Apollo Endosurgery (APEN) 10-Q 1 Nov 22 2022 Q3 Quarterly report Financial data

Cover

Cover - shares	9 Months Ended
	Sep. 30, 2022	Oct. 28, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2022
Document Transition Report	false
Entity File Number	001-35706
Entity Registrant Name	APOLLO ENDOSURGERY, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	16-1630142
Entity Address, Address Line One	1120 S. Capital of Texas Highway
Entity Address, Address Line Two	Building 1, Suite #300
Entity Address, City or Town	Austin
Entity Address, State or Province	TX
Entity Address, Postal Zip Code	78746
City Area Code	512
Local Phone Number	279-5100
Title of 12(b) Security	Common stock, par value $0.001 per share
Trading Symbol	APEN
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		41,634,162
Amendment Flag	false
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q3
Entity Central Index Key	0001251769
Current Fiscal Year End Date	--12-31

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 66,906	$ 90,691
Accounts receivable, net of allowance for doubtful accounts of $490 and $330, respectively	12,899	10,078
Inventory	16,696	11,966
Prepaid expenses and other current assets	2,270	1,965
Total current assets	98,771	114,700
Restricted cash	1,009	1,121
Property, equipment and right-of-use assets, net	7,202	5,593
Goodwill	5,290	5,290
Intangible assets, net of accumulated amortization of $15,856 and $14,814, respectively	3,363	4,400
Other assets	395	424
Total assets	116,030	131,528
Current liabilities:
Accounts payable	6,771	4,584
Accrued expenses	9,702	9,902
Total current liabilities	16,473	14,486
Long-term debt	33,839	33,473
Convertible debt	19,663	19,513
Long-term liabilities	3,741	2,819
Total liabilities	73,716	70,291
Commitments and contingencies
Stockholders’ equity:
Common stock; $0.001 par value; 100,000,000 shares authorized; 41,582,185 and 39,546,323 shares issued and outstanding at September 30, 2022 and December 31, 2021, respectively	42	40
Additional paid-in capital	362,791	356,516
Accumulated other comprehensive income	7,222	2,136
Accumulated deficit	(327,741)	(297,455)
Total stockholders’ equity	42,314	61,237
Total liabilities and stockholders’ equity	$ 116,030	$ 131,528

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 490	$ 330
Accumulated amortization	$ 15,856	$ 14,814
Common stock, par value (USD per share)	$ 0.001	$ 0.001
Common stock, shares authorized (shares)	100,000,000	100,000,000
Common stock, shares issued (shares)	41,582,185	39,546,323
Common stock, shares outstanding (shares)	41,582,185	39,546,323

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Income Statement [Abstract]
Revenues	$ 19,573	$ 16,351	$ 55,542	$ 46,818
Cost of sales	8,835	7,124	24,472	20,961
Gross margin	10,738	9,227	31,070	25,857
Operating expenses:
Sales and marketing	8,584	6,123	25,933	16,918
General and administrative	5,193	4,574	15,463	13,981
Research and development	2,802	2,567	8,432	7,045
Amortization of intangible assets	450	467	1,358	1,412
Total operating expenses	17,029	13,731	51,186	39,356
Loss from operations	(6,291)	(4,504)	(20,116)	(13,499)
Other (income) expenses:
Interest expense, net	1,155	1,342	3,583	4,028
Gain on forgiveness of PPP loan	0	0	0	(2,852)
Other expense (income), net	3,828	721	6,179	(618)
Net loss before income taxes	(11,274)	(6,567)	(29,878)	(14,057)
Income tax expense	172	90	408	220
Net loss	(11,446)	(6,657)	(30,286)	(14,277)
Other comprehensive (loss)/income:
Foreign currency translation	3,107	388	5,086	(1,014)
Comprehensive loss	$ (8,339)	$ (6,269)	$ (25,200)	$ (15,291)
Net loss per share, basic (USD per share)	$ (0.28)	$ (0.23)	$ (0.75)	$ (0.52)
Net loss per share, diluted (USD per share)	$ (0.28)	$ (0.23)	$ (0.75)	$ (0.52)
Shares used in computing net loss per share, basic (shares)	40,847,683	29,020,443	40,290,948	27,542,182
Shares used in computing net loss per share, diluted (shares)	40,847,683	29,020,443	40,290,948	27,542,182

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Changes in Stockholders’ Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income	Accumulated Deficit
Beginning balance (in shares) at Dec. 31, 2020		25,819,329
Beginning balance at Dec. 31, 2020	$ 6,751	$ 26	$ 276,569	$ 2,929	$ (272,773)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of common stock options (in shares)		643,569
Exercise of common stock options	2,352	$ 1	2,351
Exercise of common stock warrants (in shares)		2,668,247
Exercise of common stock warrants	2	$ 3	(1)
Issuance of restricted stock and performance stock units (in shares)		431,047
Issuance of common stock for convertible debt interest (in shares)		244,861
Issuance of common stock for convertible debt interest	1,229		1,229
Conversion of convertible debt (in shares)		22,644
Conversion of convertible debt	74		74
Stock-based compensation	4,791		4,791
Foreign currency translation	(1,014)			(1,014)
Net loss	(14,277)				(14,277)
Ending balance (in shares) at Sep. 30, 2021		29,829,697
Ending balance at Sep. 30, 2021	(92)	$ 30	285,013	1,915	(287,050)
Beginning balance (in shares) at Jun. 30, 2021		28,624,979
Beginning balance at Jun. 30, 2021	2,714	$ 29	281,551	1,527	(280,393)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of common stock options (in shares)		330,564
Exercise of common stock options	1,304	$ 1	1,303
Exercise of common stock warrants (in shares)		624,436
Exercise of common stock warrants	0	$ 0	0
Issuance of restricted stock and performance stock units (in shares)		178,109
Issuance of common stock for convertible debt interest (in shares)		71,609
Issuance of common stock for convertible debt interest	614		614
Stock-based compensation	1,545		1,545
Foreign currency translation	388			388
Net loss	(6,657)				(6,657)
Ending balance (in shares) at Sep. 30, 2021		29,829,697
Ending balance at Sep. 30, 2021	$ (92)	$ 30	285,013	1,915	(287,050)
Beginning balance (in shares) at Dec. 31, 2021	39,546,323	39,546,323
Beginning balance at Dec. 31, 2021	$ 61,237	$ 40	356,516	2,136	(297,455)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of common stock options (in shares)		129,005
Exercise of common stock options	379	$ 0	379
Exercise of common stock warrants (in shares)		1,361,869
Exercise of common stock warrants	0	$ 2	(2)
Issuance of restricted stock and performance stock units (in shares)		374,803
Shares held back for tax obligation in connection with restricted stock units (in shares)		(72,743)
Shares held back for tax obligation in connection with restricted stock units	(401)		(401)
Issuance of common stock for convertible debt interest (in shares)		242,928
Issuance of common stock for convertible debt interest	1,226		1,226
Conversion of convertible debt	0
Stock-based compensation	5,073		5,073
Foreign currency translation	5,086			5,086
Net loss	$ (30,286)				(30,286)
Ending balance (in shares) at Sep. 30, 2022	41,582,185	41,582,185
Ending balance at Sep. 30, 2022	$ 42,314	$ 42	362,791	7,222	(327,741)
Beginning balance (in shares) at Jun. 30, 2022		40,515,646
Beginning balance at Jun. 30, 2022	48,156	$ 41	360,295	4,115	(316,295)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of common stock options (in shares)		22,424
Exercise of common stock options	64	$ 0	64
Exercise of common stock warrants (in shares)		861,869
Exercise of common stock warrants	0	$ 1	(1)
Issuance of restricted stock and performance stock units (in shares)		21,288
Shares held back for tax obligation in connection with restricted stock units (in shares)		(6,190)
Shares held back for tax obligation in connection with restricted stock units	(40)		(40)
Issuance of common stock for convertible debt interest (in shares)		167,148
Issuance of common stock for convertible debt interest	613		613
Stock-based compensation	1,860		1,860
Foreign currency translation	3,107			3,107
Net loss	$ (11,446)				(11,446)
Ending balance (in shares) at Sep. 30, 2022	41,582,185	41,582,185
Ending balance at Sep. 30, 2022	$ 42,314	$ 42	$ 362,791	$ 7,222	$ (327,741)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash flows from operating activities:
Net loss	$ (30,286)	$ (14,277)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	2,247	2,484
Gain on forgiveness of PPP loan	0	(2,852)
Amortization of deferred financing costs	342	377
Non-cash interest	1,463	1,304
Provision for doubtful accounts receivable	240	62
Inventory impairment	71	50
Stock-based compensation	5,073	4,791
Unrealized foreign exchange on intercompany payables	6,040	(856)
Changes in operating assets and liabilities:
Accounts receivable	(3,630)	(2,312)
Inventory	(4,907)	(1,077)
Prepaid expenses and other assets	(344)	(951)
Accounts payable and accrued expenses	2,732	3,142
Net cash used in operating activities	(20,959)	(10,115)
Cash flows from investing activities:
Purchases of property and equipment	(1,907)	(743)
Purchases of intangibles and other assets	(326)	(218)
Net cash used in investing activities	(2,233)	(961)
Cash flows from financing activities:
Proceeds from exercise of stock options	379	2,352
Proceeds from exercise of warrants	0	2
Shares held back for tax obligation in connection with restricted stock units	(401)	0
Net cash (used in)/provided by financing activities	(22)	2,354
Effect of exchange rate changes on cash	(683)	(4)
Net change in cash, cash equivalents and restricted cash	(23,897)	(8,726)
Cash, cash equivalents and restricted cash at beginning of year	91,812	37,200
Cash, cash equivalents and restricted cash at end of period	67,915	28,474
Supplemental disclosure of cash flow information:
Cash paid for interest	1,867	2,359
Cash paid for income taxes	280	36
Right-of-use assets recognized in exchange for lease obligations (non-cash)	556	(577)
Gain on forgiveness of PPP loan (non-cash)	0	2,852
Issuance of common stock for convertible debt interest (non-cash)	1,226	1,229
Issuance of common stock from conversion of convertible debt (non-cash)	$ 0	$ 74

Organization and Business Descr

Organization and Business Description	9 Months Ended
	Sep. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Business Description	Organization and Business Description Apollo Endosurgery, Inc. is a Delaware corporation with both domestic and foreign wholly-owned subsidiaries. Throughout these Notes, “Apollo” and the “Company” refer to Apollo Endosurgery, Inc. and its consolidated subsidiaries. Apollo is a medical technology company primarily focused on the development of next-generation, minimally invasive medical devices to advance gastrointestinal therapeutic endoscopy. The Company develops and distributes devices that are used by surgeons and gastroenterologists for a variety of procedures related to gastrointestinal conditions including closure of gastrointestinal defects, managing gastrointestinal complications and weight loss as a treatment of obesity. The Company’s core products include the OverStitch® Endoscopic Suturing System, the OverStitch Sx TM Endoscopic Suturing System, X-Tack® Endoscopic HeliX Tacking System (collectively “ESS”) and the ORBERA® Intragastric Balloon (“IGB”). All devices are regulated by the U.S. Food and Drug Administration (the “FDA”) or an equivalent regulatory body outside the U.S. In July 2022, the Company received FDA authorization for Apollo ESG TM , Apollo REVISE TM , Apollo ESG Sx TM and Apollo REVISE Sx TM . To date, these are the first and only devices authorized by the FDA for endoscopic sleeve gastroplasty (“ESG”) and endoscopic bariatric revision. The Company has offices in the United Kingdom and Italy that oversee commercial activities outside the U.S. and a products manufacturing facility in Costa Rica. All other activities are managed and operated from facilities in Austin, Texas.

Significant Accounting Policies

Significant Accounting Policies	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Significant Accounting Policies	Significant Accounting Policies (a) Basis of Presentation The Company prepared its interim condensed consolidated financial statements in conformity with accounting principles generally accepted in the United States of America (“GAAP”). They do not include all of the information and footnotes required by GAAP for complete financial statements. The accompanying condensed consolidated financial statements include the Company’s accounts and the accounts of its wholly-owned subsidiaries. The Company has eliminated all intercompany balances and transactions. The Company has made estimates and judgments affecting the amounts reported in its condensed consolidated financial statements and the accompanying notes. The actual results that the Company experiences may differ materially from the Company’s estimates. The accounting estimates that require the Company’s most significant, difficult and subjective judgments include revenue recognition and inventory valuation. (b) Unaudited Interim Results In management’s opinion, the unaudited financial information for the interim periods presented includes all adjustments necessary for a fair presentation of the results of operations, financial position, and cash flows. All adjustments are of a normal recurring nature unless otherwise disclosed. Revenues, expenses, assets and liabilities can vary during each quarter of the year. Therefore, the results and trends in these interim financial statements may not be the same as those for the full year. This interim information should be read in conjunction with the audited consolidated financial statements in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021. (c) Recent Accounting Pronouncements In August 2020, Accounting Standards Update (“ASU”) No. 2020-06, Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity was issued, which simplifies the accounting for certain financial instruments with characteristics of liabilities and equity, including convertible instruments and contracts on an entity’s own equity. This ASU will become effective for the Company on January 1, 2024 and is not expected to have a material impact on the consolidated financial statements. In May 2021, ASU No. 2021-04, Issuer’s Accounting for Certain Modifications of Exchanges of Freestanding Equity-Classified Written Call Options

Concentrations

Concentrations	9 Months Ended
	Sep. 30, 2022
Risks and Uncertainties [Abstract]
Concentrations	Concentrations Consolidated financial instruments that potentially subject the Company to a concentration of credit risk principally consist of cash and cash equivalents and accounts receivable. At September 30, 2022, the Company’s cash, cash equivalents and restricted cash are held in deposit accounts at four different banks totaling $67,915. The Company has not experienced any losses in such accounts, and management does not believe the Company is exposed to any significant credit risk. Management further believes that credit risk in the Company’s accounts receivable is substantially mitigated by the Company’s evaluation process, relatively short collection terms, and the high level of creditworthiness of its customers. The Company continually monitors the compliance of its customers with the Company’s payment terms, but generally requires no collateral. The Company had no concentrations greater than 10% of the Company’s net accounts receivable as of September 30, 2022 or December 31, 2021. The Company had no single customer that comprised more than 10% of the Company's total revenues for the three and nine months ended September 30, 2022 or 2021.

Inventory

Inventory	9 Months Ended
	Sep. 30, 2022
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory consists of the following as of: September 30, 2022 December 31, 2021 (unaudited) Raw materials $ 5,755 $ 3,442 Work in progress 1,814 965 Finished goods 9,127 7,559 Total inventory $ 16,696 $ 11,966 Finished goods included $72 and $120 of consigned inventory at September 30, 2022 and December 31, 2021, respectively.

Property, Equipment and Right-o

Property, Equipment and Right-of-Use Assets	9 Months Ended
	Sep. 30, 2022
Property, Plant and Equipment [Abstract]
Property, Equipment and Right-of-Use Assets	Property, Equipment and Right-of-Use Assets Property, equipment and right-of-use assets consists of the following: Depreciable Lives September 30, 2022 December 31, 2021 (unaudited) Equipment 5 years $ 8,575 $ 7,472 Right-of-use assets 1-8 years 3,912 3,459 Furniture, fixtures and tooling 4-8 years 2,004 1,855 Computer hardware 3-5 years 1,766 1,444 Leasehold improvements 3-7 years 2,089 2,059 Construction in process 813 483 19,159 16,772 Less accumulated depreciation (11,957) (11,179) Property, equipment and right-of-use assets, net $ 7,202 $ 5,593 The Company recorded depreciation expense of $316 and $883 for the three and nine months ended September 30, 2022, respectively, and $285 and $1,071 for the three and nine months ended September 30, 2021, respectively. There were no impairment charges for the three and nine months ended September 30, 2022 or 2021. The Company has operating leases for office space in Texas, the United Kingdom, and Italy, and for the manufacturing facility in Costa Rica. The Company also has various operating lease agreements for vehicles. As of September 30, 2022, the maturities of the Company’s operating lease liabilities are as follows: 2022 $ 241 2023 892 2024 811 2025 785 2026 513 Thereafter 756 Total lease payments 3,998 Less imputed interest (852) Total operating lease liabilities $ 3,146 Operating lease liabilities of $590 are included in accrued expenses long-term liabilities

Accrued Expenses

Accrued Expenses	9 Months Ended
	Sep. 30, 2022
Payables and Accruals [Abstract]
Accrued Expenses	Accrued Expenses Accrued expenses consists of the following as of: September 30, 2022 December 31, 2021 (unaudited) Accrued employee compensation and expenses $ 5,822 $ 6,569 Accrued professional service fees 788 656 Accrued taxes 624 437 Lease liability 590 587 Accrued interest 307 613 Accrued returns and rebates 197 106 Other 1,374 934 Total accrued expenses $ 9,702 $ 9,902

Long-Term Debt

Long-Term Debt	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Long-Term Debt	Long-Term Debt Long-term debt consists of the following as of: September 30, 2022 December 31, 2021 (unaudited) Term loan facility $ 35,000 $ 35,000 Deferred interest 180 6 Deferred financing costs (1,341) (1,533) Long-term debt $ 33,839 $ 33,473 Term Loan Facility In December 2021, the Company entered into a term loan facility with Innovatus Capital Partners, LLC (“Innovatus”) to borrow up to $100,000 (the “Term Loans”) and drew the Term A Loan of $35,000. The Company is eligible to draw the Term B Loan of $15,000 between July 1, 2023 and December 31, 2023 and the Term C Loan of $25,000 between July 1, 2024 and December 31, 2024, in each case upon the achievement of certain minimum revenue thresholds. The Company is eligible to draw the Term D Loan of $25,000 to finance certain approved acquisitions between June 30, 2022 and June 30, 2024. The Term Loans mature on December 21, 2027, with principal payments beginning February 1, 2027, and bear interest at the greater of the Wall Street Journal Prime Rate or 3.25%, plus 4.0%. Principal payments are due on a straight-line basis after the interest-only period concludes. An additional 4.0% of the outstanding amount will be due at the end of the loan term. Prior to December 21, 2025, Innovatus will have the right to make a one-time election to convert up to 10.0% of the outstanding aggregate principal amount of the term loans into shares of common stock of the Company at a price per share equal to $11.50. The Term Loans include customary affirmative covenants and negative covenants. Additionally, it contains a minimum liquidity covenant, tested on a maintenance basis, and a minimum revenue covenant tested quarterly commencing the earlier of December 31, 2023 or the funding date of the Term B loan. The Company used $35,000 of the proceeds of the Term A Loan to repay the previous senior secured credit agreement in full, including interest. Interest expense on the Company’s long-term debt was $948 and $2,513 for the three and nine months ended September 30, 2022, respectively, and $1,048 and $3,147 for the three and nine months ended September 30, 2021, respectively. Principal payments of the Company’s long-term debt are as follows: 2022 - 2026 $ — Thereafter 35,000 $ 35,000

Convertible Debt

Convertible Debt	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Convertible Debt	Convertible Debt Convertible debt consists of the following as of: September 30, 2022 December 31, 2021 (unaudited) Convertible debt $ 20,446 $ 20,446 Deferred financing costs (783) (933) Total convertible debt $ 19,663 $ 19,513 In August 2019, the Company issued $20,000 aggregate principal amount of 6.0% convertible senior debentures (the “Convertible Debt”), primarily to existing stockholders and officers of the Company. Interest on the Convertible Debt is payable semi-annually in shares of the Company’s common stock on January 1 and July 1 of each year at a rate of 6.0% per year. The number of shares of common stock required to settle the amount of interest payable will be based on the volume-weighted average price (“VWAP”) of the Company’s common stock for the 10 consecutive trading days immediately preceding the applicable interest payment date. However, in the event that the trailing 10-trading day VWAP of the Company’s common stock is less than $2.50 per share, interest accrued and payable for the applicable interest payment period will accrete to the principal amount then outstanding. The Convertible Debt will mature on August 12, 2026 unless earlier converted or repaid in accordance with its terms. The Company issued 75,780 shares of the Company’s common stock to holders of the Convertible Debt in January 2022 in fulfillment of accrued interest as of December 31, 2021. In July 2022, the Company issued 167,148 additional shares of common stock for accrued interest as of June 30, 2022. As of September 30, 2022, accrued interest on the Convertible Debt is $307. The Convertible Debt converts, at the option of the holders, into shares of the Company’s common stock at an initial conversion price of $3.25 per share, subject to adjustment. If the VWAP of the Company’s common stock has been at least $9.75 (subject to adjustment) for at least 20 trading days during any 30 consecutive trading day period, the Company may force the conversion of all or any part of the outstanding principal amount of the Convertible Debt, accrued and unpaid interest and any other amounts then owing, subject to certain conditions. Interest expense on the Convertible Debt was $357 and $1,070 for each of the three and nine months ended September 30, 2022, respectively, and $356 and $1,070 for each of the three and nine months ended September 30, 2021, respectively.

Long-Term Liabilities

Long-Term Liabilities	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Long-Term Liabilities	Long-Term LiabilitiesIncluded in other long-term liabilities as of September 30, 2022 was $1,185 for the estimated exit fee obligation to Solar Capital Ltd., our previous lender, which was reclassified from long-term debt in December 2021. The Company remains obligated to pay $1,925 upon the earlier to occur of (i) certain exit events specified in the Solar Term Facility or (ii) the Company’s achievement of trailing twelve-month revenue of $100,000. Accretion of interest expense on this long-term liability was $124 and $368 for the three and nine months ended September 30, 2022, respectively.

Warrants

Warrants	9 Months Ended
	Sep. 30, 2022
Other Liabilities Disclosure [Abstract]
Warrants	Warrants Warrants consist of the following as of September 30, 2022: Warrant Expiration Date Number of shares Exercise price per share No expiration 12,382,395 $ 0.001 During the nine months ended September 30, 2022, pre-funded warrants were exercised into 1,361,869 shares of common stock and 163,915 warrants expired.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2022
Share-Based Payment Arrangement [Abstract]
Stock-Based Compensation	Stock-Based Compensation A summary of the stock option activity as of September 30, 2022 is presented below. Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding, December 31, 2021 3,482,883 $ 5.04 8.0 years $ 12,307 Options granted 921,063 4.29 Options exercised (129,005) 2.93 Options forfeited (132,912) 4.41 Options outstanding, vested and expected to vest, September 30, 2022 4,142,029 $ 4.96 7.8 years $ 4,857 Options exercisable 2,107,631 $ 4.89 6.8 years $ 3,072 Shares subject to awards granted under the 2017 Plan which expire, are repurchased, or are canceled or forfeited will again become available for issuance under the 2017 Plan. The shares available will not be reduced by awards settled in cash or by shares withheld to satisfy tax withholding obligations. Only the net number of shares issued upon the exercise of options by means of a net exercise will be deducted from the shares available under the 2017 Plan. The fair value of stock option grants has been estimated at the date of grant using the Black-Scholes option pricing model with the following weighted average assumptions: Nine Months Ended Nine Months Ended Risk free interest rate 3.3% 1.0% Expected dividend yield —% —% Estimated volatility 82.8% 81.1% Expected life 6.0 years 6.1 years The aggregate intrinsic value in the tables above represents the total pre-tax value of the options shown, calculated as the difference between the Company’s closing stock price on September 30, 2022 and the exercise prices of the options shown, multiplied by the number of in-the money options. This is the aggregate amount that would have been received by the option holders if they had all exercised their options on September 30, 2022 and sold the shares thereby received at the closing price of the Company’s common stock on that date. This amount changes based on the closing price of the Company’s common stock. Additional information regarding options is as follows: Nine Months Ended Nine Months Ended Weighted-average grant date fair value of options granted during the period $ 3.07 $ 4.40 Aggregate intrinsic value of options exercised during the period $ 374 $ 3,116 Unrecognized compensation expense related to unvested options was approximately $6,642 at September 30, 2022, with a weighted average remaining amortization period of 2.7 years. A summary of the restricted stock unit activity, including performance-based stock units, under the Company’s Equity Plans as of September 30, 2022 is presented below. Units Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Restricted stock units outstanding, December 31, 2021 1,194,432 $ 5.67 $ 10,069 Restricted stock units granted 1,535,351 5.16 Restricted stock units released (374,803) 5.14 Restricted stock units forfeited (115,034) 4.42 Restricted stock units outstanding, September 30, 2022 2,239,946 $ 5.47 $ 12,342 In March 2021, the Company awarded 707,278 performance-based restricted stock units to the Company’s chief executive officer in connection with the commencement of his employment. The performance-based restricted stock units vest in four equal tranches upon the achievement of revenue for the trailing four quarters equal to $50,000, $65,000, $80,000, and $95,000. The revenue milestone for the first and second tranche was achieved as of June 30, 2021 and March 31, 2022, respectively. In August 2021, the Company awarded 80,000 time-based restricted stock units and 120,000 performance-based restricted stock units to the Company’s chief financial officer in connection with the commencement of his employment. The time-based restricted stock units vest in four equal tranches upon completion of each year of employment. The performance-based restricted stock units vest in three equal tranches upon the achievement of revenue for the trailing four quarters equal to $70,000, $90,000, and $110,000. The revenue milestone for the first tranche was achieved as of September 30, 2022. In May 2022, shares of performance-based restricted stock units for the Company’s chief executive officer that vested were subject to statutory tax withholdings and the compensation committee of the Company’s board of directors authorized the Company to withhold shares of common stock to settle the tax obligation, which resulted in a forfeiture of 66,553 shares of performance-based restricted stock units and 110,267 net shares of performance-based restricted stock units being issued during the nine months ended September 30, 2022. In August 2022, shares of time-based restricted stock units for the Company’s chief financial officer that vested were subject to statutory tax withholdings and the compensation committee of the Company’s board of directors authorized the Company to withhold shares of common stock to settle the tax obligation, which resulted in a forfeiture of 6,190 shares of time-based restricted stock units and 13,810 net shares of time-based restricted stock units being issued during the three and nine months ended September 30, 2022.

Purchase Commitment

Purchase Commitment	9 Months Ended
	Sep. 30, 2022
Commitments and Contingencies Disclosure [Abstract]
Purchase Commitment	Purchase CommitmentIn May 2022, the Company entered into a one-year noncancellable purchase agreement to purchase $2,040 of raw materials in the normal course of business.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The provision for income taxes for the three and nine months ended September 30, 2022 and 2021 primarily consists of foreign income taxes. The Company has established a valuation allowance due to uncertainties regarding the realization of deferred tax assets based on the Company’s lack of earnings history and potential limitations pursuant to changes in ownership under Internal Revenue Code Section 382. As of September 30, 2022, the Company has no unrecognized tax benefits or accrued interest or penalties associated with uncertain tax positions.

Net Loss Per Share

Net Loss Per Share	9 Months Ended
	Sep. 30, 2022
Earnings Per Share [Abstract]
Net Loss Per Share	Net Loss Per Share The basic and diluted net loss per common share presented in the condensed consolidated statements of operations and comprehensive loss is calculated by dividing net loss by the weighted-average number of common shares outstanding during the period, without consideration for common stock equivalents. Potentially dilutive shares, which include warrants for the purchase of common stock, convertible debt, restricted stock units, including performance-based stock units, and options outstanding under the Company’s equity incentive plans, are considered to be common stock equivalents and are only included in the calculation of diluted net loss per share when their effect is dilutive. Potentially dilutive securities that are not included in the calculation of diluted net loss per share attributable to common stockholders because to do so would be anti-dilutive are as follows (in common stock equivalent shares on a weighted-average basis): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Warrants for common stock 12,382,395 13,948,875 12,382,395 13,948,875 Convertible debt 6,318,451 6,299,433 6,300,200 6,293,791 Common stock options 4,142,029 3,494,676 3,669,004 3,039,021 Restricted stock units 2,189,486 1,127,964 1,707,078 847,081 25,032,361 24,870,948 24,058,677 24,128,768

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2022
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements The carrying amounts of the Company’s financial instruments, which primarily include cash, cash equivalents, and restricted cash, accounts receivable, accounts payable and accrued expenses, approximate their fair values due to their short maturities. The fair value of the Company’s long-term debt and Convertible Debt is estimated by management to approximate $35,000 and $19,000, respectively at September 30, 2022. Management’s estimates are based on comparisons of the characteristics of the Company's obligations, comparable ranges of interest rates on recently issued debt, and maturity. Such valuation inputs are considered a Level 3 measurement in the fair value valuation hierarchy. The accounting guidance defines fair value, establishes a consistent framework for measuring fair value and expands disclosure for each major asset and liability category measured at fair value on either a recurring or nonrecurring basis. Fair value is defined as an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the accounting guidance establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value as follows: Level 1: Observable inputs such as quoted prices in active markets; Level 2: Inputs, other than the quoted prices in active markets, that are observable either directly or indirectly; and Level 3: Unobservable inputs in which there is little or no market data, which require the reporting entity to develop its own assumptions.

Segment and Geographic Informat

Segment and Geographic Information	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Segment and Geographic Information	Segment and Geographic Information Operating segments are defined as components of an enterprise for which separate financial information is available and evaluated regularly by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. The Company globally manages the business within one reportable segment. Segment information is consistent with how management reviews the business, makes investing and resource allocation decisions and assesses operating performance. Product sales by product group and geographic market, based on the location of the customer, whether the U.S. or outside the U.S. (“OUS”) for the periods shown were as follows: Three Months Ended September 30, 2022 Three Months Ended September 30, 2021 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 9,494 $ 4,937 $ 14,431 73.7 % $ 6,722 $ 3,504 $ 10,226 62.5 % IGB 1,813 3,134 4,947 25.3 % 2,006 3,890 5,896 36.1 % Other 191 4 195 1.0 % 215 14 229 1.4 % Total revenues $ 11,498 $ 8,075 $ 19,573 100.0 % $ 8,943 $ 7,408 $ 16,351 100.0 % % Total revenues 58.7 % 41.3 % 54.7 % 45.3 % Nine Months Ended September 30, 2022 Nine Months Ended September 30, 2021 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 25,084 $ 13,119 $ 38,203 68.8 % $ 18,977 $ 10,512 $ 29,489 63.0 % IGB 6,114 10,640 16,754 30.2 % 5,570 11,042 16,612 35.5 % Other 574 11 585 1.0 % 689 28 717 1.5 % Total revenues $ 31,772 $ 23,770 $ 55,542 100.0 % $ 25,236 $ 21,582 $ 46,818 100.0 % % Total revenues 57.2 % 42.8 % 53.9 % 46.1 % Total distributor sales were 52.9% and 49.8% of total OUS revenues for the three and nine months ended September 30, 2022 and 46.4% and 42.4% of total OUS revenues for the three and nine months ended September 30, 2021, respectively. Sales in the next largest individual country outside the U.S. were approximately 5.0%-7.0% of total revenues for the three and nine months ended September 30, 2022, respectively, compared to approximately 6.0%-7.0% for the three and nine months ended September 30, 2021. The following table represents property, equipment and right-of-use assets based on the physical location of the asset: September 30, 2022 December 31, 2021 (unaudited) U.S. $ 3,851 $ 1,855 Costa Rica 3,163 3,436 Other 188 302 Total property, equipment and right-of-use assets, net $ 7,202 $ 5,593

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Organization and Business Description	Apollo Endosurgery, Inc. is a Delaware corporation with both domestic and foreign wholly-owned subsidiaries. Throughout these Notes, “Apollo” and the “Company” refer to Apollo Endosurgery, Inc. and its consolidated subsidiaries. Apollo is a medical technology company primarily focused on the development of next-generation, minimally invasive medical devices to advance gastrointestinal therapeutic endoscopy. The Company develops and distributes devices that are used by surgeons and gastroenterologists for a variety of procedures related to gastrointestinal conditions including closure of gastrointestinal defects, managing gastrointestinal complications and weight loss as a treatment of obesity. The Company’s core products include the OverStitch® Endoscopic Suturing System, the OverStitch Sx TM Endoscopic Suturing System, X-Tack® Endoscopic HeliX Tacking System (collectively “ESS”) and the ORBERA® Intragastric Balloon (“IGB”). All devices are regulated by the U.S. Food and Drug Administration (the “FDA”) or an equivalent regulatory body outside the U.S. In July 2022, the Company received FDA authorization for Apollo ESG TM , Apollo REVISE TM , Apollo ESG Sx TM and Apollo REVISE Sx TM . To date, these are the first and only devices authorized by the FDA for endoscopic sleeve gastroplasty (“ESG”) and endoscopic bariatric revision. The Company has offices in the United Kingdom and Italy that oversee commercial activities outside the U.S. and a products manufacturing facility in Costa Rica. All other activities are managed and operated from facilities in Austin, Texas.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In August 2020, Accounting Standards Update (“ASU”) No. 2020-06, Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity was issued, which simplifies the accounting for certain financial instruments with characteristics of liabilities and equity, including convertible instruments and contracts on an entity’s own equity. This ASU will become effective for the Company on January 1, 2024 and is not expected to have a material impact on the consolidated financial statements. In May 2021, ASU No. 2021-04, Issuer’s Accounting for Certain Modifications of Exchanges of Freestanding Equity-Classified Written Call Options
Net Loss Per Share	The basic and diluted net loss per common share presented in the condensed consolidated statements of operations and comprehensive loss is calculated by dividing net loss by the weighted-average number of common shares outstanding during the period, without consideration for common stock equivalents. Potentially dilutive shares, which include warrants for the purchase of common stock, convertible debt, restricted stock units, including performance-based stock units, and options outstanding under the Company’s equity incentive plans, are considered to be common stock equivalents and are only included in the calculation of diluted net loss per share when their effect is dilutive.

Inventory (Tables)

Inventory (Tables)	9 Months Ended
	Sep. 30, 2022
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventory consists of the following as of: September 30, 2022 December 31, 2021 (unaudited) Raw materials $ 5,755 $ 3,442 Work in progress 1,814 965 Finished goods 9,127 7,559 Total inventory $ 16,696 $ 11,966

Property, Equipment and Right_2

Property, Equipment and Right-of-Use Assets (Tables)	9 Months Ended
	Sep. 30, 2022
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment	Property, equipment and right-of-use assets consists of the following: Depreciable Lives September 30, 2022 December 31, 2021 (unaudited) Equipment 5 years $ 8,575 $ 7,472 Right-of-use assets 1-8 years 3,912 3,459 Furniture, fixtures and tooling 4-8 years 2,004 1,855 Computer hardware 3-5 years 1,766 1,444 Leasehold improvements 3-7 years 2,089 2,059 Construction in process 813 483 19,159 16,772 Less accumulated depreciation (11,957) (11,179) Property, equipment and right-of-use assets, net $ 7,202 $ 5,593
Operating Lease Maturity	As of September 30, 2022, the maturities of the Company’s operating lease liabilities are as follows: 2022 $ 241 2023 892 2024 811 2025 785 2026 513 Thereafter 756 Total lease payments 3,998 Less imputed interest (852) Total operating lease liabilities $ 3,146

Accrued Expenses (Tables)

Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2022
Payables and Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses consists of the following as of: September 30, 2022 December 31, 2021 (unaudited) Accrued employee compensation and expenses $ 5,822 $ 6,569 Accrued professional service fees 788 656 Accrued taxes 624 437 Lease liability 590 587 Accrued interest 307 613 Accrued returns and rebates 197 106 Other 1,374 934 Total accrued expenses $ 9,702 $ 9,902

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Schedule of Long-term Debt	Long-term debt consists of the following as of: September 30, 2022 December 31, 2021 (unaudited) Term loan facility $ 35,000 $ 35,000 Deferred interest 180 6 Deferred financing costs (1,341) (1,533) Long-term debt $ 33,839 $ 33,473
Schedule of Maturities of Long-term Debt	Principal payments of the Company’s long-term debt are as follows: 2022 - 2026 $ — Thereafter 35,000 $ 35,000

Convertible Debt (Tables)

Convertible Debt (Tables)	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Schedule of Convertible Debt	Convertible debt consists of the following as of: September 30, 2022 December 31, 2021 (unaudited) Convertible debt $ 20,446 $ 20,446 Deferred financing costs (783) (933) Total convertible debt $ 19,663 $ 19,513

Warrants (Tables)

Warrants (Tables)	9 Months Ended
	Sep. 30, 2022
Other Liabilities Disclosure [Abstract]
Schedule of Warrants	Warrants consist of the following as of September 30, 2022: Warrant Expiration Date Number of shares Exercise price per share No expiration 12,382,395 $ 0.001

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2022
Share-Based Payment Arrangement [Abstract]
Schedule of Stock Option Activity	A summary of the stock option activity as of September 30, 2022 is presented below. Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding, December 31, 2021 3,482,883 $ 5.04 8.0 years $ 12,307 Options granted 921,063 4.29 Options exercised (129,005) 2.93 Options forfeited (132,912) 4.41 Options outstanding, vested and expected to vest, September 30, 2022 4,142,029 $ 4.96 7.8 years $ 4,857 Options exercisable 2,107,631 $ 4.89 6.8 years $ 3,072
Schedule of Stock Options, Valuation Assumptions	The fair value of stock option grants has been estimated at the date of grant using the Black-Scholes option pricing model with the following weighted average assumptions: Nine Months Ended Nine Months Ended Risk free interest rate 3.3% 1.0% Expected dividend yield —% —% Estimated volatility 82.8% 81.1% Expected life 6.0 years 6.1 years
Schedule of Other Stock Option Information	Additional information regarding options is as follows: Nine Months Ended Nine Months Ended Weighted-average grant date fair value of options granted during the period $ 3.07 $ 4.40 Aggregate intrinsic value of options exercised during the period $ 374 $ 3,116
Schedule of Restricted Stock Unit Activity	A summary of the restricted stock unit activity, including performance-based stock units, under the Company’s Equity Plans as of September 30, 2022 is presented below. Units Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Restricted stock units outstanding, December 31, 2021 1,194,432 $ 5.67 $ 10,069 Restricted stock units granted 1,535,351 5.16 Restricted stock units released (374,803) 5.14 Restricted stock units forfeited (115,034) 4.42 Restricted stock units outstanding, September 30, 2022 2,239,946 $ 5.47 $ 12,342

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	9 Months Ended
	Sep. 30, 2022
Earnings Per Share [Abstract]
Schedule of Antidilutive Securities Excluded from Computation of Diluted Loss Per Share	Potentially dilutive securities that are not included in the calculation of diluted net loss per share attributable to common stockholders because to do so would be anti-dilutive are as follows (in common stock equivalent shares on a weighted-average basis): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Warrants for common stock 12,382,395 13,948,875 12,382,395 13,948,875 Convertible debt 6,318,451 6,299,433 6,300,200 6,293,791 Common stock options 4,142,029 3,494,676 3,669,004 3,039,021 Restricted stock units 2,189,486 1,127,964 1,707,078 847,081 25,032,361 24,870,948 24,058,677 24,128,768

Segment and Geographic Inform_2

Segment and Geographic Information (Tables)	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Schedule of Product Sales by Product Group and Geographic Market	Product sales by product group and geographic market, based on the location of the customer, whether the U.S. or outside the U.S. (“OUS”) for the periods shown were as follows: Three Months Ended September 30, 2022 Three Months Ended September 30, 2021 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 9,494 $ 4,937 $ 14,431 73.7 % $ 6,722 $ 3,504 $ 10,226 62.5 % IGB 1,813 3,134 4,947 25.3 % 2,006 3,890 5,896 36.1 % Other 191 4 195 1.0 % 215 14 229 1.4 % Total revenues $ 11,498 $ 8,075 $ 19,573 100.0 % $ 8,943 $ 7,408 $ 16,351 100.0 % % Total revenues 58.7 % 41.3 % 54.7 % 45.3 % Nine Months Ended September 30, 2022 Nine Months Ended September 30, 2021 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 25,084 $ 13,119 $ 38,203 68.8 % $ 18,977 $ 10,512 $ 29,489 63.0 % IGB 6,114 10,640 16,754 30.2 % 5,570 11,042 16,612 35.5 % Other 574 11 585 1.0 % 689 28 717 1.5 % Total revenues $ 31,772 $ 23,770 $ 55,542 100.0 % $ 25,236 $ 21,582 $ 46,818 100.0 % % Total revenues 57.2 % 42.8 % 53.9 % 46.1 %
Schedule of Long-Lived Assets by Geographic Area	The following table represents property, equipment and right-of-use assets based on the physical location of the asset: September 30, 2022 December 31, 2021 (unaudited) U.S. $ 3,851 $ 1,855 Costa Rica 3,163 3,436 Other 188 302 Total property, equipment and right-of-use assets, net $ 7,202 $ 5,593

Concentrations (Details)

Concentrations (Details) $ in Thousands	Sep. 30, 2022 USD ($) bank	Dec. 31, 2021 USD ($)	Sep. 30, 2021 USD ($)	Dec. 31, 2020 USD ($)
Risks and Uncertainties [Abstract]
Number of banks | bank	4
Cash and cash equivalents and restricted cash | $	$ 67,915	$ 91,812	$ 28,474	$ 37,200

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	Sep. 30, 2022	May 31, 2022	Dec. 31, 2021
Inventory Disclosure [Abstract]
Raw materials	$ 5,755	$ 2,040	$ 3,442
Work in progress	1,814		965
Finished goods	9,127		7,559
Total inventory	16,696		11,966
Consigned inventory	$ 72		$ 120

Property, Equipment and Right_3

Property, Equipment and Right-of-Use Assets - Schedule of Property and Equipment (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Dec. 31, 2021
Property, Plant and Equipment [Line Items]
Right-of-use assets	$ 3,912	$ 3,459
Property and equipment, gross	19,159	16,772
Less accumulated depreciation	(11,957)	(11,179)
Property, equipment and right-of-use assets, net	$ 7,202	5,593
Minimum
Property, Plant and Equipment [Line Items]
Depreciable lives, right of use assets	1 year
Maximum
Property, Plant and Equipment [Line Items]
Depreciable lives, right of use assets	8 years
Equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 8,575	7,472
Depreciable Lives	5 years
Furniture, fixtures and tooling
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 2,004	1,855
Furniture, fixtures and tooling | Minimum
Property, Plant and Equipment [Line Items]
Depreciable Lives	4 years
Furniture, fixtures and tooling | Maximum
Property, Plant and Equipment [Line Items]
Depreciable Lives	8 years
Computer hardware
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 1,766	1,444
Computer hardware | Minimum
Property, Plant and Equipment [Line Items]
Depreciable Lives	3 years
Computer hardware | Maximum
Property, Plant and Equipment [Line Items]
Depreciable Lives	5 years
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 2,089	2,059
Leasehold improvements | Minimum
Property, Plant and Equipment [Line Items]
Depreciable Lives	3 years
Leasehold improvements | Maximum
Property, Plant and Equipment [Line Items]
Depreciable Lives	7 years
Construction in process
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 813	$ 483

Property, Equipment and Right_4

Property, Equipment and Right-of-Use Assets - Lease Narrative (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Property, Plant and Equipment [Abstract]
Depreciation	$ 316,000	$ 285,000	$ 883,000	$ 1,071,000
Impairment charges	0	0	0	0
Operating lease, current	$ 590,000		$ 590,000		$ 587,000
Operating lease, current, financial statement location	Accrued expenses		Accrued expenses
Operating lease, noncurrent	$ 2,556,000		$ 2,556,000
Operating lease, noncurrent, financial statement location	Long-term liabilities		Long-term liabilities
Cash paid within operating cash flows for operating leases	$ 246,000	$ 174,000	$ 758,000	$ 723,000
Weighted average remaining lease term	4 years 6 months		4 years 6 months
Weighted average discount rate, percent	9.30%		9.30%

Property, Equipment and Right_5

Property, Equipment and Right-of-Use Assets - Lease Maturity (Details) $ in Thousands	Sep. 30, 2022 USD ($)
Property, Plant and Equipment [Abstract]
2022	$ 241
2023	892
2024	811
2025	785
2026	513
Thereafter	756
Total lease payments	3,998
Less imputed interest	(852)
Total operating lease liabilities	$ 3,146

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Payables and Accruals [Abstract]
Accrued employee compensation and expenses	$ 5,822	$ 6,569
Accrued professional service fees	788	656
Accrued taxes	624	437
Lease liability	590	587
Accrued interest	307	613
Accrued returns and rebates	197	106
Other	1,374	934
Total accrued expenses	$ 9,702	$ 9,902

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-term Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Deferred financing costs	$ (1,341)	$ (1,533)
Long-term debt	33,839	33,473
Deferred interest
Debt Instrument [Line Items]
Long-term debt	180	6
Term loan facility | Term loan facility
Debt Instrument [Line Items]
Long-term debt	$ 35,000	$ 35,000

Long-Term Debt - Narrative (Det

Long-Term Debt - Narrative (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended
	Dec. 31, 2021	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Debt Instrument [Line Items]
Line of credit		$ 35,000		$ 35,000
Interest expense		$ 948	$ 1,048	$ 2,513	$ 3,147
Term loan facility
Debt Instrument [Line Items]
Percent of instrument converted	10%
Conversion price (USD per share)	$ 11.50
Term loan facility | Term loan facility
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 100,000
Interest rate	3.25%
Percent of outstanding amount due	4%
Term loan facility | Term loan facility | Prime Rate
Debt Instrument [Line Items]
Basis spread on variable rate	4%
Term loan facility | Term A Loan
Debt Instrument [Line Items]
Proceeds from term loan	$ 35,000
Term loan facility | Term B Loan
Debt Instrument [Line Items]
Line of credit	15,000
Term loan facility | Term C Loan
Debt Instrument [Line Items]
Line of credit	25,000
Term loan facility | Term D Loan
Debt Instrument [Line Items]
Line of credit	$ 25,000

Long-Term Debt - Schedule of Ma

Long-Term Debt - Schedule of Maturity of Long-term Debt (Details) $ in Thousands	Sep. 30, 2022 USD ($)
Debt Disclosure [Abstract]
2022	$ 0
2023	0
2024	0
2025	0
2026	0
Thereafter	35,000
Line of credit	$ 35,000

Convertible Debt - Schedule of

Convertible Debt - Schedule of Convertible Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Deferred financing costs	$ (1,341)	$ (1,533)
Long-term debt	33,839	33,473
Convertible debt
Debt Instrument [Line Items]
Convertible debt	20,446	20,446
Deferred financing costs	(783)	(933)
Long-term debt	$ 19,663	$ 19,513

Convertible Debt - Narrative (D

Convertible Debt - Narrative (Details) $ / shares in Units, $ in Thousands	1 Months Ended			3 Months Ended		9 Months Ended
	Jul. 31, 2022 shares	Jan. 31, 2022 shares	Aug. 31, 2019 USD ($) d $ / shares	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Dec. 31, 2021 USD ($)
Debt Instrument [Line Items]
Accrued interest				$ 307		$ 307		$ 613
Interest expense				948	$ 1,048	2,513	$ 3,147
Convertible debt
Debt Instrument [Line Items]
Proceeds from convertible debt			$ 20,000
Interest rate			6%
Stock price (USD per share) | $ / shares			$ 2.50
Conversion of convertible debt (in shares) | shares	167,148	75,780
Interest expense				$ 357	$ 356	$ 1,070	$ 1,070
Convertible debt | Conversion Ratio Less Than 2.50
Debt Instrument [Line Items]
Consecutive trading days (in days) | d			10
Convertible debt | Conversion Ratio Of 3.25
Debt Instrument [Line Items]
Consecutive trading days (in days) | d			30
Conversion price (USD per share) | $ / shares			$ 3.25
Stock price trigger (USD per share) | $ / shares			$ 9.75
Trading days (in days) | d			20

Long-Term Liabilities (Details)

Long-Term Liabilities (Details) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2022 USD ($)	Sep. 30, 2022 USD ($)
Debt Instrument [Line Items]
Exit fee liability, noncurrent	$ 1,185	$ 1,185
Interest expense on long-term liability	124	368
Solar Term Loan Facility
Debt Instrument [Line Items]
Liabilities, noncurrent	1,925	1,925
Trailing twelve month revenue	$ 100,000	$ 100,000

Warrants - Schedule of Warrants

Warrants - Schedule of Warrants (Details) - No expiration	Sep. 30, 2022 $ / shares shares
Class of Warrant or Right [Line Items]
Total number of warrants outstanding (in shares) | shares	12,382,395
Exercise price (USD per share) | $ / shares	$ 0.001

Warrants - Narrative (Details)

Warrants - Narrative (Details)	9 Months Ended
	Sep. 30, 2022 shares
Class of Warrant or Right [Line Items]
Expirations (in shares)	163,915
Warrant
Class of Warrant or Right [Line Items]
Issued warrants to purchase shares, number of shares (in shares)	1,361,869

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock Option Activity (Details) - Stock Option - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2022	Dec. 31, 2021
Options
Options outstanding, beginning balance (in shares)		3,482,883
Options granted (in shares)	921,063
Options exercised (in shares)	(129,005)
Options forfeited (in shares)	(132,912)
Options vested and expected to vest (in shares)	4,142,029
Options exercisable (in shares)	2,107,631
Weighted Average Exercise Price
Weighted average exercise price, beginning balance (in USD per share)		$ 5.04
Options granted (in USD per share)	$ 4.29
Options exercised (in USD per share)	2.93
Options forfeited (in USD per share)	4.41
Options vested and expected to vest (in USD per share)	4.96
Options exercisable (in USD per share)	$ 4.89
Weighted Average Remaining Contractual Term
Weighted Average Remaining Contractual Term		8 years
Options vested and expected to vest	7 years 9 months 18 days
Options exercisable	6 years 9 months 18 days
Aggregate Intrinsic Value
Aggregate intrinsic value		$ 12,307
Options vested and expected to vest	$ 4,857
Options exercisable	$ 3,072

Stock-Based Compensation - Fair

Stock-Based Compensation - Fair Value of Stock Options (Details) - Stock Option	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk free interest rate	3.30%	1%
Expected dividend yield	0%	0%
Estimated volatility	82.80%	81.10%
Expected life	6 years	6 years 1 month 6 days

Stock-Based Compensation - Narr

Stock-Based Compensation - Narrative (Details) $ / shares in Units, $ in Thousands	1 Months Ended		3 Months Ended	9 Months Ended
	Aug. 31, 2022 USD ($) tranche shares	Mar. 31, 2021 USD ($) tranche shares	Sep. 30, 2022 USD ($) shares	Sep. 30, 2022 USD ($) $ / shares shares	Sep. 30, 2021 USD ($) $ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation expense related to unvested options			$ 6,642	$ 6,642
Remaining amortization period				2 years 8 months 12 days
Common stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted-average grant date fair value of options granted during period (in USD per share) | $ / shares				$ 3.07	$ 4.40
Aggregate intrinsic value of options exercised during the period				$ 374	$ 3,116
Options granted (in shares) | shares				921,063
Restricted stock units and Performance shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Remaining amortization period				2 years 10 months 24 days
Restricted stock units and Performance shares | Chief Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares) | shares		707,278
Number of tranches | tranche		4
Restricted stock units and Performance shares | Chief Executive Officer | Quarter one
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount vested		$ 50,000
Restricted stock units and Performance shares | Chief Executive Officer | Quarter two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount vested		65,000
Restricted stock units and Performance shares | Chief Executive Officer | Quarter three
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount vested		80,000
Restricted stock units and Performance shares | Chief Executive Officer | Quarter four
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount vested		$ 95,000
Restricted stock units and Performance shares | Chief Financial Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares) | shares	120,000
Number of tranches | tranche	3
Restricted stock units and Performance shares | Chief Financial Officer | Quarter one
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount vested	$ 70,000
Restricted stock units and Performance shares | Chief Financial Officer | Quarter two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount vested	90,000
Restricted stock units and Performance shares | Chief Financial Officer | Quarter four
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount vested	$ 110,000
Restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Forfeiture of performance-based restricted stock units (in shares) | shares			6,190	13,810
Unrecognized compensation expense related to unvested restricted stock units			$ 7,781	$ 7,781
Restricted stock units | Chief Financial Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares) | shares	80,000
Performance shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Forfeiture of performance-based restricted stock units (in shares) | shares			66,553	110,267
Unrecognized compensation expense related to unvested restricted stock units			$ 838	$ 838

Stock-Based Compensation - Rest

Stock-Based Compensation - Restricted Stock Units Activity (Details) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2022 USD ($) $ / shares shares	Dec. 31, 2021 USD ($)
Restricted stock units and Performance shares
Units
Unvested Units (shares) | shares	1,194,432
Restricted stock units and performance stock units granted (shares) | shares	1,535,351
Unvested Units (shares) | shares	2,239,946
Weighted Average Grant Date Fair Value
Unvested Units (USD per share) | $ / shares	$ 5.67
Restricted stock units and performance stock units granted (USD per share) | $ / shares	5.16
Unvested Units (USD per share) | $ / shares	$ 5.47
Aggregate Intrinsic Value
Aggregate Intrinsic Value | $	$ 12,342	$ 10,069
Restricted stock units
Units
Restricted stock units vested (shares) | shares	(374,803)
Restricted stock units forfeited (shares) | shares	(115,034)
Weighted Average Grant Date Fair Value
Restricted stock units vested (USD per share) | $ / shares	$ 5.14
Restricted stock units forfeited (USD per share) | $ / shares	$ 4.42

Purchase Commitment (Details)

Purchase Commitment (Details) - USD ($) $ in Thousands	1 Months Ended
	May 31, 2022	Sep. 30, 2022	Dec. 31, 2021
Commitments and Contingencies Disclosure [Abstract]
Agreement period	1 year
Raw materials	$ 2,040	$ 5,755	$ 3,442

Income Taxes (Details)

Income Taxes (Details)	Sep. 30, 2022 USD ($)
Income Tax Disclosure [Abstract]
Unrecognized tax benefits	$ 0
Accrued interest	0
Tax penalties	$ 0

Net Loss Per Share (Details)

Net Loss Per Share (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share (in shares)	25,032,361	24,870,948	24,058,677	24,128,768
Warrants for common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share (in shares)	12,382,395	13,948,875	12,382,395	13,948,875
Convertible debt
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share (in shares)	6,318,451	6,299,433	6,300,200	6,293,791
Common stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share (in shares)	4,142,029	3,494,676	3,669,004	3,039,021
Restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share (in shares)	2,189,486	1,127,964	1,707,078	847,081

Fair Value Measurements (Detail

Fair Value Measurements (Details) $ in Thousands	Sep. 30, 2022 USD ($)
Fair Value Disclosures [Abstract]
Fair value of long-term debt	$ 35,000
Convertible debt, fair value	$ 19,000

Segment and Geographic Inform_3

Segment and Geographic Information - Segment Information (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) segment	Sep. 30, 2021 USD ($)
Segment Reporting [Abstract]
Number of reportable segments | segment			1
Revenue, Major Customer [Line Items]
Revenues	$ 19,573	$ 16,351	$ 55,542	$ 46,818
Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	100%	100%	100%	100%
U.S.
Revenue, Major Customer [Line Items]
Revenues	$ 11,498	$ 8,943	$ 31,772	$ 25,236
U.S. | Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	58.70%	54.70%	57.20%	53.90%
OUS
Revenue, Major Customer [Line Items]
Revenues	$ 8,075	$ 7,408	$ 23,770	$ 21,582
OUS | Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	41.30%	45.30%	42.80%	46.10%
OUS | Segment Revenue | Geographic Concentration Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	5%	6%	7%	7%
OUS | Distributor Sales | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	52.90%	46.40%	49.80%	42.40%
ESS
Revenue, Major Customer [Line Items]
Revenues	$ 14,431	$ 10,226	$ 38,203	$ 29,489
ESS | Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	73.70%	62.50%	68.80%	63%
ESS | U.S.
Revenue, Major Customer [Line Items]
Revenues	$ 9,494	$ 6,722	$ 25,084	$ 18,977
ESS | OUS
Revenue, Major Customer [Line Items]
Revenues	4,937	3,504	13,119	10,512
IGB
Revenue, Major Customer [Line Items]
Revenues	$ 4,947	$ 5,896	$ 16,754	$ 16,612
IGB | Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	25.30%	36.10%	30.20%	35.50%
IGB | U.S.
Revenue, Major Customer [Line Items]
Revenues	$ 1,813	$ 2,006	$ 6,114	$ 5,570
IGB | OUS
Revenue, Major Customer [Line Items]
Revenues	3,134	3,890	10,640	11,042
OtherProductsMember
Revenue, Major Customer [Line Items]
Revenues	$ 195	$ 229	$ 585	$ 717
OtherProductsMember | Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	1%	1.40%	1%	1.50%
OtherProductsMember | U.S.
Revenue, Major Customer [Line Items]
Revenues	$ 191	$ 215	$ 574	$ 689
OtherProductsMember | OUS
Revenue, Major Customer [Line Items]
Revenues	$ 4	$ 14	$ 11	$ 28

Segment and Geographic Inform_4

Segment and Geographic Information - Long-Lived Assets by Geographic Area (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	$ 7,202	$ 5,593
U.S.
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	3,851	1,855
Costa Rica
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	3,163	3,436
Other
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	$ 188	$ 302