Silk Road Medical (SILK) 30 Apr 242024 Q1 Earnings call transcript

Good day, and thank you for standing by. Welcome to Silk Road Medical's 2024 First Quarter Earnings Conference Call. [Operator Instructions] Please be advised that today's conference is being recorded.

I would now like to hand the conference over to Marissa Bych with Gilmartin Group. Please go ahead.

Great. today's joining for you call. Thank Road Earlier the financial for released months today, ended Silk X March results Medical XX, XXXX. A available on press release website. the copy the of company's is

will like predictions forward-looking include statements within are the federal you Before made call the Securities of contained statements to performance statements. of laws, begin, during this of provisions I'd that we Act management securities Reform make meaning pursuant harbor to statements or Litigation that expectations the remind which events, the relate future Private or this results are in XXXX. safe call that Any of forward-looking to

All performance, based assumptions. organization business regulatory physician forward-looking product our financial expense to management, opportunity relating training and expectations development and and are our adoption, and current without and penetration, expansion, statements, our our international limitation, market commercial for and those in approvals, future operating various trends and competition estimates and hiring upon reimbursement, including, growth

statements to materially and These on events by those undue or anticipated you not results from these place uncertainties cause implied actual statements. should involve reliance that statements. differ or Accordingly, could these risks forward-looking material

of business, and report Risk the and associated with XX-K uncertainties filed our Form on list a section of For and Securities please Commission. Exchange description the to latest refer risks Factors our with the

to which adjusted release, our refers loss, is to reconciliation non-GAAP EBITDA press in measure financial adjusted a comparable our available Medical which EBITDA, Road Silk Additionally, on the net included most GAAP website. A of is is directly measure.

Road of except XX, the whether because information intention and time-sensitive April accurate statements, information, by events Medical financial new forward-looking live Silk to or as law, or required disclaims future today, broadcast obligation, update revise any projections call as of only otherwise. or XXXX. or conference contains any This is

the Officer. Executive will call Charles to I that, turn With over McKhann, Chief

a share excited $XX.X reflecting more XXXX Silk joining million all by strong Road us XX% at today. marked supported Marissa, Medical. of to you, for growth, and thank revenue you -- by start procedures. year-over-year Thank I'm to quarter X,XXX than first

TCAR Our physicians tapered as adoption among growth our encouraging by stent driven uptake early well launch. from was as deepening trained

healthy to the for experience grows, demand our trends expanded Medicare TCAR our see efforts and responds encouraging as commercial continue of tenure the to and adoption innovation and bear fruit coverage. We marketplace team

We of the and look into front beyond about great ability in market XXXX through with optimism us. our to continue opportunity forward growing

as adoption carotid yielding X since last the strengthen been position leader only and to it's months the treatment our in deepen While our are update, efforts progress.

Our the as educate our sales TCAR development relationships team in at affairs physicians more as well with and networks. and our staff than continuing specialists referring remain representatives and therapy reimbursement and X,XXX hard specialists train combination work, strengthening medical to

with having important in important to approach customers toward a their driving and We to conversations individual factors first disease are treatment. understand practices carotid our the most TCAR

their dedication which customers of positive provider commercial outcomes. outstanding and contribute speak and of experiences to all the to quality the of Our consistently team patient support, our

rising patients and a another a short a clinical observing across TCAR, physicians curve, of spoken Today, phenomenon. the referring tide they're strengthening themselves. applicable learning benefits physicians of the seeing same reflecting patient broadly and best-in-class also economic outcomes, push of the also about are We TCAR, behind extensively pools side we're advantages. awareness pull We've adopting clear dynamic,

see effect are are in or new the and to physicians more transition and and such in is increasing their an to solutions, supporting out providers most patient-friendly patients push Increasingly recommend The adoption pleased field. therapy sensitive physician understandably community who in pull state. likely disease a deliberate seek we offer referring to continued any the

to data, an surgeon like full Jim standard insightful Health. remains I vascular Dr. of the in dynamics. accepted history of The pick of TCAR overview annals Jim, vein, carotid carotid Line revascularization. driver and his care of in highlight always in all options is " a treatment title in my of critical my at vascular carotid overall offers of outcomes. conclusion published that a should "I and Jeffrey do by treatment the be of care endovascular review of among push and of those be surgery the in editorial a surgery with Dr. do am [indiscernible] I revascularization." in vascular doing and evidence recent available Clinical and the I'd And what the an simply "Should as monitor share TCAR as accomplish practice, accepted all vascular best the that ending editorial believe standard available

to intervention marketplace their around disease. that and Medicare standard treatment how mentioned benefit referring is the effective Earlier, expanded to of choice artery approach. high-impact for response determination, review coverage catalyzing are seeing carotid when of we patients physicians renewed of powerful TCAR treatment of awareness the an The the great data to the and experienced carotid a coverage. I'm language in TCAR And share by healthy carotid respected deliberate expanded of to a The and in factor safe, is a pleased on and from article national which to I year's can also awareness patient-friendly first use care last represents conversations for example this a topic, comprehensive lead journal surgeon and itself.

the emphasis in patients this access, intent bottom make was on to best interest. decision their decision to the stroke The of treated of more namely be empowering treatment include prevention. And the with decision for patient access line a to an

treatment increasingly physicians. The describe benefits were awareness the since impact enacted awareness the expands marketing and it, team decision very focusing double-blind by TCAR carotid and our determination research patient a on expands among education with Towards as for efforts TCAR the last the of to end, referral year. findings TCAR we market national recent vascular of in with benefit XX volumes third-party highlight our asked to that a was In for high-volume coverage decision. survey the collected Medicare's of October are referred data on their provider, surgeons

busy On a average, the increase of as MCD. result carotid vascular these their in expanded net have surgeons a seen referral very volumes

Beyond through creation. with tide incredible an this category was new continued clinical our efforts, will rising supporting TCAR, treated driven a company. marketing single year, for awareness entirely XXX,XXX an evidence that efforts patients by we we of This endovascular therapy are exceed cumulative the accomplishment

standard XXX,XXX communicate carotid treatment disease. patient place in care its fact this opportunity arrived, and artery unique milestone in new. has of the TCAR TCAR deserves is a the Importantly, longer that fact, it no creates to as

recent outcomes endarterectomy to best-in-class Importantly, demonstrated TCAR both stenting. X in publications, carotid compared and transfemoral

Surgery characteristics, stroke we by HICL risk The criteria. baseline a XXX,XXX CMS it's first of demographics and TCAR highlighted, clinical ] lower of After patients. in patients Journal the one previously perioperative patients the odds high-risk looked adjusting the for in at versus for quality in were publication [ and vascular in similar initiative by XXXX that stratified standard CEA surgical risk and Vascular

and TCAR underutilized for infarction that techniques favorable TCAR. death captured roughly and perioperative and having other database [ from revascularization takeaway best-in-class to stroke, to Secondly, CAS. relative of a inpatient a by myocardial of recent review CEA a ADL outcomes The outcomes CAS despite procedures outcomes concluded demonstrated the national is in for across CEA clear TCAR, with analysis authors XXX,XXX Ramzi [ compared

than October there's the lower yielded carotid in rates review hospitals Vascular were then revascularization Memorial stroke that the in And XXXX, of procedures which Hermann Surgery X thirdly, of Health roughly perioperative CEA. of a Journal across X,XXX in System,

And gold that clinical so collectively, these are perioperative will X a the TCAR and of to stroke of just CA. historical standard And they anticipate grow. the publications referring TCAR robust be beginning body by in from to rate continue the we below evidence community. Furthermore, demonstrate appreciated is treating that favor both

half up procedure. down in We XXXX. the XX-day back the at post X-year we sharing for enrollment well of In ROADSTERX, investigator study, road. advancing investigating progressing by XX patients ipsilateral CEA. days will the with study XXX major completion within data as track followed as days The patients outcome forward events primary following risk events on XXX being TCAR completion, to XX treatment outcomes remain well. post-approval look is are enroll the ROADSTERX We enrollment stroke of within the outcomes standard our post adverse for to data, and adverse

are we Now the maintaining while individual to to ENROUTE we track offer discuss I'd treatment expanding premium moat like well the in patient More launched utilization a balloon which of competitive in a our balloon, expectations ENFLATE tapered recently, strategy fit launched additional through options how version year, carotid to disease transcarotid our TCAR we marketplace. stent Last the to shift to gears product continues innovation. dedicated our anatomy. pricing to

[indiscernible] the uptake and only more of customers. March, the and release stents in we in market well available configurations. cylindrical remarks. that uptake interest high initial and both full from and indications in details encouraged on We are standard surgical both is is initiated the carotid of stent offer risk as on his tapered will plan tapered the by ahead stent early the as our Lucas market

neuro fourth system And ENROUTE while simplified experience NPS This smoother finally, protection protection endovascular all ENROUTE prep to protection the transcarotid transcarotid greater generation procedure. plus. flow release device teams, deliver upon the and arterial announced exquisite next-generation neuroprotection during insertion, builds nerve reversal flow sheet in early prior or system the of maintaining April, our we a TCAR for

the customers in adoption cases faster to a further excellent with TCAR of the direct and delivering X in outcome These of initial noted and plus, the achieving features have curve. improved the enhance next-generation solutions case improve In feedback TCAR confidence ease product launches prep. support all use to NPS our help And from along an progress carefully undergoing patients continued result experience. listening and are customers

product international the long-term to for our growth are offerings, business, investing efforts core including drivers in bolster Beyond our of we additional expansion.

have efforts Japan, and regulatory approvals signed recently for local ENROUTE and where initial expertise leaders agreements regional market been and received respected and ENROUTE and distribution with with on we've capabilities. China NPS Our focused

the market in study and support our distributor activities ENROUTE NPS to partners post-market markets, access, with prep our launch stakeholders. clearance provider plus efforts underway and their and both Regulatory payer of as

We more of this efforts XXXX look through sharing and will these continue forward the over year. to course

profile. over on deliver briefly to efforts touch call a to the like turn I'd I Lucas, financial our Before strong, sustainable to

trajectory growth quarter We long-term we first the see are and pleased our business. the for with strong

a pleased of quarter our as to also million, which adjusted is are of modest years reflected improvement. was sequential well be loss significant $X.X operating year-over-year EBITDA leverage a progress driving investment. We This improvement in as significant first after

our we reach improvement hand. on profitability confident relative with to ability have to drive XXXX ability capital full and our XXXX also remain year in in adjusted We to EBITDA the

quarter. the I'll and over COO, the that, now review with results turn call CFO And our Buchanan, to for Lucas financial to

Revenue XX, X by March Charles. same million, adoption for a $XX.X driven the from XX% our and the you, months in for was Thank increase Growth TCAR portfolio of prior differentiated healthy continued products. expanding of ended year. million primarily $XX.X the demand XXXX, period increased was

X,XXX prior year. Our the over a team XX% increase TCAR within same the supported the from of procedures period quarter,

QX our and early but March, was original demand. outpaced revenue notable of ahead our from our As due our revenue procedure a entirely stent to benefit results demonstrate, growth not great This from team plan in QX our preparation partially, work tapered due to customer growth. moderately launch

cylindrical We new stent these stocking hospitals par partially demand as dynamic size within establish stents Together, levels orders our also quarter. across a saw for reflected strong variations. the

and expect demand we growth and expect past, that forward, we for and procedure some And are procedure As procedure vice That reflective said between demand will our trends variation we growth growth as metric trends growth most we the versa. continue outpace healthy from view time. sometimes current QX revenue looking revenue of to today. time pleased TCAR, those that market end have we the to growth said, remain in

called quarter the of in gross quarter was expected call. XX% to and benefit to compared we margin earnings first variances Gross XXXX purchase encountered margin as the XXXX year. QX, that the price in the as favorable year increase variances prior in the out experienced of The as first reflects in prior from in period, first the prior QX production in we quarter XX% for unfavorable well

in first the of XXXX XXXX R&D full XX% of million to first $XX.X quarter quarter improvement modestly from in operating first margin of million, we as first to the quarter a expenses XXXX $XX.X Also, decline thereafter. increase were quarter were million million expenses XXXX. of compared normalize a in XXXX. year $XX.X for Total to for and expect Accordingly, we mentioned to modest begin the $XX.X prior, expect margin over gross in gross XXXX. the continue QX

first Sales, was administrative $XX.X million the by in quarter organization. to first increase quarter our XXXX. related compared general and expenses primarily were expense headcount the and in million driven increased The XXXX commercial for of of $XX.X

R&D on a we stable we forward expect our and infrastructure, commercial revenue base growth outpace As our to to operating continue expenses rate and growth leverage full our at-scale year basis. in back-office

we for $XX.X or a terms, compared dollar for was per the prior per expenses quarterly of net $X.XX the a the to of share loss XXXX in of expect compared year. And $X.XX remainder or $XX.X period operating as as Net million share to of loss the QX. quarter same through of first million steady a loss loss

of profitability. operating call quarter loss of EBITDA in adjusted period. further $X.X to EBITDA our reminder, the was illuminate a to profile of loss our the EBITDA we introduced for million $X.X As compared path our year prior million on first XXXX framework an sustained last operating and a into Adjusted to adjusted reporting

Today, adjusted EBITDA the year to to improvement XXXX of we $XX.X an full loss maintain recorded are our million. when EBITDA expectation pleased adjusted we to recognize XXXX in relative

we million cash, $XXX.X investments. in our with Finally, to achieve quarter profitability in We our of ability with and confident XXXX equivalents capital. remain first the existing ended cash

XXXX our to Turning revenue outlook.

teams plus our and on launches. adoption on tapered driving NPS execute balloon, continuing stent Our while are focused to TCAR

earnings revisit on As on XXXX plan call. XX% guidance project previously our earnings revenue million, the XXXX XX% to $XXX to XXXX of million call, $XXX QX quarter full communicated year growth. to reflecting We fourth our we

our strategy. Ending commercial with

deep go our priority. remains focus Our

full We territories anticipate influence the company. increasing among patients eagerly XX trained on our physicians XXXX over sales are carotid as we served professionals of as X,XXX by broadening XXX dedicated actively usage pool at-scale the in over commercial to strategy our our implement and only current and we our capability field,

would back I like for to Charles point, comments. to call the this At turn closing

Lucas. Thanks,

the ourselves So Silk in core -- the we've are of continue the to carotid who's for of of everyone been conclusion, uniquely I life at artery thousands in company, that, in Carmen? our and patients all want appreciation beginning I'd to see the express the mission month, devastating on to us as their opportunities thousands are with on the awareness this now turn marks involved reminded treatment for Tomorrow to suffering stroke our Road. market. greatly success ahead Road disease. to focused stroke and artery of just my it of heartfelt a Together, and carotid here of journey improved And of us And reduce quality from over we patients Silk and of like families. and sustained position back to disease, Q&A. we'll burden at operator Medical for

of Instructions] comes One JPMorgan. [Operator our for it question. moment line with And the from Robbie first Marcus

on I And This question congrats just is guidance. nice on actually Rohin Robbie. quarter. for had on a a

guidance choose here. to wanted for a raise why Just didn't you get sense to

of have get wanted well into there pressures. competitive -- was the the from much new could as as launches? ongoing there as how well stocking from been just I obviously, potentially for any of mentioned You to factor product as sense auxiliary you that contribution kind dynamic, guidance products a a bit

that Yes. Look, Appreciate exciting us, and overall, focused for the Sure. question, clearly, term. on in Thanks, building an long opportunity call. got we're thanks we've Rohin. for and of front the joining the

under it's full pretty I quarter we out my just reimbursement QX, post company. the was As the new QX felt quarter the full year, report still environment first on completed really our first just right? with in NCD. early

in still portion their sales since only months on are to organization X discussed new And Road call, year. roles. guidance been a our the it's Silk our we we relatively for significant of prior initiated and As

as made what summarize was tapered of see would revenue I really cases Lucas stent the that, that with lot started the and we So good in year, with you pleased a launch. was progress. We we how procedure. said, per said it. solid And did driven We're growth by and higher-than-expected

to we we guidance little pulling our forward a a positive, and progress But look some then little want a more And when to was point. some get very update with so in on provide to we'll at the get has reaction And forward. and been continuing runway under bit full summer, just that customer putting really the that belts.

our It next Rick One please. question, moment for line from comes of the with Stifel. Wise

talk what's do guidance. that's very Chad, the not still I maybe we -- X fourth the add guidance year. wanted what's solid. think performance. those And into kind to that's about what with of baked with clearly, of the dynamic so to sustainability quarter, sort maybe I where the the and Lucas. mean, that pricing And points. of I some price it incorporated was about thinking How on more stent price throughout we ENROUTE tapered assume And sort in your the and year your but in X% perspective that into of you could for the are for from quite

Rick, I'll part the question. first take that of

just between So level. about the quickly to strong. delineate be let's price product continue of performance we kind at ASPs think

Our do the good products, commercial organization job level. existing continues driving launches to really product at with and price new product great a

is we about period the in ad about relative as procedures level, we've At the sold period to talked the units a in nauseam in timing the past, overall there element. procedure think

per of of strong so your the that revenue to in period was some had in We the over procedure, QX. reorder. was period point, normal And just procedures kind or the in divided revenue X,XXX, by utilization

on index size are essentially that. a very those early QX. but tapered additionally, started to don't provide an in have the did lift. expanded matrix. of rollout And now in So It And reorders it stent. happen March, over modest, the Hospitals some we want of I was

par the of new our see are of get hospitals and get they units so reordered. levels to we and on kind variation and used when in the sales shelves when the timing they may and continue team establishing putting And

you're quarters. expanded a It bogie.] likely when with size lift. would So launch future in [ X,XXX to phase in expect serve I down longer-term But an a as temporary dip the kind matrix, of that product can back towards normalization

plays of the the you just tapered year. sort for launch March. in And out that think I We started how Rick, asked over

clinical forward. so nice do good. We've it to goes reaction to more there sort And in it. a of got has as we importantly, been got Most work really reaction

we're the launch with -- So NPS our just starting of And truly happy we're that. just starting then plus.

those And in guidance. big. level. collectively our And see revenue higher levels as par a a we things adjusting where said, are period, towards so and buying really factored moving procedure more time, into be there But are over as that kind said, per of as we their Lucas people may little we're X,XXX

like sort something, quarter first cadence to like sales cadence Got XX% of quarter, you. second just first that, about sort an think think if obviously help And of a percent implies quarters. last in of I it all and remember, how if I and about right, I the or strong maybe unusually can you relative the quarter? guidance, that think we unusually past. your the high do as think of quarter to XX% did Help us I midpoint is the related maybe full year of the us years second mean through to of the relative this

and QX. Lucas quarter we're you we QX so runway especially that bit which full on -- provide -- terms in first No, through sort from in year environment, has going kind year at both experience of in more bit the often in past, play and seasonally the part of the year can best an update then to out, kind mean, dip, to to In Yes. do of that performed. the was QX little understand full little year, and wanted I call. why But a the of look tell a it's and the of the in with are a give QX to some just of looking after pleased look how we're this a learning, exactly quarters. how grown changes company here but of Last the is I seasonality there kind right?

One the And Frank Capital please. with Lake of Takkinen moment comes next from for Markets. line it question, our Street

one a on solid to Congrats with wanted the quarter. on NCD I start change.

some X- tailwind transfemoral I to think up around the XX-month stenting, train take was time. to if lag, a a it sizing just there likely were would to it given provide

had in So of transfemoral frame dynamics a in that getting months you're up. we're shift market now, in stenters seeing change place. anecdotally from more X you've close that to XX to was to time kind put NCD now since Any getting trained that

for Thanks, Frank. Appreciate joining. the question. Thanks

mean getting that TCAR. real established it traveling in in it answer the of mentioned fall, we by start just think, the of that side give distinct see around surgeon And disease. an bureaucracy, of partly participate large actually on but hospital, I the are and doing positives had been, now treatment we've this on junior the also opportunities accounts procedure. I'll had for out absolutely and out as and And example. Actually, and experienced surprised of fellow X now through an the CEA week, us, week, reimbursement. didn't their VQI awareness we're kind XXth East was Coast that they're went from doing satellite physicians, who all got in I they they last got me the to I'll required previously practice just the recent carotid graduates the doing think with survey hospitals, but I received, more seeing, wanted positive just You we've was to was going of that registry systems right? already paperwork years, you from Coast. Let sort East and account TCAR, in And for regional for one that pleasantly NCD but of well. do results and very we the question want dynamics an new recently coming have number the more your transdermal there I are around mentioned I

of front them and keep do and of to example that's a tangible will changes over believe We us, point, by of pockets there's largely of, seen Up think very established So time way, been going. got stenting. and the as carotid people characterize opportunities until already. that I that are right be the this you there existing who keep as of to of we training I we've and sort hard. in -- what kind would doing continue transdermal capitalizing Because some mentioned, as is have on

The kind learning more curve focus. It as the long. we're of of wave on we're but primary opportunity carotid surgeon the of is we've our it's still seeing customer we mean to into largest kind over big a influence. part vascular still like new talked characterize that's is again, really by still continue And it to about really market -- base focused before I the with not of grow of far, and still said, it's is training about primarily doesn't early, hearing endarterectomy mostly And pockets or happening. time. the couldn't that

Got -- an reps? it. for just how younger being of but younger last training we're update get figure good the an little wanted think sales on moving sales throughout the called overall just last on the going just than Maybe as overall -- the you've to bit. around update -- it year. a out force touched a know force sales of force call a an is color. you X/X maturing update call, briefly, and I you over that Maybe That's that to couple quarter, times I the on

meeting called is don't really had update organization a reps we've and right? are some CEO we the the QX to sort well, got wonder I like on I'll place have how collected we doing -- to you transition, work. the as our survey, really a did an because as people transition. in their hired the that of Yes. XX% got through reps partnership the just it something and specific fantastic. average organization Work. across that it's We always well. a well. is to data have a No, The new progressing going we look, a share helping just a do We metric good it people good you -- sales just the great on places organization, an completed level to energy experienced team We've is -- We've the and when great average it especially except say got rank of And doing -- be recent company,

ranked employees mid-XXs. the in Our us

And changes. after the this again, even

it's really And a the then so -- as is and our more in-house translates importantly, in standpoint, employee and good field both retention from retention that as been ever.

not And we make keep so we're people the good and any a where culture We're feel as to are. leadership place going to place really maintain granted. in going have working to I take of for that in team policies about sure to that. But

In naturally to to a training of they're really team. the first adoption. a field, right? it lot acumen But with the and clinical takes do time, ask development comes got kind harder and from really and right we the TCAR -- you've And then as of they and It's sales year. the the push through standpoint, continue develop that role. to relationships of we'll then we're building our on the And progressing kind also earning do through that, that, confidence

line from And Huzog the question, [ Bank Caroline moment of our comes One of for it America. with next please. ]

ahead expectations, Caroline which gross I on included marketing cadence well through in QX The to those some the think of year. is team. of about came dynamics. from I the margins already This ask had wanted Travis' production cost

talked QX does expectations for in the change magnitude gross expansion margin QX that that margins? And gross your gross margin year? down so of in and/or the previously do to for Or the you step had

I'm like then and it being looks margins just OpEx, take, through give just a my expectations previously at as thinking than QX higher that second maybe in the it question tick [ about milllion And $XX.XX OpEx you than year. operating on in or flat expenses, ] came about while had well, talked

higher, year you [indiscernible] previously. should So spoken given the change to expectations flat about your for came OpEx to we and $XX million through had any in that that QX that think

Thank you, Caroline and welcome.

So result I'll it in yes, margin, let year. about and take just talk what QX, then out drove gross on the me rest the of the for

pass a So call, favorable has a in the in and there that but to on get and QX. as QX, will little more about QX We'll talked variance we normalize. bit begin will been temporary prior

discipline, costs, The obviously, details, on team of I of cetera, the kind on starting margin, hit our just et other execution strong say, price on in but the would cylinders all was shipping with quarter. driver the quality-related scrap, things all kind like

So We sequential year. being benefit a of down volume to we'll normalize step continued start part great in then X start facilities equal, to kind price in thereafter. QX and manufacturing do our through a expect and the from

a in good a the the return but as message and down to normalization. step year, start to prior same So QX then

change the we On side there's with well, across this as message. for between SG&A as forward the scale at the different roughly XX, normal OpEx in and We're puts all XX at takes. same ballpark the going really and But point. and that's what variation expect quarterly We're quarters. R&D

And so continued expectation. our that's

reminder, confidence path stock in comment the table, million a to $XXX related our to XX% which to noncash just rate see release is you gives run adjusted continued OpEx quickly. in quarterly of And change as just variation. which us profitability. our to over our will that with base So press some EBITDA can comp, the And

comes the Suraj the of One And question Oppenheimer. with moment Kalia it in line from for our last queue.

a on quarter. great congrats Gentleman,

earlier R&D that a quantifiable after in put may between so could with bear all forgive choice -- Charles versus you I'm XX was store for new of variant TF if an other just quarter it's wisely if going So these this talk more configuration versus know to around where endovascular parameters few store thrombectomy given about the me same-store The If please me. a view, spent? TCAR prophylaxis totally in the questions new the multiple shuttling in and stroke more would thing resources unfair your a be question, Did are X months I between asked but redundant. CAS, about question the you same-store calls, sales wondering

I Yes. appreciate the Suraj, questions.

don't we've our we except think sales, call. on talked about say I same-store -- out I would prior is and this break what

trained, we're I from It's with of will of of about more sudden evolution same-store talking our an what not undergoing kind sort you're evolution. It's sales. think we come physicians a are where an X,XXX increasingly growth shift.

Now to additional and we opportunities have add accounts. physicians still

fellows making We possible they team many the our heavy and helping them fellowship. on identifying get while an sales that get and job them to as force, as are team certified, have make educated focus sure them they in in to a sure fellows, of doing on the tracking excellent sales -- education

area so an a there of, example that's a again, from growth And new customer standpoint.

when your on R&D can on -- mean, that we I and have -- we already. Look, being big will from I primarily and the our it in really existing part market we focus. artery the our answering as the also in and category gotten programs leader we our all to that's study, non-VQI because But coming also results just of excited that serve lead. pipeline, did in about space, are in but We leadership focusing in the we said, about and there, are the question, we that -- last working have and of were haven't I be that stage that on think what the early carotid And except into we I continue on of customers, this NITEX progression extend talk a more a that's disease. natural mentioned call, our it's accounts. base our terms say

that is terms more we'll to show really things share But about philosophy we something, it. on will. once with in like our ready stuff we're it, time when some talk team visibility and things in to the like lines we through we're FDA future we're working get of then to and pathways and things exciting My that

for see you, it final any Thank for Charles McKhann I questions turn I you. thank I And will further the do queue. in comments. back everybody, not will to participating.

for and today. very to you Take updates again Really to look joining us start us providing the additional the you Thank everyone. joined pleased care, on year year with pleased forward the progresses. and

for Thank you, participating. everyone,

You now disconnect. may