Penumbra (PEN) 1 Aug 232023 Q2 Earnings call transcript

Good afternoon. My name is Brent, and I will be your conference operator today. At this time, I would like to welcome everyone to Penumbra's Second Quarter 2023 Conference Call. [Operator Instructions] Thank you.

I would like to introduce Ms. for Relations Investor Hamlyn-Harris, Penumbra. Jee Ms. begin Hamlyn-Harris, conference. you may your

copy you joining Penumbra's our www.penumbrainc.com. financial us you, XXXX. release operator, reconciliation today's tables, on for be thank and A of GAAP quarter discuss Thank which on includes release to tab all call at viewed the under second company the Investors a website of press for non-GAAP and earnings can to the

pursuant to the Act will statements quality, During regarding trends. of make the commercialization, of status, call, this of performance, and trials, clinical statements Reform safe company the the Private course conference including our Litigation provisions financial business compliance regulatory harbor forward-looking Securities XXXX,

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

these and we factors periodic our other as any a new we for Penumbra reliance caution future you against previously may these XX-K complete risks the review a our undue placing to to mentioned, more and discussion results forward-looking forward-looking duty on stock. filings our or events, including the update you of revise disclaims or a market price result our otherwise. or statements future the that As of statements, SEC, developments with of result, encourage information, affect

a corresponding release. non-GAAP On press provided this measures The our are on non-GAAP a financial basis. GAAP in presented certain to reconciliation measures financial call, are measures and GAAP of posted

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

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

Good Jee. you XXXX Thank quarter you, conference second joining afternoon. for Penumbra's call. Thank

were on second the constant currency for revenues year-over-year and reported quarter basis. a of XX.X% $XXX.X as a total million, Our increase

of United a the our COVID XXXX. year-over-year fastest States accelerated to quarter in in revenue half the excluding second decade, Our growth XX% impacted

by as grew total U.S. products was neurothrombectomy vascular both stroke business revenue and growth growth year-over-year. in U.S. year-over-year, growth more fastest thrombectomy year-over-year U.S. vascular the driven thrombectomy in five XX% U.S. XX% our accelerated thrombectomy increased in XX% years. to our than revenue U.S. and neuro

We expanded gross make second to consistent the and more second expect quarter, margins half progress in in year. the our with the of we expectations

quarter. We also increased second our profitability operating the in

well. by X.X% grew revenue Non-GAAP sequentially million operating quarter. as million, representing $XX second the income was in cash operating of $XX.X balance We our

expansion revenue expect Looking deliver strong cash and future. forward, we gross and growth, flow to the margin increasing over profitability foreseeable

world. a the and still had very successful around stages to the in of our United proprietary in the States the are and thrombectomy we technologies Penumbra journey patients to quarter, early bring

we seeing Our each and momentum with is X in extraordinary the for being outcomes these SENDit launch patients in driven XX RED treated Flash, are the with Lightning by days of Bolt early products. of technology Lightning

in off have starting more many a had another very strong quarter. And the Starting second first coming total double-digits grew sequentially, compared cases extraordinary customers just Lightning learning try quarter Flash we about of QX. Flash, and employing new thrombectomy Flash, we to in to the volume doubled with with Lightning our We quarter Flash case number quarters. we venous next the and several the venous

transformative biggest driver adoption Flash's safety, early the is profile exceptional the product. and the efficacy speed, of Lightning power, of

simple philosophy been adheres important factor our value-sharing The the pricing, straightforward our we've same which is to committed other throughout to physicians pricing history. with resonating which

Moving to Lightning Bolt X.

from the of in Bolt in launch of We surgery, revenue thrombectomy in months X products as last other this of Lightning lytics franchise U.S. momentum. sequentially, X grew and Lightning the the cases conversion saw representing gained two growth Our double-digits XXXX. arterial early mechanical since fastest the acceleration quarter

said, with quarter. this X were than we process we launch Lightning the Bolt last earlier even time in Flash for are That

As process process many Lightning waited time Bolt prospective are in customers back for starting to quarter. same for the engaging Flash after last before allow to some pass the

X think of momentum that of and we as the into quarter quarter first through the Consequently, adoption XXXX. this Lightning move fourth will Bolt build and quarter we XXXX of

more hospitals of currently X Bolt together, X. Taken Lightning Lightning than Bolt have Flash either history. active We or in well Flash during in any customers and over Lightning our for generated have approval pending launch other X,XXX Lightning hospital submissions

group to the be order must hospitals. bringing of the for into In submission champion under specific a product physicians or physician a approval,

quarters. products. the of customers the new many we few over expect next Importantly, hospital physicians Even these majority thrombectomy represent to additional further, submissions our

the Historically, starts in have hospital, been getting approval through successful a process products our extremely we once submission these processes. at

just Bolt with are getting We started Flash and Lightning Lightning X.

Flash team's Lightning Lightning for commercial Our of strategy execution is and our Bolt X incredible.

venous annual the a patients computer-aided next years, strategy have in we reach forward. We the majority over States is and of and are the convinced clear United thrombectomy the five-plus way arterial XXX,XXX the to

and Surgery for stroke San franchise. also firsthand outstanding early The Diego. foreshadow at yesterday strong the this we results Conference catheter inner our SENDit technology momentum an I RED business exciting seeing with Society in quarter, neuro a Our XX, are had saw period with of NeuroInterventional

for once catheter of could with to clot. the in aspiration track clot XX face as intervention. face around to the and represents be the of the front catheters challenging differentiated feedback technology premium launched, for ever believe RED the the to and most is ophthalmic fast most of the as innovation the addressing suggests the the Thunderbolt the clot. of end SENDit prove early removal intervention artery SENDit We repeatable This Safe, be stroke part could important trackability stroke

shift positive have share share quarters expect ahead market we the over means see with growth furthers our don't stroke stroke. SENDit only is Thunderbolt RED for and two of enthusiasm in next it to three once market U.S. have technology to And this last and seen in for the XX a to even We share this in with four Thunderbolt confidence leading cleared. in shift to share and gains technology more meaningful wait the stroke quarters, the dominant quarters. Launching real

Internationally, products products most seeing we in computer-aided few launch have our to to we our to thrombectomy next over plans of advanced the Europe, and with success our international early access are the expand years. teams first-generation vascular

the international the In addition, further Thunderbolt in to stroke years. SENDit teams see our coming and U.S. our intervention and enormous leadership potential also partners over outside expand with

Immersive as and clinical we Veterans and success milestones physical of key mental additional rehabilitation, the the during healthcare we've quarter to private about the with applications Healthcare. VR excited monitor am across our Turning myriad of health. Affairs partners. progress I important together the Department hitting platform made cognitive working in We're

I say Before business that want I we are for our over the expectations Maggie, recognize turn call high. to to

fact, In had we high very for expectations ourselves.

term competitive succeed We have the navigate ability our near confidence while a we agitated to in lot reactions. of and

also We inevitable. the believe expediting in

And laying help thrombectomy so, our all products. benefit to we the are can foundation patients who from

guidance guidepost first within it's success, journey. Our just the but current year next near-term year the to a is year five-plus

to have Lightning than XX and the this to opportunity us owing We this clearer are Lightning patient SENDit. the paying on the it attention we to we're feedback now a and longer lot period, RED guideposts to is and larger visibility getting I ever believe Flash, over has Bolt success been, of X

to profitability gross expansion, that visibility confidence us future. we deliver significant continue foreseeable and gives the flow cash strong revenue growth, margin will That and increasing over

I'll the now quarter financial our over to to second Maggie turn for over of call the go results XXXX.

Good everyone. Thank you, afternoon, Adam.

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

increase second For the June compared of in were of currency ended revenues $XXX.X total XXXX, XX.X% the and constant our to quarter XX, XX.X% XXXX. an reported quarter second million,

international. XX% regions reported Our growth XX.X% geographic U.S. of our mix constant XX.X% currency. quarter XX.X% and the in XX.X% U.S. and and of reported international in increased sales was

across continued was Vascular X.X% sequential The momentum growth as U.S. in business by business regions. well driven our thrombectomy primarily all of as in neuro growth thrombectomy

vascular Moving the year-over-year and growth of in to to a global from of reported XX.X% the XXXX, a grew thrombectomy increase an to XX.X% our our second same XX% the in million compared in currency revenue by and by quarter constant franchise. for Vascular business $XXX.X driven year-over-year period Revenue U.S. flat business. rest year, last relatively of

quarter million and Revenue same constant Neuro of XXXX, XX.X% was XX.X% business Asia year from of to new second U.S., products the increase an in reported in by ago, driven the compared period the currency in a and Europe Pacific. our $XXX.X

quarter ramping of sequential new launches in and our by inflation second XX.X% the for expectations, compared XX.X% last to for second with is up quarter. of improvement Gross offsetting XXXX margin thrombectomy the productivity, headwinds. higher XX.X% quarter is mix and line driven product The XXXX

second increasing margin the of we in quarter, our half start-up demand margin further still and continues to the support operation reflects gross second expansion As prior costs our Lightning from execute some to quarter XXXX. well expect gross team the

assets Now on million, and to last our quarter year, the for $X.X of the $X.X for and exclude million quarter, of which $X.X million respectively. same acquired quarter, amortization this last expenses, intangible non-GAAP operating

million of the $XXX.X for million same last compared was for the quarter and to $XXX.X revenue $XXX.X million quarter XX.X% quarter. XX.X% or of last Total operating or year expense of XX.X% revenue or revenue

$XXX.X and Our $XXX.X revenue last XXXX $XXX.X XX.X% XX% QX, quarter. expenses million were $XX revenue expenses Research or for last $XX.X compared compared Development for million million million to for revenue to XXXX for QX, quarter. and of $XX.X XXXX XX.X% SG&A XXXX and were million of for QX, or million QX, or of

revenue for of quarter year million $XX.X last revenue operating $X.X or and second operating quarter. same income compared million $XX.X of recorded the X.X% of income We operating of the million of to X.X% or income of period XXXX in last

execution support invest growth to product with half new resources XXXX our continue effectively margin our operating to I'm long-term expansion investment expect trend and beyond. to pleased great we allocate very in launches, and While team's continue in of second and the and

our increase in cash We cash, the in second Turning debt, improvements balance $XX flow quarter. and securities of million balance and no a capital working is the turns. is from increase by marketable sheet. equivalents ended an of sequential which driven million and quarter cash profitability to an cash in The with last increase and $XXX.X

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

everyone. and Thank afternoon, good you, Maggie,

$X.XX We to to XX% to XX% $X.XX total XXXX XXXX range which represents of over guidance a revenue. our increased billion revenue billion, growth

global range year XXXX. We in below and to business growth to slightly this to growth our the business our global in be full Vascular be expect Neuro above for continue this range

second the we to perspective, the in from be our double-digit United growth in to quarter, quarterly record seasonality and in we fourth modestly in quarter quarter. the expect a while XX% growth digits year-over-year accelerate comparison to a From growth mid-single expect the the we and growth reaccelerate international third to due States challenging posted

In growth to XX% sum, XX% of third our revenue we grow basis, quarter expect year-over-year on accelerating quarter. the to in XX% a the in the global range to cost fourth in

Moving down income the statement.

both move gross operating through expect expand half the second margins we non-GAAP and as margins We further to XXXX. of

XX% margins target operating years We by expansion expected years. and with a over gross margins continue XXXX over of XX% in the few subsequent further within end to

to I the for Adam back will remarks. now call turn closing

Maggie Jee. you, Jason, and Thank

almost with our making, to speak clots team moment do going the their a fully see how XX defining clearly We almost arteries in our work how I say I for veins. know I are computer-aided at history, forward. much everyone that can Penumbra thrombectomy years blood in we company's we where moment now when entire with we can a help and in the innovation have understand

learned our on myself, We the physicians have the right ready companies entire team, work promise studied way. have and to and who from I the systems before done the Penumbra us hospital this market development challenge. we best will can on the it are taken and with following, take

part highest to of but the five-plus ground. trying Thank will our Penumbra we work, The journey. most be going until hard exciting you. next the We years on reach keep are

to Operator, open questions can for next the the we call minutes. now XX

[Operator of Bill Your question the Canaccord. Instructions] Plovanic is with first from line

Your is open. line

figure I understand help to RED SENDit it in Great. start. XX Thanks. is I'm I But can - with even the U.S. where neuro, you think Good evening. It's you to really trying an impressive sounds mean, surprising us quarter. like the the internally. out

you kind going on track really end update Thunderbolt? enrolled of adoption Just kind year that that what's of 'XX? then get to on the that of still have it of in then the you in an Do the terms of on that Is there expect by launch or and year? end trial the and out

with you. that Yes, surprising Bill. long Red long, questions, news, been say us. for I in won't time. is Great XX We've a the good neuro Thank Yes. SENDit

is it know for pretty heartening we So, well. us. obviously But it very

we to size navigate XX up As the years to when better and this catheters intracranial trying idea part know, tackling beyond of spent necessary. the issue, you have the right to of the and circulation MX of up

And FLEX can't obviously, a We've frankly, the is for some have had embraced struggles, in physicians few and than the product we've track matter. Thunderbolt better we've ago, had some the get there, now products. have that to great launched if but heartening. doesn't can it, updated exciting team really XTRA years you And a anything because even

of in there the part way, You have that's critical a to routine to get a procedure. and be able

asked you the glad I'm Thunderbolt. about

a of little an update. give Let me bit you

past, been pushed that a There line mentioned reasons. I've in As touch. has the two for the out are time

this roughly has as the sort -- is sign. trial enroll accelerate but to a the that's and first The the X-hour patients progressed, now we've took window, little XXX we have at longer good really due enrollment enrolled, seen a mentioned required first of to

asked specific in related reasons. the similar to seems increase symptomatic it device, our adverse other being end been and to to in trial any XX pushed knowledge, has FDA the make safety The of hours but a currently to by stroke trials does XX serious trial not was order change point or but our XX made little request request about potentially have This way, run. enrollment at size all be with anything sample to This are that second trials consistent And patients. to to hours. modify us reason, our stopped out the also not ICH for from events those

with the finalizing FDA. details the We're

which, to again, another take update market the product. But grow opportunity might the as and do Thunderbolt we the formally SENDit, to or this And the market significant we importantly, allows with for XX with it soon have we'll don't all really months that that's us this. have so. equally wait to and that, share, time said, done, but or add importantly, XX premium That to penetrate

think you ask your I up I So will have set didn't really it as question, a good run. follow-up. And but first it's know this for you Bill,

the and you XXXX this So I'll - not of is projected impact timing, our liberty does first, if don't at slightly take mind, for answering numbers that it new all XXXX, or XXXX.

to wanted I question. that sure So, I make preempted the

the question. Good. Well, half you preempted

the like for back at outperformance our the quarter taking questions. end the including and top of in it numbers, doesn't As how year? the you kind the the the I'm of of half wondering end given 'XX in Thanks seem about we not in think and the - for it range adding least much of of the are guidance in my think reflects quarter bottom And more. what you do to the range raise, you're much

question. for question. It's you, Thank a good Bill, the Yes.

I'd two that $XX So raised say first calls is far this thing by our we've the revenue year, our million. in about so guidance first

think exceeded things. that's about over the expectations results it's our of I think these forward, couple consensus two a times I look quarters. worth amount But three noting if first you cumulatively

well as our it Our anticipates as what in. and for updated updated accounts sort guidance - doesn't guidance of fully factor what maybe

driven U.S. grow That's second Flash, Bolt the obviously half business will and remarks. that We compared to SENDit. First, our the we'd prepared year expect of in from mention our did in the first. faster largely

the the expectation The an will year. U.S. second seeing hospital of accounts we're new about both our say growth number last in what I'd accelerate excited globally, and we're is thrombectomy, with of unprecedented pending. the in It in half thing reflects in the submission also that peripheral largely process

The have would of into processes say And timing, And have forward months this balance It to I stage. up lot from a these year the plus. to guidance a we about look year. of the we're next is this take anywhere our obviously, to how into months think we can this appropriate we factoring at few nine and overall, to been variable.

my for Thanks taking questions.

Bill. Thanks

the with JPMorgan. question from next Your line is Robbie Marcus of

open. line Your is

the outside Thanks was Maybe to U.S. to business Looks was the point Maybe a up coils, like for the you could my XX%. of start Oh bit taking vascular little great. vascular. what's trend-wise? flat. the The rest peripheral or Street. a to on through was walk there questions. business on just in anything Is below there going slowdown U.S. headwind

growth, what business? to trying but vascular great rest just the So to of happened the U.S. understand

overall, had there business generally Well, both Obviously, over really mentioned U.S. business Thanks was and the U.S. the - strong are thrombectomy stroke Peripheral fairly really Robbie. Internationally, the question, business, up Yes. XX%. U.S. obviously was quarter. think thrombectomy vascular The XX%. up we for total the a you early. thrombectomy coils is

Lightning just and to Lightning have lot We internationally, and getting do. there's a work of XX started X

wouldn't there that just products expected I States, don't untoward going really of in We it's anything to internationally. all United growth. have our is on. premium say the drive And

So the growth, reflects really from think, accelerating we U.S. our business, market. especially I strong guidance vascular what from driven the expect

and we markets. have look have RED Flash Thunderbolt, the Yes. international these opportunity Bolt And in and markets, as X products, opportunity continue to those Lightning to as growth similar honest particularly then we at with the bring that XX a be to because you, with and we'll SENDit the

it's that by has the always the really technology defined driven and us. So, innovation

the to maybe just then And hit of some on sequencing.

and lower higher fourth the believe in XX% has and XX% correct quarter. in and growth wrong, third quarter. I'm if to was I than than us, for greater it third That's Street me gave quarter, fourth You XX%, what

in than some takes XX% us a fourth quarter? that confidence So Thanks lot. greater puts number through and there of the maybe in walk your and just

for we Yes. Robbie. Thanks out. that did question, the point And

As think the third the States, markets in way modeled it United quarter you I we was that a quarterly, high. important don't perspective, from the we know, international the underappreciated but sort momentum was third the been too the recognize typically thought of little guide and quarter, a to consensus had just bit

the take and that's in the quarter. put third So, the

this to I the but where growth, while to market, for our next States just think I point. are that's think they United year-over-year quarter, not internationally where the at as the on the same not Flash exclusively folks want because are just expect are see fourth the we a in that's and And as where in get the - basis a Bolt comps third. growth, quarter,

as we growth. So expect double-digit mentioned,

So said again, we've that's have the compounded third second momentum, the of business with coming that the plenty U.S. still out of as obviously, we'll and quarters.

questions. taking Great. Thanks for my

Thanks Robbie.

Your of line next with Fargo. Wells from the is question Biegelsen Larry

is line open. Your

Good months, 'XX, on a by filing it now my for The basis and of afternoon. question end two filing congrats just nice XX upfront. what's delay clarification here. end was Thanks the to does 'XX? quarter out - pushed filing So there? that Thunder of the taking questions Adam, of

specifics want with you up of told Yes. thing, We'll XX really the - when when most quantify the extended to to it of about stress The finished the this. really, I out timing I with get again, months. all - that important but wanted generally,

it neuro waiting with business can of our and second Thunderbolt. the not quarter the in numbers for for see is a not are the in performance We row, our - you performance,

SNIS premium we that that just We have product talk the were capturing is at. is share. unbelievable of this It

Thunderbolt can So, that that, but just not in really every sure on the part of deal there, when to shape. getting the And we clot procedure, other get good making the really, case, with top we then in we are get comes, out. of

go question, for everyone I'm your to that want both now be And the very clear. to this the Larry, - setup us appreciate procedure So critical. very, of after I parts ability are

a think our everyone us knows while quite in And was It is. important trackability I how stroke topic a for gathers. around

how add that have great growth I think stroke great. such then on Thunderbolt taking job is that that doing the to such dominant an to see a that is my amazing in comment, And fact will and top continue share the the curve we'll So, product share we our to leading get of businesses a is sign.

thank question. So, you for the

been grow to force just business at question, products. just perhaps Yes. is to the I'm on given taking on Adam, I year, for for going And What is And to Robbie's the for vascular wondering in just good get this do has distracted first follow-up you, two Vascular? faster least. questions. neuro - faster want embolization - to a quarter? it half, vasc, one launching seems to sneak to neuro wondering than how growing so hard sales mid-teens I'm if is much Thanks grown has the than going the

Really follow-up questions. good Yes.

the with first coils, one majority a on in share The we're already market coil.

compared to the going So beginning most definition, by two in slowdown of launches company's significant that is to history. our the

me I the They benefit. think are clinical happen. you is have that. And do that's numbers to coils. and when proud get So, a wrong, significant everyone But obvious do just fairly going definition, work great by don't of our

answered we script. think I vascular, around question it in The the

We way on have. the and than X,XXX hospitals and Lightning a in board with that more Bolt over Lightning we closer for U.S. already beginning, Bolt. alone comment made submissions have Flash specific We're Flash pretty coming well I the we to have

mostly new as plays are it out, these process and - way customers that and obviously are We drive. will

who but this our this the And company's And going that. scale it folks means product history. in wanted submission process hospital. we've it I understand people seen once, in other of different - to use day, is happen one it's it's ever is happening. launched have through at the might The just then And it, any not that than

work I to it to just a use the team for that is that to driving also give got many And want product. get customers innovation extraordinary that the to it's to new but this testament going, to sales - doing

vascular the I growth think question that, math the do when around you takes care around itself. So, of

is add number just Larry. from thing The I Yes. would a only standpoint,

And in of the of will we perhaps below quarter XX% little likely climb XX%. think vascular slightly third bit, our our vascular then be was over globally XX% a total fourth in revenue. the business globally That will quarter. about I

Thanks Jason.

comes of line from the question with next Blair. William Your Margaret Kaczor

Your open. line is

everyone. taking afternoon I to two pieces. on my Hi, Thanks good questions. really for wanted follow-up

one, X,XXX to submission for a as sure the So I scale, the And plus Flash at guess, of Bolt. for that targeting people the we out relative versus active potential few us get look to sense of willing give what number hospitals I not are approval of a hospital that and the guess, today, I'm hospitals, X,XXX you're and you're accounts, right?

bring And go on then of of the Can curve of Bolt. few as trialed X, year, try and give a a adoption we it question Flash side, you on give month this us cases, that just kind similar their it us has it growth? have of it Or the a kind reached Is will throughout those of a relatively maybe kind is - on? sense inflection of put to the quickly sense month it scale?

question. Yes. Really great

what That's well to the frame. sort than closer - launch, me put best do are of of to this way talk best is beginning we're The answer my okay? X,XXX of way to of the submissions it. the it end a of right we is in it's sort about to to The over it Let answer how this launch mean?

been up? already accomplished. to more go has than fast somebody ramps We How have

being it on You this really one maybe - process. or two without than formally can't through cases, product brought a can't really other you use

So that's item. gating the

somebody has what to bring interested, sharing talking a their of so, customers been to word it physicians on, is sticky Once going. so very experience I so lot has we And be far, partly sticky. does driving that's it's get because new go haven't physicians, that that that to think have a pretty before that And our mouth, business. experiences had to been we

innovative this that future technology - as as prior a driving this where we the year, you And had can years but interest wanting tend happen this we just of start get to like going the So, seen. itself they physicians the an fast of is We why into or as to not of confidence possible scale well. hear using the is with about rest the experience so not to have you the just lot a adoption - have have have like - this.

of year referenced And in kind think Okay. then know the I should are the we But got the at commentary feels you're like on neuro. all so you've into the a right, mid-teens, just rapid you've growth be is will the not commentary And it saying about this how QX. which vascular what positive, easier that? 'XX. we XX%-plus Street pretty suggesting. is both is than and comps yourself as deceleration, Because get obviously they it's

just maybe Thanks. clear versus up those two opportunity? comments So

summertime. Yes. still It's

I'm to the XXXX So XXXX. guidance I give hope in not it. you for summer middle don't mind of for going

those our confidence. all into quantify front as the best be about launching. I of tough at think of currently not To products in we're you can in have down is to point. this any that But, take enthusiastic our commentary and what a way a sign we're not sharing premature about that of percentage we what that's us three

had Okay. to Thanks. I try.

effort. appreciate I the

Joanne of question line next Wuensch the from is from Citi. Your

line open. is Your

Anthony This taking afternoon. good Joanne. on questions. for our Thanks Hi, for is

I think or last headwind to quarter, gating factor maybe supply a you called as Flash out update.

Flash if that about the adoption peak just Just and was this curious with case a versus as cases And seeing you're can PE you you. Thank again. DVT? trends then follow-up, quick quarter just talk

going limit hard real particularly ensure team - you. the is we operations don't and Thank keep And expect I mean incredibly really curve - we're wrong. at working beginning The don't that I ahead supply. of have to question. of that us. to me not the said did very is I The on hoping didn't great and we diligently. have get team issue. the quarter, to focus working Yes, that to forward, We

and DVT, not case competitive obviously, it's and of are physicians areas, reactions viewpoints versus or As whether to seeing seeing successful is going who physicians relates PE really we're But both are, are what There difference. case are those to different it PE to that. DVT start. a incredibly responding we're have to

Some that we're versa. point. the or a navigate the There point the of cases might and other sheer this I success is one not out. and than and one other I then case at seeing. different given start vice the would is better trend the yet And volume to be to with that expect That don't

Great. you. Thank

Thank you.

Your question O'Brien from with the Sandler. of line Piper next Matthew is

Your line is open.

Maybe more some the U.S. in questions. down the taking the the sure X% because as for was the on aftermarket, probably of to Thanks look tease at half back this business, its I'm even vascular stock though out Great. acceleration awesome. I but just Thunderbolt, about

the we half acceleration Jason, because around to bigger acceleration, QX the second second with up terms as what's QX utilization? in of submissions far users ramp. or So them know about And their these bulking hitting converting vascular concerns active and those existing the business assumed you half ramps and big all you have hospitals as a

I'll and take clean front me. question then of Yes. up Adam the maybe the Matt. that, Thanks for end can after

XX% strong quarter guidance, at The end third - growth last year. those the third in the - a range. top pretty of The off obviously, third quarter, quarter pretty strong

that second acceleration we of United States, driven So, put at growth the the accelerate and third. we can We it's up the in the by quarter. do States think think, that, some maybe that United in we hard least off that the will be to show in growth

to things, But over read that that that that, when appropriate submission I'll history we also what positively. to turn getting being submission We're having success timing we the other notwithstanding more to that answer asked Adam a high mean we're the thoroughly process. in, about of a think it not with say we of and I commented starts, in been respect factored we've degree things I about have when process it, you can to And you have we factoring control don't appropriate. through or and

is Yes. also SENDit, we've we're answered and don't the I be realistic, submissions to around and hospitals guidance That's our as for and neuro why that than for specific that I to around don't you think - pretty that and our of anything the really sharing other answer while. well. going always number information significant the it at growth this. done quite both making some of we're giving have looked very you of Bolt a in I complete part - a sure commentary Flash because

on I'll know third add and in that's business fact, quarter to bit this We growth sort the Matt, the put And both internationally comments. third guidance. of comment a internationally our that of we or we've fourth the and in call. what much as seasonal what products trends. we for our you in from for - as quarter United probably to know, Usually, about And normal with the internationally quarter, matter tends just of that's reflected quarter, expectations lastly, so seasonal a on the be fourth strongest this fourth just it those expect those about can talked reflective the quarters, States three the

Appreciate it. One one. Got that feedback. more, quick

about talking products, Are have ones new are what - you of VACs, everybody then about rates. new but specifically centers the you reorder seeing reorder rates seeing utilization terms got have from terms accounts? that And of that what all the that looking is reviewing ahead - trends? in are in through and Just adopted these these XX-plus active

Yes, it's great a question.

about is that. rates try thrombectomy the new obviously me product that, answer our excitement it. wanted reorder to all are of driven that the never answer extraordinarily products. otherwise you talking are using use for product Without The being That's people who to today the ever strong. wouldn't by that have Let these this and customers

linked. So, the two are

- There been this, field time. this this know for and in room having is long still you watched, all a I think is

physicians area, you three particular ones every different in in subspecialties to physicians up multiple and of our multiple hospital. have have You

not the hospital in product it. doesn't a does, it cases, in, it gets some and when every use that three but mean starting now physician subgroups always are So single to all

approved. there room the that opportunity places So, additional over the hospitals for to period been addition within to the significant have in coming next time new is already still are drive of usage

Thanks. it. Got

you. Thank

Matt. Thanks

from line of Your question with Pito comes the Chickering Deutsche Bank. next

open. is line Your

Hi, good quarter. afternoon. Nice

XQ? of third the we much quarter? consider then the sequentially guided accelerating quantified in largely vascular into from from XQ XX% U.S. year-over-year. growth market U.S. How perspective, sequential You much quarter. how a first the growing grew that U.S. how Again, the vascular much some And from to grow you

Yes.

quantify double-digits. such in also was arterial U.S. the didn't we said that grew sequential sequentially we grew said did So venous we total strong - And growth. What actually, in we U.S. double-digits.

quarter it. as year-over-year So another double-digits that's was basis, a strong well. didn't grow had quite We of majority vast well. It the in coronary as it on fast, as but

growth. for done of Okay. updated think Can we rate about how provide Great. the for year? strong any quarter exit you margins guidance should revenue nicely And fourth quarter this this then the margins, on with on given

then indeed, in be and we And and I year. above start would your to subsequent part that? forma stopping. I We, add is question. with respect your a margins pro latter XX% my beyond. expect think this see place Maggie, of importantly, prepared I'll to to operating We what to in we remarks, you as continued that Yes, maybe as XXXX see not it expansion exit that said

well. and continue continuing mix the to No, and continue volume I think you year. sum mean, see leverage to the it we'll scale, with I throughout trend up favorable that's

Great. Thanks much. so

comes Your the line next Capital. Shagun from with of Singh question RBC

Your line is open.

Thank figure wanted about one? launch. two what just in this ask a to trying just year being looks multiyear so out perhaps the You much. way. I'm you talked year have question to like a I different Great. XXXX versus

You've talked about at X-year least a runway.

the on that about think to there's get and a it year does we product process as seem So two, board. also

be think So anything stronger, expect do similar helpful? as growth would 'XX? help Just be opportunity can us year better or that handicap to you you about two, the below

for try And it It's going the me question. I'll all, in and XXXX. question repeat still of thanks up for frame answer. way. heads that different you importantly, a to as that first giving to summertime you the thank were Well, ask the

So, we're and us sort us sort between to what's maybe behind ahead of ahead not I of what's what's the going to to not of quarter obviously around want answer we've comments summarize this made is What of differentiate specifics. the that in really kind of us.

example, But And and deep way the our place seen a into a product just it before we've means to that's that any because explain not the that in we level at ever ever exciting, interest pretty they're in to have subspecialties of surgeon, never the - years working, work. who for to doing wanted on generations. arterial listen a are prior vascular surgery go even has side and done to years you products open for our When has launched.

ahead an and How then intrigued between normal. have both happening. and And XXXX do us. ahead. It over moment and And when to that they that's That's see exciting they're lot that of and there's everything. it one means going not of means forward? not now a does we to us, for work XXXX, convert XXXX, that quantify tells us That's is we going lot a case

the work. We do have to

hospitals. We in get the have to

We have to make have that. sure we

of puts it us in is a positive, All and that good really shape.

all is for these at good for So, being things in do it. not launches able we're we're quantify the are them time. had a really - this We we've will - different, it I to pretty we XXXX three spot, work to have yet. than we apologize know the and before. but appropriate about Obviously, But of excited

so getting XX%. thinking plus perhaps a directional you the and just just be you're expect helpful? be beyond about more the for Or margin questions. maybe about it year help then think you I think this margins. should through was question on expansion wondering it differently? you would do taking to plus linear? XX%, can we And us future in the it. Thank color years, to And Got how Just any

thanks the question. Yes, for

in portion, confirmed I Jason's years. or think terms a gross XX% continue margin, in few to So we margin in target of

operating and infrastructure So, trend well we to good continue and effectively. I also on pretty pace in pretty place that's resources have directionally are think scale the beyond, to to 'XX continue we as and allocate to And 'XX us see expansion. same the between margin to a scale to allow translates to

So, I can terms forward we far next to we continue in margin of think in have seen going the year. what trend, expect so expansion that

Thank you.

you. Thank

Thanks Shagun.

line of is question next from with BTIG. Your the Durno Sam

open. is line Your

his actually Hi. Sam's in Can at you SNIS, me? hear line. so Okay. I'm Ryan was I on line. It's on calling

you. hear can you. Yes, we we hear Yes, can

Oh, All guys. good. Hi right.

come relative large changed it's and think you clinical for of a the kind what Thunderbolt. it market things does embarked Adam, maybe competing want all in couple like or year market? So And can has on cyclic to just in questions. kind of this understand in Has sessions to aspiration to it the you as you're here terms on opportunity I what ago kind and versus aspiration endeavor. when maybe of not of aspiration today was do trials it clear listening your view eventually these I'm changed? patients cyclic of bore the Or that a to with Thunderbolt for

appropriate you're Yes, and now. it's a question great SNIS right right given in of an that the one, middle

cyclic sure effect. not doesn't on Cyclic any Let because really, don't couple being terminologies We something aspiration. means It different. It is nothing. or is seemed really third - saying all is have I'm to - I'm - a the me real fourth same then not of and make just I like why And do And what registering. off. sure pump that question That's page. aspiration turning to asked. we're the want on this a

we've Lightning obviously, doing amazing It's extraordinary. is what And changing It's aspiration years that Thunderbolt different treated very what I And Lightning as patients with else. it's treating after and does. now it's Bolt X,XXX of also about people's Bolt. - does. Modulated is technology just something thoughts patients that's like said,

any - that clear. out enthusiasm crystal cannot modulated to level excitement about be So be there want get body. of my clot and aspiration the of misunderstanding about to I

around of a those of they're on. used actually where aspirations, trying bore a in a of are guide Because an going sizes they're label. None - been that my them Thunderbolt push a trial while. are understanding to have bore large in indication - cleaner, catheters up neuro There's bunch there's as in or aspiration a question being them for are the large they're Now they either MX. are trials to catheter trial. or off guide catheter Those a typically have

I around can is that's think currently or fairly, answer ask whether You obvious. the inside not,

important a to start case. the thing So stroke let's focus on most

there. get to got You

up or sized excited That now clot We brings has faster there. had we've get something other to that else about. a have anyone had. technology got ever the to than You should we're any product appropriate easier and catheter be ever

little wait take a That's period, share likely which and know about Lightning in But process. we're the learning Thunderbolt have time the do come growing of taking we much we same It out, At works. - both to so to the significant it will how longer that the and Thunder immediately. Bolt results doesn't can't time. and time, what and in for we It already don't at because market obviously, excited happen doing, that, the same with wait that used Thunderbolt. for we're trial being is also to

missing like an that the catheter in XX just physicians pre-pandemic with access to appropriate clot And community all-time into the back and yesterday, It's a getting We I was about had necessary meetings But talking there it's drive is this. I apologize you. doing at And with of of the work levels to for who with high. idea level SENDit part, an around large answer. going RED size the the are enthusiasm enthusiasm. is

is thinks a RED there nice saying SENDit. is is - if Thunderbolt negative. which is misunderstanding to what else I'm Thunderbolt with anyone - great. about a have also does I'm to want that It's terrible equally something I So XX great something

me. Adam. Thank saying you that. clear, Last from question for Crystal

some volume the think about year? we these about any that about on for give you pricing Lightning. you the price getting say, when getting remainder getting on in the benefit are your in assumed us pricing Or in the and benefit XX. talked of the relative Can technologies talked You to, you're mix SENDit guidance color you're guidance terms RED of benefit vascular with for you for a given premium

just really really, price. everyone that's a And priced We valuable, I fairly, simple and there, always being have way always That have got out system. been stays we're - a slightly our asked It's it. I'm good a you we and been glad it. that It's is question, said, our a for hearing we're really and a different valuable pricing a knows that reason, reputation reputation. business. that, Yes. easy, conduct to mentioned

time, long I obviously, about That the talked there's a It's separator. how And a price you small bit this business Flash, because for for mitigated new being products. said, and that's and yourself think reputation like because charge in you need for a the fair. We is products. important your you little you're conduct our what a premium don't

our of products, majority guidance and increased of past success couple vast not pure is the the price. the usage so, in And of off driven quarters being

not one, it. than short-term that, it's say to we've that a an when bump true, sustainable but our important shelf has that's a different very reason more want is with full business And share life something to the Price price ever to it's gain price. And necessary, take but grow appropriate one-year we it's growth, short importantly, and sustainable. will market which

Thanks, Adam.

you. Thank

question your line the Rescott Baird. is Given call from with on the final of David today's time

open. is line Your

that start Thanks position implies that this majority guess than my an to what getting within does SENDit three the dominant congrats taking is to being Should four strong next within off, to on in I guess, this a four U.S. Adam, or Thunderbolt, share I for quarters. the have basic around great. assume dominant dependent U.S. to next longer the the market Oh expect expectation Thunderbolt? your stroke question. share we imply quarter. that stroke rather generally space three to given time the quarters? less more comments line you you for And share I'll on is question. that a Maybe more in one And the on

Yes.

But what Yes. on in Thunderbolt for fun. comes, we wait have meant don't SENDit, the we want will to - expand to that's benefit to add The there'll We'll be more is, yes. that me to our answer have - by that? You more benefit when I have It now. growth. and future. wait don't

talking started first didn't few years was ago, SENDit. Thunderbolt, a we which when and we have - have about We

wait. we So, we didn't not have that to know would

were We kind and and really had tech over curve. we They don't patient the a we And that's had they to that is SENDit it fact suite don't about who and failed without the getting over all that's again. products It's to we And around stuck SENDit see, try up And have were SNIS. is trying like, at we thought right and amazing. a safety. wait, positive. now and we did, And of exciting. the reaction physicians with then the

out It's take about there you've two, to a using takes in and XX improvement in out minute Thunderbolt again, clot you're it getting minutes you get or case. to But get work. the if room for if if took there, clot, you a done or can but you get there's minute minute it the can the clot the that a out two, or - because, if clot two, get in really you fast and the still then

work the So, for of we'll the get And that for set add there. then first comes. to we're it the case, doing part important, success most to when many years. now pretty Thunderbolt feels that getting with good up a Frankly, like

spend And three-year years. based thought on with or of side, be helpful. Okay. should incremental two - question, - about frame with you. time margins or a to launches operating within if Are to answer just margin of Longer-term able above five-year more kind on said then today? the set No, half Thank the side the view? that few for XXXX? your there you'd within just closer wondering XX% is the be as just in that's you the any qualify the to the something you my Wondering into a And force margin guess any business sales maybe accelerating kind this on goals? less I you Thank and where force or maybe of back year gross I maybe sales longer today, think with second gross operating the margin. that's there. margin the on

thanks for your question. No, Yes.

and both right is margin, we've both volume mix factors think to two previously to to we the I the terms and and in all margin, scalability. think three yes, of continue the I we'll target mentioned And that look see gross years out been seeing favorable at.

it's be person sales we side, really And good and and whole have an we're to because going to grow. think real pretty launching - part, team, need really one question. there most add this get care some we'll a incredible - - busiest We the we But two it's U.S. new effectively. have don't on is be the person, to - for a of products. leverage going to cover here We not force there. able they'll may We the they're sort to the we're

through they're going hospitals the case They're process somebody raised in these all business. and and the as doing coil coverage

time, over normalized. remarks in people just half sheer first And more the of have it of for that them the done called year. out is think amazing. I volume prepared I the in work team get will our the

think need out because get lot we'll fundamentally of we the size not I think leverage I team. that, the of a do to of change

Thank you.

Hamlyn-Harris. At to this time, I will back the turn call Ms.

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

Ladies concludes today's and this call. conference gentlemen,

now You may disconnect.