Penumbra (PEN) 22 Feb 242023 Q4 Earnings call transcript

Good afternoon. My name is Audra, and I will be your conference operator today. At this time, I would like to welcome everyone to Penumbra's Fourth Quarter and Year-end 2023 Conference Call. [Operator Instructions]. I would like to introduce Ms. for Relations Investor Hamlyn-Harris, Penumbra. Jee Ms. begin Hamlyn-Harris, conference. you may your

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

by make this including Securities to risks be trials, During our pursuant SEC call, of conference ended forward-looking scheduled the business our XX, will provisions forward-looking Private results statements filed commercialization, referenced regulatory the materially company the notice December XXXX, is XXXX. of the and could compliance Litigation for trends. harbor safe differ statements clinical course and quality XX, financial performance, certain regarding implied from to the uncertainties, the to Actual our with Act or those XX-K status, in including of statements which year February XXXX, Reform due on stated

our As to mentioned, update measures forward-looking basis. statements, are measures results we including discussion or price measures financial this you of the a undue as corresponding expense our a certain a provided review and assets CEO, operating the against EBITDA will you stock otherwise. On future provide to a Elsesser, and and excludes of business amortization listed or events, and may result of acquisition intangible Yuen, Penumbra IPR&D of Strategy, and a on the like acquisition reconciliation and to release. with with non-GAAP guidance. periodic full of for revise previously information, discuss market will call, press adjusted other duty discuss call and stock. a then executive our presented future factors filings of acquired more President the or a the I associated associated GAAP With and to of expenses IPR&D our and GAAP financial our Elsesser. encourage developments the non-GAAP expense in our any disclaims are the onetime a Non-GAAP compensation. Adam these these statements on the Maggie The new financial of Chairman XX-K XXXX; result, update; exclude Officer, onetime that, SEC, Jason caution that affect reliance we XXXX forward-looking placing with to Penumbra's turn results complete risks Chief our Mills, fourth Vice for will Financial our quarter year our over Adam would

Quarter Thank you for Full you, Penumbra's Fourth Jee. Conference afternoon. Thank Call. XXXX and joining Good Year

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

$X.XXXX year total XX.X% full currency the and year For [ were annual over ], XXXX, revenues constant in representing XX% billion XXXX. growth of our reported full as

of During XX.X% the reported our a basis. as record business growing XX.X% achieved currency thrombectomy fourth year-over-year on $XXX.X revenue and in global million, constant quarter,

X.X% as increasing and a currency global period the Our over reported same representing was ago. $XX.X in revenue and X.X% access million embolization constant year

vacuum U.S. ago, in Our year growth driven a by growth driving same the products increasing our quarter with vascular thrombectomy. business XX.X% U.S. compared thrombectomy to continued computer-assisted continued or outsized thrombectomy CAVT

we quarter the product U.S. continue to gross catheters the the aspiration Thunderbolt. in in margins mix margins XXXX, expect XX.X%, year-over-year the for productivity. and for the fourth We to technology gross in expanded favorable groundwork owing to expanding XX% than more standard delivered growth laying our stroke to increasing continuing with Ascended RED also set XX in We thrombectomy in and market

fourth another record quarter. making the total Non-GAAP we're profitability. record in operating the and future, into $XX.X are also million We EBITDA representing revenue. was XX.X% We of cash revenue, our growth delivering million posted of strong increasing $XX.X income important XX.X% sequentially. grew adjusted investments or by balance we operating of $XX.X delivered million, While profitability to of sustain quarter we

second-generation operating opportunity in to expect year in we and The while for our beyond, clot XXXX this now time us physicians patients. about technology in and recognition watershed successfully confluence ] of CAVT this thrombectomy expand treat of that VTE a of thrombectomy. XXXX the pursue is ahead the thrombectomy a unique characteristic all can arterial defining profitability We thrombectomy was and [ broadening platform technology. true majority in technology significant moment both

promise out on the to quarter areas VTE Flash innovation technology, this desire treatment to are customers mission treatment. To other our physicians, now time work, the interconnected base start words, and have vast changed to on doing opportunity past getting next of three not a of in fulfill work phase the several of patients is the Lightning third together in areas of pathways the thrombectomy help thrombectomy the of United in arterial during the following thrombectomy our Penumbra of for which community call. critical with Lightning of the the care are cloud with They market and earnings systems to are their all of work These X Starting readiness In patients our us innovation, communicated and to years States XXXX. of work we reach health I XX innovation, patients. Bolt expand to focused the who internal access. yet of months, to are for patients. with Over trajectory this our care and began these expanded for important hospital their laying majority

saw in transformational trajectory the the we the customers new thrombectomy commercial many as the in in process the of work business U.S., new products for late trajectory see As we year, growth vascular submission late these with our Coupled of U.S. through November. team this our sustainable. accelerate

any as remain As product high both Flash we've launched for as thrombectomy. ever reorder rates in Bolt and

Flash the XX new core at bar expected raises of Lightning [ the year remains just into thrombectomy. that We and ago over of Flash the look established high the a recently X.X Bolt months. VTE first in As by products Penumbra. X.X, Flash for FDA we next CAVT clearance XXXX and innovation already received our Flash delivered beyond, the ] four

which of the areas [ further tackles expand CAVT PE optimizes next of the CAVT procedures. X.X CAVT's the and will and will enhance the safety, As variety DVT simplicity breadth and of advantages the more body ] morthology products in Further, utility the to ]. speed clot with [ three of

CAVT the with share our with new systems individual important as thrombectomy by platform can the and this further Through innovation treatment strategy to information, we front, aspiration in physicians have stroke catheters. Further integrate especially years increasing in excited we patients, to that In be and reflection in on we enhance physicians time in many we hospital Thunder case, This for seamlessly valuable each are and in efficiencies and technology ], addition, patient-specific. work, bring come. computer both well, stroke dividends for into procedure. that very is could market to that Thunderbolt procedural are pay care every dedicated fact and study [ a advantages progressing our chip real utilized to of leverage the will to will collect information patient the advancing to produce

was was time the to areas Penumbra. in the for quarter We focus vascular hiring significant and of sales important team. moment XXXX overall. some throughout readiness. The during internal more as accomplished CAVT Bolt quarter team the and of fourth team in this a gave fourth as place capabilities bring scale augmented to on The hiring very was with Flash and in more and to training thrombectomy of opportunity momentum the Moving in us well quarter. taking the efficiency current the size our increase the continued Much

efficient benefit gross In progress manufacturing to commercial the in scale, would addition significant to margins our U.S., make we continue at forward. our going which team on

how Given evolve. in internal will to work timely, we important for and the early and this continue is penetration readiness thrombectomy, CAVT curve are

the XXX,XXX we are We CAVT safety, data more an PE, benefit validate for work economic procedures real-world out We and by CAVT traditional number evidence the from Market which therapies. through will primarily The system on increasing clinical over hospital third systems hospital work speed treatment a health paradigms. large least year. our CAVT advantageous and both are majority we and is these reach on physician of outcomes collecting decisions U.S. in the area of simplicity DVT, benefits these will initiatives With the areas of will and data which additional make of In to work each platform arterial can clot systems this accrue critical. X our optimizing the is to thrombectomy VTE to work believe next patients focus clinical stroke. X-plus business. analyzing partners, at systems doing economics. The These and XXXX in and on compared with are patient, the access the arterial us thrombectomy in there U.S. getting developing hospital are terms with to in to believe the validate patients informed Access with is years, of health order and hospital market our we

year-over-year business we new U.S. is In Given growth. these that XX% the built Flash will coming in have Bolt to products for first X CAVT place in XXXX, momentum, the reimbursement XX% U.S. and already deliver our and are to thrombectomy procedures. project

the traditional in across mechanical the are thrombectomy associated years. Outside compelling also will the well. growth, our America years, think begin and build bodies profitability. of system will I regulatory and over these strategy Pacific first-generation opportunity future CAVT portfolio into in to to well the is as therapies growth, with not XXXX. areas This three only into impact patients work and we we Latin XXXX more therapy work just few in CAVT receive positive revenue timing momentum the our with displacing While the and long-term the we U.S., described entire patients to more bring sustaining next business part drive the believe see on in allows international for it in reimbursement will products U.S. U.S. to to focus our to but Asia outside move Europe, increasing even CAVT us and also the We the with

has in innovation platform. and XX has become to what from clot last doing, worked Penumbra led blood team head hard the innovate very This removing the the thrombectomy CAVT the to to toe. built the largest For company so has has world, continuously in years,

next have Now phase the time strategy, start is we which the detail again of in to today. the outlined

Our our to will be technology everyone will of can benefit. a not strategy be will This hard make available work always successful and this line. execution who straight

positively in point company patient extremely now the over will Penumbra impact any and our to over The other the The untreated technology turn been full to be few products and fourth Maggie call vast our ways position our team to the And best CAVT no is motivating. history. the than profound before. I'll platform years, go population quarter is XXXX. next results However, over stronger been. ever in the for year financial we've able has can it at in

I results revenue basis. provided on a GAAP this measures release. press Thank measures income and on the you, non-GAAP GAAP are and everyone. afternoon, financial posted on quarter Good and results margin of operating to discuss Today, full call The financial of non-GAAP our for a basis reconciliation operating corresponding while GAAP expenses for growth fourth Financial will year and Adam. the XXXX. in a

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

XX.X% Our and U.S. was geographic fourth for XXXX mix the international. of quarter XX.X% sales

of year-over-year XX.X% quarter XX.X%, fourth primarily growth thrombectomy. driven U.S. the U.S. growth by XXXX, For regions our in reported

and thrombectomy our vascular Our our or increased primarily driven XX.X% business $XX.X in currency. by growth XX.X% of regions sequential constant an X.X% The million of international total revenue XX.X%. reported increase in was in global

better Moving disclosures providing to Starting this align are our revenue products. by new with quarter, revenue we that business.

and year. constant last was XX.X% XX.X% XXXX, embolization globally. our in detailed and global and in increase results our the million business, our States, thrombectomy As revenue presented the business XXXX, Revenue of $XXX.X an fourth embolization to from press access release, our of providing are business to grew the increase of quarter international thrombectomy of period United we quarter in period from access reported million and reported business compared year an in in the same our X.X% compared ago. and of fourth X.X% and constant currency a currency same the to $XX.X in Revenue respectively,

XX.X%, quarter compared was of of forward. statement, our year, to million, basis we I Before $XX.X On turning X.X%, new million, vascular an million, fourth quarter used was to neurothrombectomy X%, will we vascular increase global million, an million, $X.X the of and million, a revenues revenue the format $XX.X transition U.S. provide going an last of $XX.X revenue increase a the was thrombectomy neuro driver results an primary have we XX.X% of for we fourth income embolization embolization XXXX. forward. of are disclosure increase format $XXX.X increase our to an our previously the profitability access before our from decrease neuro XX%, was are in XX.X%. driving were thrombectomy in growth was also strong embolization revenue In of disciplined quarter commercial our $X.X other and And fourth increasing be growth with sum, was increase strategy will focused and going portfolio. on both and in being

The favorable productivity have product labor is of XXXX year driven increases. compared quarter. Turning to inflation launches XX.X% reflects the quarter basis in margin, product margin. point variation and point XXXX prior mix support in Gross regional the to and and quarter expansion material volume and continued by thrombectomy XX.X% investment compared which improvement cost mix, thrombectomy of distributor gross offset for and for while price In basis we product savings new to last fourth and and improvements XXX to XXX leverage improvement higher XX.X% of mixes. to XXX target XXXX, gross margin fourth

revenue of revenue and income quarter the Now quarter expense and or last on XX.X% million XX.X% non-GAAP to operating or expenses, our EBITDA. last for compared million quarter. and the to XX.X% $XXX.X same non-GAAP revenue $XXX.X of Total for million operating or operating $XXX.X year, margins of was for adjusted

$XXX.X increase same by of XX.X% quarter. development or fourth operating commercial to or X.X% or head Increases revenue $XX period expenses income $XXX.X $XX.X XX.X% operating of and expenses of an driven million XXXX or research and QX $XXX.X revenue the of $X.X XX.X% were our in of and to million XX.X% for revenue revenue $XX of of U.S. revenue compared an for and were million or last recorded last income quarter. Our We of last in XX.X% for income operating count the QX XXXX XXXX QX or the XXXX of $XX.X quarter XXXX, compared in last million SG&A team. compared for fourth million of for million million for QX million for to million $XX.X year were revenue quarter quarter.

access focus on innovation our treated. to continue number our arterial team and commercial in increased DVT, and which to stroke, products, opportunity of evolution front of of of sales an We in PE, U.S. market of supports address the increased programs patients us all

compared will in target to we the present. fourth these our to to quarter last us in total into revenue XXX organization to future, year full or will spend to our operating in summarize million allow spend long-term While expansion other of the of point in projects full of self-discipline of basis for XX.X% also exercise performance XXX that now XXXX. year continue adjusted posted on our year. I continue we XXXX, We EBITDA we $XX.X our XX.X% margin. scale record In the improvement the

Our total XXXX. the which in reported to $X.XXX [ currency an revenue full was ] compared of increase represents year and year for XX.X% billion, constant XX%

and the year in International. Our geographic in sales were U.S. XX.X% XX.X% mix in of

was in was full million, increase XX.X% constant XXXX the of embolization in million reported our constant reported Vascular increase $XXX.X year full of Revenue XXXX, from XX.X% business growth million, business constant reported and our in of increased in of XX.X% U.S. our reported of an XX.X% an XXXX global XXXX, XX.X% XX%, XX.X% an and international access was million, reported currency. full from thrombectomy currency. by the vascular and business of business Revenue of for currency. our $XXX.X for full from XX.X% currency. and XX.X% business, growth currency. global constant was year the XXXX, Neuro XX% year increase XX.X% of increase Revenue driven for year For our reported of an from regions thrombectomy constant and and year our of $XXX.X from Revenue primarily for the $XXX.X and XX.X% in full the

the Our We of of revenue for income the year the to XXXX. full for for million operating full had compared year XX.X% was gross margin year million ordering compared revenue of to XX.X% income non-GAAP non-GAAP XXXX. of $XX.X $XXX.X a for

revenue to year. Our compared adjusted million EBITDA total of or last is XX.X% $XXX.X X.X%

ended million We balance debt, fourth million quarter. which flow last $XX.X of cash and equivalents $XXX.X is marketable quarter of to with Turning no from balance and an cash, securities and sheet. the increase cash

to We our to I'd trend like expect guidance. turn Jason And continue to flow to positive now the over operating call in XXXX. cash discuss

afternoon, and Thank you, Maggie, everyone. good

For growth XX% in billion forecasted ] $X.XXX of revenue thrombectomy of ] our guide or XXXX, end distributors high currently year-over-year to to guidance we above billion the be growth to year introduced the on the the in to in XX% the and Primarily range, in year-over-year. revenue XX% we based then revenue the billion half of from in [ of compared international year. We we total product mid-teens revenue to XX% half guidance timing U.S. to expect second [ to in growth in orders global range [ total representing range our first accelerate $X.XXX ] XX% of to the to range $X.XXX the XXXX. expect new for of of growth XX% launches,

the range be quarters growth year. of in expect this U.S. to consistently the thrombectomy We four strong in throughout

XXXX. our consistent U.S. our reimbursement our a on our Outside initiatives be we to markets progress. our for outside worked the in embolization the double-digit global legacy with to years our in to XX% range throughout the States. expect patients In XXXX. of the to the business U.S. to two contribute in strong, products, access business our access past represent international total, expect regulatory, will XX% made in United the have focus to States, growth our of foundation business XX% therefore, have We in year. From significant United to we CAVT to market low thrombectomy XXXX, distribution expand perspective, and more and bring expect and revenue growth products geographical XX% U.S. deliver we And

our XXXX expect to XXXX revenue thrombectomy As we our do initiatives expect expect international and new come growth these international XXXX. Also, front, our certain not double-digit we our driving plan international accelerate access prices accelerate to value disciplined with our levels, international work we products products. strategy in In At we products same these this international over embolization focusing to we through, in to the agencies this areas. do near year, for international in in think we And XXXX. work the reflect in modestly grow revenue and as are growth. be in our total thrombectomy similar international in our We to sum, with the currently our markets, time, we XXXX with continuing on to are where be will term on more and our continue profitable commercial XXXX of regulatory to growth levels. reimbursement the revenue

minutes. believe CAVT for year, call thought, we products as as the the will now we or next As years. ensuing for XX can a open questions the Operator, final current the over the growth company beyond for our mentioned, sustain strong XX Adam look we

Wuensch to Joanne go Citi. We'll Instructions] at [Operator first

may thrombectomy. how more and to view ongoing do then ask of on impacting may that or metrics. you. finding ask hearing mechanical increased to you're And longer-term several of more scrutiny sort number LRP payer stocks I'm where two. -- comes we wanted medtech I'm profitability be about gross that curious, an One, two, curious I'm not I margins. and on up operating how on and I'm going sort about think

mechanical We, scrutiny. that aren't of cases. shows not we -- the what procedures clots type removing see calling blood in up in it, thrombectomy of the That we clot fact, other a types you're as is seen not -- have in particularly

So really seen that. we haven't

increases this opposite some the arterial, saw In year. we were related use. there to particularly outpatient interesting fact, hospital In increases,

we're seeing think opposite. the I So

As want where it how continue business. beginning for profitability, sort relates think our and to on outlined areas embolization the focusing we how of the our price thoughts access same some plans we're not we of to on about certain by value around sort this seeing to accelerate we've that of call,

to So need if disciplined that out have, We of last it. disciplined the we're of coming the of the U.S. rest years. and revenue CAVT about we don't when be dollar to the of you the being going luxury in sort growth about world will, we have in because every

an So And last the beginning more focus the I think strong. away growth. you'll without you're taking of seeing see pretty in on you'll I think more that's focus I that continue the that and couple And think see -- of on important that quarters.

next And [indiscernible] we'll Huang. go

thank on the bit from ] color little My the This think how running talk cadence guidance, of given the many quite have sales XX% pointing different is I breakdown. question Can a dynamics about a different through the a And to segments? so [ just mid is year, Biegelsen the through XX% the to there's And follow-up. the calling about you deceleration. XXXX Fargo. Lei in for for Wells Larry at growth, XX%. around the you bit That's

Lei. Yes. absolutely,

since CAVT growth me now comment our in where it to us right our achievable. of last also want your for only CAVT lot by when September that's actually focuses guidance markets which thrombectomy guidance we future. U.S. our added international is our important is project number platform, we XX% and more business we by by first projecting confidence growth. which the now in I our U.S. that XX% our to on the XXXX it Let probably prepare that in we more allows also we transparency, And start platform right our providing And the thing made to, to think at though, stand -- our that you emphasize, XX% reflects -- overall by conference alluded I a

business. digest we've throughout have years. And the I talked the following in you thinking given we slightly a and world of to way, how do the excitement around where That's how XX business. the that that's different our which we're accelerated lot the years is, growth, in opportunity with we're we we that's the how acknowledge about growth also this it's similar managing finally business set what lot numbers there's out we that's So different to because the to but see growth a have about platform, And the is what do can a visibility. ago,

We have the large can this seeing to strategy customers, everyone systems, head their from We're we that from we're around cases. making in to the body that toe. sure hearing caught hospital bring we're has that who from hearing

opportunity company. we're of the to that our focus because discipline always that and takes on been So the focus some it hasn't trying energies sole

our the U.S. seeing our matter, now. parts the how business, thinking what of about we're other our business follow to is our that that about up. ] and coil in and Jason, thinking business with you're [ growth But And thrombectomy but So XX% we're access international can is focus right XX% again, focus.

with to cadence. Lei, to Yes. follow on the up that just respect

things consistent that business repeat So U.S. at to to over delivering a thrombectomy want XX% as the We the of in in well couple growth U.S. commented as I XX% pretty about again. go to year. range that through and just XX% XX% entire

as visibility we is product on visibility, well, which distributor we believe. really again, So the good primarily have, launches cadence good well to timing order of very as based to have which as quarterly timing we

commented so thrombectomy XXXX. in as to we And number that number international that really business we've look U.S. is the mentioned, also and Adam at primarily, accelerate should think the our

of high that a have as well. degree in We confidence

what you a Just just said, on clarification Jason.

pretty the that's half consistent versus really that ] where XX% old half distributor second growth about at you're U.S. growth [ higher. timing it's the overall mid-teens [indiscernible]? talking first in or Is U.S. the is So so driving

That's we throughout timing. how It's into very land they correct. the year. have just And the visibility good

of in thrombectomy your you vascular both assumptions Ontario? market for just terms for ] my U.S. And for about [ follow-up, growth in talk what's Venus the assumed can and guidance your

not in confidence of to the is continuing, very month consistency the XXXX, had two, what what specific give but saw last uptick new have or you into And reason right and business. or of alluded -- it so why in last trajectory a been confidence went them different in we level, didn't we've at of days November, We that that throughout is platform at but most that December, consistent. think and gives I've it continued. this we hear and that's the I projections, late stayed the of us we November year. And lot now momentum the that which saw also is has this the Yes. won't basis and in only those -- come breakdowns a a fundamental for we end our up in throughout those wasn't assumption for a customers, the the which event. of in between is is been lot It and which of notable saying It now onetime that through a the the

an just into before. we've nothing ever gives It headed have having hospital physicians, which the it, the lot dialogues with us confidence in to been able is right direction. awful we're that add You and systems we're of

VTE U.S. and just [ growth. thrombectomy and to the arrears, XX%, I with market it's share those that, healthy. think, to is we market range. to and that And the in expect, grow the growth, to are our that lower XX% growth add addition add well stroke. range, in in bit, but Again, Lei growth which And those, that course, ], coronary to Part implied that is the really again franchise arterial we're than to for arterial, above growth VTE growth best is while rates year. expected of strong of of our cataracts about portfolios, a that still excited includes in thrombectomy are throughout stroke U.S. little referencing to observed healthy

We'll Genuity. go at Plovanic to Bill next Canaccord

here. clarity some Just

last flash So you thrombectomy, the U.S. launched at you as starting we launched thereafter. early soon year, look Bolt

sales it's U.S., keep that growth year, kind least help in you're the of about as and a and work follow-up. I the you actually then half It that. And back really first sounds continue going like all the going. thinking access into to Am of in go pretty on the correctly? going growth force the we it's that keep growth half terms done at the as comps that of then easy I you've So changes have the the in market the

strong can that we early Flash, Bill, had existing start early Jason. with bit new really quite well. first success in. as launch our customers, on Yes. last with Adam chime I'll actually especially We a it's maybe customers with a and quarter in of year and

Of course, that continued.

don't any out there have the particular why point those consistency pretty which I grow. good to that's And quarter we if in outweighing with know So comps are another. one confidence that

Lightning X.X the really quarter The you sort I too launching point other launches to the would out And second won't in the quarter. of thing just well. this impact not much conservative things full other that be factoring get until is on later into through Flash likely year, product launch as were

contributing now business? thrombectomy earlier made, Okay. just to think in I Thunderbolt, on I that And in then U.S. is some the XXXX into you terms pushing of think, year, comments the

kind it's question. still any ongoing. of going to Obviously, give careful to Bill, a a on that's Yes, great be specificity I'm trial

We well, I going we revenue. put the are think is or I'm 'XX so during the in time around we when going to resist. The 'XX trial of said that timing well, were expectations last Thunderbolt lesson enrolling I going resetting for any not well. our number Thunderbolt that learned we're time cases have the my

deal then, 'XX the anyway, I said at And year so on not boat comes that until counting not, was ] over that revenue ago a we're with not that still or time. we'll we the that month. or last that's [ true But it whether or said whenever what and from

So that's stayed consistent.

Red obviously, really So And continue with to was which growth CAVT, share. we're growth, of need said, [ more Ascended, can in setting that setting Thunderbolt think talking that more the the the for in Bolt gained you of you now. choice and and -- and forward. ] the as on share, use lot Thunderbolt take which because, on XX the table A about success then going continued that extraordinary fourth first, it's in our just Flash products is, the just success catheter this we that new afterwards. standard, I of We've quarter, is significant is is catheter store again, is the and is I

of So punch those X again, sort remain the very two X, products. we with about optimistic there

that on some selling if And are of U.S.? discontinue of going a products of international, clarification year? in point Is could, the the and countries you in kind some delays downdraft in I some this the first what half of to

with of What of a and we that was profitable said -- where in the sort commensurate isn't business. just our business, product, certain not we're countries value are it's not access pricing embolization reimbursement there and the

pay what for. this using opportunity, we're they want that, are to they we So need to where can products do more with if the don't and that are with will, success that commensurate use you we having

is areas And so that and answer yes, are is certain the countries that, true. there

we to markets. focus profitability in are So those on going

We'll of question from take JPMorgan. Robbie next our Marcus

since XX% at don't sound belittle did and you've numbers conference the January, ask, quarter, pretty time Street the rate, but great missed want to our I to at you all you because is a I would and growth say comment first robust. this want didn't it's the growth on IPO I in but

during So and sell-side quarter you ended the what guidance the your midpoint up missing the range happened that numbers? of

our it revenue you is What the but just QX within but was number, just number. obviously, shy true, still guidance, of said consensus Yes. our it's

That still like? All us be were we that this. of with saw accounts were this were And on success there's excitement to see what's from acknowledge gives guide. focused beyond our Robbie, my trajectory moment. what to consensus our the that and sort thrombectomy to They of here the in very moment for so within today late sort doubt since And -- extraordinary I -- and But conference XXXX confidence the business and your of what that about yes, assure not day, to November, is the I at amount we in us and in the waiting succeeding and that? into coming. these notable that's dollars XX% not I an saw led then happen team then we every to single entire XXXX our short of What's now However, without platform. again new million continued like said visibility, day U.S. U.S. to a the it a ] totally excitement XX% year. you, confidence which a will couple about guide fact our CAVT and my the gives is since a the of led to growth this uptick [ with

we And up should the year do you more and of at about the stocking How in stocking. look much just when throughout the The from higher versus we on [ the at before think guidance Because to the cadence. that back due quarters? see of about higher question part dollar different comps ], pretty year. amount were from much end difficult in the follow range be to outside, maybe a first beginning, the we OUS the within values. lower U.S., the said the

how about volume? think sense underlying what we of so amount do stocking the get could we of a So is

Yes, it's a question. great

orders. will. We really What Let international on, our tend right, really distributor these of different. of of are about if most so in we're sure slightly word don't of in that Europe make order stocking direct sometimes used. is me as terminology distributors we're considered sort sort all but they markets, because and -- do parts just to it's talking not and is you

then don't And don't sell thrombectomy is time Some majority those even order they the not get coming. They're those seen We should numbers, forecasted of of say, folks, orders orders on ordering have [indiscernible] the then then We those ] into those go most of put folks all from They patterns. [ less every vast in get They All quarter-by-quarter, projected, those order linear. those now. give week. it number. orders and our side, We've than forecasted I the and but this it. we them CAVT we sometimes And them. that. different advance. know from that

in and because they don't inventory, when is obviously, much with common product order generation to coming that's just not better going want they as sense. know excess obvious careful to be be So they're a left

thoughtful we're it. So we're account, taking into about being that

profitability The opportunity to that, other run. a retain business, embolization in part in anything really an that to already the it coil that with the of relates to our addressed way now growth this and business of losing focus us that access allows the long I've business us sort without and and is long,

only continue a we me the to U.S., which, get latest So dipping some negative, replicated lot are and the of transparency, have curve having when that best because technology sort brings the growth [ that that to we are going That's we're products there. not number think will putting good those of really a our years, is in back for international of away we just those to think again, the are markets and in measure be of that thing. into ] we're

kind markets business. too. We're ready have the getting those we we're So growth, where can of that in international go to

of those And size country in I Adam, could the sales? discontinued if just sneak

public call. Those it the to. but add size and the out When question. gets to by we country calling I we the out get alluding without each great feels same countries, numbers to think that number -- you all them can don't and are were think up, on right the a I country great you partners by appreciate and is it country, calling I

We'll Deutsche move Chickering at Pito Bank. to next

quick One clarification.

just Just because for sort then there focused of are ] slower today, commentary is growth we anything at difference comments Or at of between guidance looking international the you're the is [ profitability? where else? XQ only and previously and growth XXXX least your on XX% on today is

Yes.

you've on the think embolization, cetera, it. XX% further, of really XX% focusing and implies U.S. XXXX. well step we've certain to discipline you're at the question we've we've to in access, the got XX% taking both with as well of here to now neuro a respect XX% portfolio international bit working something for as growth seen and I growth. markets timing That little thrombectomy a little is yes, in talked as a on et been that with entire And while about

So this, pretty think you've have noted. that the that is I we visibility difference good but into

Or sales guys that the to you seasoned then right because about many And a you new have last demand? meet force can hired? the And And ramping you in then talk sales versus order throughout the XX Where Sales cadence [ minute. force guidance? have your of the these the What last sales seeing you for hiring are How months? sales force do new more? churn need ads the ]? of the looking pretty is up 'XX it for force is you reps to question, today hire do Or good? of any was

down. I long try to them questions. There's all of write list a

one if ones, -- please missed the reask let specific me So of it. I

is. in As the of majority done, the not but is most prepared said all the it I remarks, of hiring

focused of in territories, expansion This we've most years had. we're a related folks having was ability more very to it from tell part as as them team, benefit think, moving sort maturely doing bringing Now seamless understood other actually on the accounts. large to will than getting operated. new as patients professional, in this. all trained around long the you in and I I less focus the And our will because they of run that will that's by on and our any

of way. We with have our it part And it's been two don't and we sort has But that happened, really, had our needed numbers. a large why sales advantage. we integration. people. or a We ahead, all it these But work really the been larger two earlier do, force have which gone stays a out also turned to we territories, and lot growth big ahead of would very competitors, of is launches It than much probably that of our that well, sort just have the and differently. remarkable should more out a day it's done have give

vascular remarkable. hear think peripheral ability attracted. we on just and to The that from companies up most the sort part they the other of [ the so reason have I that of of professionalism, ever ] sales pretty and that quickly seasoned the other we've reps move success and And is part what that thing most and attracted products CAVT been for of the the talented, pick has know in is

think some it so gone on. them it's been one well, classes of in get takes obviously run, them the train started and easiest it's things. that. the and had I training and But effort all long So to We've

this is team bear year, it really to projected that evolve continues I to will the fruit, well. go, current that working to in through need access But the we we're that market that As as now this on our projects shape. growth, for there. might relates and we're Obviously, us good get as think

We'll take Matthew our next at Sandler. question Piper O'Brien from

go I Samantha to and is I -- Matt. on a on for on bit. guess This guidance back touch first, touch like would

the in compared range? guess to I does what XX%, lower consider So top the the that the end guidance or bake end of is of revenue scenario

detail business, Obviously, things expectations and every market U.S. have every of of one lower, But a join for have a embolization to a Yes, Adam also access low each where it would end a event, what growth, I is for And visibility. I'll above that is start, you on can the call think thrombectomy or pretty drives in contemplate through the go year XX% respectively. range our time then we and U.S. higher a it has internationally, to it's XX%, those range and of we there's where let and out. good like But have hard play finite our end numbers. what we probably which the that course, U.S. low end in. for on

execution don't just the anything or demonstrable So at to low out the between day. end, it's end there's point think the of upper I

the one then I margins we thing, the in were And of than quarter higher for term? where kind do was expecting. the I EBIT spots moving one long guess of see us was guess bright the this you

demonstrate yes, with same to it kind at year. this mean continue the I time. and that think, profitability we scale pleased of I our invest very can we're

product Our mix. continuing seeing we favorable are gross margin,

invest, sure we line. on continue target. And up track to So pretty good infrastructure setting we a margin the percent bottom I to And are our longer-term for pull but that to are will very we think scale. we'll through I'm to XX-plus

Jefferies. our at Michael question Sarcone take from We'll next

would for do of the an one, to VAC give and status working just I an update love update you can you processes think first the get the just So you're through that Bolt? us on Flash there. with

a It's Yes. great question.

lot So and starting products. continuing more and board using November late we in customers that obviously, assumes the the of a that uptick saw on have those started come

the we're is, a is and up which but of into had using were on just of the November bolus continue, we big came on in we now as product and the some really seeing we're in to ] obviously, moving running like late lot And third we're of continuing now remainder in focus a But quarter, still coming. country not the we a those. [ We said the go. getting have in So getting i.e., the physicians and getting on for. focuses to regular those We're hoped and we yes, have basis. account every the through we what that. benefit more And December,

all and and really And on. reps how the some is ] tax in done cases a going of it's part pictures excitement cloud So just early and from and good and [ so enjoying cases, derisked. phase, we the now that we're of administrative early get texts they're

that moving is of phase, more there. the administrative fun the So a than which heavy into lot load burden we're

one more to different think bells I me. that any that on the and of CAVT, help you but the anything color for added give crystallize you've last advantages X.X? optimizes could Flash us Could then it the more? And us whistles you just said

clot way. out blood think following the I frame you more would loss Yes, even it We before. get than less with faster

at Newitter Truist next, And Richard we'll to Securities. move

and the what kind guess on the the with of the you're Thank question guide, Jason. philosophy like accountable necessarily it that. for in relative but you your Adam, The guidance or close, XXXX to this is last revenue and the guide there, year philosophically upside wasn't the You the just know, guidance very quarter? came going I consensus. particularly metrics on there, what the to off approach breakdown. year, fourth U.S., earlier, respect to to Robbie's Maybe I'd

And built hardest. execution? cushion think of greater So Is can we numbers What I'm you're aspirational? where particularly the in going about is this in? and give floor your in that's about to how how approach for how this [ better because Is think talking terms set And management thrombectomy U.S. you this you expectations I be us you should up year? a ]? to much the

but running pun, is fact you I I time I had our would around that year intended not a lot. on that's product and us. history. of We Last and great appreciate learned had So aspirational, this, don't year pun, a a that your The for our we is the learned we're effort, the if that you comment we sell. that the company's products in our think guide out a of did. was we have year growth excitement lot, fact scale the

as to move of I'm having the pretty important to grow close figure from proper in and to the scale continue proud year. it run, hard on. to we the But really guidance was of can of on. the get give it last that hit and And we and that, so information not growth long as really How the better kind given so in transformational do Obviously, that came the And is of aspect number year-over-year. out. foundation

and we've it. level we're understand going about thoughtful So of products further the think it. be careful these interest. and we better, the into lot, to We rhythm more a learned I understand them, of We're

information. lot So more we a have

to So really again, And is think the and use aspirationally of our you'll XXXX. kind in to guide philosophy we've to the see return, in done not information clarity that with past. guide that but your I

next Rescott Baird. David at to We'll go

I'll ask both upfront. them questions. Two

X.X. First, I heard you call out Flash

you little bit think talked maybe a more the specifically, areas about I in expanding to body.

question, think international. investment. then It specifically just Bolt sounds second And mean? about kind So just big on then some of like wondering my X.X? And is a maybe XXXX obviously of should what the we comments those

in seeing heard think accelerate XXXX range. I you out to double-digit that call I a

Just maybe supportive wondering that or if XXXX of line outlook growth just into would international company? be the is the maybe of accretive for top total more something that growth

I'm can these around tell opportunity going what question been had I've wait. hear products and do. about The to able much I to every it. and we going can't to can The to be is about clots both, I we I touch of body playing and than they that, excited who of do that start sort We specific really the the I'm those. have products What 'XX new to one them. are products, opportunity parts on expand get different different about as the designing Jason just them, to types are the the on. the These in goal to of where kind following. them, of and as is see And body go you me the talk sometimes sometimes so them not That's go. think clot can to be again folks of then to Let more after goal. with want of simple. and

about of algorithms. I to understood go think this has after, how we changed this, we can can CAVT we're platform have now continue totally we the we what improve how thinking think

is we'll it those body keep When out think for bring products great get can here with up are that's to set those we'll keep part adding, done, nice we run because I we're be works. after to clot And confidence not going goal X.X even that's here. go in And innovating, any X.X, we're to be done. and a to. a the how able technology of to closer of so that what the We're us pretty keep going adding lot

XXXX. international thanks Yes. could my guidance products really next you're well, penetration we I thought was sustaining the comment the And for second prepared market made We the in have is because revenue strong into say thrombectomy the still CAVT and levels. penetration year And in In and double international about about did helped really, business, we talked is, rate doing patients, that reality mentioned even then will XXXX, have, in David, accelerate and remarks growth our right. I hitting digits prepared U.S. the and really of that question. we those the number your low that we our remarks, this

ways to We go. will have long a

ensuing has that growth on So intended mentioned number that to as the about years, I that is, this in extend about of right the that of comment years. making international fact the can several comment made the the next Adam past, a times was over heels talk

And looks while going I'm what XXXX optimistic yet, not to and beyond. think XXXX so pretty about quantify we we're like

go We'll Matson Company. to next Mike Needham & at

enough sounds I a guess, first, you it cost that or with it whatnot, and outside -- the to not but just reimbursement products? the get and some Is just generally, U.S. want the is varies the I I market, to need products probably like the feel in it's reimbursement get efforts by CAVT country on of just it know it there's place. understand, there's to there to cover like, the

and different in We're reimbursement have a Europe same that's question. in Yes. that many geographies, Latin country-by-country, schemes large America different talking about Mike, good countries Asia Pacific.

because There yet expensive more to yet in go basic it. stuff we is reimbursed through is for all. one each there's cases syringe And is. is procedure different. the for is which which at be system, know no reimbursement. have of then And that seen And catheter other that and never it in They effort. type reimbursement not really don't they've what reimbursement very are most cases, obviously an then to not sophisticated sort going So there

doing in years is ago. ironically, for work to So areas And certain years many what we're give on larger some then and was countries, effort. did focusing context it's continue not first a still of almost of better each. some now. the XX different do we'll that to we've of little obviously, at and not And just stroke Not many, to in all. reimbursed been part that the we Stroke

because So think I right we this we to have It it benefit the need because takes sure particularly rush in we do of just and we know time, U.S. don't growth, want do it. to how and the now to make

some distributor and there certain it. to ordering commentary the in forecast around as Okay. then far the know VBP because has categories pricing. things was you're the exiting [ been exiting product in expecting there in the patterns And you're certain XXXX, I Got just or Is as markets due lower ] over China markets a ] patterns ordering distributor factor either of or area. those neurovascular I [ either wondering

Yes, to and China. want Mike, buckets different I'm really maybe that question. you it. asked you I everyone glad just we a three have that's important from of remind else revenue

distribution. have and fees, license We royalties

longer-term we've about So that couple as the years current lot the that basis, climate in over think, I last of on know some that the of structure, sometimes has created same past structure provided talked quarter-by-quarter funny you has of us, a in a China. movement that protection from

feel pretty about we it. good So

products, have the an lot Chinese platform, we're partner got about think do, And our work we it. Genesis. for we're incredible that, a really and have in but set excited we CAVT particularly up to in ultimately I We've that of a place the can believe pretty forward, Going really important market.

final We'll take Kaczor question today our from Blair. Margaret William at

This you is Margaret. [ squeezing in I McCoy ] appreciate for on me here.

Just as put obviously kind bridge I we SENDit. I to within stroke or expect XXXX, gap how But you Thunder in of neuro line on any rollout to mentioned your questions to growth might tailwind? in second? a point, then the of look longer in the about trial, two Bolt, SENDit throw Flash U.S. into and to in terms time to large of the should able we of be one. the part adoption trial? you that do which have thunder towards terms think to update Just on And guess, that compared XX% know the

Yes.

the So going I'll question last -- around Enrollment I start continued. me It's one. answered with of that the Thunderbolt let trial. sort well.

any counting until revenue XXXX. that of aren't We

off, ways well. the a is got going we've So but trial

XX%, what And of don't we XX%. really not is did have That market. XXX% greater yet is the So strong. we than business

base physicians. going people used the [ to those more now to after we're have clot as We're mouth to seeing of ]. get continue it. of more so Word conversion go strong to And more and physicians platform the is really and and it more

But the business I yes, good then be continue continue is got the Thunderbolt even stands Thunderbolt. more So year and going for to to growth some a so gap going again, our will and think first, XXXX when have ] see there an stroke we're get to of that Thunderbolt there. meantime, to anticipation use can you've as because, in you comes. it [ Obviously,

us. setup kind really of for So perfect the is

I'll session. back the Ms. question-and-answer the conclude Hamlyn-Harris. over turn does that conference And to

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

today's this conference you for And call. your Thank concludes participation.

You disconnect. may now