LeMaitre Vascular (LMAT) 10-K 28 Feb 22 2021 FY Annual report Financial data

Document And Entity Information

Document And Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2021	Feb. 02, 2022	Jun. 30, 2021
Document Information [Line Items]
Entity Central Index Key	0001158895
Entity Registrant Name	LEMAITRE VASCULAR INC
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	FY
Document Fiscal Year Focus	2021
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2021
Document Transition Report	false
Entity File Number	001-33092
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	04-2825458
Entity Address, Address Line One	63 Second Avenue
Entity Address, City or Town	Burlington
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	01803
City Area Code	781
Local Phone Number	221-2266
Title of 12(b) Security	Common stock, $0.01 par value per share
Trading Symbol	LMAT
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Public Float			$ 729,212,310
Entity Common Stock, Shares Outstanding		21,928,942
Auditor Name	GRANT THORNTON LLP
Auditor Location	Boston, Massachusetts
Auditor Firm ID	248
ICFR Auditor Attestation Flag	true

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Assets
Cash and cash equivalents	$ 13,855	$ 26,764
Short-term marketable securities	56,104	214
Accounts receivable, net of allowances of $679 at December 31, 2021, and $623 at December 31, 2020	19,631	19,552
Inventory and other deferred costs	46,104	45,115
Prepaid expenses and other current assets	4,189	2,618
Total current assets	139,883	94,263
Property and equipment, net	17,059	15,036
Right-of-use leased assets	15,071	16,066
Goodwill	65,945	65,945
Other intangibles, net	52,710	58,905
Deferred tax assets	1,566	1,686
Other assets	568	909
Total assets	292,802	252,810
Liabilities and stockholders’ equity
Current portion of long-term debt	0	2,500
Accounts payable	2,340	2,394
Accrued expenses	16,332	17,525
Acquisition-related obligations	1,271	772
Lease liabilities - short-term	1,870	1,954
Total current liabilities	21,813	25,145
Long-term debt, net	0	35,532
Lease liabilities - long-term	14,067	14,791
Deferred tax liabilities	70	127
Other long-term liabilities	2,701	4,643
Total liabilities	38,651	80,238
Stockholders’ equity:
Preferred stock, $0.01 par value; authorized 3,000,000 shares; none outstanding	0	0
Common stock, $0.01 par value; authorized 37,000,000 shares; issued 23,477,784 shares at December 31, 2021, and 22,061,554 shares at December 31, 2020	235	221
Additional paid-in capital	181,630	114,924
Retained earnings	88,125	70,554
Accumulated other comprehensive loss	(3,435)	(1,525)
Treasury stock, at cost; 1,554,905 shares at December 31, 2021 and 1,538,572 shares at December 31, 2020	(12,404)	(11,602)
Total stockholders’ equity	254,151	172,572
Total liabilities and stockholders’ equity	$ 292,802	$ 252,810

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parentheticals) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Accounts receivable, allowances	$ 679	$ 623
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	3,000,000	3,000,000
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	37,000,000	37,000,000
Common stock, shares issued (in shares)	23,477,784	22,061,554
Treasury stock, at cost (in shares)	1,554,905	1,538,572

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Net sales	$ 154,424	$ 129,366	$ 117,232
Cost of sales	53,042	44,748	37,379
Gross profit	101,382	84,618	79,853
Sales and marketing	27,655	23,700	30,339
General and administrative	25,501	22,501	19,055
Research and development	11,801	10,099	9,276
Gains on sale of building, acquisitions and divestitures	0	(470)	0
Total operating expenses	64,957	55,830	58,670
Income from operations	36,425	28,788	21,183
Other income (expense):
Interest income	197	207	698
Interest expense	(2,219)	(1,310)	0
Foreign currency loss	(116)	(329)	(202)
Income before income taxes	34,287	27,356	21,679
Provision for income taxes	7,380	6,136	3,745
Net income	$ 26,907	$ 21,220	$ 17,934
Earnings per share of common stock:
Basic (in dollars per share)	$ 1.27	$ 1.05	$ 0.91
Diluted (in dollars per share)	$ 1.25	$ 1.04	$ 0.88
Weighted-average shares outstanding:
Basic (in shares)	21,157	20,246	19,813
Diluted (in shares)	21,475	20,479	20,326
Cash dividends declared per common share (in dollars per share)	$ 0.44	$ 0.38	$ 0.34

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Net income	$ 26,907	$ 21,220	$ 17,934
Other comprehensive income (loss):
Foreign currency translation adjustment, net	(1,604)	2,468	(234)
Unrealized gain (loss) on short-term marketable securities	(306)	14	127
Total other comprehensive income (loss)	(1,910)	2,482	(107)
Comprehensive income	$ 24,997	$ 23,702	$ 17,827

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]	Treasury Stock [Member]	Total
Balance (in shares) at Dec. 31, 2018	21,110,224				1,501,511
Balance at Dec. 31, 2018	$ 211	$ 98,442	$ 45,831	$ (3,900)	$ (10,349)	$ 130,235
Net income			17,934			17,934
Other comprehensive income (loss)				(107)		$ (107)
Issuance of common stock for stock options exercised (in shares)	509,693					509,693
Issuance of common stock for stock options exercised	$ 6	4,850				$ 4,856
Vested restricted stock units (in shares)	59,010
Vested restricted stock units	$ 0	0				0
Stock-based compensation expense		2,642				2,642
Repurchase of common stock for net settlement of equity awards (in shares)					20,524
Repurchase of common stock for net settlement of equity awards					$ (683)	(683)
Common stock cash dividend paid			(6,736)			(6,736)
Repurchase of common stock for net settlement of equity awards					$ (683)	(683)
Balance (in shares) at Dec. 31, 2019	21,678,927				1,522,035
Balance at Dec. 31, 2019	$ 217	105,934	57,029	(4,007)	$ (11,032)	148,141
Net income			21,220			21,220
Other comprehensive income (loss)				2,482		$ 2,482
Issuance of common stock for stock options exercised (in shares)	331,958					331,958
Issuance of common stock for stock options exercised	$ 3	5,968				$ 5,971
Vested restricted stock units (in shares)	50,669
Vested restricted stock units	$ 1	0				1
Stock-based compensation expense		3,022				3,022
Repurchase of common stock for net settlement of equity awards (in shares)					16,537
Repurchase of common stock for net settlement of equity awards					$ (570)	(570)
Common stock cash dividend paid			(7,695)			(7,695)
Repurchase of common stock for net settlement of equity awards					$ (570)	(570)
Balance (in shares) at Dec. 31, 2020	22,061,554				1,538,572
Balance at Dec. 31, 2020	$ 221	114,924	70,554	(1,525)	$ (11,602)	172,572
Net income			26,907			26,907
Other comprehensive income (loss)				(1,910)		$ (1,910)
Issuance of common stock for stock options exercised (in shares)	217,121					217,121
Issuance of common stock for stock options exercised	$ 2	4,544				$ 4,546
Vested restricted stock units (in shares)	49,109
Vested restricted stock units	$ 0	0				0
Stock-based compensation expense		3,479				3,479
Repurchase of common stock for net settlement of equity awards (in shares)					16,333
Repurchase of common stock for net settlement of equity awards					$ (802)	(802)
Common stock cash dividend paid			(9,336)			(9,336)
Issuance of common stock, net of issuance costs (in shares)	1,150,000
Issuance of common stock, net of issuance costs	$ 12	58,683				58,695
Repurchase of common stock for net settlement of equity awards					$ (802)	(802)
Balance (in shares) at Dec. 31, 2021	23,477,784				1,554,905
Balance at Dec. 31, 2021	$ 235	$ 181,630	$ 88,125	$ (3,435)	$ (12,404)	$ 254,151

Consolidated Statements of Cash

Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Operating activities
Net income	$ 26,907	$ 21,220	$ 17,934
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	11,070	8,395	5,416
Stock-based compensation	3,479	3,022	2,642
Fair value adjustments to contingent consideration obligations	(674)	182	171
Provision for doubtful accounts and allowances	263	293	388
Provision for inventory write-downs	3,779	1,523	747
Provision (benefit) for deferred income taxes	79	(328)	824
Gains on sale of building, acquisitions and divestitures	0	(470)	0
Foreign currency transaction gain	163	100	(57)
Changes in operating assets and liabilities:
Accounts receivable	(818)	(939)	(1,301)
Inventory and other deferred costs	(5,485)	(2,609)	(11,335)
Prepaid expenses and other assets	(1,927)	89	(654)
Accounts payable and other liabilities	(1,734)	4,322	(596)
Net cash provided by operating activities	35,102	34,800	14,179
Investing activities
Purchases of property and equipment	(4,882)	(2,982)	(3,761)
Proceeds from sale of building	0	2,023	0
Payments related to acquisitions	0	(72,627)	(21,240)
Purchases of short-term marketable securities	(59,194)	(2,205)	(22,699)
Proceeds from sales of marketable securities	3,000	22,900	23,600
Net cash used in investing activities	(61,076)	(52,891)	(24,100)
Financing activities
Payment of deferred acquisition consideration	(401)	(2,800)	(2,059)
Proceeds from revolving line of credit	0	25,000	0
Proceeds from issuance of long-term debt	0	40,000	0
Payments of revolving line of credit	0	(25,000)	0
Payments of long-term debt	(39,000)	(1,000)	0
Payment of deferred debt issuance costs	0	(1,751)	0
Proceeds from issuance of common stock	63,241	5,971	4,856
Purchase of treasury stock for net settlement of equity awards	(802)	(570)	(683)
Common stock cash dividend paid	(9,336)	(7,695)	(6,736)
Net cash provided by (used in) financing activities	13,702	32,155	(4,622)
Effect of exchange rate changes on cash and cash equivalents	(637)	914	11
Net increase (decrease) in cash and cash equivalents	(12,909)	14,978	(14,532)
Cash and cash equivalents at beginning of year	26,764	11,786	26,318
Cash and cash equivalents at end of year	$ 13,855	$ 26,764	$ 11,786

Note 1 - Significant Accounting

Note 1 - Significant Accounting Policies and Related Matters	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Significant Accounting Policies [Text Block]	1. Description of Business Unless the context requires otherwise, references to LeMaitre, LeMaitre Vascular, we, our, and us refer to LeMaitre Vascular, Inc. and our subsidiaries. We develop, manufacture, and market medical devices and implants used primarily in the field of vascular surgery. We also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. We operate in a single Consolidation and Basis of Presentation Our consolidated financial statements include the accounts of LeMaitre Vascular and the accounts of our wholly-owned subsidiaries, LeMaitre Vascular GmbH, LeMaitre Vascular GK, Vascutech Acquisition LLC, LeMaitre Acquisition LLC, LeMaitre Vascular SAS, LeMaitre Vascular S.r.l., LeMaitre Vascular Spain SL, LeMaitre Vascular Switzerland GmbH, LeMaitre Vascular ULC, LeMaitre Vascular AS, LeMaitre Vascular Pty Ltd, Bio Nova International Pty Ltd, LeMaitre Vascular, Ltd., LeMaitre Medical Technology (Shanghai) Co. Ltd, LeMaitre Cardial SAS and LeMaitre Pte Ltd. All significant intercompany accounts and transactions have been eliminated in consolidation. Foreign Currency Translation Balance sheet accounts of foreign subsidiaries are translated into U.S. dollars at year-end exchange rates. Operating accounts are translated at average exchange rates for each year. Net translation gains or losses are adjusted directly to a separate component of other comprehensive income (loss) within stockholders’ equity. Foreign exchange transaction gains (losses), substantially all of which relate to intercompany activity between us and our foreign subsidiaries, are included in other income (expense) in the accompanying consolidated statements of operations. Estimates The preparation of financial statements in conformity with U.S. generally accepted accounting principles (GAAP) requires management to make estimates and assumptions that affect the amounts reported in in our consolidated financial statements and accompanying notes. Due to the COVID- 19 19 not February 28, 2022, 10 19. Revenue Recognition Our revenue is derived primarily from the sale of disposable or implantable devices used during vascular surgery. We sell primarily directly to hospitals and to a lesser extent to distributors, as described below, and, during the periods presented in our consolidated financial statements, entered into consigned inventory arrangements with either hospitals or distributors on a limited basis. With the acquisition of the RestoreFlow allograft business, we also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. These revenues are recognized when services have been provided and the tissue has been shipped to the customer, provided all other revenue recognition criteria discussed in the succeeding paragraph have been met. We record revenue under the provisions of ASU 2014 09, Revenue from Contracts with Customers (Topic 606 606 Step 1: Step 2: Step 3: Step 4: Step 5: Revenue is recognized when or as a company satisfies a performance obligation by transferring a promised good or service to a customer (which is when the customer obtains control of that good or service). In instances in which shipping and handling activities are performed after a customer takes control of the goods (such as when title passes upon shipment from our dock), we have made the policy election allowed under Topic 606 not We generally reference customer purchase orders to determine the existence of a contract. Orders that are not one not We record revenue, net of allowances for returns and discounts, fees paid to group purchasing organizations, and any sales and value added taxes required to be invoiced, which we have elected to exclude from the measurement of the transaction price as allowed by the standard, at the time of shipment (taking into consideration contractual shipping terms), or in the case of consigned inventory, when it is consumed. Shipment is the point at which control of the product and title passes to our customers, and at which LeMaitre has a present right to receive payment for the goods. Below is a disaggregation of our revenue by major geographic area, which is among the primary categorizations used by management in evaluating financial performance, for the periods indicated (in thousands): Year ended December 31, 2021 2020 Americas $ 102,265 $ 81,470 Europe, Middle East and Africa 42,132 39,193 Asia Pacific 10,027 8,703 Total $ 154,424 $ 129,366 We do not no not no Customers returning products may 18 twelve 30 not not Research and Development Expense Research and development costs, principally salaries, laboratory testing, and supplies, are expensed as incurred and also include royalty payments associated with licensed and acquired intellectual property. Shipping and Handling Costs Shipping and handling fees paid by customers are recorded within net sales, with the related expense recorded in cost of sales. Advertising Costs Advertising costs are expensed as incurred and are included as a component of sales and marketing expense in the accompanying consolidated statements of operations. Advertising costs are as follows: Year ended December 31, 2021 2020 2019 (in thousands) Advertising expense $ 236 $ 216 $ 286 Cash and Cash Equivalents We consider all highly liquid instruments purchased with maturity dates of 90 Short-term Marketable Securitie Our short-term marketable securities are available-for-sale securities carried at fair value, with unrealized gains and losses recorded in other comprehensive income. They include a managed income mutual fund investing mainly in short-term investment-grade, U.S. dollar denominated fixed and floating rate debt, and a short-duration bond fund. Concentrations of Credit Risk Our financial instruments that are exposed to concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. Cash equivalents represent highly liquid investments with maturities of 90 $250,000. December 31, 2021. Our accounts receivable are with customers based in the United States and internationally. Accounts receivable generally are due within 30 90 may 90 240 We closely monitor outstanding receivables for potential collection risks, including those that may may December 31, 2021 December 31, 2021, may not may We write off accounts receivable when they become uncollectible. Such credit losses have historically been within our expectations and allowances. The allowance for doubtful accounts is our best estimate of the amount of probable credit losses in our existing accounts receivable. We review our allowance for doubtful accounts on a monthly basis and all past due balances are reviewed individually for collectability. The provision for the allowance for doubtful accounts is recorded in general and administrative expenses. The following is a summary of our allowance for doubtful accounts and sales returns: Balance at Additions Deductions Balance at Beginning (recoveries) charged from End of of Period to Income Reserves Period (in thousands) Allowance for doubtful accounts and sales returns: Year ended December 31, 2021 $ 623 $ 263 $ 207 $ 679 Year ended December 31, 2020 522 293 192 623 Year ended December 31, 2019 399 388 265 522 Fair Value of Financial Instruments Our financial instruments include cash and cash equivalents, short-term marketable securities, accounts receivable and trade payables. The fair value of these instruments approximates their carrying value based upon their short-term nature or variable rates of interest. Unrealized gains and losses on our short-term marketable securities are recorded in other comprehensive income and were not December 31, 2021. Inventory and Other Deferred Costs Inventory and Other Deferred Costs consists of finished products, work-in-process, raw materials and costs deferred in connection with human tissue cryopreservation services of our RestoreFlow allograft business. We value inventory and other deferred costs at the lower of cost or market value. Cost includes materials, labor and manufacturing overhead and is determined using the first first may not may Property and Equipment Property and equipment are recorded at cost. Depreciation is provided over the estimated useful lives of the related assets using straight-line method as follows: Description Useful Life (in years) Computers and equipment 3 – 5 Machinery and equipment 3 – 10 Leasehold improvements The shorter of its useful life or lease term Expenditures for maintenance and repairs are charged to operations when incurred, while additions and betterments are capitalized. When assets are retired or disposed, the asset’s original cost and related accumulated depreciation are eliminated from the accounts and any gain or loss is reflected in the statement of operations. Valuation of Business Combinations We assign the value of the consideration transferred to acquire a business to the tangible assets and identifiable intangible assets acquired and liabilities assumed on the basis of their fair values at the date of acquisition. We assess the fair value of assets, including intangible assets, using a variety of methods and are usually performed by an independent appraiser who measures fair value from the perspective of a market participant. Acquisitions have been accounted for using the acquisition method, and the acquired companies’ results have been included in the accompanying consolidated financial statements from their respective dates of acquisition. Acquisition transaction costs have been recorded in general and administrative expenses, and are expensed as incurred. Allocation of the purchase price for acquisitions is based on estimates of the fair value of the net assets acquired and, for acquisitions completed within the past year, is subject to adjustment upon finalization of the purchase price allocation. Our acquisitions have historically been made at prices above the fair value of the acquired assets, resulting in goodwill, due to expectations of synergies of combining the businesses. These synergies include use of our existing commercial infrastructure to expand sales of the acquired businesses’ products, use of the commercial infrastructure of the acquired businesses to cost-effectively expand sales of our products, and the elimination of redundant facilities, functions and staffing. Contingent Consideration Contingent consideration for acquisitions is recognized at the date of acquisition, based on the fair value at that date, and then re-measured periodically through adjustments to net income. Impairment of Long-lived Assets We review our long-lived assets (primarily property and equipment and intangible assets) subject to amortization quarterly to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the remaining useful life. Conditions that may not Goodwill Goodwill represents the amount of consideration paid in connection with business acquisitions in excess of the fair value of assets acquired and liabilities assumed. Goodwill is evaluated for impairment annually, or more frequently if indicators of impairment are present or changes in circumstances suggest that an impairment may December 31 not” not” 50 not December 31, 2021, 2020 2019. Other Intangible Assets Other intangible assets consist primarily of patents, trademarks, technology licenses, and customer relationships acquired in connection with business acquisitions and asset acquisitions and are amortized over their estimated useful lives, ranging from 2 to 16 years. Stock-based Compensation We recognize, as expense, the estimated fair value of stock options to employees determined using the Black-Scholes option pricing model. Share-based compensation charges are recorded across the consolidated statement of operations based upon the grantee’s primary function. We have elected to recognize the compensation cost of all share-based awards on a straight-line basis over the vesting period of the award. In periods that we grant stock options, fair value assumptions are based on volatility, interest, dividend yield, and expected term over which the stock options will be outstanding. The computation of expected volatility is based on the historical volatility of the company’s stock. The interest rate for periods within the contractual life of the award is based on the U.S. Treasury risk-free interest rate in effect at the time of grant. Historical data on exercise patterns is the basis for estimating the expected life of an option. The expected annual dividend rate was calculated by dividing our annual dividend, based on the most recent quarterly dividend rate, by the closing stock price on the grant date. We also issue restricted stock units (RSUs) and performance-based restricted stock units (PSUs) as additional forms of equity compensation to our employees, officers, and directors, pursuant to our stockholder-approved 2006 no 2021 2021 Commitments and Contingencies In the normal course of business, we are subject to proceedings, lawsuits, and other claims and assessments for matters related to, among other things, patent infringement, business acquisitions, employment, commercial matters and product recalls. We assess the likelihood of any adverse judgments or outcomes to these matters as well as potential ranges of probable losses. A determination of the amount of reserves required, if any, for these contingencies is made after careful analysis of each individual issue. The required reserves may December 31, 2021, 2020 2019, not Sales of medical devices outside the U.S. are subject to international regulatory requirements that vary from country to country. These requirements and the amount of time required for approval may no Income Taxes We account for income taxes under the asset and liability method of accounting for income taxes. Under the asset and liability method, deferred taxes are determined based on the difference between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect in the years in which the differences are expected to reverse. The provision for income taxes includes taxes currently payable and deferred taxes resulting from the tax effects of temporary differences between the financial statement and tax bases of assets and liabilities. We maintain valuation allowances where it is more likely than not not We recognize, measure, present and disclose in our financial statements, uncertain tax positions that we have taken or expect to take on a tax return. We recognize in our financial statements the impact of tax positions that meet a “more likely than not” fifty Our policy is to classify interest and penalties related to unrecognized tax benefits as income tax expense. Comprehensive Income Comprehensive income is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Other than reported net income, comprehensive income includes foreign currency translation adjustments and unrealized gains and losses on our marketable securities, which are disclosed in the accompanying consolidated statements of comprehensive income. There were no reclassifications out of comprehensive income for the years ended December 31, 2021, 2020 2019. Accumulated other comprehensive loss consisted primarily of foreign currency translation adjustment losses of $3.1 million and $1.6 million as of December 31, 2021 2020, Restructuring We record restructuring charges incurred in connection with consolidation or relocation of operations, exited business lines, reductions in force, or distributor terminations. These restructuring charges, which reflect our commitment to a termination or exit plan that will begin within twelve Earnings per Share We compute basic earnings per share by dividing net income available for common stockholders by the weighted average number of shares outstanding during the year. Except where the result would be anti-dilutive to net income per share, diluted earnings per share has been computed using the treasury stock method and reflects the potential vesting of restricted common stock and the potential exercise of stock options, as well as their related income tax effects. The computation of basic and diluted net income per share is as follows: Year ended December 31, 2021 2020 2019 (in thousands, except per share data) Basic: Net income available for common stockholders $ 26,907 $ 21,220 $ 17,934 Weighted average shares outstanding 21,157 20,246 19,813 Basic earnings per share $ 1.27 $ 1.05 $ 0.91 Net income available for common stockholders $ 26,907 $ 21,220 $ 17,934 Weighted-average shares outstanding 21,157 20,246 19,813 Common stock equivalents, if dilutive 318 233 513 Shares used in computing diluted earnings per common share 21,475 20,479 20,326 Diluted earnings per share $ 1.25 $ 1.04 $ 0.88 Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive 10 483 468 Recent Accounting Pronouncements In December 2019, 2019 12 740 740 740. January 1, 2021, not

Note 2 - Acquisitions

Note 2 - Acquisitions	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Business Combination Disclosure [Text Block]	2. Acquisitions are accounted for using the acquisition method and the acquired businesses’ results have been included in the accompanying consolidated financial statements from their respective dates of acquisition. In each case for the acquisitions disclosed below, pro forma information assuming the acquisition had occurred at the beginning of the earliest period presented is not Our acquisitions have historically been made at prices above the fair value of the acquired identifiable assets, resulting in goodwill, due to expectations of synergies that will be realized by combining businesses. These synergies include the use of our existing sales channel to expand sales of the acquired businesses’ products, consolidation of manufacturing facilities, and the leveraging of our existing administrative infrastructure. The fair market valuations associated with these transactions fall within Level 3 13 Artegraft Biologic Grafts On June 22, 2020, December 31, 2021 Three earn-out payments of $5,833,333 ● $5.8 million upon final determination that 20,000 units of Product have been sold to third January 1, 2021 December 31, 2021 ( not no ● $5.8 million upon final determination that 24,000 units of Product have been sold to third January 1, 2022 December 31, 2022; ● $5.8 million upon final determination that 28,800 units of Product have been sold to third January 1, 2023 December 31, 2023. The Artegraft APA includes a catch-up feature on the earn-outs such that, at the end of the three three three On the date of acquisition, the Company allocated the consideration given to the individual assets acquired and the liabilities assumed based on a preliminary estimate of their fair values. During the three September 30, 2020, Allocated Fair Value (in thousands) Inventory $ 3,859 Accounts receivable 1,789 Equipment and supplies 1,140 Accounts payable and other (53 ) Intangible assets 39,056 Goodwill 27,115 Purchase price $ 72,906 The goodwill results from expected synergies of combining the acquired products and customer information to our existing operations, and is deductible for tax purposes over 15 years. The following table reflects the allocation of purchase consideration to the acquired intangible assets and related estimated useful lives: Allocated Estimated Fair Value Useful Life (in years) (in thousands) Customer relationships $ 20,310 15.0 Intellectual property 16,449 10.0 Non-compete agreement 104 5.0 Tradenames 2,193 10.0 Total intangible assets $ 39,056 The weighted-average amortization period of the acquired intangible assets was 12.6 years. CardioCel and VascuCel Biologic Patches On October 11, 2019 ( three August 2021, July 11, 2023. Under the Admedus APA we agreed to pay Admedus a total of up to $15.3 million for the purchase of substantially all of its biologic patch business assets, other than specifically identified excluded assets, plus $8.0 million for the technology license. The acquired assets (in combination with the license) included inventory, intellectual property, permits and approvals, data and records, and customer and supplier information, as well as a small amount of machinery and equipment. At closing, $14.2 million of the purchase price was paid to Admedus. Shortly thereafter another $0.3 million was paid in connection with delivery of audited financial statements of the acquired business to LeMaitre. Additional payments of $0.7 million are due within 15 first third first October 2020. may ● $2.5 million if revenues in the first 12 $20 first 12 $15 not no ● $2.5 million if revenues in the second 12 $30 second 12 $22.5 not no ● $0.5 million if, by the first 36 60 not no ● $2.0 million within 15 This contingent consideration of $7.5 million was initially valued in total at $2.0 million and is being re-measured each reporting period until the payment requirement ends, with any adjustments reported in income from operations. During the quarter ended September 30, 2021, 15 15 September 30, 2021 During the quarter ended September 30, 2020, The goodwill results from expected synergies of combining the acquired products and customer information to our existing operations, and is deductible for tax purposes over 15 The following table reflects the allocation of purchase consideration to the acquired intangible assets and related estimated useful lives: Allocated Fair Value (in thousands) Inventory and other $ 1,343 Deferred tax assets 1,345 Intangible assets 8,725 Goodwill 5,999 Purchase price $ 17,412 The weighted-average amortization period of the acquired intangible assets was 10.4 years. Tru-Incise Valve Cutter On July 12, 2019, The purchase price for the acquired assets, which included inventory, machinery and equipment, intellectual property, and customer and supplier information, was $8.0 million. Of this amount, $6.8 million was paid at closing, with three second third no may first second July 2020 July 2021, The following table summarizes the preliminary purchase price allocation: Allocated Fair Value (in thousands) Inventory $ 276 Equipmentand supplies 70 Intangible assets 4,844 Goodwill 2,748 Purchase price $ 7,938 The goodwill results from expected synergies of combining the acquired products and customer information to our existing operations, and is deductible for tax purposes over 15 The following table reflects the allocation of purchase consideration to the acquired intangible assets and related estimated useful lives: Weighted Average Allocated Fair Value Useful Life (in years) (in thousands) Customer relationships $ 3,945 13.0 Intellectual property 563 7.0 Non-compete agreement 233 5.0 Tradenames 103 7.0 Total intangible assets $ 4,844 The weighted-average amortization period of the acquired intangible assets was 11.8 years.

Note 3 - Inventories and Other

Note 3 - Inventories and Other Deferred Costs	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Inventory and Other Deferred Costs Disclosure [Text Block]	3. Inventory and other deferred costs consists of the following: December 31, 2021 December 31, 2020 (in thousands) Raw materials $ 5,945 $ 5,044 Work-in-process 9,416 6,004 Finished products 25,286 28,117 Other deferred costs 5,457 5,950 Total inventory and other deferred costs $ 46,104 $ 45,115 We had inventory on consignment at customer sites of $2.1 million as of both December 31, 2021 2020. In connection with our RestoreFlow allograft business, other deferred costs include costs incurred for the preservation of human vascular tissues available for shipment, tissues currently in active processing, and tissues held in quarantine pending release to implantable status. By federal law, human tissues cannot be bought or sold. Therefore, the tissues we preserve are not

Note 4 - Property and Equipment

Note 4 - Property and Equipment	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Property, Plant and Equipment Disclosure [Text Block]	4. Property and equipment consists of the following: As of December 31, 2021 2020 (in thousands) Computers and equipment $ 5,667 $ 5,046 Machinery and equipment 18,439 17,266 Building and leasehold improvements 15,884 12,809 Gross property and equipment 39,990 35,121 Less accumulated depreciation (22,931 ) (20,085 ) Property and equipment, net $ 17,059 $ 15,036 During the years ended December 31, 2021, 2020 2019 Depreciation expense is as follows: Year ended December 31, 2021 2020 2019 (in thousands) Depreciation expense $ 3,280 $ 3,181 $ 2,979

Note 5 - Goodwill and Other Int

Note 5 - Goodwill and Other Intangible Assets	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Goodwill and Intangible Assets Disclosure [Text Block]	5. Goodwill consists of the following: As of December 31, 2021 2020 Balance at beginning of year $ 65,945 $ 39,951 Additions for acquisitions - 27,115 Purchase accounting adjustments - (1,345 ) Effects of currency exchange - 224 Balance at end of year $ 65,945 $ 65,945 During 2020, Other intangibles consist of the following: December 31, 2021 December 31, 2020 Gross Net Gross Net Carrying Accumulated Carrying Carrying Accumulated Carrying Value Amortization Value Value Amortization Value (in thousands) Product technology and intellectual property $ 29,549 $ 10,473 $ 19,076 $ 29,951 $ 7,947 $ 22,004 Trademarks, tradenames and licenses 3,647 1,139 2,508 4,000 1,094 2,906 Customer relationships 36,197 5,674 30,523 38,525 5,424 33,101 Other intangible assets 1,461 858 603 1,767 873 894 Total identifiable intangible assets $ 70,854 $ 18,144 $ 52,710 $ 74,243 $ 15,338 $ 58,905 These assets are being amortized over useful lives ranging from 2 December 31, 2021, Year ended December 31, 2021 2020 2019 (in thousands) Amortization expense $ 6,195 $ 5,043 $ 2,437 During the years ended December 31, 2021 2019, five December 31, 2021, Year ended December 31, 2022 2023 2024 2025 2026 (in thousands) Amortization expense $ 6,016 $ 5,884 $ 5,702 $ 5,464 $ 4,997

Note 6 - Revolving Line of Cred

Note 6 - Revolving Line of Credit and Long-term Debt	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Debt Disclosure [Text Block]	6. In connection with the acquisition of the Artegraft biologic graft business, we incurred debt in the amount of $65 million under a senior secured credit facility with a group of banks. This credit arrangement included a $25 million revolving credit line that was fully drawn at inception, as well as a $40 million five December 31, 2020, December 31, 2021, Under the terms of the agreement, the loans bore interest at a rate per annum of, at our option, either (i) the Base Rate plus an applicable margin of from 1.25% to 1.75% depending on our consolidated leverage ratio, or (ii) the Eurodollar Rate plus an applicable margin of from 2.25% to 2.75% depending on our consolidated leverage ratio. Base Rate is defined in the credit agreement as a fluctuating rate per annum of the Federal Funds rate plus 0.5% or the prime rate of interest established from time to time by KeyBank National Association. Cash paid for interest during both of the years ended December 31, 2021 2020 We incurred debt issuance costs in connection with this credit arrangement of approximately $1.8 million. These costs were allocated between the revolving line of credit and the term loans, with the portion related to the revolving line of credit of $0.7 million recorded in other assets on our balance sheet, and the portion allocated to the term loan recorded as a deduction from the amount of the debt. All of these transaction costs were being amortized into interest expense on a straight-line basis as the result would not five During the three September 30, 2021, five June 22, 2025. November 2021

Note 7 - Accrued Expenses and O

Note 7 - Accrued Expenses and Other Long-term Liabilities	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Accounts Payable, Accrued Liabilities, and Other Liabilities Disclosure, Noncurrent [Text Block]	7. Accrued expenses consist of the following: December 31, 2021 December 31, 2020 (in thousands) Compensation and related taxes $ 10,236 $ 8,675 Income and other taxes 551 2,394 Professional fees 129 39 Other 5,416 6,417 Total $ 16,332 $ 17,525 Other long-term liabilities consist of the following: December 31, 2021 December 31, 2020 (in thousands) Acquisition-related liabilities $ 1,761 $ 3,700 Income taxes 799 813 Other 141 130 Total $ 2,701 $ 4,643

Note 8 - Commitments and Contin

Note 8 - Commitments and Contingencies	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	8. Leases We conduct the majority of our operations in leased facilities, all of which are accounted for as operating leases, as they do not five five December 2030. August 2023. two five June 30, 2021 October 2029. June 2021 six six five February 2023. twelve None no no December 31, 2021. We also lease automobiles under operating leases in the United States as well as certain of our international subsidiaries. The terms of these leases are generally three June 30, 2021 five We account for leases under the provisions of ASU No. 2016 02, Leases (Topic 842 2018 11, Leases (Topic 842 Our most significant judgment involved in determining the amounts to initially record as lease liabilities and right-of-use assets upon initial adoption of this standard, and for leases entered into subsequently, was the selection of a discount rate; because we had no no Additional information with respect to our leases is as follows: Year ended Year ended December 31, December 31, 2021 2020 (in thousands) (in thousands) Lease cost Operating lease cost $ 2,275 $ 1,912 Short-term lease cost 458 192 Total lease cost $ 2,733 $ 2,104 Other information Cash paid for amounts included in the measurement of operating lease liabilities $ 2,859 $ 2,404 Right-of-use assets obtained in exchange for new operating lease liabilities $ 1,277 $ 2,770 Weighted average remaining lease term - operating leases (in years) 7.3 7.8 Weighted average discount rate - operating leases 4.86 % 5.02 % At December 31, 2021, one Year ending December 31, 2022 $ 2,666 2023 2,300 2024 2,104 2025 2,151 2026 2,153 Thereafter 8,198 Adjustment to net present value as of December 31, 2021 (3,635 ) Minimum noncancelable lease liability $ 15,937 Purchase Commitments As part of our normal course of business, we have commitments to purchase approximately $6.2 million of inventory through 2022. not

Note 9 - Income Taxes

Note 9 - Income Taxes	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Income Tax Disclosure [Text Block]	9. Income (loss) before income taxes is as follows: Year ended December 31, 2021 2020 2019 (in thousands) United States $ 34,153 $ 25,308 $ 17,989 Foreign 134 2,048 3,690 Total $ 34,287 $ 27,356 $ 21,679 Certain of our foreign subsidiaries are included in the U.S. tax return as branches but are included as foreign for purposes of the table above. The provision (benefit) for income taxes is as follows: Year ended December 31, 2021 2020 2019 (in thousands) Current: Federal $ 5,024 $ 4,594 $ 1,501 State 990 806 304 Foreign 1,287 1,064 1,116 7,301 6,464 2,921 Deferred: Federal 63 (397 ) 538 State (9 ) (48 ) 144 Foreign 25 117 142 79 (328 ) 824 Provision for income taxes $ 7,380 $ 6,136 $ 3,745 We have reviewed the tax positions taken, or to be taken, in our tax returns for all tax years currently open to examination by a taxing authority. As of December 31, 2021, may twelve December 31, 2022. 2030. 2021 2020 2019 (in thousands) Unrecognized tax benefits at the beginning of year $ 820 $ 848 $ 711 Additions/adjustments for tax positions of current year - - 74 Additions/adjustments for tax positions of prior years (52 ) 37 63 Reductions for settlements with taxing authorities. - (65 ) - Reductions for lapses of the applicable statutes of limitations - - - Unrecognized tax benefits at the end of the year $ 768 $ 820 $ 848 Deferred taxes are attributable to the following temporary differences: As of December 31, 2021 2020 (in thousands) Deferred tax assets: Inventory $ 2,231 $ 1,629 Net operating loss carryforwards 1,153 1,348 Tax credit carryforwards 1,033 1,019 Capital loss carryforwards 492 521 Reserves and accruals 712 994 Operating lease liabilities 3,562 3,664 Intangible assets 4,426 4,386 Stock options 440 359 Other 140 105 Total deferred tax assets 14,189 14,025 Deferred tax liabilities: Property and equipment (1,713 ) (1,831 ) Goodwill (4,825 ) (4,055 ) Operating lease right-of-use assets (3,355 ) (3,503 ) Foreign branch deferred offset (843 ) (954 ) Other (213 ) (299 ) Total deferred tax liabilities (10,949 ) (10,642 ) Net deferred tax assets before valuation allowance 3,240 3,383 Valuation allowance (1,744 ) (1,824 ) Net deferred tax liabiltity $ 1,496 $ 1,559 Deferred tax classification Long-term deferred tax asset $ 1,566 $ 1,686 Long-term deferred tax liability (70 ) (127 ) Net long-term deferred tax asset $ 1,496 $ 1,559 In 2020, 2021, As of December 31, 2021, not may Realization of our deferred tax assets is dependent on our generating sufficient taxable income in future periods. Although we believe it is more likely than not not may As of December 31, 2021, not not not not not 2030, In December 2018, no no not A reconciliation of the U.S. federal statutory rate to our effective tax rate is as follows: 2021 2020 2019 Federal statutory rate 21.0 % 21.0 % 21.0 % State tax, net of federal benefit 2.7 % 2.2 % 1.9 % Effect of foreign taxes 3.7 % 1.1 % 2.1 % Federal tax on foreign income 0.2 % 0.4 % 0.8 % Valuation allowance (0.1 %) 1.4 % 0.6 % Foreign deferred tax liability offset (0.1 %) (0.2 %) (0.4 %) Research & development tax credits (0.4 %) (0.6 %) (1.2 %) Stock options (3.1 %) (2.3 %) (8.8 %) Uncertain tax positions 0.2 % 0.3 % 1.0 % Other permanent differences (2.4 %) (0.6 %) 0.5 % Other (0.2 %) (0.3 %) (0.2 %) Effective tax rate 21.5 % 22.4 % 17.3 % We are not As of December 31, 2021, United States 2018 Foreign 2014 Supplemental disclosures of cash flow information are as follows: Year ended December 31, 2021 2020 2019 (in thousands) Cash paid for income taxes, net $ 10,147 $ 4,470 $ 4,817

Note 10 - Stockholders' Equity

Note 10 - Stockholders' Equity	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Stockholders' Equity Note Disclosure [Text Block]	10. Equity Authorized Shares Our certificate of incorporation, as amended and restated from time to time, authorizes the issuance of up to 37,000,000 shares of common stock and up to 3,000,000 shares of undesignated preferred stock. Under the terms of our certificate of incorporation, our board of directors is authorized to issue shares of the preferred stock in one Equity Offering On July 16, 2021, On August 4, 2021, Stock Award Plans In May 2006 2006 2006 2006 not four five no ten 2006 no 2006 may 2006 December 31, 2021. We have computed the fair value of employee stock options granted each year using the following weighted average assumptions: 2021 2020 2019 Dividend yield 0.91 % 1.02 % 0.96 % Volatility 46.0 % 47.3 % 42.8 % Risk-free interest rate 1.1 % 0.3 % 1.7 % Weighted average expected option term (in years) 4.6 4.9 4.7 Weighted average fair value per share of options granted $ 17.64 $ 13.24 $ 12.51 A summary of option activity as of December 31, 2021 three Weighted Weighted Average Aggregate Number Average Remaining Intrinsic of Shares Exercise Price Contractual Term Value (in years) (in thousands) Balance outstanding at December 31, 2018 1,462,575 $ 16.41 4.54 $ 12,214 Granted 195,379 $ 35.53 Exercised (509,693 ) $ 9.53 $ 11,488 Canceled / Expired (101,167 ) $ 17.90 Balance outstanding at December 31, 2019 1,047,094 $ 28.22 4.31 $ 13,367 Granted 222,110 $ 36.67 Exercised (331,958 ) $ 17.99 $ 5,413 Canceled / Expired (5,406 ) $ 27.49 Balance outstanding at December 31, 2020 931,840 $ 28.22 4.49 $ 11,442 Granted 151,161 $ 48.60 Exercised (217,121 ) $ 20.95 $ 6,975 Canceled / Expired (19,126 ) $ 23.18 Balance outstanding at December 31, 2021 846,754 $ 33.83 4.50 $ 13,888 Exercisable at: December 31, 2019 309,501 $ 19.64 3.50 $ 5,047 December 31, 2020 274,411 $ 23.08 3.50 $ 4,781 December 31, 2021 301,692 $ 27.40 3.30 $ 6,886 Expected to vest at: December 31, 2019 737,593 $ 24.68 4.65 December 31, 2020 657,429 $ 30.37 4.93 December 31, 2021 545,062 $ 37.38 5.16 Cash received from stock options exercised during the years ended December 31, 2021, 2020 2019 Restricted Stock Units and Performance-based Restricted Stock Units The fair value of restricted stock unit awards with time-based vesting is based on the intrinsic value of the awards at the date of grant. We also issue restricted stock unit awards with vesting based on performance conditions. Performance-based restricted stock units awarded in 2021 A summary of our restricted stock unit activity as of December 31, 2021 three Weighted Average Number Grant Date of Shares Fair Value Balance outstanding at December 31, 2018 217,895 $ 21.21 Granted 56,567 $ 35.41 Vested (61,058 ) $ 18.46 Canceled (24,723 ) $ 22.19 Balance outstanding at December 31, 2019 188,681 $ 26.14 Granted 46,146 $ 36.86 Vested (50,669 ) $ 22.76 Canceled (37,143 ) $ 27.88 Balance outstanding at December 31, 2020 147,015 $ 30.24 Granted 48,298 $ 48.65 Vested (51,414 ) $ 26.32 Canceled (10,068 ) $ 30.70 Balance outstanding at December 31, 2021 133,831 $ 38.26 A summary of our performance-based restricted stock unit activity as of December 31, 2021 three Weighted Average Number Grant Date of Shares Fair Value Balance outstanding at December 31, 2020 - $ - Granted 31,181 $ 48.60 Vested - $ - Canceled - $ - Balance outstanding at December 31, 2021 31,181 $ 48.60 The number of RSUs vested includes the shares that we withheld on behalf of employees to satisfy minimum statutory tax withholding requirements. The fair values of the RSUs that vested during 2021, 2020 2019 We repurchase shares of our common stock in order to cover any minimum tax withholding liability associated with RSU vestings. A summary of our repurchases is as follows: 2021 2020 2019 Shares of common stock repurchased for net settlement of equity awards 16,333 16,537 20,524 Average per share repurchase price $ 49.10 $ 34.47 $ 33.28 Aggregage purchase price (in thousands) $ 802 $ 570 $ 683 Stock-based Compensation The components of stock-based compensation expense included in the consolidated statements of operations are as follows: 2021 2020 2019 (in thousands) Stock option awards $ 2,199 $ 1,938 $ 1,580 Restricted stock units 1,247 1,084 1,062 Performance-based restricted stock units 33 - - Total stock-based compensation $ 3,479 $ 3,022 $ 2,642 Stock-based compensation is included in our statements of operations as follows: 2021 2020 2019 (in thousands) Cost of sales $ 407 $ 333 $ 310 Sales and marketing 527 516 544 General and administrative 2,185 1,883 1,509 Research and development 360 290 279 Total stock-based compensation $ 3,479 $ 3,022 $ 2,642 We expect to record the unamortized portion of share-based compensation expense of $13.1 million for existing stock options and RSUs outstanding at December 31, 2021, Stock Repurchase Plans On February 22, 2022, February 22, 2023. may not Dividends In February 2011, Record Date Payment Date Per Share Amount Dividend Payment (in thousands) Fiscal Year 2021 March 9, 2021 March 25, 2021 $ 0.110 $ 2,262 May 19, 2021 June 3, 2021 $ 0.110 $ 2,267 August 26, 2021 September 9, 2021 $ 0.110 $ 2,401 November 19, 2021 December 2, 2021 $ 0.110 $ 2,405 Fiscal Year 2020 March 3, 2020 March 19, 2020 $ 0.095 $ 1,917 May 20, 2020 June 4, 2020 $ 0.095 $ 1,917 August 27, 2020 September 10, 2020 $ 0.095 $ 1,925 November 19, 2020 December 3, 2020 $ 0.095 $ 1,936 On February 22, 2022, March 24, 2022 March 8, 2022 ,

Note 11 - Profit-sharing Plan

Note 11 - Profit-sharing Plan	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Compensation and Employee Benefit Plans [Text Block]	11. We offer a 401 may six 2021, 2020 2019,

Note 12 - Segment and Enterpris

Note 12 - Segment and Enterprise-wide Disclosures	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Segment Reporting Disclosure [Text Block]	12. The FASB establishes standards for reporting information regarding operating segments in financial statements. Operating segments are identified as components of an enterprise that engage in business activities for which separate, discrete financial information is available and is regularly reviewed by the chief operating decision-maker in making decisions on how to allocate resources and assess performance. We view our operations and manage our business as one operating segment. No Most of our revenues are generated in the United States, Germany, and other European countries, Canada, the United Kingdom and Japan, and substantially all of our assets are located in the United States, Germany and France. Net sales to unaffiliated customers by country were as follows: Year ended December 31, 2021 2020 2019 (in thousands) United States $ 93,866 $ 75,222 $ 63,130 Germany 12,968 12,365 12,400 Other countries 47,590 41,779 41,702 Net sales $ 154,424 $ 129,366 $ 117,232 Long-term assets by country, including property and equipment, net and right-of-use leased assets were as follows: As of December 31, 2021 2020 (in thousands) United States $ 28,402 $ 27,660 France 1,038 1,140 Germany 781 1,138 Other countries 1,909 1,164 Total long-term assets $ 32,130 $ 31,102

Note 13 - Fair Value Measuremen

Note 13 - Fair Value Measurements	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Fair Value Disclosures [Text Block]	13. The fair value accounting guidance requires that assets and liabilities carried at fair value be classified and disclosed in one three • Level 1 • Level 2 1, not • Level 3 no Level 1 December 31, 2021 We had no 2 December 31, 2021. As discussed in Notes 1 2, 3 2020 2, first three December 31, 2021 During 2019, first 12 24 November 2019 first 12 24 not August 2021 may September 30, 2021 The following table provides a rollforward of the fair value of these liabilities, as determined by Level 3 Year ended December 31, 2021 2020 2019 (in thousands) Beginning balance $ 2,240 $ 1,764 $ 72 Additions - 406 1,989 Payments - - (309 ) Change in fair value included in earnings (748 ) 70 12 Ending balance $ 1,492 $ 2,240 $ 1,764

Note 14 - Accumulated Other Com

Note 14 - Accumulated Other Comprehensive Income (Loss)	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Comprehensive Income (Loss) Note [Text Block]	14. Year ended December 31, 2021 2020 2019 (in thousands) Beginning balance $ (1,525 ) $ (4,007 ) $ (3,900 ) Other comprehensive income (loss) before reclassifications (1,910 ) 2,482 (107 ) Amounts reclassified from accumulated other comprehensive loss - - - Ending Balance $ (3,435 ) $ (1,525 ) $ (4,007 ) Changes to our accumulated other comprehensive loss consisted primarily of foreign currency translation for the years ended December 31, 2021, 2020 2019.

Note 15 - Quarterly Financial D

Note 15 - Quarterly Financial Data (Unaudited)	12 Months Ended
	Dec. 31, 2021
Notes to Financial Statements
Quarterly Financial Information [Text Block]	15. Three months ended 2021 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 35,883 $ 40,670 $ 38,368 $ 39,503 Gross profit 23,799 26,761 24,866 25,956 Income from operations 7,945 11,106 9,073 8,301 Net income 5,929 8,299 6,504 6,175 Earnings per share Basic $ 0.29 $ 0.40 $ 0.30 $ 0.28 Diluted $ 0.28 $ 0.40 $ 0.30 $ 0.28 Three months ended 2020 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 30,551 $ 24,851 $ 36,416 $ 37,548 Gross profit 20,483 17,029 22,704 24,402 Income from operations 4,353 4,872 10,018 9,545 Net income 3,174 3,500 7,513 7,033 Earnings per share Basic $ 0.16 $ 0.17 $ 0.37 $ 0.35 Diluted $ 0.16 $ 0.17 $ 0.37 $ 0.34

Significant Accounting Policies

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2021
Accounting Policies [Abstract]
Basis of Accounting, Policy [Policy Text Block]	Description of Business Unless the context requires otherwise, references to LeMaitre, LeMaitre Vascular, we, our, and us refer to LeMaitre Vascular, Inc. and our subsidiaries. We develop, manufacture, and market medical devices and implants used primarily in the field of vascular surgery. We also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. We operate in a single
Consolidation, Policy [Policy Text Block]	Consolidation and Basis of Presentation Our consolidated financial statements include the accounts of LeMaitre Vascular and the accounts of our wholly-owned subsidiaries, LeMaitre Vascular GmbH, LeMaitre Vascular GK, Vascutech Acquisition LLC, LeMaitre Acquisition LLC, LeMaitre Vascular SAS, LeMaitre Vascular S.r.l., LeMaitre Vascular Spain SL, LeMaitre Vascular Switzerland GmbH, LeMaitre Vascular ULC, LeMaitre Vascular AS, LeMaitre Vascular Pty Ltd, Bio Nova International Pty Ltd, LeMaitre Vascular, Ltd., LeMaitre Medical Technology (Shanghai) Co. Ltd, LeMaitre Cardial SAS and LeMaitre Pte Ltd. All significant intercompany accounts and transactions have been eliminated in consolidation.
Foreign Currency Transactions and Translations Policy [Policy Text Block]	Foreign Currency Translation Balance sheet accounts of foreign subsidiaries are translated into U.S. dollars at year-end exchange rates. Operating accounts are translated at average exchange rates for each year. Net translation gains or losses are adjusted directly to a separate component of other comprehensive income (loss) within stockholders’ equity. Foreign exchange transaction gains (losses), substantially all of which relate to intercompany activity between us and our foreign subsidiaries, are included in other income (expense) in the accompanying consolidated statements of operations.
Use of Estimates, Policy [Policy Text Block]	Estimates The preparation of financial statements in conformity with U.S. generally accepted accounting principles (GAAP) requires management to make estimates and assumptions that affect the amounts reported in in our consolidated financial statements and accompanying notes. Due to the COVID- 19 19 not February 28, 2022, 10 19.
Revenue from Contract with Customer [Policy Text Block]	Revenue Recognition Our revenue is derived primarily from the sale of disposable or implantable devices used during vascular surgery. We sell primarily directly to hospitals and to a lesser extent to distributors, as described below, and, during the periods presented in our consolidated financial statements, entered into consigned inventory arrangements with either hospitals or distributors on a limited basis. With the acquisition of the RestoreFlow allograft business, we also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. These revenues are recognized when services have been provided and the tissue has been shipped to the customer, provided all other revenue recognition criteria discussed in the succeeding paragraph have been met. We record revenue under the provisions of ASU 2014 09, Revenue from Contracts with Customers (Topic 606 606 Step 1: Step 2: Step 3: Step 4: Step 5: Revenue is recognized when or as a company satisfies a performance obligation by transferring a promised good or service to a customer (which is when the customer obtains control of that good or service). In instances in which shipping and handling activities are performed after a customer takes control of the goods (such as when title passes upon shipment from our dock), we have made the policy election allowed under Topic 606 not We generally reference customer purchase orders to determine the existence of a contract. Orders that are not one not We record revenue, net of allowances for returns and discounts, fees paid to group purchasing organizations, and any sales and value added taxes required to be invoiced, which we have elected to exclude from the measurement of the transaction price as allowed by the standard, at the time of shipment (taking into consideration contractual shipping terms), or in the case of consigned inventory, when it is consumed. Shipment is the point at which control of the product and title passes to our customers, and at which LeMaitre has a present right to receive payment for the goods. Below is a disaggregation of our revenue by major geographic area, which is among the primary categorizations used by management in evaluating financial performance, for the periods indicated (in thousands): Year ended December 31, 2021 2020 Americas $ 102,265 $ 81,470 Europe, Middle East and Africa 42,132 39,193 Asia Pacific 10,027 8,703 Total $ 154,424 $ 129,366 We do not no not no Customers returning products may 18 twelve 30 not not
Research and Development Expense, Policy [Policy Text Block]	Research and Development Expense Research and development costs, principally salaries, laboratory testing, and supplies, are expensed as incurred and also include royalty payments associated with licensed and acquired intellectual property.
Shipping and Handling [Policy Text Block]	Shipping and Handling Costs Shipping and handling fees paid by customers are recorded within net sales, with the related expense recorded in cost of sales.
Advertising Cost [Policy Text Block]	Advertising Costs Advertising costs are expensed as incurred and are included as a component of sales and marketing expense in the accompanying consolidated statements of operations. Advertising costs are as follows: Year ended December 31, 2021 2020 2019 (in thousands) Advertising expense $ 236 $ 216 $ 286
Cash and Cash Equivalents, Policy [Policy Text Block]	Cash and Cash Equivalents We consider all highly liquid instruments purchased with maturity dates of 90
Marketable Securities, Policy [Policy Text Block]	Short-term Marketable Securitie Our short-term marketable securities are available-for-sale securities carried at fair value, with unrealized gains and losses recorded in other comprehensive income. They include a managed income mutual fund investing mainly in short-term investment-grade, U.S. dollar denominated fixed and floating rate debt, and a short-duration bond fund.
Concentration Risk, Credit Risk, Policy [Policy Text Block]	Concentrations of Credit Risk Our financial instruments that are exposed to concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. Cash equivalents represent highly liquid investments with maturities of 90 $250,000. December 31, 2021. Our accounts receivable are with customers based in the United States and internationally. Accounts receivable generally are due within 30 90 may 90 240 We closely monitor outstanding receivables for potential collection risks, including those that may may December 31, 2021 December 31, 2021, may not may We write off accounts receivable when they become uncollectible. Such credit losses have historically been within our expectations and allowances. The allowance for doubtful accounts is our best estimate of the amount of probable credit losses in our existing accounts receivable. We review our allowance for doubtful accounts on a monthly basis and all past due balances are reviewed individually for collectability. The provision for the allowance for doubtful accounts is recorded in general and administrative expenses. The following is a summary of our allowance for doubtful accounts and sales returns: Balance at Additions Deductions Balance at Beginning (recoveries) charged from End of of Period to Income Reserves Period (in thousands) Allowance for doubtful accounts and sales returns: Year ended December 31, 2021 $ 623 $ 263 $ 207 $ 679 Year ended December 31, 2020 522 293 192 623 Year ended December 31, 2019 399 388 265 522
Fair Value of Financial Instruments, Policy [Policy Text Block]	Fair Value of Financial Instruments Our financial instruments include cash and cash equivalents, short-term marketable securities, accounts receivable and trade payables. The fair value of these instruments approximates their carrying value based upon their short-term nature or variable rates of interest. Unrealized gains and losses on our short-term marketable securities are recorded in other comprehensive income and were not December 31, 2021.
Inventory and Other Deferred Costs [Policy Text Block]	Inventory and Other Deferred Costs Inventory and Other Deferred Costs consists of finished products, work-in-process, raw materials and costs deferred in connection with human tissue cryopreservation services of our RestoreFlow allograft business. We value inventory and other deferred costs at the lower of cost or market value. Cost includes materials, labor and manufacturing overhead and is determined using the first first may not may
Property, Plant and Equipment, Policy [Policy Text Block]	Property and Equipment Property and equipment are recorded at cost. Depreciation is provided over the estimated useful lives of the related assets using straight-line method as follows: Description Useful Life (in years) Computers and equipment 3 – 5 Machinery and equipment 3 – 10 Leasehold improvements The shorter of its useful life or lease term Expenditures for maintenance and repairs are charged to operations when incurred, while additions and betterments are capitalized. When assets are retired or disposed, the asset’s original cost and related accumulated depreciation are eliminated from the accounts and any gain or loss is reflected in the statement of operations.
Business Combinations Policy [Policy Text Block]	Valuation of Business Combinations We assign the value of the consideration transferred to acquire a business to the tangible assets and identifiable intangible assets acquired and liabilities assumed on the basis of their fair values at the date of acquisition. We assess the fair value of assets, including intangible assets, using a variety of methods and are usually performed by an independent appraiser who measures fair value from the perspective of a market participant. Acquisitions have been accounted for using the acquisition method, and the acquired companies’ results have been included in the accompanying consolidated financial statements from their respective dates of acquisition. Acquisition transaction costs have been recorded in general and administrative expenses, and are expensed as incurred. Allocation of the purchase price for acquisitions is based on estimates of the fair value of the net assets acquired and, for acquisitions completed within the past year, is subject to adjustment upon finalization of the purchase price allocation. Our acquisitions have historically been made at prices above the fair value of the acquired assets, resulting in goodwill, due to expectations of synergies of combining the businesses. These synergies include use of our existing commercial infrastructure to expand sales of the acquired businesses’ products, use of the commercial infrastructure of the acquired businesses to cost-effectively expand sales of our products, and the elimination of redundant facilities, functions and staffing.
Contingent Consideration [Policy Text Block]	Contingent Consideration Contingent consideration for acquisitions is recognized at the date of acquisition, based on the fair value at that date, and then re-measured periodically through adjustments to net income.
Impairment or Disposal of Long-Lived Assets, Policy [Policy Text Block]	Impairment of Long-lived Assets We review our long-lived assets (primarily property and equipment and intangible assets) subject to amortization quarterly to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the remaining useful life. Conditions that may not
Goodwill and Intangible Assets, Goodwill, Policy [Policy Text Block]	Goodwill Goodwill represents the amount of consideration paid in connection with business acquisitions in excess of the fair value of assets acquired and liabilities assumed. Goodwill is evaluated for impairment annually, or more frequently if indicators of impairment are present or changes in circumstances suggest that an impairment may December 31 not” not” 50 not December 31, 2021, 2020 2019.
Goodwill and Intangible Assets, Intangible Assets, Policy [Policy Text Block]	Other Intangible Assets Other intangible assets consist primarily of patents, trademarks, technology licenses, and customer relationships acquired in connection with business acquisitions and asset acquisitions and are amortized over their estimated useful lives, ranging from 2 to 16 years.
Share-based Payment Arrangement [Policy Text Block]	Stock-based Compensation We recognize, as expense, the estimated fair value of stock options to employees determined using the Black-Scholes option pricing model. Share-based compensation charges are recorded across the consolidated statement of operations based upon the grantee’s primary function. We have elected to recognize the compensation cost of all share-based awards on a straight-line basis over the vesting period of the award. In periods that we grant stock options, fair value assumptions are based on volatility, interest, dividend yield, and expected term over which the stock options will be outstanding. The computation of expected volatility is based on the historical volatility of the company’s stock. The interest rate for periods within the contractual life of the award is based on the U.S. Treasury risk-free interest rate in effect at the time of grant. Historical data on exercise patterns is the basis for estimating the expected life of an option. The expected annual dividend rate was calculated by dividing our annual dividend, based on the most recent quarterly dividend rate, by the closing stock price on the grant date. We also issue restricted stock units (RSUs) and performance-based restricted stock units (PSUs) as additional forms of equity compensation to our employees, officers, and directors, pursuant to our stockholder-approved 2006 no 2021 2021
Commitments and Contingencies, Policy [Policy Text Block]	Commitments and Contingencies In the normal course of business, we are subject to proceedings, lawsuits, and other claims and assessments for matters related to, among other things, patent infringement, business acquisitions, employment, commercial matters and product recalls. We assess the likelihood of any adverse judgments or outcomes to these matters as well as potential ranges of probable losses. A determination of the amount of reserves required, if any, for these contingencies is made after careful analysis of each individual issue. The required reserves may December 31, 2021, 2020 2019, not Sales of medical devices outside the U.S. are subject to international regulatory requirements that vary from country to country. These requirements and the amount of time required for approval may no
Income Tax, Policy [Policy Text Block]	Income Taxes We account for income taxes under the asset and liability method of accounting for income taxes. Under the asset and liability method, deferred taxes are determined based on the difference between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect in the years in which the differences are expected to reverse. The provision for income taxes includes taxes currently payable and deferred taxes resulting from the tax effects of temporary differences between the financial statement and tax bases of assets and liabilities. We maintain valuation allowances where it is more likely than not not We recognize, measure, present and disclose in our financial statements, uncertain tax positions that we have taken or expect to take on a tax return. We recognize in our financial statements the impact of tax positions that meet a “more likely than not” fifty Our policy is to classify interest and penalties related to unrecognized tax benefits as income tax expense.
Comprehensive Income, Policy [Policy Text Block]	Comprehensive Income Comprehensive income is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Other than reported net income, comprehensive income includes foreign currency translation adjustments and unrealized gains and losses on our marketable securities, which are disclosed in the accompanying consolidated statements of comprehensive income. There were no reclassifications out of comprehensive income for the years ended December 31, 2021, 2020 2019. Accumulated other comprehensive loss consisted primarily of foreign currency translation adjustment losses of $3.1 million and $1.6 million as of December 31, 2021 2020,
Costs Associated with Exit or Disposal Activities or Restructurings, Policy [Policy Text Block]	Restructuring We record restructuring charges incurred in connection with consolidation or relocation of operations, exited business lines, reductions in force, or distributor terminations. These restructuring charges, which reflect our commitment to a termination or exit plan that will begin within twelve
Earnings Per Share, Policy [Policy Text Block]	Earnings per Share We compute basic earnings per share by dividing net income available for common stockholders by the weighted average number of shares outstanding during the year. Except where the result would be anti-dilutive to net income per share, diluted earnings per share has been computed using the treasury stock method and reflects the potential vesting of restricted common stock and the potential exercise of stock options, as well as their related income tax effects. The computation of basic and diluted net income per share is as follows: Year ended December 31, 2021 2020 2019 (in thousands, except per share data) Basic: Net income available for common stockholders $ 26,907 $ 21,220 $ 17,934 Weighted average shares outstanding 21,157 20,246 19,813 Basic earnings per share $ 1.27 $ 1.05 $ 0.91 Net income available for common stockholders $ 26,907 $ 21,220 $ 17,934 Weighted-average shares outstanding 21,157 20,246 19,813 Common stock equivalents, if dilutive 318 233 513 Shares used in computing diluted earnings per common share 21,475 20,479 20,326 Diluted earnings per share $ 1.25 $ 1.04 $ 0.88 Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive 10 483 468
New Accounting Pronouncements, Policy [Policy Text Block]	Recent Accounting Pronouncements In December 2019, 2019 12 740 740 740. January 1, 2021, not

Note 1 - Significant Accounti_2

Note 1 - Significant Accounting Policies and Related Matters (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Disaggregation of Revenue [Table Text Block]	Year ended December 31, 2021 2020 Americas $ 102,265 $ 81,470 Europe, Middle East and Africa 42,132 39,193 Asia Pacific 10,027 8,703 Total $ 154,424 $ 129,366
Schedule of Advertising Expenses [Table Text Block]	Year ended December 31, 2021 2020 2019 (in thousands) Advertising expense $ 236 $ 216 $ 286
Financing Receivable, Allowance for Credit Loss [Table Text Block]	Balance at Additions Deductions Balance at Beginning (recoveries) charged from End of of Period to Income Reserves Period (in thousands) Allowance for doubtful accounts and sales returns: Year ended December 31, 2021 $ 623 $ 263 $ 207 $ 679 Year ended December 31, 2020 522 293 192 623 Year ended December 31, 2019 399 388 265 522
Schedule of Property, Plant and Equipment Estimated Useful Lives [Table Text Block]	Description Useful Life (in years) Computers and equipment 3 – 5 Machinery and equipment 3 – 10 Leasehold improvements The shorter of its useful life or lease term
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Year ended December 31, 2021 2020 2019 (in thousands, except per share data) Basic: Net income available for common stockholders $ 26,907 $ 21,220 $ 17,934 Weighted average shares outstanding 21,157 20,246 19,813 Basic earnings per share $ 1.27 $ 1.05 $ 0.91 Net income available for common stockholders $ 26,907 $ 21,220 $ 17,934 Weighted-average shares outstanding 21,157 20,246 19,813 Common stock equivalents, if dilutive 318 233 513 Shares used in computing diluted earnings per common share 21,475 20,479 20,326 Diluted earnings per share $ 1.25 $ 1.04 $ 0.88 Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive 10 483 468

Note 2 - Acquisitions (Tables)

Note 2 - Acquisitions (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]	Allocated Fair Value (in thousands) Inventory $ 3,859 Accounts receivable 1,789 Equipment and supplies 1,140 Accounts payable and other (53 ) Intangible assets 39,056 Goodwill 27,115 Purchase price $ 72,906 Allocated Fair Value (in thousands) Inventory and other $ 1,343 Deferred tax assets 1,345 Intangible assets 8,725 Goodwill 5,999 Purchase price $ 17,412 Allocated Fair Value (in thousands) Inventory $ 276 Equipmentand supplies 70 Intangible assets 4,844 Goodwill 2,748 Purchase price $ 7,938
Schedule of Finite-Lived Intangible Assets Acquired as Part of Business Combination [Table Text Block]	Allocated Estimated Fair Value Useful Life (in years) (in thousands) Customer relationships $ 20,310 15.0 Intellectual property 16,449 10.0 Non-compete agreement 104 5.0 Tradenames 2,193 10.0 Total intangible assets $ 39,056 Weighted Average Allocated Fair Value Useful Life (in years) (in thousands) Customer relationships $ 3,945 13.0 Intellectual property 563 7.0 Non-compete agreement 233 5.0 Tradenames 103 7.0 Total intangible assets $ 4,844

Note 3 - Inventories and Othe_2

Note 3 - Inventories and Other Deferred Costs (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Schedule of Inventory, Current [Table Text Block]	December 31, 2021 December 31, 2020 (in thousands) Raw materials $ 5,945 $ 5,044 Work-in-process 9,416 6,004 Finished products 25,286 28,117 Other deferred costs 5,457 5,950 Total inventory and other deferred costs $ 46,104 $ 45,115

Note 4 - Property and Equipme_2

Note 4 - Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Property, Plant and Equipment [Table Text Block]	As of December 31, 2021 2020 (in thousands) Computers and equipment $ 5,667 $ 5,046 Machinery and equipment 18,439 17,266 Building and leasehold improvements 15,884 12,809 Gross property and equipment 39,990 35,121 Less accumulated depreciation (22,931 ) (20,085 ) Property and equipment, net $ 17,059 $ 15,036
Depreciation Expense [Table Text Block]	Year ended December 31, 2021 2020 2019 (in thousands) Depreciation expense $ 3,280 $ 3,181 $ 2,979

Note 5 - Goodwill and Other I_2

Note 5 - Goodwill and Other Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Schedule of Goodwill [Table Text Block]	As of December 31, 2021 2020 Balance at beginning of year $ 65,945 $ 39,951 Additions for acquisitions - 27,115 Purchase accounting adjustments - (1,345 ) Effects of currency exchange - 224 Balance at end of year $ 65,945 $ 65,945
Schedule of Finite-Lived Intangible Assets [Table Text Block]	December 31, 2021 December 31, 2020 Gross Net Gross Net Carrying Accumulated Carrying Carrying Accumulated Carrying Value Amortization Value Value Amortization Value (in thousands) Product technology and intellectual property $ 29,549 $ 10,473 $ 19,076 $ 29,951 $ 7,947 $ 22,004 Trademarks, tradenames and licenses 3,647 1,139 2,508 4,000 1,094 2,906 Customer relationships 36,197 5,674 30,523 38,525 5,424 33,101 Other intangible assets 1,461 858 603 1,767 873 894 Total identifiable intangible assets $ 70,854 $ 18,144 $ 52,710 $ 74,243 $ 15,338 $ 58,905
Finite-lived Intangible Assets Amortization Expense [Table Text Block]	Year ended December 31, 2021 2020 2019 (in thousands) Amortization expense $ 6,195 $ 5,043 $ 2,437
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	Year ended December 31, 2022 2023 2024 2025 2026 (in thousands) Amortization expense $ 6,016 $ 5,884 $ 5,702 $ 5,464 $ 4,997

Note 7 - Accrued Expenses and_2

Note 7 - Accrued Expenses and Other Long-term Liabilities (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Schedule of Accrued Liabilities [Table Text Block]	December 31, 2021 December 31, 2020 (in thousands) Compensation and related taxes $ 10,236 $ 8,675 Income and other taxes 551 2,394 Professional fees 129 39 Other 5,416 6,417 Total $ 16,332 $ 17,525
Other Noncurrent Liabilities [Table Text Block]	December 31, 2021 December 31, 2020 (in thousands) Acquisition-related liabilities $ 1,761 $ 3,700 Income taxes 799 813 Other 141 130 Total $ 2,701 $ 4,643

Note 8 - Commitments and Cont_2

Note 8 - Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Lease, Cost [Table Text Block]	Year ended Year ended December 31, December 31, 2021 2020 (in thousands) (in thousands) Lease cost Operating lease cost $ 2,275 $ 1,912 Short-term lease cost 458 192 Total lease cost $ 2,733 $ 2,104 Other information Cash paid for amounts included in the measurement of operating lease liabilities $ 2,859 $ 2,404 Right-of-use assets obtained in exchange for new operating lease liabilities $ 1,277 $ 2,770 Weighted average remaining lease term - operating leases (in years) 7.3 7.8 Weighted average discount rate - operating leases 4.86 % 5.02 %
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	Year ending December 31, 2022 $ 2,666 2023 2,300 2024 2,104 2025 2,151 2026 2,153 Thereafter 8,198 Adjustment to net present value as of December 31, 2021 (3,635 ) Minimum noncancelable lease liability $ 15,937

Note 9 - Income Taxes (Tables)

Note 9 - Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Schedule of Income before Income Tax, Domestic and Foreign [Table Text Block]	Year ended December 31, 2021 2020 2019 (in thousands) United States $ 34,153 $ 25,308 $ 17,989 Foreign 134 2,048 3,690 Total $ 34,287 $ 27,356 $ 21,679
Schedule of Components of Income Tax Expense (Benefit) [Table Text Block]	Year ended December 31, 2021 2020 2019 (in thousands) Current: Federal $ 5,024 $ 4,594 $ 1,501 State 990 806 304 Foreign 1,287 1,064 1,116 7,301 6,464 2,921 Deferred: Federal 63 (397 ) 538 State (9 ) (48 ) 144 Foreign 25 117 142 79 (328 ) 824 Provision for income taxes $ 7,380 $ 6,136 $ 3,745
Schedule of Unrecognized Tax Benefits Roll Forward [Table Text Block]	2021 2020 2019 (in thousands) Unrecognized tax benefits at the beginning of year $ 820 $ 848 $ 711 Additions/adjustments for tax positions of current year - - 74 Additions/adjustments for tax positions of prior years (52 ) 37 63 Reductions for settlements with taxing authorities. - (65 ) - Reductions for lapses of the applicable statutes of limitations - - - Unrecognized tax benefits at the end of the year $ 768 $ 820 $ 848
Schedule of Deferred Tax Assets and Liabilities [Table Text Block]	As of December 31, 2021 2020 (in thousands) Deferred tax assets: Inventory $ 2,231 $ 1,629 Net operating loss carryforwards 1,153 1,348 Tax credit carryforwards 1,033 1,019 Capital loss carryforwards 492 521 Reserves and accruals 712 994 Operating lease liabilities 3,562 3,664 Intangible assets 4,426 4,386 Stock options 440 359 Other 140 105 Total deferred tax assets 14,189 14,025 Deferred tax liabilities: Property and equipment (1,713 ) (1,831 ) Goodwill (4,825 ) (4,055 ) Operating lease right-of-use assets (3,355 ) (3,503 ) Foreign branch deferred offset (843 ) (954 ) Other (213 ) (299 ) Total deferred tax liabilities (10,949 ) (10,642 ) Net deferred tax assets before valuation allowance 3,240 3,383 Valuation allowance (1,744 ) (1,824 ) Net deferred tax liabiltity $ 1,496 $ 1,559 Deferred tax classification Long-term deferred tax asset $ 1,566 $ 1,686 Long-term deferred tax liability (70 ) (127 ) Net long-term deferred tax asset $ 1,496 $ 1,559
Schedule of Effective Income Tax Rate Reconciliation [Table Text Block]	2021 2020 2019 Federal statutory rate 21.0 % 21.0 % 21.0 % State tax, net of federal benefit 2.7 % 2.2 % 1.9 % Effect of foreign taxes 3.7 % 1.1 % 2.1 % Federal tax on foreign income 0.2 % 0.4 % 0.8 % Valuation allowance (0.1 %) 1.4 % 0.6 % Foreign deferred tax liability offset (0.1 %) (0.2 %) (0.4 %) Research & development tax credits (0.4 %) (0.6 %) (1.2 %) Stock options (3.1 %) (2.3 %) (8.8 %) Uncertain tax positions 0.2 % 0.3 % 1.0 % Other permanent differences (2.4 %) (0.6 %) 0.5 % Other (0.2 %) (0.3 %) (0.2 %) Effective tax rate 21.5 % 22.4 % 17.3 %
Schedule of Cash Flow, Supplemental Disclosures [Table Text Block]	Year ended December 31, 2021 2020 2019 (in thousands) Cash paid for income taxes, net $ 10,147 $ 4,470 $ 4,817

Note 10 - Stockholders' Equity

Note 10 - Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	2021 2020 2019 Dividend yield 0.91 % 1.02 % 0.96 % Volatility 46.0 % 47.3 % 42.8 % Risk-free interest rate 1.1 % 0.3 % 1.7 % Weighted average expected option term (in years) 4.6 4.9 4.7 Weighted average fair value per share of options granted $ 17.64 $ 13.24 $ 12.51
Share-based Payment Arrangement, Option, Activity [Table Text Block]	Weighted Weighted Average Aggregate Number Average Remaining Intrinsic of Shares Exercise Price Contractual Term Value (in years) (in thousands) Balance outstanding at December 31, 2018 1,462,575 $ 16.41 4.54 $ 12,214 Granted 195,379 $ 35.53 Exercised (509,693 ) $ 9.53 $ 11,488 Canceled / Expired (101,167 ) $ 17.90 Balance outstanding at December 31, 2019 1,047,094 $ 28.22 4.31 $ 13,367 Granted 222,110 $ 36.67 Exercised (331,958 ) $ 17.99 $ 5,413 Canceled / Expired (5,406 ) $ 27.49 Balance outstanding at December 31, 2020 931,840 $ 28.22 4.49 $ 11,442 Granted 151,161 $ 48.60 Exercised (217,121 ) $ 20.95 $ 6,975 Canceled / Expired (19,126 ) $ 23.18 Balance outstanding at December 31, 2021 846,754 $ 33.83 4.50 $ 13,888 Exercisable at: December 31, 2019 309,501 $ 19.64 3.50 $ 5,047 December 31, 2020 274,411 $ 23.08 3.50 $ 4,781 December 31, 2021 301,692 $ 27.40 3.30 $ 6,886 Expected to vest at: December 31, 2019 737,593 $ 24.68 4.65 December 31, 2020 657,429 $ 30.37 4.93 December 31, 2021 545,062 $ 37.38 5.16
Share-based Payment Arrangement, Restricted Stock Unit, Activity [Table Text Block]	Weighted Average Number Grant Date of Shares Fair Value Balance outstanding at December 31, 2018 217,895 $ 21.21 Granted 56,567 $ 35.41 Vested (61,058 ) $ 18.46 Canceled (24,723 ) $ 22.19 Balance outstanding at December 31, 2019 188,681 $ 26.14 Granted 46,146 $ 36.86 Vested (50,669 ) $ 22.76 Canceled (37,143 ) $ 27.88 Balance outstanding at December 31, 2020 147,015 $ 30.24 Granted 48,298 $ 48.65 Vested (51,414 ) $ 26.32 Canceled (10,068 ) $ 30.70 Balance outstanding at December 31, 2021 133,831 $ 38.26
Share-based Payment Arrangement, Performance Shares, Activity [Table Text Block]	Weighted Average Number Grant Date of Shares Fair Value Balance outstanding at December 31, 2020 - $ - Granted 31,181 $ 48.60 Vested - $ - Canceled - $ - Balance outstanding at December 31, 2021 31,181 $ 48.60
Accelerated Share Repurchases [Table Text Block]	2021 2020 2019 Shares of common stock repurchased for net settlement of equity awards 16,333 16,537 20,524 Average per share repurchase price $ 49.10 $ 34.47 $ 33.28 Aggregage purchase price (in thousands) $ 802 $ 570 $ 683
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Table Text Block]	2021 2020 2019 (in thousands) Stock option awards $ 2,199 $ 1,938 $ 1,580 Restricted stock units 1,247 1,084 1,062 Performance-based restricted stock units 33 - - Total stock-based compensation $ 3,479 $ 3,022 $ 2,642 2021 2020 2019 (in thousands) Cost of sales $ 407 $ 333 $ 310 Sales and marketing 527 516 544 General and administrative 2,185 1,883 1,509 Research and development 360 290 279 Total stock-based compensation $ 3,479 $ 3,022 $ 2,642
Schedule of Dividends Payable [Table Text Block]	Record Date Payment Date Per Share Amount Dividend Payment (in thousands) Fiscal Year 2021 March 9, 2021 March 25, 2021 $ 0.110 $ 2,262 May 19, 2021 June 3, 2021 $ 0.110 $ 2,267 August 26, 2021 September 9, 2021 $ 0.110 $ 2,401 November 19, 2021 December 2, 2021 $ 0.110 $ 2,405 Fiscal Year 2020 March 3, 2020 March 19, 2020 $ 0.095 $ 1,917 May 20, 2020 June 4, 2020 $ 0.095 $ 1,917 August 27, 2020 September 10, 2020 $ 0.095 $ 1,925 November 19, 2020 December 3, 2020 $ 0.095 $ 1,936

Note 12 - Segment and Enterpr_2

Note 12 - Segment and Enterprise-wide Disclosures (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Schedule of Revenue from External Customers Attributed to Foreign Countries by Geographic Area [Table Text Block]	Year ended December 31, 2021 2020 2019 (in thousands) United States $ 93,866 $ 75,222 $ 63,130 Germany 12,968 12,365 12,400 Other countries 47,590 41,779 41,702 Net sales $ 154,424 $ 129,366 $ 117,232
Schedule of Revenue from External Customers and Long-Lived Assets, by Geographical Areas [Table Text Block]	As of December 31, 2021 2020 (in thousands) United States $ 28,402 $ 27,660 France 1,038 1,140 Germany 781 1,138 Other countries 1,909 1,164 Total long-term assets $ 32,130 $ 31,102

Note 13 - Fair Value Measurem_2

Note 13 - Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]	Year ended December 31, 2021 2020 2019 (in thousands) Beginning balance $ 2,240 $ 1,764 $ 72 Additions - 406 1,989 Payments - - (309 ) Change in fair value included in earnings (748 ) 70 12 Ending balance $ 1,492 $ 2,240 $ 1,764

Note 14 - Accumulated Other C_2

Note 14 - Accumulated Other Comprehensive Income (Loss) (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Schedule of Accumulated Other Comprehensive Income (Loss) [Table Text Block]	Year ended December 31, 2021 2020 2019 (in thousands) Beginning balance $ (1,525 ) $ (4,007 ) $ (3,900 ) Other comprehensive income (loss) before reclassifications (1,910 ) 2,482 (107 ) Amounts reclassified from accumulated other comprehensive loss - - - Ending Balance $ (3,435 ) $ (1,525 ) $ (4,007 )

Note 15 - Quarterly Financial_2

Note 15 - Quarterly Financial Data (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2021
Notes Tables
Quarterly Financial Information [Table Text Block]	Three months ended 2021 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 35,883 $ 40,670 $ 38,368 $ 39,503 Gross profit 23,799 26,761 24,866 25,956 Income from operations 7,945 11,106 9,073 8,301 Net income 5,929 8,299 6,504 6,175 Earnings per share Basic $ 0.29 $ 0.40 $ 0.30 $ 0.28 Diluted $ 0.28 $ 0.40 $ 0.30 $ 0.28 Three months ended 2020 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 30,551 $ 24,851 $ 36,416 $ 37,548 Gross profit 20,483 17,029 22,704 24,402 Income from operations 4,353 4,872 10,018 9,545 Net income 3,174 3,500 7,513 7,033 Earnings per share Basic $ 0.16 $ 0.17 $ 0.37 $ 0.35 Diluted $ 0.16 $ 0.17 $ 0.37 $ 0.34

Note 1 - Significant Accounti_3

Note 1 - Significant Accounting Policies and Related Matters (Details Textual) $ in Thousands	1 Months Ended	9 Months Ended	12 Months Ended
	Dec. 31, 2021USD ($)	Sep. 30, 2021	Dec. 31, 2021USD ($)	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Number of Operating Segments	1		1
Accounts Receivable, after Allowance for Credit Loss, Current, Total	$ 19,631		$ 19,631	$ 19,552
Goodwill, Impairment Loss			0	0	$ 0
Reclassification from Accumulated Other Comprehensive Income, Current Period, Net of Tax			0	0	$ 0
Accumulated Other Comprehensive Income (Loss), Foreign Currency Translation Adjustment, Net of Tax, Ending Balance	3,100		3,100	$ 1,600
ITALY
Accounts Receivable, after Allowance for Credit Loss, Current, Total	1,000		1,000
SPAIN
Accounts Receivable, after Allowance for Credit Loss, Current, Total	700		700
Geographic Distribution, Foreign [Member]
Cash, Ending Balance	$ 9,400		$ 9,400
Minimum [Member]
Period of Payments Received from Customers (Day)		30 days
Finite-Lived Intangible Asset, Useful Life (Year)			2 years
Maximum [Member]
Period of Payments Received from Customers (Day)		60 days
Finite-Lived Intangible Asset, Useful Life (Year)			16 years

Note 1 - Significant Accounti_4

Note 1 - Significant Accounting Policies and Related Matters - Disaggregation of Revenue by Major Geographic Area (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Revenue	$ 154,424	$ 129,366
Americas [Member]
Revenue	102,265	81,470
EMEA [Member]
Revenue	42,132	39,193
Asia Pacific [Member]
Revenue	$ 10,027	$ 8,703

Note 1 - Significant Accounti_5

Note 1 - Significant Accounting Policies and Related Matters - Summary of Advertising Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Advertising expense	$ 236	$ 216	$ 286

Note 1 - Significant Accounti_6

Note 1 - Significant Accounting Policies and Related Matters - Allowance for Doubtful Accounts and Sales Returns (Details) - Allowance for Doubtful Accounts and Sales Returns [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Balance	$ 623	$ 522	$ 399
Additions (recoveries) charged to income	263	293	388
Deductions from reserves	207	192	265
Balance	$ 679	$ 623	$ 522

Note 1 - Significant Accounti_7

Note 1 - Significant Accounting Policies and Related Matters - Summary of Property and Equipment (Details)	12 Months Ended
	Dec. 31, 2021
Computers and Equipment [Member] | Minimum [Member]
Useful life (Year)	3 years
Computers and Equipment [Member] | Maximum [Member]
Useful life (Year)	5 years
Machinery and Equipment [Member] | Minimum [Member]
Useful life (Year)	3 years
Machinery and Equipment [Member] | Maximum [Member]
Useful life (Year)	10 years
Leasehold Improvements [Member] | Minimum [Member]
Estimated useful life	The shorter of its useful life or lease term
Leasehold Improvements [Member] | Maximum [Member]
Estimated useful life	The shorter of its useful life or lease term

Note 1 - Significant Accounti_8

Note 1 - Significant Accounting Policies and Related Matters - Computation of Basic and Diluted Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2021	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Basic:
Net income available for common stockholders	$ 6,175	$ 6,504	$ 8,299	$ 5,929	$ 7,033	$ 7,513	$ 3,500	$ 3,174	$ 26,907	$ 21,220	$ 17,934
Weighted average shares outstanding (in shares)									21,157	20,246	19,813
Basic earnings per share (in dollars per share)	$ 0.28	$ 0.30	$ 0.40	$ 0.29	$ 0.35	$ 0.37	$ 0.17	$ 0.16	$ 1.27	$ 1.05	$ 0.91
Common stock equivalents, if dilutive (in shares)									318	233	513
Shares used in computing diluted earnings per common share (in shares)									21,475	20,479	20,326
Diluted earnings per share (in dollars per share)	$ 0.28	$ 0.30	$ 0.40	$ 0.28	$ 0.34	$ 0.37	$ 0.17	$ 0.16	$ 1.25	$ 1.04	$ 0.88
Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive (in shares)									10	483	468

Note 2 - Acquisitions (Details

Note 2 - Acquisitions (Details Textual)	Jun. 22, 2020USD ($)	Oct. 11, 2019USD ($)	Jul. 12, 2019USD ($)	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Dec. 31, 2021USD ($)	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Mar. 31, 2021USD ($)
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration, Liability						$ (674,000)	$ 182,000	$ 171,000
Goodwill, Purchase Accounting Adjustments						0	(1,345,000)
Artegraft Inc [Member]
Payments to Acquire Businesses, Gross	$ 72,500,000
Escrow Deposit Disbursements Related to Property Acquisition	$ 7,500,000
Business Combination, Contingent Consideration, Liability, Total						$ 400,000
Business Acquisition, Purchase Price Allocation, Goodwill Expected Tax Deductible, Period (Year)	15 years
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life (Year)	12 years 7 months 6 days
Artegraft Inc [Member] | First Earn-out [Member]
Business Combination, Contingent Consideration, Liability, Total	$ 5,800,000
Business Combination, Contingent Consideration, Unit Sales	20,000
Artegraft Inc [Member] | Second Earn-out [Member]
Business Combination, Contingent Consideration, Liability, Total	$ 5,800,000
Business Combination, Contingent Consideration, Unit Sales	24,000
Artegraft Inc [Member] | Third Earn-out [Member]
Business Combination, Contingent Consideration, Liability, Total	$ 5,800,000
Business Combination, Contingent Consideration, Unit Sales	28,800
Artegraft Inc [Member] | Catch-Up Payment [Member]
Business Combination, Contingent Consideration, Liability, Total	$ 400,000
Business Combination, Contingent Consideration, Minimum Unit Sales in Three Years	58,240
Business Combination, Contingent Consideration, Minimum Unit Sales in Three Years, Percent of Combined Individual Year Targets	80.00%
Business Combination, Contingent Consideration, Before Multiplied by Fraction	$ 17,500,000
Business Combination, Contingent Consideration, Denominator, Less Amount Paid	72,800
Artegraft Inc [Member] | Maximum [Member]
Business Combination, Consideration Transferred, Total	$ 90,000,000
CardioCel and VascuCel Biologic Patches [Member]
Payments to Acquire Businesses, Gross		$ 14,200,000
Business Combination, Contingent Consideration, Liability, Total		7,500,000							$ 2,000,000
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life (Year)						10 years 4 months 24 days
Goodwill, Purchase Accounting Adjustments					$ (1,300,000)		$ 1,300,000
CardioCel and VascuCel Biologic Patches [Member] | Technology Licenses [Member]
Business Combination, Consideration Transferred, Total		8,000,000
CardioCel and VascuCel Biologic Patches [Member] | Achieving Audited Financial Statements of Acquired Business [Member]
Payments to Acquire Businesses, Gross		300,000
CardioCel and VascuCel Biologic Patches [Member] | First Holdback [Member]
Business Combination, Contingent Consideration, Liability, Total		700,000
CardioCel and VascuCel Biologic Patches [Member] | Revenues Exceeding Twenty Million in the First Twelve Month Period After Closing Date [Member]
Business Combination, Contingent Consideration, Liability, Total		2,500,000
CardioCel and VascuCel Biologic Patches [Member] | Revenues Exceeding Fifteen Million in the First Twelve Month Period After Closing Date [Member]
Business Combination, Contingent Consideration, Liability, Total		1,200,000
CardioCel and VascuCel Biologic Patches [Member] | Revenues Exceeding Thirty Million in the Second Twelve Month Period After Closing Date [Member]
Business Combination, Contingent Consideration, Liability, Total		2,500,000
CardioCel and VascuCel Biologic Patches [Member] | Revenues Exceeding Twenty-Two and a Half Million in the First Twelve Month Period After Closing Date [Member]
Business Combination, Contingent Consideration, Liability, Total		1,200,000
CardioCel and VascuCel Biologic Patches [Member] | Extension of Product Shelf Life from 36 Months to 60 Months in the First Anniversary of Closing Date [Member]
Business Combination, Contingent Consideration, Liability, Total		500,000
CardioCel and VascuCel Biologic Patches [Member] | Third Holdback [Member]
Business Combination, Contingent Consideration, Liability, Total		2,000,000
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration, Liability				$ (500,000)
CardioCel and VascuCel Biologic Patches [Member] | Third Holdback [Member] | CardioCel Product [Member]
Business Combination, Contingent Consideration, Liability, Percent				75.00%
CardioCel and VascuCel Biologic Patches [Member] | Third Holdback [Member] | VascuCel Product [Member]
Business Combination, Contingent Consideration, Liability, Percent				25.00%
CardioCel and VascuCel Biologic Patches [Member] | Maximum [Member] | Biological Patch Business Assets [Member]
Business Combination, Consideration Transferred, Total		$ 15,300,000
Tru-Incise Valve Cutter [Member]
Business Combination, Consideration Transferred, Total			$ 8,000,000
Payments to Acquire Businesses, Gross			$ 6,800,000
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life (Year)			11 years 9 months 18 days
Business Combination, Deferred Purchase Consideration, Installment Payment			$ 400,000
Business Combination, Deferred Purchase Consideration			1,200,000
Acquisition Date Fair Value			$ 1,100,000
Business Combination ,Fair Value Inputs, Discount Rate			4.19%

Note 2 - Acquisitions - Assets

Note 2 - Acquisitions - Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Jun. 22, 2020	Dec. 31, 2019	Oct. 11, 2019	Jul. 12, 2019
Goodwill	$ 65,945	$ 65,945		$ 39,951
Artegraft Inc [Member]
Inventory			$ 3,859
Accounts receivable			1,789
Equipment and supplies			1,140
Accounts payable and other			53
Intangible assets			39,056
Goodwill			27,115
Purchase price			72,906
Equipmentand supplies			$ 1,140
CardioCel and VascuCel Biologic Patches [Member]
Intangible assets					$ 8,725
Goodwill					5,999
Purchase price					17,412
Inventory and other					1,343
Deferred tax assets					$ 1,345
Tru-Incise Valve Cutter [Member]
Inventory						$ 276
Equipment and supplies						70
Intangible assets						4,844
Goodwill						2,748
Purchase price						7,938
Equipmentand supplies						$ 70

Note 2 - Acquisitions - Acquire

Note 2 - Acquisitions - Acquired Intangible Assets and Related Estimated Useful Lives (Details) - USD ($) $ in Thousands	Jun. 22, 2020	Sep. 20, 2018
Artegraft Inc [Member]
Allocated Fair Value	$ 39,056
Weighted Average Useful Life (Year)	12 years 7 months 6 days
Artegraft Inc [Member] | Customer Relationships [Member]
Allocated Fair Value	$ 20,310
Weighted Average Useful Life (Year)	15 years
Artegraft Inc [Member] | Intellectual Property [Member]
Allocated Fair Value	$ 16,449
Weighted Average Useful Life (Year)	10 years
Artegraft Inc [Member] | Noncompete Agreements [Member]
Allocated Fair Value	$ 104
Weighted Average Useful Life (Year)	5 years
Artegraft Inc [Member] | Trade Names [Member]
Allocated Fair Value	$ 2,193
Weighted Average Useful Life (Year)	10 years
Applied Medical [Member]
Allocated Fair Value		$ 4,844
Applied Medical [Member] | Customer Relationships [Member]
Allocated Fair Value		$ 3,945
Weighted Average Useful Life (Year)		13 years
Applied Medical [Member] | Intellectual Property [Member]
Allocated Fair Value		$ 563
Weighted Average Useful Life (Year)		7 years
Applied Medical [Member] | Noncompete Agreements [Member]
Allocated Fair Value		$ 233
Weighted Average Useful Life (Year)		5 years
Applied Medical [Member] | Trade Names [Member]
Allocated Fair Value		$ 103
Weighted Average Useful Life (Year)		7 years

Note 3 - Inventories and Othe_3

Note 3 - Inventories and Other Deferred Costs (Details Textual) - USD ($) $ in Millions	Dec. 31, 2021	Dec. 31, 2020
Other Inventory, Materials, Supplies and Merchandise under Consignment, Gross	$ 2.1	$ 2.1

Note 3 - Inventories and Othe_4

Note 3 - Inventories and Other Deferred Costs - Summary of Inventories and Other Deferred Costs (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Raw materials	$ 5,945	$ 5,044
Work-in-process	9,416	6,004
Finished products	25,286	28,117
Other deferred costs	5,457	5,950
Total inventory and other deferred costs	$ 46,104	$ 45,115

Note 4 - Property and Equipme_3

Note 4 - Property and Equipment (Details Textual) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Impairment, Long-Lived Asset, Held-for-Use, Total	$ 0.1	$ 0.6	$ 0.5

Note 4 - Property and Equipme_4

Note 4 - Property and Equipment - Summary of Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Gross property and equipment	$ 39,990	$ 35,121
Less accumulated depreciation	(22,931)	(20,085)
Property and equipment, net	17,059	15,036
Computers and Equipment [Member]
Gross property and equipment	5,667	5,046
Machinery and Equipment [Member]
Gross property and equipment	18,439	17,266
Building and Leasehold Improvements [Member]
Gross property and equipment	$ 15,884	$ 12,809

Note 4 - Property and Equipme_5

Note 4 - Property and Equipment - Depreciation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Depreciation expense	$ 3,280	$ 3,181	$ 2,979

Note 5 - Goodwill and Other I_3

Note 5 - Goodwill and Other Intangible Assets (Details Textual) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Sep. 30, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Goodwill, Purchase Accounting Adjustments		$ 0	$ (1,345)
Impairment of Intangible Assets, Finite-lived		$ 3,400		$ 4,500
Minimum [Member]
Finite-Lived Intangible Asset, Useful Life (Year)		2 years
Maximum [Member]
Finite-Lived Intangible Asset, Useful Life (Year)		16 years
Weighted Average [Member]
Finite-Lived Intangible Asset, Useful Life (Year)		11 years
CardioCel and VascuCel Biologic Patches [Member]
Goodwill, Purchase Accounting Adjustments	$ (1,300)		$ 1,300

Note 5 - Goodwill and Other I_4

Note 5 - Goodwill and Other Intangibles - Schedule of Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Balance at beginning of year	$ 65,945	$ 39,951
Additions for acquisitions	0	27,115
Purchase accounting adjustments	0	(1,345)
Effects of currency exchange	0	224
Balance at end of year	$ 65,945	$ 65,945

Note 5 - Goodwill and Other I_5

Note 5 - Goodwill and Other Intangible Assets - Components of Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Gross carrying value	$ 70,854	$ 74,243
Accumulated amortization	18,144	15,338
Net carrying value	52,710	58,905
Product Technology and Intellectual Property [Member]
Gross carrying value	29,549	29,951
Accumulated amortization	10,473	7,947
Net carrying value	19,076	22,004
Trademarks, Tradenames and Licenses [Member]
Gross carrying value	3,647	4,000
Accumulated amortization	1,139	1,094
Net carrying value	2,508	2,906
Customer Relationships [Member]
Gross carrying value	36,197	38,525
Accumulated amortization	5,674	5,424
Net carrying value	30,523	33,101
Other Intangible Assets [Member]
Gross carrying value	1,461	1,767
Accumulated amortization	858	873
Net carrying value	$ 603	$ 894

Note 5 - Goodwill and Other I_6

Note 5 - Goodwill and Other Intangible Assets - Amortization Expense Included in General and Administrative Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Amortization expense	$ 6,195	$ 5,043	$ 2,437

Note 5 - Goodwill and Other I_7

Note 5 - Goodwill and Other Intangible Assets - Estimated Amortization Expense for Each of Five Succeeding Fiscal Years (Details) $ in Thousands	Dec. 31, 2021USD ($)
2022	$ 6,016
2023	5,884
2024	5,702
2025	5,464
2026	$ 4,997

Note 6 - Revolving Line of Cr_2

Note 6 - Revolving Line of Credit and Long-term Debt (Details Textual) - Senior Secured Credit Facility [Member] - USD ($) $ in Millions	Jun. 22, 2020	Dec. 31, 2021	Dec. 31, 2021	Dec. 31, 2020	Nov. 30, 2021
Debt Instrument, Face Amount	$ 65
Debt Issuance Costs, Net, Total	1.8
Debt Instrument, Interest Rate, Effective Percentage		4.20%	4.20%
Term Loan [Member]
Debt Instrument, Face Amount	$ 40
Debt Instrument, Term (Year)	5 years
Repayments of Long-term Debt, Total			$ 1	$ 1
Interest Paid, Including Capitalized Interest, Operating and Investing Activities, Total			$ 0.9
Amortization of Debt Issuance Costs		$ 0.6
Term Loan [Member] | Base Rate [Member] | Minimum [Member]
Debt Instrument, Basis Spread on Variable Rate	1.25%
Term Loan [Member] | Base Rate [Member] | Maximum [Member]
Debt Instrument, Basis Spread on Variable Rate	1.75%
Term Loan [Member] | Eurodollar [Member] | Minimum [Member]
Debt Instrument, Basis Spread on Variable Rate	2.25%
Term Loan [Member] | Eurodollar [Member] | Maximum [Member]
Debt Instrument, Basis Spread on Variable Rate	2.75%
Term Loan [Member] | Fed Funds Effective Rate Overnight Index Swap Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	0.50%
Interest Paid, Including Capitalized Interest, Operating and Investing Activities, Total				$ 0.9
Revolving Credit Facility [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 25
Debt Instrument, Term (Year)	5 years
Unamortized Debt Issuance Expense					$ 0.5
Revolving Credit Facility [Member] | Other Assets [Member]
Debt Issuance Costs, Line of Credit Arrangements, Net, Total	$ 0.7

Note 7 - Accrued Expenses and_3

Note 7 - Accrued Expenses and Other Long-term Liabilities - Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Compensation and related taxes	$ 10,236	$ 8,675
Income and other taxes	551	2,394
Professional fees	129	39
Other	5,416	6,417
Total	$ 16,332	$ 17,525

Note 7 - Accrued Expenses and_4

Note 7 - Accrued Expenses and Other Long-term Liabilities - Other Long-term Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Acquisition-related liabilities	$ 1,761	$ 3,700
Income taxes	799	813
Other	141	130
Total	$ 2,701	$ 4,643

Note 8 - Commitments and Cont_3

Note 8 - Commitments and Contingencies (Details Textual) $ in Thousands	Dec. 31, 2021USD ($)	Jun. 30, 2021	Dec. 31, 2020ft²
Finance Lease, Right-of-Use Asset | $	$ 0
Lessee, Operating Lease, Discount Rate	5.25%
Purchase Obligation, Total | $	$ 6,200
Senior Secured Credit Facility [Member] | Term Loan [Member]
Debt Instrument, Interest Rate, Stated Percentage	3.50%
Leased Automobiles [Member]
Lessee, Operating Lease, Term of Contract (Year)	3 years
Leased Printing Equipment [Member]
Lessee, Operating Lease, Term of Contract (Year)		5 years
North Brunswick, New Jersey [Member] | Artegraft Inc [Member]
Area of Real Estate Property (Square Foot)			16,732
ITALY | Customer Service and Warehouse Facility [Member]
Lessee, Operating Lease, Renewal Term (Year)		6 years
Lessee, Operating Lease, Term of Contract (Year)		6 years
CANADA
Lessee, Operating Lease, Renewal Term (Year)		5 years
Principal Worldwide Executive, Distribution, and Manufacturing Operations Facilities [Member] | Massachusetts [Member]
Area of Real Estate Property (Square Foot)			109,354
International Operations Headquarter Facility [Member] | GERMANY
Area of Real Estate Property (Square Foot)			16,470
Lessee, Operating Lease, Renewal Term (Year)			5 years

Note 8 - Commitments and Cont_4

Note 8 - Commitments and Contingencies - Additional Lease Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Operating lease cost	$ 2,275	$ 1,912
Short-term lease cost	458	192
Total lease cost	2,733	2,104
Cash paid for amounts included in the measurement of operating lease liabilities	2,859	2,404
Right-of-use assets obtained in exchange for new operating lease liabilities	$ 1,277	$ 2,770
Weighted average remaining lease term - operating leases (in years) (Year)	7 years 3 months 18 days	7 years 9 months 18 days
Weighted average discount rate - operating leases	4.86%	5.02%

Note 8 - Commitments and Cont_5

Note 8 - Commitments and Contingencies - Minimum Rental Commitments (Details) $ in Thousands	Dec. 31, 2021USD ($)
2022	$ 2,666
2023	2,300
2024	2,104
2025	2,151
2026	2,153
Thereafter	8,198
Adjustment to net present value as of December 31, 2021	(3,635)
Minimum noncancelable lease liability	$ 15,937

Note 9 - Income Taxes (Details

Note 9 - Income Taxes (Details Textual) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Unrecognized Tax Benefits, Ending Balance	$ 768	$ 820	$ 848	$ 711
Deferred Tax Assets, Valuation Allowance, Total	1,744	1,824
Deferred Tax Assets, Operating Loss Carryforwards, Total	1,153	1,348
Deferred Tax Assets, Capital Loss Carryforwards	492	521
Foreign Tax Authority [Member] | AUSTRALIA
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount	(100)	$ 400
Deferred Tax Assets, Operating Loss Carryforwards, Total	1,400
Deferred Tax Assets, Capital Loss Carryforwards	1,600
Foreign Tax Authority [Member] | FRANCE
Deferred Tax Assets, Operating Loss Carryforwards, Total	2,100
Foreign Tax Authority [Member] | SPAIN
Deferred Tax Assets, Operating Loss Carryforwards, Total	800
Foreign Tax Authority [Member] | NORWAY
Deferred Tax Assets, Operating Loss Carryforwards, Total	100
State and Local Jurisdiction [Member]
Tax Credit Carryforward, Amount	$ 1,600

Note 9 - Income Taxes - Income

Note 9 - Income Taxes - Income (Loss) Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
United States	$ 34,153	$ 25,308	$ 17,989
Foreign	134	2,048	3,690
Income before income taxes	$ 34,287	$ 27,356	$ 21,679

Note 9 - Income Taxes - The Pro

Note 9 - Income Taxes - The Provision (Benefit) for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Current:
Federal	$ 5,024	$ 4,594	$ 1,501
State	990	806	304
Foreign	1,287	1,064	1,116
Current Income Tax Expense (Benefit), Total	7,301	6,464	2,921
Deferred:
Federal	63	(397)	538
State	(9)	(48)	144
Foreign	25	117	142
Deferred Income Tax Expense (Benefit), Total	79	(328)	824
Provision for income taxes	$ 7,380	$ 6,136	$ 3,745

Note 9 - Income Taxes - Reconci

Note 9 - Income Taxes - Reconciliation of Beginning and Ending Amount of Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Unrecognized tax benefits at the beginning of year	$ 820	$ 848	$ 711
Additions/adjustments for tax positions of current year	0	0	74
Additions/adjustments for tax positions of prior years	(52)
Additions/adjustments for tax positions of prior years		37	63
Reductions for settlements with taxing authorities.	0	(65)	0
Reductions for lapses of the applicable statutes of limitations	0	0	0
Unrecognized tax benefits at the end of the year	$ 768	$ 820	$ 848

Note 9 - Income Taxes - Deferre

Note 9 - Income Taxes - Deferred Taxes (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Deferred tax assets:
Inventory	$ 2,231	$ 1,629
Net operating loss carryforwards	1,153	1,348
Tax credit carryforwards	1,033	1,019
Capital loss carryforwards	492	521
Reserves and accruals	712	994
Operating lease liabilities	3,562	3,664
Intangible assets	4,426	4,386
Stock options	440	359
Other	140	105
Total deferred tax assets	14,189	14,025
Deferred tax liabilities:
Property and equipment	(1,713)	(1,831)
Goodwill	(4,825)	(4,055)
Operating lease right-of-use assets	(3,355)	(3,503)
Foreign branch deferred offset	(843)	(954)
Other	(213)	(299)
Total deferred tax liabilities	(10,949)	(10,642)
Net deferred tax assets before valuation allowance	3,240	3,383
Valuation allowance	(1,744)	(1,824)
Net deferred tax liabiltity	1,496	1,559
Deferred tax classification
Deferred tax assets	1,566	1,686
Long-term deferred tax liability	(70)	(127)
Net long-term deferred tax asset	$ (1,496)	$ (1,559)

Note 9 - Income Taxes - Recon_2

Note 9 - Income Taxes - Reconciliation of the Federal Statutory Rate to Effective Tax Rate (Details)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Federal statutory rate	21.00%	21.00%	21.00%
State tax, net of federal benefit	2.70%	2.20%	1.90%
Effect of foreign taxes	3.70%	1.10%	2.10%
Federal tax on foreign income	0.20%	0.40%	0.80%
Valuation allowance	(0.10%)	1.40%	0.60%
Foreign deferred tax liability offset	(0.10%)	(0.20%)	(0.40%)
Research & development tax credits	(0.40%)	(0.60%)	(1.20%)
Stock options	(3.10%)	(2.30%)	(8.80%)
Uncertain tax positions	0.20%	0.30%	1.00%
Other permanent differences	(2.40%)	(0.60%)	0.50%
Other	(0.20%)	(0.30%)	(0.20%)
Effective tax rate	21.50%	22.40%	17.30%

Note 9 - Income Taxes - Schedul

Note 9 - Income Taxes - Schedule of Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Cash paid for income taxes, net	$ 10,147	$ 4,470	$ 4,817

Note 10 - Stockholders' Equit_2

Note 10 - Stockholders' Equity (Details Textual) - USD ($)	Feb. 22, 2022	Aug. 04, 2021	Jul. 16, 2021	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Common Stock, Shares Authorized (in shares)				37,000,000	37,000,000
Preferred Stock, Shares Authorized (in shares)				3,000,000	3,000,000
Preferred Stock, Shares Outstanding, Ending Balance (in shares)				0	0
Stock Issued During Period, Shares, New Issues (in shares)			1,000,000
Common Stock, Par or Stated Value Per Share (in dollars per share)			$ 0.01	$ 0.01	$ 0.01
Shares Issued, Price Per Share (in dollars per share)			$ 54.50
Stock Issued During Period, Value, New Issues			$ 51,000,000	$ 58,695,000
Proceeds from Issuance of Common Stock				$ 63,241,000	$ 5,971,000	$ 4,856,000
Share-based Compensation Arrangement by Share-based Payment Award, Number of Additional Shares Authorized (in shares)				5,500,000
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period (Year)				10 years
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized (in shares)				7,118,003
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant (in shares)				658,935
Proceeds from Stock Options Exercised				$ 4,500,000	$ 6,000,000	$ 4,900,000
Common Stock, Dividends, Per Share, Declared (in dollars per share)				$ 0.44	$ 0.38	$ 0.34
Subsequent Event [Member]
Common Stock, Dividends, Per Share, Declared (in dollars per share)	$ 0.125
Dividends Payable	$ 2,700,000
Dividends Payable, Date to be Paid	Mar. 24, 2022
Dividends Payable, Date of Record	Mar. 8, 2022
Common Stock [Member]
Stock Issued During Period, Shares, New Issues (in shares)				1,150,000
Stock Issued During Period, Value, New Issues				$ 12,000
Treasury Stock, Shares, Acquired (in shares)
Stock Repurchase Program [Member] | Common Stock [Member]
Treasury Stock, Shares, Acquired (in shares)				0
Stock Repurchase Program [Member] | Common Stock [Member] | Subsequent Event [Member]
Stock Repurchase Program, Authorized Amount	$ 20,000,000
Share-based Payment Arrangement, Option [Member] | Share-based Payment Arrangement, Tranche One [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period (Year)				4 years
Share-based Payment Arrangement, Option [Member] | Share-based Payment Arrangement, Tranche Two [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period (Year)				5 years
Restricted Stock Units (RSUs) [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Fair Value				$ 2,500,000	$ 1,800,000	$ 2,100,000
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total				$ 13,100,000
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)				3 years 3 months 18 days
Underwriters [Member]
Stock Issued During Period, Value, New Issues		$ 150,000
Proceeds from Issuance of Common Stock		$ 7,600,000

Note 10 - Stockholders' Equit_3

Note 10 - Stockholders' Equity - Weighted Average Assumptions (Details) - Share-based Payment Arrangement, Option [Member] - $ / shares	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Dividend yield	0.91%	1.02%	0.96%
Volatility	46.00%	47.30%	42.80%
Risk-free interest rate	1.10%	0.30%	1.70%
Weighted average expected option term (Year)	4 years 7 months 6 days	4 years 10 months 24 days	4 years 8 months 12 days
Weighted average fair value per share of options granted (in dollars per share)	$ 17.64	$ 13.24	$ 12.51

Note 10 - Stockholders' Equit_4

Note 10 - Stockholders' Equity - Summary of Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Outstanding (in shares)	931,840	1,047,094	1,462,575
Outstanding, weighted average exercise price (in dollars per share)	$ 28.22	$ 28.22	$ 16.41
Outstanding, weighted average contractual term (Year)	4 years 6 months	4 years 5 months 26 days	4 years 3 months 21 days	4 years 6 months 14 days
Outstanding, aggregate intrinsic value	$ 13,888	$ 11,442	$ 13,367	$ 12,214
Granted (in shares)	151,161	222,110	195,379
Granted, weighted average exercise price (in dollars per share)	$ 48.60	$ 36.67	$ 35.53
Exercised (in shares)	(217,121)	(331,958)	(509,693)
Exercised, weighted average exercise price (in dollars per share)	$ 20.95	$ 17.99	$ 9.53
Exercised, aggregate intrinsic value	$ 6,975	$ 5,413	$ 11,488
Canceled / Expired (in shares)	(19,126)	(5,406)	(101,167)
Canceled / Expired, weighted average exercise price (in dollars per share)	$ 23.18	$ 27.49	$ 17.90
Outstanding (in shares)	846,754	931,840	1,047,094	1,462,575
Outstanding, weighted average exercise price (in dollars per share)	$ 33.83	$ 28.22	$ 28.22	$ 16.41
Exercisable (in shares)	301,692	274,411	309,501
Exercisable, weighted average exercise price (in dollars per share)	$ 27.40	$ 23.08	$ 19.64
Exercisable, weighted average contractual term (Year)	3 years 3 months 18 days	3 years 6 months	3 years 6 months
Exercisable, aggregate intrinsic value	$ 6,886	$ 4,781	$ 5,047
Expected to vest (in shares)	545,062	657,429	737,593
Expected to vest, weighted average exercise price (in dollars per share)	$ 37.38	$ 30.37	$ 24.68
Expected to vest, weighted average contractual term (Year)	5 years 1 month 28 days	4 years 11 months 4 days	4 years 7 months 24 days

Note 10 - Stockholders' Equit_5

Note 10 - Stockholders' Equity - Summary of RSU Activity (Details) - Restricted Stock Units (RSUs) [Member] - $ / shares	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Outstanding (in shares)	147,015	188,681	217,895
Outstanding, weighted average grant date fair value (in dollars per share)	$ 30.24	$ 26.14	$ 21.21
Granted (in shares)	48,298	46,146	56,567
Granted, weighted average grant date fair value (in dollars per share)	$ 48.65	$ 36.86	$ 35.41
Vested (in shares)	(51,414)	(50,669)	(61,058)	[1]
Vested, weighted average grant date fair value (in dollars per share)	$ 26.32	$ 22.76	$ 18.46	[1]
Canceled (in shares)	(10,068)	(37,143)	(24,723)
Canceled, weighted average grant date fair value (in dollars per share)	$ 30.70	$ 27.88	$ 22.19
Outstanding (in shares)	133,831	147,015	188,681
Outstanding, weighted average grant date fair value (in dollars per share)	$ 38.26	$ 30.24	$ 26.14
[1]	The number of RSUs vested includes the shares that we withheld on behalf of employees to satisfy minimum statutory tax withholding requirements. The fair values of the RSUs that vested during 2020, 2019 and 2018 were $1.8 million, $2.1 million, and $1.9 million, respectively.

Note 10 - Stockholders' Equit_6

Note 10 - Stockholders' Equity - Summary of PBS Activity (Details) - Performance Shares [Member]	12 Months Ended
	Dec. 31, 2021$ / sharesshares
Outstanding (in shares) | shares	0
Outstanding, weighted average grant date fair value (in dollars per share) | $ / shares	$ 0
Granted (in shares) | shares	31,181
Granted, weighted average grant date fair value (in dollars per share) | $ / shares	$ 48.60
Vested (in shares) | shares	0	[1]
Vested, weighted average grant date fair value (in dollars per share) | $ / shares	$ 0	[1]
Canceled (in shares) | shares	0
Canceled, weighted average grant date fair value (in dollars per share) | $ / shares	$ 0
Outstanding (in shares) | shares	31,181
Outstanding, weighted average grant date fair value (in dollars per share) | $ / shares	$ 48.60
[1]	The number of RSUs vested includes the shares that we withheld on behalf of employees to satisfy minimum statutory tax withholding requirements. The fair values of the RSUs that vested during 2020, 2019 and 2018 were $1.8 million, $2.1 million, and $1.9 million, respectively.

Note 10 - Stockholders' Equit_7

Note 10 - Stockholders' Equity - Summary of Repurchases (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Shares of common stock repurchased for net settlement of equity awards (in shares)	16,333	16,537	20,524
Restricted Stock Units (RSUs) [Member]
Average per share repurchase price (in dollars per share)	$ 49.10	$ 34.47	$ 33.28
Aggregage purchase price (in thousands)	$ 802	$ 570	$ 683

Note 10 - Stockholders' Equit_8

Note 10 - Stockholders' Equity - Stock-based Compensation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Stock-based compensation	$ 3,479	$ 3,022	$ 2,642
Cost of Sales [Member]
Stock-based compensation	407	333	310
Sales [Member]
Stock-based compensation	527	516	544
General and Administrative Expense [Member]
Stock-based compensation	2,185	1,883	1,509
Research and Development Expense [Member]
Stock-based compensation	360	290	279
Share-based Payment Arrangement, Option [Member]
Stock-based compensation	2,199	1,938	1,580
Restricted Stock Units (RSUs) [Member]
Stock-based compensation	1,247	1,084	1,062
Performance Shares [Member]
Stock-based compensation	$ 33	$ 0	$ 0

Note 10 - Stockholders' Equit_9

Note 10 - Stockholders' Equity - Dividend Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Per share amount (in dollars per share)	$ 0.44	$ 0.38	$ 0.34
Quarterly Dividends 1 [Member]
Payment date	Mar. 25, 2021	Mar. 19, 2020
Per share amount (in dollars per share)	$ 0.110	$ 0.095
Dividend payment	$ 2,262	$ 1,917
Quarterly Dividends 2 [Member]
Payment date	Jun. 3, 2021	Jun. 4, 2020
Per share amount (in dollars per share)	$ 0.110	$ 0.095
Dividend payment	$ 2,267	$ 1,917
Quarterly Dividends 3 [Member]
Payment date	Sep. 9, 2021	Sep. 10, 2020
Per share amount (in dollars per share)	$ 0.110	$ 0.095
Dividend payment	$ 2,401	$ 1,925
Quarterly Dividends 4 [Member]
Payment date	Dec. 2, 2021	Dec. 3, 2020
Per share amount (in dollars per share)	$ 0.110	$ 0.095
Dividend payment	$ 2,405	$ 1,936

Note 11 - Profit-sharing Plan (

Note 11 - Profit-sharing Plan (Details Textual) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Defined Contribution, Plan Employers Matching Contribution, Annual Vesting Period (Year)	6 years
Deferred Profit Sharing [Member]
Defined Contribution Plan, Employer Discretionary Contribution Amount	$ 0.5	$ 0.3	$ 0.4

Note 12 - Segment and Enterpr_3

Note 12 - Segment and Enterprise-wide Disclosures (Details Textual)	1 Months Ended	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2021
Number of Operating Segments	1	1

Note 12 - Segment and Enterpr_4

Note 12 - Segment and Enterprise-wide Disclosures - Net Sales to Unaffiliated Customers by Geography (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2021	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Net sales	$ 39,503	$ 38,368	$ 40,670	$ 35,883	$ 37,548	$ 36,416	$ 24,851	$ 30,551	$ 154,424	$ 129,366	$ 117,232
UNITED STATES
Net sales									93,866	75,222	63,130
GERMANY
Net sales									12,968	12,365	12,400
Other Countries [Member]
Net sales									$ 47,590	$ 41,779	$ 41,702

Note 12 - Segment and Enterpr_5

Note 12 - Segment and Enterprise-wide Disclosures - Long-term Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Long-term Assets	$ 32,130	$ 31,102
UNITED STATES
Long-term Assets	28,402	27,660
FRANCE
Long-term Assets	1,038	1,140
GERMANY
Long-term Assets	781	1,138
Other Countries [Member]
Long-term Assets	$ 1,909	$ 1,164

Note 13 - Fair Value Measurem_3

Note 13 - Fair Value Measurements (Details Textual) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Mar. 31, 2021	Oct. 11, 2019
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration, Liability		$ (674)	$ 182	$ 171
Artegraft Inc [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High		17,500
Business Combination, Contingent Consideration, Liability, Total		400
CardioCel and VascuCel Biologic Patches [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High				7,800
Business Combination, Contingent Consideration, Liability, Total					$ 2,000	$ 7,500
CardioCel and VascuCel Biologic Patches [Member] | Audited Carve-Out Financial Statements of the Acquired Business [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High				300
CardioCel and VascuCel Biologic Patches [Member] | Third Holdback [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High				2,000
Business Combination, Contingent Consideration, Liability, Total						2,000
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration, Liability	$ (500)
CardioCel and VascuCel Biologic Patches [Member] | Extension of Product Shelf Life from 36 Months to 60 Months in the First Anniversary of Closing Date [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High				500
Business Combination, Contingent Consideration, Liability, Total						500
CardioCel and VascuCel Biologic Patches [Member] | Achievement of Specified Levels of Revenues [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High				$ 5,000
Fair Value, Inputs, Level 2 [Member] | Fair Value, Recurring [Member]
Assets, Fair Value Disclosure		$ 0
Fair Value, Inputs, Level 3 [Member] | CardioCel and VascuCel Biologic Patches [Member]
Business Combination, Contingent Consideration, Liability, Total						$ 2,300

Note 13 - Fair Value Measurem_4

Note 13 - Fair Value Measurements - Rollforward of the Fair Value as Determined by Level 3 (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Beginning balance	$ 2,240	$ 1,764	$ 72
Additions	0	406	1,989
Payments	0	0	(309)
Change in fair value included in earnings	(748)	70	12
Ending balance	$ 1,492	$ 2,240	$ 1,764

Note 14 - Accumulated Other C_3

Note 14 - Accumulated Other Comprehensive Income (Loss) - Schedule of Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Balance	$ 172,572	$ 148,141	$ 130,235
Balance	254,151	172,572	148,141
AOCI Attributable to Parent [Member]
Balance	(1,525)	(4,007)	(3,900)
Other comprehensive income (loss) before reclassifications	(1,910)	2,482	(107)
Amounts reclassified from accumulated other comprehensive loss	0	0	0
Balance	$ (3,435)	$ (1,525)	$ (4,007)

Note 15 - Quarterly Financial_3

Note 15 - Quarterly Financial Data (Unaudited) - Quarterly Financial Data (Unaudited) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2021	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Total net sales	$ 39,503	$ 38,368	$ 40,670	$ 35,883	$ 37,548	$ 36,416	$ 24,851	$ 30,551	$ 154,424	$ 129,366	$ 117,232
Gross profit	25,956	24,866	26,761	23,799	24,402	22,704	17,029	20,483	101,382	84,618	79,853
Income from operations	8,301	9,073	11,106	7,945	9,545	10,018	4,872	4,353	36,425	28,788	21,183
Net income	$ 6,175	$ 6,504	$ 8,299	$ 5,929	$ 7,033	$ 7,513	$ 3,500	$ 3,174	$ 26,907	$ 21,220	$ 17,934
Basic:
Basic (in dollars per share)	$ 0.28	$ 0.30	$ 0.40	$ 0.29	$ 0.35	$ 0.37	$ 0.17	$ 0.16	$ 1.27	$ 1.05	$ 0.91
Diluted (in dollars per share)	$ 0.28	$ 0.30	$ 0.40	$ 0.28	$ 0.34	$ 0.37	$ 0.17	$ 0.16	$ 1.25	$ 1.04	$ 0.88
Total net sales	$ 39,503	$ 38,368	$ 40,670	$ 35,883	$ 37,548	$ 36,416	$ 24,851	$ 30,551	$ 154,424	$ 129,366	$ 117,232
Gross profit	25,956	24,866	26,761	23,799	24,402	22,704	17,029	20,483	101,382	84,618	79,853
Income from operations	8,301	9,073	11,106	7,945	9,545	10,018	4,872	4,353	36,425	28,788	21,183
Net income	$ 6,175	$ 6,504	$ 8,299	$ 5,929	$ 7,033	$ 7,513	$ 3,500	$ 3,174	$ 26,907	$ 21,220	$ 17,934