarter of last year. Now, turning to Cash Flow and Balance Sheets. We ended the second quarter with cash, cash equivalents, and marketable securities of $339.7 million and no debt.

Maggie: As Adam discussed in our strategic move for immersive healthcare, we expect to reduce over $20 million in ongoing operating expense and save over $20 million in cash over the next 12 months.

Maggie: This will contribute to our Operating Margin Expansion in 2025.

Maggie: We posted adjusted EBITDA of $46.3 million or 15.5% of total revenue compared to 14.6% in the second quarter of last year.

Maggie Yuan: Turning to cash flow and balance sheet, we ended the second quarter with cash equivalence and marketable securities balance of $339.7 million and no debt, an increase of $26.2 million driven by operational profitability and improvements in working capital turns. We continue to expect operating cash flow turns for the rest of 2024.

Maggie: Turning to Cash Flow and Balance Sheet.

Maggie: We ended the second quarter with cash equivalence and marketable securities balance of $339.7 million and no debt.

Jason Richard Mills: An increase of $26.2 million driven by operational profitability and improvements in working capital terms. We continue to expect positive cash flow trends for the rest of 2024. Now, I'd like to turn the call over to Jason to discuss our guidance. Thank you, Maggie.

Maggie: An increase of $26.2 million driven by operational profitability and improvements in working capital terms. We continue to expect positive operating cash flow trends for the rest of 2024.

Jason Mills: And now I'd like to turn the call over to Jason to discuss our guidance. Thank you, Maggie. Our updated guidance range for 2024 includes total revenue of $1,180 million to $1,200 million, which is a reduction of $60 million at the midpoint from our previous guidance range. The $60 million change in guidance comes from four distinct components impacting our revenue in the second half of the year. $20 million reduction to our business in China due to a much more challenging economic backdrop for medical devices in the near term. $15 million from our European business primarily as a result of a slight delay to our expected launch timing of Flash and Bolt 7 CAVT products in Europe.

Maggie: And now I'd like to turn the call over to Jason to discuss our guidance.

Jason Richard Mills: Our updated guidance range for 2024 includes total revenue of $1,180,000,000 to $1,200,000,000, which is a reduction of $60,000,000 at the midpoint from our previous guidance range. The $60 million change in guidance comes from four distinct components impacting our revenue in the second half of the year. $20 million reduction to our business in China due to a much more challenging economic backdrop for medical devices in the near term, and $15 million from our European business primarily as a result of a slight delay to our expected launch timing of flash and Bolt 7 CAVT products in Europe.

Jason: Thank you, Maggie. Our updated guidance range for 2024 includes total revenue of $1,180,000,000 to $1,200,000,000, which is a reduction of $60,000,000 at the midpoint from our previous guidance range.

Jason: The $60 million change in guidance comes from four distinct components impacting our revenue in the second half of the year.

Jason: $20 million reduction to our business in China due to much more challenging economic backdrop for medical devices in the near term.

Jason: $15 million from our European business primarily as a result of a slight delay to our expected launch timing of Flash and Bolt 7 CAVT products in Europe .

Jason Richard Mills: $5 million in revenue from our immersive health care business due to our strategic move and approximately $20 million change to our guidance for U.S. thrombectomy growth for full year 2024, which is now expected to be 23 to 25 percent year-over-year compared to 2023. This change aligns with our new guidance philosophy. We continue to expect non-GAAP gross margin expansion in the range of 100 to 150 basis points in 2024 compared to full year 2023.

Jason Mills: $5 million in revenue from our immersive healthcare business due to our strategic move, and approximately $20 million change to our guidance for US thrombectomy growth for full year 2024, which is now expected to be 23 to 25 percent year-over-year compared to 2023. This change aligns with our new guidance philosophy. We continue to expect non-GAAP gross margin expansion in the range of 100 to 150 basis points in 2024 compared to full year 2023. We also continue to expect non-GAAP operating margin expansion of 100 to 200 basis points in 2024, with the timing of the reduction of immersive healthcare expenses being a primary driver of where we will land relative to this range.

Jason: $5 million in revenue from our immersive healthcare business due to our strategic move.

Jason: and approximately $20 million change to our guidance.

Jason: for U.S. thrombectomy growth for full year 2024.

Jason: which is now expected to be 23 to 25 percent year-over-year compared to 2023. This change aligns with our new guidance philosophy.

Jason: We continue to expect non-GAAP gross margin expansion in the range of 100 to 150 basis points in 2024 compared to full year 2023. We also continue to expect non-GAAP operating margin expansion.

Jason: of 100 to 200 basis points in 2024, with the timing of the reduction of immersive healthcare expenses being a primary driver of where we will land relative to this range.

Jason Mills: I will wrap up our prepared remarks there to allow ample time for Q&A. We look forward to your questions.

Speaker Change: I will wrap up our prepared remarks there to allow ample time for Q&A. We look forward to your questions. Operator, we can now open the call to questions.

Operator: We also continue to expect non-GAAP operating margin expansion of 100 to 200 basis points in 2024, with the timing of the reduction of immersive health care expenses being a primary driver of where we will land relative to this range. I will wrap up our prepared remarks there to allow ample time for Q&A. We look forward to your questions. Operator, we can now open the call to questions. Thank you. At this time, ladies and gentlemen, I would like to remind everyone that in order to ask a question, press the star followed by the number one on your telephone keypad.

Operator: Operator, we can now open the call to questions. Thank you.

Operator: At this time, ladies and gentlemen, I would like to remind everyone that in order to ask a question, press star followed by the number one on your telephone keypad. I will pause for just a moment to compile the roster.

Operator: We'll pause for just a moment to compile the list. Our first question comes from the line of Michael Sarcone, with Jeff, and others. This is the end of today's webinar. We will be back shortly. Good afternoon, and thanks for taking the questions.

Speaker Change: Thank you

Speaker Change: At this time, ladies and gentlemen, I would like to remind everyone that in order to ask a question, press star followed by the number one on your telephone keypad. We'll pause for just a moment to compile the roster.

Michael Sarcone: Our first question comes from the line of Michael Sarcone with Jeffries. Good afternoon, and thanks for taking the question. Just a start. You think maybe you could delve a little bit more into kind of the new guidance, philosophy that you mentioned.

Speaker Change: Our first question comes from the line of Michael Sarcone with Jeffries.

Speaker Change: Your line is live.

Adam Elsesser: Just to start, do you think maybe you could delve a little bit more into kind of the new guidance philosophy that you mentioned, Jason? I know Adam, you also mentioned that you're taking a more conservative tack, but I would love if you could flesh that out a little bit more for us. And really just curious about kind of the moving pieces that got you from U.S. thrombectomy plus 27 to 30 to down 23 to 25.

Michael Anthony Sarcone: Good afternoon and thanks for taking the questions.

Michael Anthony Sarcone: Just to start...

Michael Anthony Sarcone: Do you think maybe you could delve a little bit more into kind of the new guidance philosophy that you mentioned, Jason? I know, Adam, you also mentioned kind of you're taking a more conservative tack.

Michael Sarcone: Jason, I know Adam. You also mentioned, kind of, you're taking a more conservative tack, but with all that, you could flesh that out a little bit more for us and really just curious about kind of the moving pieces that got you from US, from Becker. That can be plus 27 to 30, to down 23 to 25.

Michael Anthony Sarcone: But we'd love if you could flesh that out a little bit more for us and really just curious about kind of the moving pieces that got you from U.S. thrombectomy plus 27 to 30 to down 23 to 25. Thank you.

Adam Elsesser: Thank you. Thank you, Michael, for the questions, Adam. Look, over the course of the almost 10 years, not quite that we've been a public company, we've obviously evolved a great deal from the kind of what we sold. We started out focusing just on stroke and expanded pretty dramatically. You know, almost, you know, the size of the company over that time.

Adam Elsesser: Thank you. Yes. Thank you, Michael, for the questions, Adam. Look, we've, over the course of the almost 10 years, not quite, that we've been a public company, obviously evolved a great deal from the kind of what we sold. We started out focusing just on stroke and expanded pretty dramatically, you know, almost the size of the company over that time. And by definition, it's time, obviously, for our guidance philosophy to expand and grow with that. When we were a much smaller company, guiding was a lot easier. There were very few moving parts.

Michael Anthony Sarcone: Yes, thank you, Michael, for the questions, Adam.

Speaker Change: Look, we've...

Speaker Change: Over the course of almost 10 years, not quite, that we've been a public company, we've obviously evolved a great deal from the kind of what we sold. We started out

Speaker Change: focusing just on stroke and expanded pretty dramatically, you know, almost, you know, the size of the company over that time.

Adam Elsesser: And, and by definition, it's time, obviously, for our guidance philosophy to expand and grow with that. When we were a much smaller company, guiding was a lot easier. There was very few moving parts. And we, we did a pretty credible job of guiding based on what we knew we could achieve. I think we're at a point now where there are a lot of variables. We've obviously heard, you know, the market talk about that and how we guide, and we wanted to build a little bit more comfort into the way we guide. That being said, you know, I'm not saying, you know, guys are now like layups, but we've had a lot of work to do every quarter to continue to grow the business at the rate.

Speaker Change: And by definition, it's time, obviously, for our guidance philosophy to expand and grow with that.

Speaker Change: When we were a much smaller company, guiding was a lot easier. There was very few moving parts, and we did a pretty credible job of

Adam Elsesser: And we did a pretty credible job of guiding based on what we knew we could achieve. I think we're at a point now where there are a lot of variables. We've obviously heard the market talk about that and how we guide, and we wanted to build a little bit more comfort into the way we guide. That being said, I'm not saying that guides are now like layups, but we still have a lot of work to do every quarter to continue to grow the business at the rate we think we can grow.

Speaker Change: of guiding based on what we knew we could achieve. I think we're at a point now where there are a lot of variables. We've obviously heard

Speaker Change: You know, the market talk about that and how we guide and we wanted to build a little bit more comfort into the way we guide. That being said, you know, I'm not saying, you know,

Speaker Change: The guides are now...

Speaker Change: like layups, but we still have a lot of work to do every quarter.

Adam Elsesser: But I think it's an important acknowledgement and moment in our time to make sure that that's not the topic that we're talking about all the time. I think we've lost something in the story of the company when we spend most of our time talking about our guide and not the extraordinary strength of the innovation that has brought us here with products that have totally transformed the way thrombectomy works. That's the story of the company.

Adam Elsesser: We think we can grow, but I think it's an important acknowledgement, a moment in our time to make sure that that's not the topic that we're talking about all the time. I think we've lost something in the, the story of the company when we're spending most of our time talking about our guide and not the extraordinary strength of the innovation that has brought us here with products that have totally transformed the way thrombectomy works. That's the story of the company. That's the success that we have. That's our future.

Speaker Change: to continue to grow the business at the rate we think we can grow.

Speaker Change: But I think it's an important acknowledgement, a moment in our time to make sure that that's not the topic.

Speaker Change: that we're talking about all the time. I think we've lost something in the...

Speaker Change: The story of the company when we're spending most of our time talking about our guide and not the extraordinary strength of the innovation that has brought us here with products that have totally transformed the way thrombectomy works.

Adam Elsesser: That's the success that we have. That's our future, and it's time we didn't spend a lot of time talking about the guiding philosophy of our company, more about the innovation and the extraordinary road ahead we have through this year into 2025 and beyond.

Speaker Change: That's the story of the company, that's the success that we have, that's our future, and it's time we don't spend a lot of time talking about the guiding philosophy of our company, more the innovation and the extraordinary road ahead we have.

Adam Elsesser: And it's time we don't spend a lot of time talking about the guiding philosophy of our company, more of the innovation and the extraordinary road ahead we have through this year into 2025 and beyond.

Michael Sarcone: I understood, thanks Adam, and just my follow up and figured out a try for you talked about some of the tougher comps that you're facing this year.

Speaker Change: through this year into 2025 and beyond.

Adam Elsesser: And just my follow-up, you know, I figured I'd try for, you talked about some of the tougher comps that you're facing this year. When we look at 2025, particularly for U.S. thrombectomy, do you think you could talk about, you know, either quantitatively, you know, what we might see versus 24 for U.S. thrombectomy growth, or if not, qualitatively Yeah, well, first of all, I absolutely appreciate the question, and I don't think you would expect me to potentially make maybe the mistake I made in 2024 by answering that with a quantitative answer, so I will respectfully decline.

Speaker Change: Understood. Thanks, Adam. And just my follow-up, you know, figured out I'd try for it. You talked about some of the tougher comps that you're facing this year. When we looked at 2025, particularly on U.S. Storm Vectomy,

Michael Sarcone: When we looked at 2025, particularly on US thrombectomy, you think you can talk about, you know, either quantitatively, you know, what we might be versus 24 for US thrombectomy growth or if not qualitatively what are kind of the key moving pieces. Thank you. Well, first of all, I absolutely appreciate the question, and I don't think you would expect me to potentially make maybe the mistake I made in 2024 by answering that with a quantitative answer. So I will respectfully decline, but I will tell you, you know, what we did, what we have looking forward to, and I alluded to this a little bit in the prepared remarks.

Speaker Change: Do you think you could talk about, you know...

Speaker Change: either quantitatively, you know...

Speaker Change: versus 24 for U.S. thrombectomy growth, or if not, qualitatively, what are kind of the

Speaker Change: The key moving pieces for that trajectory.

Speaker Change: Thank you. Yeah. Well, first of all, I absolutely appreciate the question. And...

Speaker Change: I...

Speaker Change: I don't think you would expect me to...

Speaker Change: I will potentially make maybe the mistake I made in 2024 by answering that with a quantitative answer, so I will respectfully decline.

Adam Elsesser: But I will tell you, you know, what we did, what we are looking forward to, and I alluded to this a little bit in my prepared remarks. There are things about 2025, you know, that are a little different. First of all, we don't have some of the same transient headwinds that we talked about on the last boarders call, and we reiterated this, related to the EMBO and access business and exiting some of those markets, that will be – well, anniversary, that will be behind us.

Speaker Change: But I will tell you, you know, what we did, what we have looking forward to, and I alluded to this a little bit in the prepared remarks.

Adam Elsesser: There are things about 2025, you know, that are a little different. First of all, we don't have some of the same transient headwinds that we talked about on the last quarter's call, and we reiterate on this related to the embo and access business and exiting some of those markets that will be will anniversary. That will be behind us. There are some issues with China that we've, you know, talked about in the past on the last call. We highlighted again with a particular, you know, number this time that will be behind us. And then we will have the benefit of new product launches that we've talked about in terms of new products in the US, but also in Europe with Flash 2.0 and Lightning Bolt coming.

Speaker Change: There are things about 2025, you know, that are a little different.

Speaker Change: First of all, we don't have...

Speaker Change: Some of the same transient headwinds that we talked about on the last boarders call and we reiterated on this.

Speaker Change: related to

Speaker Change: The Embo and Access business and exiting some of those markets that will be

Adam Elsesser: There are some issues with China that we've talked about in the past on the last call, and we highlighted them again with a particular number this time. That will sort of be behind us, and then we will have the benefit of new product launches that we've talked about in terms of new products in the U.S., but also in Europe with Flash 2.0 and Lightning Bolt coming. So, there's a lot to look forward to in the back half of this year, but there's also, I think, a lot to look forward to in 2025.

Speaker Change: well anniversary that that will be behind us. There's some issues with China that we've, you know, talked about in the past on the last call. We highlighted again with a particular, you know, number this time.

Speaker Change: That will sort of be behind us and then we will have the benefit of new product launches.

Speaker Change: that we've talked about in terms of new products in the US but also in in Europe with flash 2.0 and lightning bolt coming so there's a lot

Adam Elsesser: So there's a lot to look forward to in the back after year, but there's also, I think, a lot to look forward to in 2025. And again, I'm not going to quantify that, but I can. I hope you can hear, I think, you know, with 2024 and some of the things we're sort of working through this year to get past, 2025 is going to be another really fun year. Thank you.

Speaker Change: to look forward to in the back half of this year, but there's also...

Speaker Change: I think a lot to look forward to in 2025.

Speaker Change: And again, I'm not going to quantify that.

Adam Elsesser: And again, I'm not going to quantify that, but I hope you can hear that I think, you know, with 2024 and some of the things we're sort of working through this year to get past 2025, it's going to be another really fun year. Got it. Figured I'd try.

Speaker Change: But I can, I hope you can hear.

Speaker Change: I think, you know, with 2024 and some of the things we're sort of working through this year, to get past 2025 is going to be another really fun year for us.

Adam Elsesser: Thank you. Thank you. I appreciate that. Thanks for your question. Our next question comes from the line of Matthew O'Brien with Piper Sandler. Thank you. Thank you. Hey, this is Phil on format.

Michael Sarcone: I appreciate that. Thanks for your question.

Matthew O'brien: Our next question comes from the line of Matthew O'Brien with Piper Sandler. Your line is pointed.

Speaker Change: Thanks for your question. Our next question comes from the line of Matthew O'Brien with Piper Sandler.

Matthew O'brien: Today, this is still on from that. Thanks for taking our questions.

Adam Elsesser: Thanks for taking our questions. And I guess, for starters, from back to me, how should we think about, you know, call it the 20% growth for the second half of the year in the context of the rest of the market, understanding your lap in some difficult comps, but is this more, you know, just your general shift to the conservative guidance philosophy? And, I guess more acutely, any further commentary on some incremental competitive pressure?

Speaker Change: Your line is closed.

Matthew O'brien: And I guess for starters on US from back to me, how should we think about, you know, call us the 20% growth for the second half of the year and the context of the rest of the market, understanding your lap in some difficult comp. But is this more, you know, I'm just your general shift to the conservative guidance philosophy, and I guess more. Yeah. I think what we were talking about on our guidance was pretty clear. If you look at what we just did this quarter, works right here, we brought it out of that.

Phil: Hey, this is Phil on for Matt. Thanks for taking our questions. And I guess for starters on US thrombectomy, how should we think about, you know, call it the 20% growth for the second half of the year in the context of the rest of the market?

Speaker Change: I'm understanding you're lapping some difficult comps, but is this more, you know, on just your general shift to the conservative guidance philosophy and, I guess, more acutely, any further commentary on some incremental competitive pressures? Yeah, I think...

Adam Elsesser: Yeah, um, I think what we were talking about in the guidance was pretty clear. If you look at what we just did this quarter, we're extraordinarily proud of that. Let's start and sort of go through it.

Speaker Change: What we were talking about on our guidance was pretty clear. If you look at what we just did this quarter, we're extraordinarily proud of that. Let's start and sort of go through it. Our stroke business, you know, which is now...

Adam Elsesser: Let's start and sort of go through it. Our stroke business, you know, which is now pretty, you know, mature, so grew 19% year over year. So, so I hope people understand that that that is a position of strength that is not what other companies that we compete against is. You remember, there's something like 30 some odd catheters in the market we compete against; to do that is pretty significant. And the feeling and the mood and the morale at the SNS meeting just last week was, you know, I've been going at me, you know, I think 21 years.

Adam Elsesser: Our stroke business, you know, which is now, and the market is pretty mature, still grew 19% year over year. So I hope people understand that that is a position of strength that is not what other companies that we compete against. You remember there are something like 30 odd catheters in the market we compete against. It's pretty significant. And the feeling and the mood and the morale at the S&IS meeting just last week were, you know, I've been going to that meeting, I think, for 21 years.

Speaker Change: pretty, you know, mature, still grew 19% year over year. So I hope people understand that that is...

Speaker Change: A position of strength that is not what other companies that we compete against is, you remember, there's something like 30 some odd catheters.

Speaker Change: in the market we compete against. To do that.

Speaker Change: is pretty significant.

Speaker Change: The feeling and the mood and the morale at the SNAS meeting just last week was...

Adam Elsesser: And I've never seen it around our technology and our success.

Speaker Change: You know, I've been going to that meeting, I think, 21 years, and

Speaker Change: I've never seen it around our technology and our success, it was a lot of fun.

Adam Elsesser: And I've never seen it around our technology and our success. It was a lot of fun to be at S&IS this year. So that's on the stroke side. On VTE, you know, what I said is that we grew in the higher end of our pre-state range. So that's in the very high 20% range. Obviously, that meant we took share, and the market grew significantly. That's a great setup for the back half of the year when we have full quarters with Flash 2.0, and we really move into this next phase.

Adam Elsesser: It was a lot of fun to be at SNS this year. So that's on the stroke side. On VTE, you know, what I said is we grew in the high end of our pre-state range. So that's in the very high 20% range. Obviously, that meant we took share, and the market grew significantly. That's a great setup for the back half of the year when we have full quarters with Flash 2.0 and we really move into this next phase. And again, the feedback I laid out, not only on the speed of the cases, which is really the first thing people recognize.

Speaker Change: to be at SNIS this year. So that's on the stroke side. On VTE, you know, what I said is we grew in the higher end of our pre-state range. So that's in the very high 20.

Speaker Change: percent range.

Speaker Change: obviously that meant we took share and the market grew significantly. That's a great setup for the back half of the year when we have full quarters with flash 2.0

Adam Elsesser: And again, the feedback I laid out, not only on the speed of the cases, which is really the first thing people notice, and then some of the issues around safety and performance that I highlighted in prepared remarks. And then, you know, we also have Arterial, which grew way above that range.

Speaker Change: and we really move into this next phase. And again, the feedback I laid out.

Speaker Change: not only on the speed of the cases, which is really the first thing people recognize, and then some of the issues around safety and performance that I highlighted in prepared remarks. And then, you know, we also have arterial, which grew way above that range.

Adam Elsesser: And then some of the issues around safety and performance that that I highlighted in prepared remarks. And then, you know, we also have arterial, which grew way above that range. And that's, you know, a year into the launch, you know, so that's coming up against the launch quarter comparing to, and we still did really, really well.

Adam Elsesser: And that's, you know, a year into the launch. So that's coming up against the launch quarter, and we still did really, really well. So I think we're really set up again for an extraordinary rest of this year but a really great 2025. And we might have just gotten ahead of ourselves a little bit. It's pretty hard not to when you get the kind of feedback we get every day from customers on the success, innovation, and performance of our company right now. That's helpful.

Speaker Change: And that's, you know, a year into the launch, you know, so that's coming up against.

Speaker Change: The launch quarter, comparing to, and we still did really, really well. So, I think we're really set up, again, for...

Adam Elsesser: So I think we're really set up again for an extraordinary rest of this year, but into a really great 2025. And we might have just gotten ahead of ourselves a little bit. It's pretty hard not to when you get the kind of feedback we get every day from customers, and you know that's on me personally. Obviously, it takes that responsibility, but it really doesn't have an impact in the underlying. success and innovation and performance of our company right now.

Speaker Change: extraordinary rest of this year but into a really great 2025 and and we we might just gotten ahead of ourselves a little bit it's it's pretty hard not to

Speaker Change: When you get the kind of feedback we get every day from customers and and and you know, that's on me personally Obviously it takes that responsibility, but it really doesn't have an impact in the underlying

Speaker Change: success and innovation and and performance of our company right now.

Matthew O'brien: That's helpful, thank you. And it just has a quick follow-up on the solid U.S. from Back to Me growth in Q2.

Adam Elsesser: Thank you. And I just have a quick follow-up on the solid US thrombectomy growth in Q2. As we start to lap some of the ASP mixed benefits, can you help parse out, you know, the underlying volumes, how those trended in the quarter, and your expectations for the rest of the year? Yeah, in our thrombectomy business, the underlying volumes are all up in correlation to the numbers that I was talking about. You know, as you know, we've anniversaryed a lot of the price aspect. So at this point, the vast majority is solely volume and unit based.

Speaker Change: So that's helpful, thank you. And I just have a quick follow-up on the solid US thrombectomy growth in Q2. As we start to lap some of the ASP mixed benefits, can you help parse out

Adam Elsesser: As we start to laugh, some of the ASP mixed benefits, can you help parse out, you know, the underlying volumes, how those trended in the quarter and your expectations for the year. Yeah, in those, in our thrombectomy business, the underlying volumes are all up in correlation to the numbers that I was talking about. You know, as you know, we're we've anniversary a lot of the the price aspect. So at this point, it's the vast majority is solely volume and unit based, and that will continue obviously going forward.

Speaker Change: You know, the underlying volumes, how those trended in the quarter, and your expectations for the rest of the year. Yeah, in those...

Adam Elsesser: And that will continue, obviously, going forward. Yeah, this is Jason just adding to that. We get asked a lot about that with respect to our VTE business. And indeed, the entirety of the growth of this quarter year over year was increased cases or unit volume. Great to hear it. Thanks so much.

Speaker Change: In our thrombectomy business, the underlying volumes are all up in correlation to the numbers that I was talking about. You know, as you know, we've anniversaried a lot of the price aspect, so at this point it's

Speaker Change: The vast majority is solely volume and unit-based, and that will continue, obviously, going forward.

Jason Mills: Yeah, this is Jason just adding to that. We get asked a lot about that with respect to our VTE business. And indeed, the entirety of the growth of this quarter year over year was increasing cases or unit volume. Great to hear it. Thanks a much. Thank you.

Speaker Change: Yeah this is Jason just adding to that. We get asked a lot about that with respect to our VTE business and indeed the entirety of the growth of this quarter year-over-year was increasing cases or unit volume.

Larry Beigelsen: Thanks for your thanks for your question. Our next question comes from the line of Larry Beagelson with Wells Fargo.

Speaker Change: Great to hear it. Thanks so much. Thank you. Thanks for your question. Our next question comes from the line of Larry Biegelsen with Wells Fargo. Your line is live.

Adam Elsesser: Thank you. Thank you. Thank you for your question. Our next question comes from the line of Larry Biegelsen with Wells Fargo. Your line is live. Hi, it's Lei calling in for Larry.

Ray: Your line is live. Hi, it's Ray calling in for Larry. Thanks for taking the question. You're your QT or US thrombectomy numbers came in stronger than we expected. 25% plus year over year. Can you just talk about what role it was? Is there anything one time and related to that? If you can comment it out, look for OUS thrombectomy. I think you were looking for myth to high single digit growth for the year. What does that mean now? Given the way in light and bold, lighting flash, but be too strong. And if you can just comment generally about US and US MBO and access for the rest of the year, if your growth outlook has changed for any of those things.

Speaker Change: Hi, it's Lei calling in for Larry. Thanks for taking the question.

Adam Elsesser: Thanks for taking the question. Your QT OUS thrombectomy numbers came in stronger than we expected, up 25% plus year over year. Can you just talk about what drove you? Was there anything particular that stood out?

Speaker Change: Your QTOU at ConvectiME numbers came in stronger than we expected.

Speaker Change: 25% plus year-over-year. Can you just talk about what drove you? Was there anything one time? And related to that, if you can comment at Outlook for, oh, you have some back to me. I think you were looking for mid to high single-digit growth.

Adam Elsesser: And related to that, if you can comment on Outlook for OUS thrombectomy, I think you were looking for mid to high single-digit growth for the year. What does that mean now, given the delay in lightning bolt, lightning flash, but feature was strong? And if you can just comment generally about US and OUS EMBO and access for the rest of the year, if your growth outlook has changed for any of those segments.

Speaker Change: for the year. What does that mean now given the delay in lightning bolt lightning flash but future is strong. And if you can just comment generally about US and OUS EMBO and access for the rest of the year if your girl's outlook has changed for any of those segments.

Adam Elsesser: All right. So great question. The way I interpret it is we're going to talk about our thrombectomy business worldwide and our MBO and access business worldwide. So let me try to make the best of that. Our OUS thrombectomy business was sort of inside the general range, give or take a little. There's nothing unique to call out about what happened this quarter. And again, going forward, we called out both China and then Europe. Europe is very clear, just so you know as we go forward, which is a slight delay in regulatory clearance of both Lightning Flash 2.0 and Lightning Bolt 7.

Adam Elsesser: All right, so great question. The way I interpret it is we're going to talk about our thrombectomy business worldwide and our embone access business worldwide. So let me try to make the best of that. Our OUS thrombectomy business was sort of inside the general range, give or take a little. There's nothing unique to call out about what happened this quarter.

Speaker Change: All right.

Speaker Change: So, great question. The way I interpret it is we're going to talk about our thrombectomy business worldwide and our M-Bone access business worldwide. So, let me try to make...

Speaker Change: The best of that.

Speaker Change: are

Speaker Change: The O.U.S. thrombectomy business

Speaker Change: This was sort of inside the general range, give or take a little. There's nothing unique to call out about what happened this quarter. And again, going forward, you know, we called out both

Adam Elsesser: And again, going forward, we called out both China and then Europe. Europe is very clear, just so you know, as we go forward, which is us, a slight delay in regulatory clearance for both Lightning Flash 2.0 and Lightning Bolt 7. Nothing about that has given us any indication at all that there's any issue with the approvals, that they're not in jeopardy, and we fully expect them to launch later this year, just not on the same timeframe to generate that full amount of expected revenue. So that will, again, come to help so that revenue is not lost.

Speaker Change: China and then Europe . Europe is very clear, just so you know, as we go forward, which is we

Speaker Change: You know, a slight delay in regulatory clearance of both Lightning Flash 2.0 and Lightning Bolt 7. Nothing about...

Adam Elsesser: Nothing about that has given us any indication at all that there's any issue with the approval that they're not in jeopardy. And we fully expect them to launch later this year, just not with the same timeframe to generate that full amount of expected expected revenue. So that will again come to help that revenue is not lost. Obviously, it'll just come to help more in 2025 and beyond. And China, that business, as you know, we have three revenue streams there. We have licensing, we have royalties, and distribution. And we're moving as we move from the licensing from our older generation products that are sort of labeled for local use.

Speaker Change: That has given us any indication at all that there's any issue with the approvals, that they're not in jeopardy, and we fully expect them to launch.

Speaker Change: later this year, just not with the same time frame to generate that full amount of expected revenue.

Adam Elsesser: Obviously, it'll just come to help more in 2025 and beyond. And in China, that business, you know, as you know, we have three revenue streams there. We have licensing. We have royalties, and distribution.

Speaker Change: So that will, again, come to...

Speaker Change: Help, that revenue's not lost, obviously it'll just come to help more in 2025 and beyond.

Speaker Change: And in China, that...

Speaker Change: That business, you know, as you know, we have three revenue streams there, we have licensing, we have

Adam Elsesser: And we're moving, as we move from the licensing of our older generation products that are sort of, you know, labeled, you know, for local use. We're moving, you know; we have gotten approval for sort of more of our current flagship products that come with a higher price. And given the economy and everything else, that is not going to be as viable a revenue stream in the short term.

Speaker Change: royalties and distribution and we're moving as we move from the licensing from our older generation products that are sort of you know labeled you know for local use we're moving you know we have

Jason Mills: We're moving; we have gotten approval for sort of more of our current flagship product that come with a higher price, and given the economy and everything else that is not going to be as viable a revenue stream in the short term. But everything we've talked to, we have an incredible distribution, a partner in China. They think that that likely will come back sometime next year. And again, we'll continue to be a valuable part of our business. You know, just as a level setting, you know, China's sort of 2% or so of our business. It's not a substantial amount to put us at risk.

Speaker Change: gotten approval for sort of more of our current flagship.

Speaker Change: Products that come with a higher price and given the economy and everything else that that is

Adam Elsesser: But everything we've talked to, we have an incredible distributor, a partner in China. They think, you know, that that likely will come back sometime next year. And again, it'll continue to be a valuable part of our business. You know, just as a level setting, you know, China is sort of 2 percent or so of our business. It's not a substantial amount to put us at risk.

Speaker Change: But, I'am not going be as viable a revenue stream in the short term, but everything we've talked to, we have an incredible distribution partner in China. They think that B?? inom Bowen Trade ein

Speaker Change: Likely we'll come back sometime next year and again, we'll continue to be a valuable part of our business, you know, just as a level setting, you know, China's

Speaker Change: sort of 2% or so of our business. It's not a substantial amount to put us at risk.

Jason Mills: As it relates to embo and access, it's really related to our getting out of certain countries with both those product categories and moving through that year. And again, without that as the comparable, you know, we will be in really good shape from growth in those markets.

Adam Elsesser: As it relates to Embone Access, it's really related to our getting out of certain countries with both those product categories and moving through that this year. And again, without that as a comparable, we'll be in really good shape for growth in those markets. And again, just to finally call out one thing, you know, last quarter there was discussion, and obviously, our Embone Access business came slightly under the expected numbers. And this time, you know, we responded to competitive threats and launches. And I got to tell you, I'm extremely proud of our team.

Speaker Change: As it relates to Emboat Access, it's really related to our getting out of certain countries with both those product categories and moving through that this year. And again, without that, as...

Speaker Change: The Comparable, you know, will be in really good shape for growth in those markets.

Adam Elsesser: And again, just to finally call out the one thing, you know, last quarter, there was discussion and obviously our embo and access business came slightly under the expected numbers. And this time, you know, we responded to the competitive threats and launches. And I got to tell you, I'm extremely proud of our team. It helps to have the best product in the market. It certainly helps to remind physicians, you know, that they always want to use the best product. And I think that business is in really good shape moving forward.

Speaker Change: And again, just to finally call out the one thing, you know, last...

Speaker Change: In the last quarter, there was discussion and obviously our M-Bone Access business came slightly under.

Speaker Change: the expected numbers.

Speaker Change: And this time, you know, we responded to the competitive threats and launches.

Adam Elsesser: It helps to have the best product in the market. It certainly helps to remind physicians, you know, that they always want to use the best product. And I think that business is in really good shape moving forward. Yeah, and Lei, just to add a little bit to what Adam said, again echoing his comments about the comps in 2025 being much better. He mentioned that in China, the economic conditions mostly affect our distribution and royalty streams of our business.

Speaker Change: And I gotta tell you, I'm extremely proud of our team. It helps to have the best product in the market. It certainly helps to remind physicians that they always wanna use the best product. And I think that business is in really good shape moving forward.

Jason Mills: Yeah, and Lei, just to add a little bit to what Adam said, again echoing his comments about the Compton 2025 being much better. He mentioned that in China, the economic conditions affect mostly our distribution and royalty streams of our business. And that is that $20 million that I called out in my prepared remarks. And that's about $10 million per quarter. And if you couple that with a delay in the European CAVT launch, that will result in, relative to the second quarter, our OUS thrombectomy coming down sequentially about $10 million from the second. And then you know, sort of flat into the fourth.

Speaker Change: Yeah, and Lei, just to add a little bit to what Adam said, again,

Leigh: echoing his comments about the comps in 2025 being much better.

Leigh: He mentioned that in China...

Leigh: The economic conditions affect mostly our distribution and royalty streams of our business.

Jason Richard Mills: And that, that is that $20 million that I called out in my prepared remarks, and that's about $10 million per quarter. And if you couple that with a delay in the European CAVT launch, that will result in, relative to the second quarter, our OUS thrombectomy coming down sequentially about $10 million from the second, and then, you know, sort of flat into the fourth. Again, we'll benefit from all of this as we turn into 2025, but that should give you a little bit more context. That's super helpful. If I can just sneak in one more,

Speaker Change: That is that $20 million that I called out in my prepared remarks, and that's about...

Speaker Change: $10 million per quarter. And if you couple that with the delay in the European CAVT launch, that will result in, relative to the second quarter, our OUS thrombectomy coming down sequentially about $10 million from the second.

Jason Mills: Again, we'll benefit from all of this as we turn into 2025. But that should give you a little bit more context.

Speaker Change: And then, you know, sort of flat into the fourth. Again, we'll benefit from all of this as we turn into 2025, but that should give you a little bit more context.

Larry Beigelsen: That's super helpful. In fact, you just mentioned one more. Jason, you mentioned the 100 to 200 basis points of operating margin improvement year over year, and where you land depends on, you know, immersive health.

Maggie S. Yuen: Jason, you mentioned the 100 to 200 basis points of operating margin improvement year over year, and where you land depends on, you know, immersive health. I guess I'm a little surprised the margin guidance doesn't change with the immersive health decision. The 100 to 200 basis point improvement was something we talked about earlier in the year. I assume the move in immersive health was not in those numbers to begin with. Yeah, Lei. This is Maggie.

Speaker Change: That's super helpful. If I can just sneak in one more.

Speaker Change: Jason, you mentioned the 100 to 200 basis points of operating margin improvement year over year and where you'll land depends on.

Maggie Yuan: I guess I'm a little surprised that the margin guiding doesn't change with the immersive health decision. The 100 to 200 basis point improvement was something talked about earlier in the year. I assume the move in immersive health was not in those numbers to begin with.

Speaker Change: Immersive Health. I guess I'm a little surprised the margin guidance doesn't change with the Immersive Health decision. The 100 to 200 basis point improvement was

Speaker Change: something we talked about earlier in the year, I assume the move in immersive health was not in those numbers to begin with.

Maggie Yuan: Yeah, Lay, this is Maggie. Thanks for the question. There's actually quite a few factors that affect our range of operating margin, especially without updated revenue guidance. That will have approximately $30 million of reduced growth profit; that the impact will pull through to the bottom line in the operating profit. But at the same time, I mean, given our first half of the year, we are more than 200 basis point operating margin expansion. So we are already in a good start. And then, so it depends on the timing of the immersive health care savings in the second half of the year.

Maggie S. Yuen: Thanks for the question. Um, there's actually quite a few factors that affect our range of operating margin, especially without updated revenue guidance, which will have approximately $30 million of reduced gross profit that the impact will pull through to the bottom line in operating profit. But at the same time, I mean, given our first half of the year, we've achieved more than 200 basis points of operating margin expansion, so we are already on a good start.

Maggie: Yeah Lei, this is Maggie. Thanks for the question. Um, there's actually quite a few factors that affect our range of operating margin especially with our updated revenue guidance that will have approximately 30 million dollars of reduced gross profit

Speaker Change: that the impact will pull through to the bottom line in the operating profit.

Speaker Change: But at the same time, I mean, given our first half of the year, we're more than 200.

Speaker Change: basis point operating margin expansion. So we are already in a good start. And then, so it depends on the timing of the immersive healthcare savings in the second half of the year. This will give us a good range between 100 and 200 basis point expansion.

Maggie S. Yuen: And then it depends on the timing of the immersive health care savings in the second half of the year. This will give us a good range between 100 and 200 basis points. That's helpful. Thank you so much.

Larry Beigelsen: This will give us a good range between 100 and 200 basis point expansion. That's helpful. Thank you so much.

Larry Beigelsen: Yep. Thank you, Lay.

Maggie S. Yuen: Thank you, Lei. Our next question comes from the line of Peter Chickering with Deutsche. Your line is live. Hey, good afternoon.

Speaker Change: That's helpful. Thank you so much. Yep. Thank you, Lei.

Philip Chickering: Our next question comes to the line of pitochickening with Deutsche Bank. Your line is live.

Speaker Change: Our next question comes from the line of Peter Chickering with Deutsche Bank.

Philip Chickering: Hey, good afternoon. Back to the guidance question for US on chemical after back to me. There's the 24% growth rate still implies a pretty steep potential growth for US after back to me in the inverse, what we saw in two queue. I guess what gives us confidence you can get to that sequential growth is sort of embedded within the guidance. So Pito, the 23 to 25% for US thrombectomy is an annual number. And so what that implies for the third and fourth quarter year-over-year growth, respectively, is about the same: about 20% growth on a year-over-year basis.

Adam Elsesser: Back short of the guidance question for U.S. clinical throbectomy, the 24% growth rate still implies a pretty steep sequential growth for U.S. throbectomy and the inverse of what we saw in 2Q. I guess it will give you guys confidence that you can get to that sequential growth sort of embedded within the guidance. So, Peter, the 23 to 25% for U.S. thrombopectomy is an annual number, and so what that implies for the third and fourth quarter year-over-year growth, respectively, is about the same, about 20% growth on a year-over-year basis.

Speaker Change: Your line is live.

Philip Chickering: Hey, good afternoon.

Speaker Change: Back short of the guidance question for U.S. chemical thrombectomy, the 24% growth rate still implies a pretty steep sequential growth for U.S. thrombectomy and the inverse of what we saw in 2Q. What gives you guys confidence you can get to that sequential growth sort of embedded within the guidance?

Speaker Change: So, Peter, the 23 to 25% for U.S. thrombectomy is an annual number.

Speaker Change: And so, what that implies for the third and fourth quarter year-over-year growth, respectively, is about the same, about 20% growth on a year-over-year basis.

Adam Elsesser: Right. So I guess it will be asked about sequentially, you know, US, you know, it grew in a three million hours sequentially into queue. This 19% growth at the midpoint applies 60 million growth in the third quarter. And then in 9 million and the fourth quarter, it's a pretty steep sequential ramp. So I guess you know what gives you guys the confidence that you can get to that to the growth rate.

Adam Elsesser: Right, so I guess let me ask about sequentially, you know, US, you know, it grew $3 million sequentially into Q. This 19% growth at the midpoint implies $6 million growth in the third quarter and then $9 million in the fourth quarter. So pretty steep sequential ramps, I guess. What gives you guys the confidence that you can get to that growth rate? Yeah, this is Adam.

Speaker Change: Right. So, I guess, let me ask about sequentially, you know, U.S., you know, it grew $3 million sequentially into Q. This 19% growth at the midpoint implies $6 million growth in the third quarter.

Speaker Change: And $9 million in the fourth quarter, so pretty steep sequential ramps, I guess, you know, what gives you guys the confidence that you can get to that growth rate?

Adam Elsesser: Yeah, this is Adam. I mean, on the prepared remarks, we laid out how our first of our new products are doing Flash 2.0 and what we're seeing with that. So now we are not just guessing; you know, we have a half plus of a quarter, you know, six weeks plus to really understand how that's going. We did not put a lot of, you know, revenue on the other new products for obvious reasons. Because we don't totally control the regulatory process. But obviously that, you know, that's not impossible. You know, one of them's under submission. And it's not possible can add to it.

Adam Elsesser: I mean, in my prepared remarks, we laid out how the first of our new products are doing flash 2.0 and what we're seeing with that. So now we are not just guessing, you know; we have a half plus of a quarter, you know, six weeks plus, to really understand how that's going. We did not put a lot of revenue on the other new products, for obvious reasons, because we don't totally control the regulatory process. But obviously, that's not impossible, you know. One of them's under submission, and it's not possible to add to it.

Speaker Change: Yeah, this is Adam. I mean, on our prepared remarks, we laid out how the first of our new products are doing, Flash 2.0, and what we're seeing with that. So now we are not just guessing, you know, we have

Speaker Change: a half plus of a quarter, you know, six weeks plus to really understand how that's going. We did not put a lot of...

Speaker Change: You know revenue on the other new products for obvious reasons because we don't totally control the regulatory process, but obviously That you know, that's not impossible. You know, one of them's under submission And it's not possible can add to it when you add

Adam Elsesser: When you add that up and add the level of discussion around the speed of flash, the success with lightning bolt on the arterial side, you know, some of the safety issues I brought up. I think the momentum is clearly on our side. I think you can see that, obviously, today, you know, in a broader review of, you know, the field and the market. You know, we're in the driver's seat on this now. And I think that's crystal clear. And I think that the new numbers, obviously, are we wouldn't have put them out in that, but they were, you know, very doable.

Speaker Change: that up and add the level of discussion around

Speaker Change: The speed of flash, the success with flash.

Adam Elsesser: When you add that up and add the level of discussion around the speed of flash, the success with lightning bolt on the arterial side, you know, some of the safety issues I brought up, I think the momentum is clearly on our side. I think you can see that, obviously, today in a broader review of the field and the market. You know, we're in the driver's seat on this now.

Speaker Change: Lightning Bolt on the arterial side.

Speaker Change: you know, some of the safety issues I brought up. I think the momentum is

Speaker Change: clearly on our side.

Speaker Change: I think you can see that obviously today, you know, in a broader review of, you know, the field and the market.

Adam Elsesser: And I think that's crystal clear. And I think that the new numbers, obviously, are, we wouldn't have put them out and not thought they were, you know, very doable. Okay, great. And then, you know, a question on 25, and I understand that we're not going to cut in.

Speaker Change: You know, we're in the driver's seat on this now.

Speaker Change: And I think that's crystal clear, and I think that the new numbers obviously are, we wouldn't have put them out and not thought they were, you know, very doable.

Adam Elsesser: Okay. Great.

Adam Elsesser: And then, you know, it's a question on 25, and I understand that we're not going to add in. But, you know, your sort of fourth quarter growth rates are applying 10%. You talked about, you know, the transient issues, the China coming out and new launches.

Speaker Change: Okay, great. And then, you know, a question on 25, and I understand that we're not going

Adam Elsesser: But, you know, your third and fourth quarter growth rates are flying 10 percent. You talk about, you know, the transient issues, China coming out, new launches. Is it fair to still think about an acceleration from the 10 percent exit rate into 2025? So again, I'm going to stick with my more qualitative language and not actually use the terms that you just said or quantify them for obvious reasons. And I, please, hope you will respect that and indulge me.

Speaker Change: But, you know, your 3rd and 4th quarter growth rates are applying 10%, you talk about, you know, the transient issues, the China comping out, new launches. Is it fair to still think about an acceleration from the 10% exit rate into 2025?

Adam Elsesser: Is there something about an acceleration from the 10% XR8 into 2025? So again, I'm going to stick with my more qualitative language and not actually use the terms that you just said or quantify him for obvious reasons. And I please hope you will respect that and indulge me. But yes, you obviously understood the point of what 2025 looks like through my qualitative discussion. Great.

Speaker Change: So again, I'm going to stick with my...

Speaker Change: more qualitative language and not...

Speaker Change: use the terms that you just said or quantify them for obvious reasons and I please hope you will respect that and indulge me but yes you obviously understood the point of what 2025 looks like through my qualitative discussion.

Adam Elsesser: But yes, you obviously understood the point of what 2025 looks like through my qualitative discussion. Great, thanks so much. Our next question comes from the line Robbie Marcus with J.P. Morgan. Your line is live. Hi, this is Alan on behalf of Robbie.

Adam Elsesser: Thanks so much.

Robbie Marcus: Our next question comes from a line of Robbie Marcus with JP Morgan.

Speaker Change: Great, thanks so much.

Speaker Change: Our next question comes from the line of Robbie Marcus with J.P. Morgan. Your line is live.

Alan: Your line is live. Hi, this is Alan on for Robbie. You know, I had one question. Then a quick follow up. You know, I hate to belabor it, but kind of just looking at the back half guide. Right. The kind of paraphrase and you guide and see if it does. It sounds like you're talking to a range that you feel like should be conservative and should be achievable. So when we think about, you know, how you get to, you know, maybe the guidance range that you had previously, right, if we're talking about potentially outperforming that, what really gets you there.

Adam Elsesser: You know, I had one question and then a quick follow-up. You know, I hate to belabor it, but I was kind of just looking at the back half of the guide, right? I'm kind of paraphrasing your new guidance because it sounds like you're talking about a range that you feel like should be conservative and should be achievable. So when we think about, you know, how you get to, you know, maybe the guidance range that you had previously, right?

Speaker Change: Hi, this is Alan on for Robbie. You know, I had one question and then a quick follow-up. You know, I hate to belabor it, but kind of just looking at the back half guide, right,

Speaker Change: To kind of paraphrase your new guidance, because it sounds like you're talking to a range that you feel like should be conservative and should be achievable.

Speaker Change: So, when we think about, you know, how you get to, you know, maybe the guidance range that you had previously, right, if we're talking about potentially outperforming that.

Adam Elsesser: If we're talking about potentially outperforming that, what really gets you there? And, you know, are there any market dynamics you would call out that, you know, led you to take a bit of a more conservative route on the guide this quarter? Yeah, it's a really good question. There isn't anything new or unexpected in the market. And I think if you look at, are, you know, if you just focus, for example, on VTE, you know, we did better than anyone else, we did really well this quarter. Obviously, arterial is a little bit different dynamic.

Alan: And, you know, are there any market dynamics you'd call out that, you know, led you to take a bit of a more conservative route on the guide this quarter. Yeah, it's a really good question. There aren't anything new or unexpected in the market. And I think if you look at. You know, if you just focus, for example, on VT, you know, we did better than anyone else. You know, we did really well this quarter. Obviously, arterial is a little bit different dynamic. We're not competing really with other companies and products, but, you know, sort of decades of tradition around treatment.

Speaker Change: What really gets you there? And, you know, are there any market dynamics you would call out that, you know, led you to take a bit of a more conservative route on the guide this quarter?

Speaker Change: Yeah, it's a really good question. There aren't anything new or unexpected in the market and I think if you look at

Speaker Change: Our, you know, if you just focus, for example, on VTE, you know, we did

Speaker Change: better than anyone else. We did really well this quarter. Obviously, Arterial is a little bit different dynamic. We're not competing really with other companies and products, but sort of decades of...

Adam Elsesser: We're not really competing with other companies and products but, you know, sort of decades of tradition around treatment. And then stroke continued to do well in the crowded field. Those are the positive dynamics that have played out now and, really, you know, we think will continue to play out throughout the quarter. What I said earlier is, given the success of where we are, given the strength of our innovation, given the continued innovation coming, it just seems... to not make sense that we would be spending all of our time talking about our guidance and our justification for our guidance. Let's just spend our time performing and putting up the kind of numbers that we just described.

Adam Elsesser: And then stroke continued to do well with the crowded field that those are the positive dynamics that have played out now. And really, you know, we think we'll continue to play out throughout the quarter.

Speaker Change: tradition around treatment. And then stroke continued to do well with the crowded field. That those are the

Speaker Change: And so we've seen some positive dynamics that have played out now and really we think will continue to play out throughout the quarter. What I said earlier is...

Adam Elsesser: What I said earlier is, given the success of where we are, given the strength of our innovation, given the continued innovation coming, it just seemed to not make sense that we would be spending all of our time talking about our guidance and our justification for our guidance. Let's just spend our time performing and putting up the kind of numbers that we just described. So that's really the point more than anything. And I know more than anything that you guys appreciate that and respect it. So now we get to work, and that's where we're in our best spot when we're out in the field doing the work, talking about the success of the products, the safety element of the products, and it's more important than ever right now that we have those conversations.

Speaker Change: Given the success of where we are, given the strength of our innovation, given the continued innovation coming, it just seemed...

Speaker Change: To not make sense that we would be spending all of our time talking about our guidance and our justification for our guidance

Speaker Change: Let's just...

Speaker Change: Spend our time performing.

Adam Elsesser: So, that's really the point more than anything, and I know more than anything that you guys appreciate that and respect it. So, now we get to work, and that's where we're in our best spot when we're out in the field doing the work, talking about the success of the products, the safety element of the products, and it's more important than ever right now that we have those conversations.

Speaker Change: and putting up the kind of numbers that we just described. So that's really.

Speaker Change: The point, more than anything, and I know more than anything that you guys appreciate that and respect it. So now we get to work.

Speaker Change: And that's...

Speaker Change: where we're in our best spot when we're out in the field doing the work talking about the

Speaker Change: The success of the products, the safety element of the products, and it's more important than ever right now that we have those conversations.

Alan: Got it.

Adam Elsesser: And then just a quick follow up is, you know, again, to kind of maybe get to some upside, how should we think about, you know, it talks about how you had some competitive dynamics that surfaced in the quarter in response to the new launch. At least relative to our expectations, it looked like U.S. on back to me, you know, still good year over year growth, but definitely looks like it's slowed down a little bit sequential So when we think about, you know, the potential for those competitive dynamics to continue into the back half and, you know, even for your new product launches that you have, you know, benefiting from in 2025, the potential for, you know, heightened competitive dynamics. How do you plan to work through those going forward? Thank you.

Alan: And then just a quick follow-up is, you know, again, to kind of maybe get to some upside, how should we think about, you know, the, you know, talk about how you had some competitive dynamics that service in the quarter in response to the new launch. You know, at least relative to our expectations that look like us on back to me, you know, still good year-over-year growth, but definitely looks like it's low down below the sequentially. So when we think about, you know, the potential for those competitive dynamics to continue into the back half, and you know, even for your new product launches that you have, you know, benefiting you 2025, the potential for, you know, high and competitive dynamics.

Speaker Change: Got it. And then just a quick follow-up is, you know, again, to kind of maybe get to some upside, how should we think about, you know, you know, talk about how you had some competitive dynamics that surfaced in the quarter in response to the new launch.

Speaker Change: you know, at least relative to our expectations, it looks like U.S.

Speaker Change: So when we think about, you know,

Speaker Change: The potential for those competitive dynamics to continue into the back half, and you know, even for your new product launches that you have, you know, benefiting in 2025, the potential for, you know, heightened competitive dynamics.

Adam Elsesser: How do you plan to work through those going forward? Thank you. Yeah, look, I want to make sure when we talk about competitive dynamics, you know, we've always competed. And obviously, you guys have covered us since we went public and, you know, we competed against some of the biggest, best companies in Medtech and in stroke, and we emerged, obviously, in a pretty good spot. So we're not; this was not unexpected. I think the only thing that may be unexpected was the tactics, given the circumstances. I would, I think we were a little surprised at some of those tactics.

Adam Elsesser: Yeah, look, I mean, I want to make sure when we talk about competitive dynamics, you know, we've always competed. And obviously, you guys have covered us since we went public. And, you know, we competed against some of the biggest, best companies in medtech and in stroke, and we emerged, obviously, in a pretty good spot. So this was not unexpected. I think the only thing that may be unexpected was the tactics given the circumstances. I would have been a little surprised at some of those tactics.

Speaker Change: How do you plan to work through those going forward? Thank you.

Speaker Change: Yeah, look, I want to make sure when we talk about competitive dynamics, you know, we've always competed.

Speaker Change: and obviously you guys have covered us

Speaker Change: Since we went public.

Speaker Change: And, you know, we competed against some of the biggest, best companies in medtech.

Speaker Change: and Stroke, and we emerged obviously in a pretty good spot.

Speaker Change: So, we're not, this was not unexpected. I think the only

Speaker Change: One thing that may be unexpected was the tactics given the circumstances. I would, I think we were a little surprised at some of those tactics. I, I'm not sure.

Adam Elsesser: I'm not sure that it makes sense, but that's okay. You know, we're used to that. I think the other thing that changed on the other side of the ledger is the level of interest, the level of conversations physicians are having, physicians are initiating, not us. We're not talking about this around the safety elements, particularly around cardiac decompensation, particularly around putting in compromised blood.

Adam Elsesser: I, I'm not sure that it made sense, but that's okay. You know, we're, we're used to that. I think the other thing that changed that on the other side of the ledger is the level of interest, the level of conversations physicians are having; physicians are initiating, not us. We're not talking about this around the safety elements, particularly around cardiac decompensation, particularly around putting in compromised blood. Those are conversations that are happening with physicians all over the place. And I think that's great because it's information that we knew about, but it wasn't really our place to talk about other people's products.

Speaker Change: that it made sense. But that's OK. We're used to that.

Adam Elsesser: Those are conversations that are happening with physicians all over the place. And I think that's great, because it's information that we knew about, but it wasn't really our place to talk about other people's products, and now physicians are doing it, not us, and I think that is great for the field in the long run because, obviously, the field needs to grow, and it's only going to grow if you're using safe products.

Speaker Change: thing that changed that on the other side of the ledger is the level of interest, the level of conversations physicians are having, physicians are initiating, not us.

Speaker Change: We're not talking about this around the safety elements, particularly around cardiac decompensation, particularly around putting in compromised blood. Those are conversations that are happening with physicians all over the place.

Speaker Change: And I think that's great because it's information that...

Speaker Change: We knew about, but it wasn't really our place to talk about other people's products. And now physicians are doing it, not us. And I think that is great for the field in the long run, because obviously the field needs to grow, and it's only going to grow if you're using safe products.

Adam Elsesser: And now physicians are doing it, not us. And I think that is great for the field in the long run, because obviously the field needs to grow. And it's only going to grow if you're using safe products. So I think it puts us in the field in a really good spot going forward.

Speaker Change: I think it puts us in the field in a really good spot going forward.

Adam Elsesser: Thanks for your question.

Adam Elsesser: So I think it puts us on the field in a really good spot going forward. Thanks for your questions. Thank you. Our next question is from the line of Richard Newitter with Truist Securities. Your line is live.

Richard Newitter: Our next question is from the line of Richard Newitter with Truest Securities.

Speaker Change: Thanks for your questions. Thank you. Our next question is from the line of Richard Newitter with Truist Securities. Your line is live.

Richard Newitter: Your line is live. Great, thanks for taking the question. Maybe to start off with respect to the US on back to me business. I'm just looking at the components that we have modeled. You know, obviously, Venus is growing faster in the US on back to me than Neuro. But Neuro is really posting some nice performance in the first half: 27% 1Q, 90% 2Q. That's above what we were thinking. I guess the question here is, should we be thinking about the components of the US on back to me being a little more maybe driven relative to your thoughts heading into the year with the boost up for US Neuro on back to me.

Adam Elsesser: Great. Thanks for taking the questions. Maybe to start off, with respect to the U.S. thrombectomy business, I'm just looking at the components that we have modeled. Obviously, vein is growing faster in the U.S. thrombectomy market than neuro, but neuro is really posting some nice performance in the first half, 27 percent 1Q, 90 percent 2Q. That's above what we were thinking. I guess the question here is, should we be thinking about the components of the U.S. thrombectomy being a little more maybe driven relative to your thoughts heading into the year with a boost for U.S. neurothrombectomy, and maybe, to get to the earlier question of sequential growth, that buoys the sequential growth pattern a little bit into the back half, and that allows the venous Yeah, I can't give you answers to that, like detailed modeling questions is not something I can do right now.

Richard Samuel Newitter: Great, thanks for taking the questions.

Speaker Change: The U.S. thrombectomy business

Richard Samuel Newitter: I'm just, I'm just looking at the components that we have modeled, you know, obviously Venus is growing faster in the U.S. thrombectomy than Neuro, but Neuro, Neuro is really posting some nice performance in the first half, 27% 1Q, 90% 2Q, that's above what we were thinking.

Speaker Change: I guess the question here is, should we be thinking about the components of the U.S. thrombectomy being a little more maybe driven relative to your thoughts heading into the year?

Adam Elsesser: And that maybe to get to the early question of sequential growth. That blue is a sequential growth pattern. A little bit into the back half, and that allows the Venus maybe to come down a little bit, but you still are able to get to that healthy 23 to 25%.

Speaker Change: with a boost up for U.S. neurothrombectomy and that maybe to get to the earlier question of sequential growth that buoys the sequential growth pattern a little bit into the back half and that allows the venous maybe to come down a little bit But you still are able to get to that healthy 23 to 25 percent

Adam Elsesser: Yeah, I to to give you answers to that like detailed modeling question is, is not something I can do right now. I can tell you qualitatively are again sort of going through it. The momentum we have with Flash 2.0 and BT is great. I don't expect that momentum to debate. So that's just a qualitative answer. The success of our arterial franchise with lightning bolt. Obviously, you've seen the numbers now. It's done incredibly well. I don't have the exact number, but I think we've done over 20,000 cases with Lightning Bolt. Seven technology, which by the way is very similar technology, almost identical to what we're using with Thunderbolt.

Adam Elsesser: I can tell you qualitatively we are again sort of going through it. The momentum we have with Flash 2.0 and VTE is great. I don't expect that momentum to abate, so that's just a qualitative answer. The success of our arterial franchise, the Lightning Bolt, obviously, you've seen the numbers now. It's done incredibly well. I don't have the exact number, but I think we've done over 20,000 cases with Lightning Bolt 7 technology, which, by the way, is a very similar technology, almost identical to what we're using with Thunderbolt.

Speaker Change: Yeah, I...

Speaker Change: To give you

Speaker Change: Answers to that like detailed modeling question is is not something I can do right now. I can tell you qualitatively

Speaker Change: are, again, sort of going through it.

Speaker Change: The momentum we have...

Speaker Change: with Flash 2.0 and VTE is great. I don't expect that momentum to abate. So that's just a qualitative answer. The success of our Arterial franchise with Lightning Bolt, obviously you've seen the numbers now. It's done incredibly well.

Speaker Change: I don't have the exact number, but I think we've done over 20,000 cases with Lightning Bolt 7 technology, which, by the way, is

Speaker Change: Very similar technology, almost identical to what we're using with Thunderbolt, so it bodes really well for when Thunderbolt comes, obviously. But, you know, to speak to specifically the success of Neuro, you know, we have...

Adam Elsesser: So it bodes really well for when Thunderbolt comes, obviously. But, you know, to speak to. Specifically, the success of Neuro. We're pretty proud of our products. We've done a really good job. I alluded to that feeling at SNIS. You know, there was, again, a year or two where we had a ton of competitors and everyone was coming out with 30-some-odd catheters, all these large catheters, this and that. But I think that moment has now passed.

Adam Elsesser: So it bodes really well for when Thunderbolt comes, obviously. But, you know, to speak to specifically that the success of Neuro, you know, we have. We're pretty proud of our products. We've done a really good job. I alluded to the feeling at SNIS. You know, there was again a year or two where we had a ton of competitors, and everyone was coming 30 somewhat catheters. All these large catheters this and that. And I think that that moment has now passed. People are coming back to the best products. They tried stuff. They know what works best.

Speaker Change: We're pretty proud of our products. We've done a really good job. I alluded to the the feeling at SNIS You know there was again a year or two where we had a ton of competitors And everyone was coming 30 some odd catheters all these large Catheters this and that and I think that that moment has now passed people are coming back to the best products

Adam Elsesser: People are coming back to the best products. They've tried stuff. They know what works best. And I think that sets us up again for some real success going forward. And then the setup for Thunderbolt is exactly what I had hoped for, which is that the more and more people are using our catheter, the easier it is to launch Thunderbolt because Thunderbolt, then, is just an add-on.

Adam Elsesser: And I think that sets us up again for some real success going forward. And then the setup for Thunderbolt is exactly what I hope for, which is the more and more people are using our catheter. The easier it is to launch Thunderbolt, because Thunderbolt then is just an add on. We don't have to convince them to switch catheters. So again, I can't totally predict exactly the future. But, but I like our chances. The setup is really good for us. And risk just that. Okay. Thank you.

Speaker Change: They've tried stuff, they know what works best, and I think that sets us up again for some real success going forward. And then the setup for Thunderbolt is exactly what I had hoped for, which is

Speaker Change: The more and more people are using our catheter, the easier it is to launch Thunderbolt, because Thunderbolt then is just an add-on. We don't have to convince them to switch catheters. So, again,

Adam Elsesser: We don't have to convince them to switch catheters. So, again. I can't totally predict the exact future, but I like our chances.

Speaker Change: I can't totally predict exactly the future but but I like our chances. The setup is really good for us.

Adam Elsesser: The setup is really good for us. And Rich, just to add to that as well, so what's implicit in our updated guidance is a trend, because we don't guide by category of US thrombectomy, but just qualitatively health is a similar pattern to what we've seen in the first half of the year, where VTE and arterial are expected to grow above that range, stroke close to it, and coronary likely, you know, in the double digits, but low double digits.

Jason Mills: Just to add to that as well. So what's implicit in our updated guidance is a trend because we don't guide by category of US from vector. I mean, but just qualitatively help is a similar pattern to what we've seen in the first half of the year. Where you know, BTE and arterio are expected to grow above that range, stroke close to it, and coronary likely, you know, in the double digits, but low double digits.

Speaker Change: And we're just at... Okay, thanks.

Speaker Change: Just to add to that as well, so what's implicit?

Speaker Change: and our updated guidance.

Speaker Change: A trend, because we don't guide by category of U.S. thrombectomy, but just to qualitatively help.

Speaker Change: is a similar pattern to what we've seen in the first half of the year.

Speaker Change: where, you know, VTE and arterial are expected to grow above that range, stroke close to it, and coronary likely, you know, in the double digits but low double digits.

Adam Elsesser: Okay, thank you for that, Jason. And then, just going back to the competitive dynamic questions that you talked to in Venus, I'm trying to just understand what the underlying market rate is and kind of where you are relative to that rate. Did you gain a little less share? I understand it's always going to be linear, and do you feel good in the first few weeks at 3Q that you're back on a share gain trajectory that you were on? What's the message that we should be taking around competition, underlying market growth and kind of where you were and where you're going?

Adam Elsesser: Okay, thank you for that, Jason. And then just going back to the competitive dynamic questions that you talked about in Venus, I'm trying to just understand what the underlying market rate is and kind of where you are relative to that rate. And did you just gain a little less share? I understand it's not always going to be linear.

Speaker Change: Okay, thank you for that Jason. And then just going back to the competitive dynamic questions that you talked to in Venus.

Speaker Change: I'm trying to just understand what the underlying market rate is, and kind of where you are relative to that rate.

Speaker Change: Did you just gain a little less share? I understand it's not always going to be linear, and do you feel good in the first...

Adam Elsesser: And do you feel good in the first few weeks of 3Q that you're back on the share gain trajectory that you were on? What's the message that we should be taking about competition, underlying market growth, and kind of where you were and where you're going? Well, listen. I mean, obviously, in Q1, the market grew well and was healthy, and we also took a share. I'm at a touch of a disadvantage because our BT competitor is having their call at the exact same time. So, you know, I can't tell you all the details of their number at this point.

Speaker Change: A few weeks at 3Q that you're back on a share gain trajectory that you were on, but what's the message that we should be taking around competition, underlying market growth, and kind of where you were and where you're going?

Adam Elsesser: Well, listen, obviously Q1, the market grew well and was healthy, and we also took share. I'm at a touch of a disadvantage because our BT competitor is having their call at the exact same time, so I can't tell you all the details of their number at this point, but from the headline that I seem to get right before we went on to this call. Again, the market grew, and we took share; and so, as long as those two things are happening, the first is critical that the market's growing, and the second is equally critical that we're taking share in two quarters in a row.

Speaker Change: Well, listen, I mean, obviously, in Q1, the market grew and helped.

Speaker Change: well and was healthy, and we also took care.

Speaker Change: I'm at a touch of a disadvantage because

Speaker Change: The, are.

Speaker Change: VT competitor is having their call at the exact same time. So, you know, I can't.

Adam Elsesser: But from the headline that I seemed to get right before we went on to this call, we again, the market grew, and we took share. And so, as long as those two things are happening, the first is critical that the market's growing, and the second is equally critical that we're taking share two quarters in a row. Now we're going to have a couple of full quarters of lightning flash 2.0.

Speaker Change: I can't tell you all the details of their number at this point, but from the headline that...

Speaker Change: that I seemed to get right before we went on to this call, we, again,

Speaker Change: The market grew, and we took share.

Speaker Change: And so, as long as those two things are happening, the first is critical that the market's growing, and the second is equally critical that we're taking share two quarters in a row, now we're going to have a couple of full quarters of lightning.

Adam Elsesser: Now we're going to have a couple of full quarters of Lightning Flash 2.0. I think it really sets us up again for a really good continued improvement in share as well as market growth. Thank you.

Adam Elsesser: I think it really sets us up again for a really good continued improvement in share as well as market growth. Thank you. Our next question comes from the line of Bill Plovanic with Canaccord Genuity. Your line is live. Hey, it's Zachary Allen for Bill.

Speaker Change: Flash 2.0. I think it really sets us up, again, for a really good continued improvement in share as well as market growth.

Bill Plavonic: Our next question comes from a line of Bill Plavonic with Canaccord Genuity.

Speaker Change: Thank you. Thank you.

Speaker Change: Our next question comes from the line of Bill Plovanic with Canaccord Genuity. Your line is live.

Zachary: Your line is live. Hey, it's Zachary on the bill. Thanks for taking the question.

Adam Elsesser: Thanks for taking the question. To dive a little more on the coronary performance, I know you just touched on it briefly there, but can you provide any additional details on the growth? Do you think you'll need to conduct another trial to prove that? Um, yeah, that's a good question. So, um, and we haven't spent a lot of time talking about, uh, the coronary space. As you remember, we, um, we don't have CAVT in the coronary, and I think, if you remember, the trial that we did run showed a case time of around one minute for the product, you know, sort of being in the body. It's hard to get faster than that.

Zachary: To dive a little more on the corner at performance and are you just touched on it briefly there? Can you provide any incremental details on the growth? Do you think you'll need to conduct another trial to drive that? Yeah, that's the good question. So, and we haven't spent a lot of time talking about the coronary space. As you remember, we don't have CAVT in the coronary. And I think if you remember, the trial that we did run showed a case time of around one minute for the product, you know, sort of being in the body. Hard to get faster than that.

Zachary Allen: Hey, it's Zachary Owen for Bill. Thanks for taking the question. To dive a little more on the coronary performance, I know you just touched on it briefly there, but can you provide any incremental details on the growth? Do you think you'll need to conduct another trial to drive that?

Speaker Change: Yeah, that's a good question. So and we haven't spent a lot of time talking about the coronary space. As you remember, we

Speaker Change #100: We don't have CAVT in the coronary, and I think if you remember, the trial that we did run showed a case time of around one minute for the product, you know, sort of being in the body.

Adam Elsesser: So the product already works. Coronary clots, mostly different. There are some exceptions, and there's a small category of cases where it's a little harder to get out and maybe have a CAVT product, but it's a small number comparatively. So really, you're looking at a dynamic where you're seeing. And the question that you're asking is, you know, would that, would that work better, would we get more share if we ran a randomized trial that could affect guidelines? We've looked at that, we had talked about that a few years ago. I think you remember the decision around the cost, The trade-off of that, you know, that product, again, doesn't use CAVT. It's a, you know; it doesn't have its own reimbursement.

Adam Elsesser: So, so the product already worked to coronary clots mostly different. There are some exceptions, and there's a small category cases where it's a little harder to get out, and maybe having a CAVT product, but it's a small number comparatively. So, really, you're looking at a dynamic where you're seeing steady sort of, you know, movement toward our product because obviously it works incredibly well, but it's just a different animal. And the question that you're asking is, you know, would that work better? Would it, you know, we get more share if we ran a randomized trial that could affect guidelines?

Speaker Change #100: Hard.

Speaker Change #100: To get faster than that. So, so the product already works. Coronary clots mostly different. There are some exceptions and there's a small category of cases where it's a little harder to get out and maybe having a CABT product, but, but it's a small number comparatively.

Speaker Change #100: So really you're looking at a dynamic where you're seeing

Speaker Change #100: steady sort of, you know, movement toward our product because obviously it works incredibly well, but it's just a different animal. And the question that you're asking is, you know, would that

Speaker Change #100: would that work better would it you know we get more share if we ran a like a randomized trial that could affect guidelines we've looked at that we had talked about that a few years ago I think you remember that the decision around the the cost

Adam Elsesser: We've looked at that. We had talked about that a few years ago. I think you remember that. The decision around the cost trade-off of that, you know, that product, again, doesn't use safety. It's a rel, you know, it doesn't have its own reimbursement. It's sort of tucked into, you know, procedural reimbursement. We made the decision that wasn't a logical thing to do, but we constantly look at that, look at that issue. And if it changes or there are elements of that decision that change, we would potentially make a different decision. But, but right now, if you think about the benefit that we can have to patients, the benefit is in the vascular beds: VTE, PE, arterial, and stroke.

Speaker Change #100: trade off of that you know that product again doesn't use JVT it's a

Speaker Change #100: It doesn't have its own reimbursement, it's sort of tucked into a procedural reimbursement.

Adam Elsesser: It's sort of tucked into procedural reimbursement. We made a decision that wasn't a logical thing to do, but we constantly look at that, look at that issue, and if it changes, or there are elements of that decision that change, we would potentially make a different decision. But right now, if you think about the benefit that we can have for patients, the benefit is in the vascular beds, VTE, PE, arterial, and stroke, where CAVT will be front and center, the reimbursements unique and separate, and I think that's where we can have the biggest impact.

Speaker Change #101: We made the decision that wasn't a logical thing to do, but we constantly look at that issue, and if it changes or there are elements of that decision that change, we would potentially make a different decision. But right now...

Speaker Change #101: If you think about the benefit that we can have to patients.

Speaker Change #101: The benefit is in the vascular beds.

Speaker Change #101: VTE, PE, arterial, and stroke.

Adam Elsesser: Where CABT will be front and center, the reimbursements unique and separate. And I think that's where we can have the biggest impact.

Speaker Change #101: where CAVT will be front and center, the reimbursements unique and separate.

Adam Elsesser: So that's where our focus is going to be in the short term. That being said, Catarex, which is the product for coronary artery disease, is still an extraordinary product, and those who use it, it remains, you know, tied as one of the stickiest products with our new CAVT products of anything we've ever done.

Adam Elsesser: So that's where our focus is going to be in the short term. That being said, you know, cataracts, which is the product for for corner, is still an extraordinary product. And those who use it, it remains, you know, tied as one of the stickiest products with our new CABT products of anything we've ever done. Great.

Speaker Change #101: And I think that's where we can have the biggest impact. So that's where our focus is gonna be in the short term. That being said, you know, Cataracts, which is the product for coronary is still an extraordinary product. And those who use it.

Speaker Change #101: It remains, you know, tied as one of the stickiest products with our new CAVT products of anything we've ever done.

Adam Elsesser: Great. Thank you very much. And just as a follow-up, is there any update that you can provide on the Thunder Study? Well, I sort of did.

Zachary: Thank you very much.

Adam Elsesser: And just as a follow-up, is there any update that you can provide on the thunder study? Well, I sort of did in my prepared remarks. Dr. Perella did a great job of summarizing the trial and the design, and the technology showed some cases. So I think we're, and, you know, we're we're very excited.

Speaker Change #102: Great. Thank you very much. And just as a follow-up, is there any update that you can provide on the Thunder Study?

Adam Elsesser: In my prepared remarks, Dr. Fiorella did a great job of summarizing the trial and the design and the technology and showing some cases. So I think we're very excited. I'm not going to give any particular commentary around timing. I obviously, particularly with the Thunder study, have made that mistake in the past as well.

Speaker Change #103: Well, I sort of did in my prepared remarks. Dr. Fiorella did a great job of summarizing the the trial and the design and the technology, showed some cases. So I think we're and you know we're we're very excited. I'm going to

Adam Elsesser: I'm going to not give particularly commentary around timing. I obviously, particularly with the thunder study, have made that mistake in the past as well. So I'm going to be disciplined, which is kind of an awesome thing to not give you an update, but I think if you listen to my words, particularly, you know, you would get a sense of my excitement about it.

Speaker Change #104: particularly commentary around timing.

Adam Elsesser: So I'm going to be disciplined, which is kind of an awesome thing to not give you an update. But I think if you listen to my words, particularly, you would get a sense of my excitement about it. Thanks for your question. We have a final question from the line of Margaret Kayser-Andrew, from William Blair. Your line is live. Hi, everyone. This is Macaulay on behalf of Margaret.

Speaker Change #104: Made that mistake in the past as well, so I'm going to be disciplined, which is kind of an awesome thing to not give you an update, but I think if you listen to my words particularly, you know, you would get a sense of my excitement about it.

Zachary: Thank you very much.

Operator: Thanks for your question. Thanks.

Speaker Change #104: Thank you very much.

Maggie Yuan: You have a final question from the line of Margaret Cazer Andrew from William Blair. Your line is live. Hi, everyone. This is McCollion from Margaret. Thanks for taking our question. So one on margins, you obviously reiterated the growth and operating God for this year. I'm wondering if you could kind of help bridge the gap towards the 70% longer-term growth margin, which kind of put it around that first half 2026 timeframe. Should we think of that as expedited now that, you know, the decision with the immersive healthcare exit. And what could we see within leverage specifically within that op-axe line that you mentioned in the prepared remarks.

Speaker Change #105: Thanks for your question. Thanks.

Speaker Change #105: We have a final question from the line of Margaret Kayser Andrew from William Blair.

Speaker Change #106: Your line is live.

Macaulay: Hi, everyone. This is Macaulay on for Margaret. Thanks for taking our question. So one on margins, you obviously reiterated the gross and operating guide for this year. Wondering if you could kind of help bridge the gap towards the 70% longer term gross margin, which kind of put it around that first half 2026 timeframe. Should we think of that as expedited now that, you know, the decision with the immersive health care exit?

Speaker Change #108: And what could we see within leverage, specifically within that OPEX line that you mentioned in the prepared remarks?

Maggie S. Yuen: Thanks for taking our question. As far as margins are concerned, you obviously reiterated the gross and operating guide for this year. I'm wondering if you could kind of help bridge the gap towards the 70% longer term gross margin, which kind of puts it around that first half 2026 timeframe. Should we think of that as expedited now that, you know, the decision with the immersive healthcare exit? And what can we see within leverage, specifically within that OPEX line that you mentioned in the prepared remarks? Thanks for the question. For gross margin, the decision on immersive healthcare will have a minimal impact on our gross margin.

Maggie Yuan: Thanks for the question. For gross margin, the decision on the immersive healthcare will have minimal impact on a gross margin. But since the last few quarters, since we launched of CAVD, we have seen quite a gradual expansion on a gross margin due to product mix. So we expect in the near term to continue to see that trend. But then I'm also very pleased to see that our operation Pink Team actually continue to execute and improve of them on their manufacturing process. So I think in the longer term, it will allow us to achieve a larger scale cost improvement to take us to the 70% plus target in terms of operating expense, as I discussed in the remarks.

Speaker Change #109: Thanks for the question.

Speaker Change #110: For gross margin, the decision on immersive healthcare will have minimal impact on our gross margin.

Maggie S. Yuen: But in the last two quarters, since we launched CAVD, we have seen quite a gradual expansion in our gross margin due to product mix. So we expect in the near term to continue to see that trend. But then I'm also very pleased to see that our operations team actually continues to execute and improve on their manufacturing process. So I think in the longer term, it will allow us to achieve a larger-scale cost improvement to take us to the 70 percent plus target.

Speaker Change #111: But since the last two quarters, since the launch of CAVD, we have seen

Speaker Change #112: It's quite a gradual expansion on our gross margin due to product mix. So we expect in the near term to continue to see that trend.

Speaker Change #112: But then I'm also very pleased to see that our operations team actually continue to execute and improve on their manufacturing process.

Speaker Change #112: So, I think in the longer term, it will allow us to achieve a larger scale cost improvement to take us to the 70% plus target. In terms of operating expense, as I mentioned earlier, we're going to be spending $1.5 billion

Maggie S. Yuen: In terms of operating expenses, as I discussed in the remarks, within the next 12 months, we'll see more than $20 million of operating savings from immersive healthcare. Got it. And then if I could add one more real quick.

Adam Elsesser: But within the next 12 months, we'll see more than $20 million savings operating savings for the immersive. to the health care. Got it. And if I could add one more real quick, I know you mentioned the competitive dynamics weren't necessarily different, and you've gone through similar dynamics and stroke.

Speaker Change #112: Discussing the remarks, within the next 12 months, we'll see more than $20 million of savings, operating savings, from the immersive healthcare business.

Adam Elsesser: I know you mentioned the competitive dynamics weren't necessarily different, and you've gone through similar dynamics in stroke. So what steps, I guess, have you taken more recently within that thrombectomy kind of competitive dynamics and VT overall? Is it more about being aggressive with the new sales force or more about the continuous generation of the clinical data that you expect to produce? Yeah, I think it's a fair question.

Speaker Change #113: Got it. And then if I could add one more real quick. I know you mentioned the competitive dynamics weren't necessarily different and you've gone through similar dynamics in stroke.

Adam Elsesser: So, so what steps, I guess, have you taken more recently within that trauma back to me, kind of competitive dynamics and BT overall, is it, is it more about being aggressive, aggressive with the new Salesforce or more about the continuous generation of the clinical data that you expect to produce? Yeah, I think it's a fair question. Obviously, some of what we're doing, I'm not going to announce, you know, on a call so that, you know, we're learning our competitors to what we're doing, and I know that you would appreciate and understand that. I think it really comes down to allowing and engaging with customers around what is happening, what are people doing, what is, what are the products actually doing?

Speaker Change #115: So, what steps, I guess, have you taken more recently within that thrombectomy, kind of competitive dynamics and VT overall? Is it more about being aggressive?

Speaker Change #116: aggressive with the new sales force or more about the continuous generation of the clinical data that you expect to produce.

Adam Elsesser: Obviously, some of what we're doing, I'm not going to announce on a call so that, you know, we're alerting our competitors to what we're doing. And I know that you would appreciate and understand that. I think it really comes down to allowing and engaging with customers around what is happening, what people are doing, and what the product is actually doing. And I think when you do that, and again, we've done that, but I think doors open, and for people who have been really pretty adamant that they're fine with what they used a year ago, to see their openness now to using Flash 2.0 and then their openness to talk about the benefit of 2.0 in comparison, that's the most heartening thing.

Speaker Change #114: Yeah, I think it's a fair question. Obviously, some of what we're doing I'm not going to announce, you know, on a call.

Speaker Change #114: So that, you know, we're alerting our competitors to what we're doing, and I know that you would appreciate and understand that. I think it really comes down to allowing and engaging with customers around what

Speaker Change #114: What is happening? What are people doing? What is...

Adam Elsesser: And I think, I think when you do that, and again, we've not, we've done that, but I think doors open and for people who have been really pretty adamant that they're fine with what they use a year ago to see their openness now to using Flash 2.0 and then their openness to the market. And to talk about the benefit of 2.0 in comparison, that's the most heartening thing. And I think that's given us the ability to really go after business everywhere, you know, versus, you know, we have our accounts, somebody else has their accounts. I think it's permission.

Speaker Change #114: What are the products actually doing?

Speaker Change #114: And I think, I think when you do that, and again, we've not always done that, but I think doors open and for people who have been really pretty adamant that they're fine with what they use.

Speaker Change #114: a year ago to to see their openness now.

Speaker Change #114: to using Flash 2.0 and then their openness to talk about the benefit of 2.0 in in comparison That's the most heartening thing and I think that's given us the ability to really go after

Adam Elsesser: And I think that's given us the ability to really go after business everywhere, you know, versus, you know, we have our accounts, somebody else has their accounts, I didn't get permission. And I think if you were to do work in the field and talk to folks like that's happening everywhere.

Adam Elsesser: And you can talk to, you know, former reps, and everything is clearly moving in our direction. And that's because, at the end of the day, and look, competition isn't so much about tactics; you can have them. They don't always work. It's always about having the best product. At the end of the day, I will tell you honestly, after 20 some odd years of doing this, I've always known that physicians ultimately use the best product.

Speaker Change #114: Business everywhere.

Speaker Change #117: You know, versus, you know, we have our accounts, somebody else has their accounts.

Adam Elsesser: And I think if you, you know, were to do work in the field and talk to folks like that's happening, it's happening everywhere. And you can talk to, you know, former reps; everything that the mood morale is clearly moving in our direction. And that that's because at the end of the day, and look, competition isn't so much about tactics; you can have them, they don't always work. It's always about having the best products in the field. At the end of the day, I will tell you, honestly, 20 somebody years of doing this, I have always known that physicians ultimately use the best product.

Speaker Change #118: I didn't get permission and I didn't give you, you know, where to do work in the field and...

Speaker Change #118: talk to folks like that's happening. It's happening everywhere. And you can talk to, you know, former reps, everything that the mood, the morale is, is clearly moving in our direction. And that, that's because at the end of the day, and look, competition isn't so much about tactics.

Speaker Change #118: You can have them. They don't always work. It's always about having the best products in the future.

Speaker Change #118: At the end of the day, I will tell you honestly, 20 some odd years of doing this, I've always known that physicians...

Adam Elsesser: And for that, that's how you compete. You have the best products, and you're not shy about talking about them and educating people about them. And that's, that's the winning strategy, and it's gotten us this far for 20 years, and that's what we're going to do going forward. Very helpful. Thanks again for medicine.

Adam Elsesser: And because of that, that's how you compete. You have the best products, and you're not shy about talking about them and educating people about them. And that's the winning strategy.

Speaker Change #118: ultimately use the best product. And for that, that's how you compete. You have the best products and you're not shy about talking about them and educating people about them. And that's the winning strategy and it's gotten us this far for 20 years and that's what we're going to do going forward.

Cecilia Furlong: And it's gotten us this far for 20 years, and that's what we're going to do going forward. Very helpful. Thanks again for attending. Thank you for your questions, and with that, Ms. Furlong, I'll turn the call back over to you. Thank you, operator. On behalf of our management team, thank you all again for joining us today and for your interest in Penumbra. We look forward to updating you on our third quarter call.

Operator: Thank you for your question.

Speaker Change #119: Very helpful. Thanks again for attending this time.

Cecilia Furlong: And with that, miss for a long, I'll turn the call back over to you. Thank you, operator, on behalf of our management team. Thank you all again for joining us today and for your interest in Penumbra. We look forward to updating you on our third quarter call.

Speaker Change #118: Thank you for your questions. And with that, Ms. Furlong, I'll turn the call back over to you.

Cecilia Furlong: Thank you, Operator. On behalf of our management team, thank you all again for joining us today and for your interest in Penumbra. We look forward to updating you on our third quarter call.

Operator: Record your call.

Speaker Change #120: Recorder call.