Penumbra (PEN) 10-Q 2 May 23 2023 Q1 Quarterly report Financial data

Cover

Cover - shares	3 Months Ended
	Mar. 31, 2023	Apr. 18, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2023
Document Transition Report	false
Entity File Number	001-37557
Entity Registrant Name	Penumbra, Inc
Entity Address, Address Description	One Penumbra Place
Entity Address, City or Town	Alameda
Entity Address, State or Province	CA
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	05-0605598
Entity Address, Postal Zip Code	94502
City Area Code	510
Local Phone Number	748-3200
Title of 12(b) Security	Common Stock, Par value $0.001 per share
Trading Symbol	PEN
Security Exchange Name	NYSE
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 Common Stock, Shares Outstanding		38,252,969
Entity Central Index Key	0001321732
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q1
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 94,688	$ 69,858
Marketable investments	104,409	118,172
Accounts receivable, net of allowance for credit losses of $937 and $862 at March 31, 2023 and December 31, 2022, respectively	207,364	203,384
Inventories	344,042	334,006
Prepaid expenses and other current assets	35,987	30,279
Total current assets	786,490	755,699
Property and equipment, net	65,224	65,015
Operating lease right-of-use assets	189,839	192,636
Finance lease right-of-use assets	32,569	33,323
Intangible assets, net	78,669	81,161
Goodwill	166,161	166,046
Deferred taxes	65,173	64,213
Other non-current assets	11,173	12,793
Total assets	1,395,298	1,370,886
Current liabilities:
Accounts payable	28,199	26,679
Accrued liabilities	105,869	106,300
Current operating lease liabilities	10,303	10,033
Current finance lease liabilities	1,957	1,920
Total current liabilities	146,328	144,932
Non-current operating lease liabilities	196,837	198,955
Non-current finance lease liabilities	24,423	24,865
Other non-current liabilities	3,241	3,276
Total liabilities	370,829	372,028
Commitments and contingencies
Stockholders’ equity:
Common stock	38	38
Additional paid-in capital	978,826	963,040
Accumulated other comprehensive loss	(6,861)	(8,124)
Retained earnings	52,466	43,904
Total Penumbra, Inc. stockholders’ equity	1,024,469	998,858
Total liabilities and stockholders’ equity	$ 1,395,298	$ 1,370,886

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Allowance for credit losses	$ 937	$ 862

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Statement [Abstract]
Revenue	$ 241,398	$ 203,895
Cost of revenue	90,326	76,477
Gross profit	151,072	127,418
Operating expenses:
Research and development	19,986	20,564
Sales, general and administrative	123,078	110,900
Total operating expenses	143,064	131,464
Income (loss) from operations	8,008	(4,046)
Interest income (expense), net	554	(47)
Other income (expense), net	90	(1,011)
Income (loss) before income taxes	8,652	(5,104)
Provision for (benefit from) income taxes	90	(5,183)
Net income	$ 8,562	$ 79
Net income per share:
Basic (in dollars per share)	$ 0.22	$ 0
Diluted (in dollars per share)	$ 0.22	$ 0
Weighted average shares outstanding:
Basic (in shares)	38,186,342	37,646,122
Diluted (in shares)	39,075,388	38,708,657

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive (Loss) Income - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 8,562	$ 79
Other comprehensive income (loss), net of tax:
Foreign currency translation adjustments, net of tax	403	(868)
Net change in unrealized gains (losses) on available-for-sale securities, net of tax	860	(2,474)
Total other comprehensive income (loss), net of tax	1,263	(3,342)
Comprehensive income (loss)	$ 9,825	$ (3,263)

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity (Deficit) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income (Loss)	Retained Earnings (Accumulated Deficit)
Beginning balance (in shares) at Dec. 31, 2021		37,578,483
Beginning balance at Dec. 31, 2021	$ 953,927	$ 37	$ 910,614	$ (2,630)	$ 45,906
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock (in shares)		103,984
Issuance of common stock	1,103	$ 1	1,102
Shares held for tax withholdings (in shares)		(14,243)
Shares held for tax withholdings	(3,181)		(3,181)
Stock-based compensation	10,716		10,716
Other comprehensive income (loss)	(3,342)			(3,342)
Net income (loss)	79				79
Ending balance (in shares) at Mar. 31, 2022		37,668,224
Ending balance at Mar. 31, 2022	959,302	$ 38	919,251	(5,972)	45,985
Beginning balance (in shares) at Dec. 31, 2022		38,107,977
Beginning balance at Dec. 31, 2022	998,858	$ 38	963,040	(8,124)	43,904
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock (in shares)		134,936
Issuance of common stock	2,209		2,209
Shares held for tax withholdings (in shares)		(813)
Shares held for tax withholdings	(204)		(204)
Stock-based compensation	13,781		13,781
Other comprehensive income (loss)	1,263			1,263
Net income (loss)	8,562				8,562
Ending balance (in shares) at Mar. 31, 2023		38,242,100
Ending balance at Mar. 31, 2023	$ 1,024,469	$ 38	$ 978,826	$ (6,861)	$ 52,466

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Cash Flows [Abstract]
Net income	$ 8,562	$ 79
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Depreciation and amortization	6,575	5,726
Stock-based compensation	12,766	8,893
Inventory write-downs	1,009	593
Deferred taxes	(953)	(4,378)
Other	140	(1,012)
Changes in operating assets and liabilities:
Accounts receivable	(3,540)	(8,710)
Inventories	(10,641)	(11,764)
Prepaid expenses and other current and non-current assets	(3,994)	(3,809)
Accounts payable	2,074	1,389
Accrued expenses and other non-current liabilities	1,131	8,249
Proceeds from lease incentives	0	230
Net cash provided by (used in) operating activities	13,129	(4,514)
CASH FLOWS FROM INVESTING ACTIVITIES:
Proceeds from maturities of marketable investments	14,605	20,668
Purchases of property and equipment	(3,894)	(4,957)
Net cash provided by (used in) investing activities	10,711	15,711
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from exercises of stock options	2,209	1,102
Payment of employee taxes related to vested stock	(204)	(3,181)
Payments of finance lease obligations	(474)	(425)
Other	(155)	(137)
Net cash provided by (used in) financing activities	1,376	(2,641)
Effect of foreign exchange rate changes on cash and cash equivalents	(386)	228
NET INCREASE IN CASH AND CASH EQUIVALENTS	24,830	8,784
CASH AND CASH EQUIVALENTS—Beginning of period	69,858	59,379
CASH AND CASH EQUIVALENTS—End of period	94,688	68,163
NONCASH INVESTING AND FINANCING ACTIVITIES:
Right-of-use assets obtained in exchange for lease obligations	341	47,678
Right-of-use assets obtained in exchange for finance lease obligations	68	81
Purchase of property and equipment funded through accounts payable and accrued liabilities	1,781	1,626
SUPPLEMENTAL CASH FLOW INFORMATION:
Cash paid for amounts included in the measurement of operating lease liabilities	4,706	4,266
Cash paid for income taxes	$ 1,413	$ 1,798

Organization and Description of

Organization and Description of Business	3 Months Ended
	Mar. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	1. Organization and Description of Business Penumbra, Inc. (the “Company”) is a global healthcare company focused on innovative therapies. The Company designs, develops, manufactures and markets novel products and has a broad portfolio that addresses challenging medical conditions in markets with significant unmet need. The Company focuses on developing, manufacturing and marketing novel products for use by specialist physicians and other healthcare providers to drive improved clinical and health outcomes. The Company believes that the cost-effectiveness of our products is attractive to our customers.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Basis of Presentation and Consolidation The accompanying condensed consolidated balance sheet as of March 31, 2023, the condensed consolidated statements of operations, the condensed consolidated statements of comprehensive income (loss), and the condensed consolidated statements of stockholders’ equity for the three months ended March 31, 2023 and 2022, and the condensed consolidated statements of cash flows for the three months ended March 31, 2023 and 2022 are unaudited. The unaudited condensed consolidated financial statements included herein have been prepared by the Company in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) and the applicable rules and regulations of the U.S. Securities and Exchange Commission (the “SEC”) for interim financial information. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. The condensed consolidated balance sheet data as of December 31, 2022 was derived from the audited financial statements as of that date. The unaudited condensed consolidated financial statements have been prepared on the same basis as the audited consolidated financial statements and, in the opinion of management, reflect all adjustments of a normal recurring nature considered necessary to state fairly the Company’s financial position as of March 31, 2023, the results of its operations for the three months ended March 31, 2023 and 2022, the changes in its comprehensive income (loss) and stockholders’ equity for the three months ended March 31, 2023 and 2022, and its cash flows for the three months ended March 31, 2023 and 2022. The results for the three months ended March 31, 2023 are not necessarily indicative of the results that may be expected for the year ending December 31, 2023 or for any other future annual or interim period. The information included in this Quarterly Report on Form 10-Q should be read in conjunction with the audited consolidated financial statements and notes thereto for the fiscal year ended December 31, 2022, included in the Company’s Annual Report on Form 10-K. There have been no changes to the Company’s significant accounting policies during the three months ended March 31, 2023, as compared to the significant accounting policies described in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022, except for the granting of restricted stock units with performance conditions to senior management during the three months ended March 31, 2023. Refer to Note “9. Stockholders’ Equity” for information on the Company’s accounting policy. The condensed consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation. Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities and equity accounts; disclosure of contingent assets and liabilities at the date of the financial statements; and the reported amounts of revenues and expenses during the reporting period. On an ongoing basis, the Company evaluates its estimates, including those related to marketable investments, allowances for credit losses, the amount of variable consideration included in the transaction price, warranty reserve, valuation of inventories, useful lives of property and equipment, intangibles, operating and financing lease right-of-use (“ROU”) assets and liabilities, income taxes, contingent consideration and other contingencies, including the probability of achieving performance targets associated with equity awards with performance conditions, among others. The Company bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other data. Actual results could differ from those estimates. Segments

Investments and Fair Value of F

Investments and Fair Value of Financial Instruments	3 Months Ended
	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Investments and Fair Value of Financial Instruments	3. Investments and Fair Value of Financial Instruments Marketable Investments The Company’s marketable investments have been classified and accounted for as available-for-sale. The following table presents the Company’s marketable investments as of March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 Securities with net gains or losses in accumulated other comprehensive income (loss) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Allowance Fair Value U.S. treasury $ 11,987 $ — $ (321) $ — $ 11,666 U.S. agency and government sponsored securities 6,998 — (102) — 6,896 U.S. states and municipalities 13,355 — (358) — 12,997 Corporate bonds 74,710 — (1,860) — 72,850 Total $ 107,050 $ — $ (2,641) $ — $ 104,409 December 31, 2022 Securities with net gains or losses in accumulated other comprehensive income (loss) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Allowance Fair Value U.S. treasury $ 14,482 $ — $ (478) $ — $ 14,004 U.S. agency and government sponsored securities 6,999 — (176) — 6,823 U.S. states and municipalities 23,460 — (501) — 22,959 Corporate bonds 76,731 — (2,345) — 74,386 Total $ 121,672 $ — $ (3,500) $ — $ 118,172 As of March 31, 2023, the total amortized cost basis of the Company’s available-for-sale securities in an unrealized loss position exceeded its fair value by $2.6 million, which was primarily attributable to widening credit spreads and rising interest rates since purchase. The Company reviewed its available-for-sale securities in an unrealized loss position and concluded that the decline in fair value was not related to credit losses and is recoverable. During the three months ended March 31, 2023, no allowance for credit losses was recorded and instead the unrealized losses are reported as a component of accumulated other comprehensive income (loss). The following tables present the gross unrealized losses and the fair value for those marketable investments that were in an unrealized loss position for less than twelve months or for twelve months or more as of March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 Less than 12 months 12 months or more Total Fair Value Gross Unrealized Losses Fair Value Gross Unrealized Losses Fair Value Gross Unrealized Losses U.S. treasury $ — $ — $ 11,666 $ (321) $ 11,666 $ (321) U.S. agency and government sponsored securities — — 6,896 (102) 6,896 (102) U.S. states and municipalities — — 12,997 (358) 12,997 (358) Corporate bonds 10,812 (77) 62,038 (1,783) 72,850 (1,860) Total $ 10,812 $ (77) $ 93,597 $ (2,564) $ 104,409 $ (2,641) December 31, 2022 Less than 12 months 12 months or more Total Fair Value Gross Unrealized Losses Fair Value Gross Unrealized Losses Fair Value Gross Unrealized Losses U.S. treasury — — 14,004 (478) 14,004 (478) U.S. agency and government sponsored securities — — 6,823 (176) 6,823 (176) U.S. states and municipalities 4,567 (68) 13,772 (433) 18,339 (501) Corporate bonds 15,327 (101) 59,059 (2,244) 74,386 (2,345) Total $ 19,894 $ (169) $ 93,658 $ (3,331) $ 113,552 $ (3,500) The following table presents the contractual maturities of the Company’s marketable investments as of March 31, 2023 (in thousands): March 31, 2023 Amortized Cost Fair Value Due in less than one year $ 66,527 $ 65,133 Due in one to five years 40,523 39,276 Total $ 107,050 $ 104,409 Fair Value of Financial Instruments Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the measurement date. The accounting guidance establishes a three-tiered hierarchy, which prioritizes the inputs used in the valuation methodologies in measuring fair value: Level 1 - Quoted prices in active markets for identical assets or liabilities. Level 2 - Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. Level 3 - Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. The categorization of a financial instrument within the valuation hierarchy is based on the lowest level of input that is significant to the fair value measurement. The Company classifies its cash equivalents and marketable investments within Level 1 and Level 2, as it uses quoted market prices or alternative pricing sources and models utilizing market observable inputs. The Company determined the fair value of its Level 1 financial instruments, which are traded in active markets, using quoted market prices for identical instruments. Marketable investments classified within Level 2 of the fair value hierarchy are valued based on other observable inputs, including broker or dealer quotations or alternative pricing sources. When quoted prices in active markets for identical assets or liabilities are not available, the Company relies on non-binding quotes from its investment managers, which are based on proprietary valuation models of independent pricing services. These models generally use inputs such as observable market data, quoted market prices for similar instruments, historical pricing trends of a security as relative to its peers. To validate the fair value determination provided by its investment managers, the Company reviews the pricing movement in the context of overall market trends and trading information from its investment managers. In addition, the Company assesses the inputs and methods used in determining the fair value in order to determine the classification of securities in the fair value hierarchy. The Company did not hold any Level 3 marketable investments as of March 31, 2023 or December 31, 2022. During the three months ended March 31, 2023 and 2022, the Company did not have any transfers between Level 1, Level 2 or Level 3 of the fair value hierarchy. Additionally, the Company did not have any financial assets and liabilities measured at fair value on a non-recurring basis as of March 31, 2023 or December 31, 2022. The following tables set forth the Company’s financial assets measured at fair value by level within the fair value hierarchy as of March 31, 2023 and December 31, 2022 (in thousands): As of March 31, 2023 Level 1 Level 2 Level 3 Fair Value Financial Assets Cash equivalents: Money market funds $ 32,384 $ — $ — $ 32,384 Marketable investments: U.S. treasury 11,666 — — 11,666 U.S. agency and government sponsored securities — 6,896 — 6,896 U.S. states and municipalities — 12,997 — 12,997 Corporate bonds — 72,850 — 72,850 Total $ 44,050 $ 92,743 $ — $ 136,793 As of December 31, 2022 Level 1 Level 2 Level 3 Fair Value Financial Assets Cash equivalents: Money market funds $ 21,521 $ — $ — $ 21,521 Marketable investments: U.S. treasury 14,004 — — 14,004 U.S. agency and government sponsored securities — 6,823 — 6,823 U.S. states and municipalities — 22,959 — 22,959 Corporate bonds — 74,386 — 74,386 Total $ 35,525 $ 104,168 $ — $ 139,693

Balance Sheet Components

Balance Sheet Components	3 Months Ended
	Mar. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Balance Sheet Components	4. Balance Sheet Components Inventories The following table shows the components of inventories as of March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 December 31, 2022 Raw materials $ 90,980 $ 90,786 Work in process 32,761 26,793 Finished goods 220,301 216,427 Inventories $ 344,042 $ 334,006 Accrued Liabilities The following table shows the components of accrued liabilities as of March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 December 31, 2022 Payroll and employee-related cost $ 59,685 $ 60,480 Accrued expenses 11,147 10,902 Deferred revenue 9,114 9,158 Other accrued liabilities 25,923 25,760 Total accrued liabilities $ 105,869 $ 106,300 The following table shows the changes in the Company’s estimated product warranty accrual, included in accrued liabilities, for the three months ended March 31, 2023 and twelve months ended December 31, 2022, respectively (in thousands): March 31, 2023 December 31, 2022 Balance at the beginning of the period $ 5,370 $ 4,310 Accruals of warranties issued 500 2,451 Settlements of warranty claims (282) (1,391) Balance at the end of the period $ 5,588 $ 5,370

Intangible Assets

Intangible Assets	3 Months Ended
	Mar. 31, 2023
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Intangible Assets	5. Intangible Assets Acquired Intangible Assets The following tables present details of the Company’s acquired finite-lived intangible assets as of March 31, 2023 and December 31, 2022 (in thousands, except weighted-average amortization period): As of March 31, 2023 Weighted-Average Amortization Period Gross Carrying Amount Accumulated Amortization Net Finite-lived intangible assets: Developed technology 8.8 years $ 83,289 $ (12,495) $ 70,794 Customer relationships 15.0 years 6,484 (2,485) 3,999 Trade secrets and processes 20.0 years 5,256 (1,380) 3,876 Total intangible assets 9.6 years $ 95,029 $ (16,360) $ 78,669 As of December 31, 2022 Weighted-Average Gross Carrying Amount Accumulated Amortization Net Finite-lived intangible assets: Developed technology 8.8 years $ 83,289 $ (10,113) $ 73,176 Customer relationships 15.0 years 6,383 (2,340) 4,043 Trade secrets and processes 20.0 years 5,256 (1,314) 3,942 Other 5.0 years 1,646 (1,646) — Total intangible assets 9.6 years $ 96,574 $ (15,413) $ 81,161 The gross carrying amount and accumulated amortization of the customer relationships are the only intangible assets subject to foreign currency translation effects. The Company reviews indefinite-lived intangible assets for impairment annually during the fourth quarter or more frequently if events or circumstances indicate that an impairment loss may have occurred. The Company determined that there were no impairment indicators as of March 31, 2023. The following table presents the amortization expense recorded related to the Company’s finite-lived intangible assets for the three months ended March 31, 2023 and 2022 (in thousands): Three Months Ended March 31, 2023 2022 Cost of revenue $ 66 $ 66 Sales, general and administrative 2,486 1,982 Total $ 2,552 $ 2,048

Goodwill

Goodwill	3 Months Ended
	Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	6. Goodwill The following table presents the changes in goodwill during the three months ended March 31, 2023 (in thousands): Total Company Balance as of December 31, 2022 $ 166,046 Foreign currency translation 115 Balance as of March 31, 2023 $ 166,161 Goodwill Impairment Review The Company reviews goodwill for impairment annually during the fourth quarter or more frequently if events or circumstances indicate that an impairment loss may have occurred. The Company determined there were no impairment indicators as of March 31, 2023.

Debt

Debt	3 Months Ended
	Mar. 31, 2023
Debt Disclosure [Abstract]
Indebtedness	7. Indebtedness Credit Agreement On April 24, 2020, the Company entered into a Credit Agreement (the “Credit Agreement”) with JPMorgan Chase Bank, N.A., as administrative agent and lender, and Bank of America, N.A. and Citibank, N.A. as lenders. The Credit Agreement is secured and provides for up to $100 million in available revolving borrowing capacity with an option, subject to certain conditions, for the Company to increase the aggregate borrowing capacity to up to $150 million, and originally matured on April 23, 2021. During the three months ended March 31, 2021 and 2022, the Credit Agreement was amended to extend the maturity date and make other changes to the terms of the Credit Agreement. In the first quarter of 2023, the Company and JPMorgan Chase Bank, N.A., as administrative agent and lender, and Bank of America, N.A. and Citibank, N.A., as lenders, entered into Amendment No. 3 to the Credit Agreement. Pursuant to the amendment, (i) the maturity date of the Credit Agreement was extended from February 17, 2023 to February 16, 2024, (ii) certain changes were made to the reference benchmark interest rates, applicable margins and borrowing mechanics under the Credit Agreement, which have the overall effect of increasing the interest rates payable by the Company on amounts borrowed under the Credit Agreement, and (iii) the commitment fee payable on the average daily unused amount under the Credit Agreement was increased to 0.35% per annum. The Credit Agreement requires the Company to maintain a minimum fixed charge coverage ratio and to not exceed a maximum leverage ratio. As of March 31, 2023, the Company was in compliance with these requirements. As of March 31, 2023 and December 31, 2022, there were no borrowings outstanding under the Credit Agreement.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	8. Commitments and Contingencies Royalty Obligations In March 2005, the Company entered into a license agreement that requires the Company to make minimum royalty payments to the licensor on a quarterly basis. In July 2019, the Company amended the license agreement to extend its term for an additional ten years and to increase the required minimum annual royalty payments by $0.2 million. As of both March 31, 2023 and December 31, 2022, the amended license agreement required minimum quarterly royalty payments of $0.3 million. Unless terminated earlier, the term of the amended license agreement shall expire June 30, 2029. In April 2012, the Company entered into an agreement that requires the Company to pay, on a quarterly basis, a 5% royalty on sales of products covered under applicable patents. The first commercial sale of covered products occurred in April 2014. Unless terminated earlier, the royalty term for each applicable product shall continue for fifteen years following the first commercial sale of such patented product, or when the applicable patent covering such product has expired, whichever is sooner. Royalty expense included in cost of revenue for the three months ended March 31, 2023 and 2022 was $0.7 million and $0.6 million, respectively. Contingencies From time to time, the Company may have certain contingent liabilities that arise in the ordinary course of business. The Company accrues a liability for such matters when it is probable that future expenditures will be made and such expenditures can be reasonably estimated. Indemnification The Company enters into standard indemnification arrangements in the ordinary course of business. In many such arrangements, the Company agrees to indemnify, hold harmless, and reimburse the indemnified parties for losses suffered or incurred by the indemnified parties in connection with any trade secret, copyright, patent or other intellectual property infringement claim by any third-party with respect to the Company’s technology. The Company also agrees to indemnify many indemnified parties for product defect and similar claims. The term of these indemnification agreements is generally perpetual. The maximum potential amount of future payments the Company could be required to make under these agreements is not determinable because it involves claims that may be made against the Company in the future, but have not yet been made. The Company has entered into indemnification agreements with its directors and officers that may require the Company to indemnify its directors and officers against liabilities that may arise by reason of their status or service as directors or officers, other than liabilities arising from willful misconduct of the individual. The Company has not incurred costs to defend lawsuits or settle claims related to these indemnification agreements. No liability associated with any of these indemnification requirements has been recorded to date. Litigation From time to time, the Company is subject to other claims and assessments in the ordinary course of business. The Company is not currently a party to any such litigation matter that, individually or in the aggregate, is expected to have a material adverse effect on the Company’s business, financial condition, results of operations or cash flows.

Stockholder's Equity

Stockholder's Equity	3 Months Ended
	Mar. 31, 2023
Share-Based Payment Arrangement [Abstract]
Stockholder's Equity	9. Stockholders’ Equity Stock-based Compensation Stock-based compensation expense is associated with restricted stock units (“RSUs”), RSUs with performance conditions (“PSUs”), stock options, and the Company’s Employee Stock Purchase Plan. Certain RSUs granted to senior management during the three months ended March 31, 2023, will vest subject to the achievement of pre-established financial performance targets for the year ending December 31, 2023, and continued service. The fair value of these PSUs is based on the closing price of the Company's common stock on the date of grant. Stock-based compensation costs associated with these PSUs are recognized over the requisite service period of 4.25 years using graded vesting which results in more accelerated expense recognition compared to traditional time-based vesting over the same vesting period. Each reporting period, the Company monitors the probability of achieving the performance targets and may adjust periodic stock-based compensation expense based on its determination of the likelihood of achieving these performance targets and the estimated number of shares of common stock that will vest. The actual number of PSUs awarded is based on the actual performance during the performance period compared to the performance targets. The following table sets forth the stock-based compensation expense included in the Company’s condensed consolidated statements of operations for the three months ended March 31, 2023 and 2022 (in thousands): Three Months Ended March 31, 2023 2022 Cost of revenue $ 1,191 $ 856 Research and development 2,278 1,386 Sales, general and administrative 9,297 6,651 Total $ 12,766 $ 8,893 As of March 31, 2023, total unrecognized compensation cost related to unvested share-based compensation arrangements, excluding PSUs, was $76.4 million, which is expected to be recognized over a weighted average period of 3.0 years. As of March 31, 2023, total unrecognized compensation cost related to unvested PSU share-based compensation arrangements was $18.5 million, which is expected to be recognized over a weighted average period of 4.0 years. The total stock-based compensation cost capitalized in inventory was $2.2 million and $2.2 million as of March 31, 2023 and December 31, 2022, respectively.

Accumulated Other Comprehensive

Accumulated Other Comprehensive Income (Loss)	3 Months Ended
	Mar. 31, 2023
Equity [Abstract]
Accumulated Other Comprehensive Income (Loss)	10. Accumulated Other Comprehensive Income (Loss) Other comprehensive income (loss) consists of two components: unrealized gains or losses on the Company’s available-for-sale marketable investments and gains or losses from foreign currency translation adjustments. Until realized and reported as a component of consolidated net income, these comprehensive income (loss) items accumulate and are included within accumulated other comprehensive income (loss). Unrealized gains and losses on the Company’s marketable investments are reclassified from accumulated other comprehensive income (loss) into earnings when realized upon sale, and are determined based on specific identification of securities sold. Gains and losses from the translation of assets and liabilities denominated in non-U.S. dollar functional currencies are included in accumulated other comprehensive income (loss). The following table summarizes the changes in the accumulated balances during the period and includes information regarding the manner in which the reclassifications out of accumulated other comprehensive income (loss) into earnings affect the Company’s condensed consolidated statements of operations and condensed consolidated statements of comprehensive income (loss) (in thousands): Three Months Ended March 31, 2023 Three Months Ended March 31, 2022 Marketable Currency Translation Total Marketable Currency Translation Total Balance, beginning of the period $ (3,500) $ (4,624) $ (8,124) $ (595) $ (2,035) $ (2,630) Other comprehensive income (loss) before reclassifications: Unrealized gains (losses) — marketable investments 860 — 860 (2,474) — (2,474) Foreign currency translation gains (losses) — 403 403 — (868) (868) Net of tax 860 403 1,263 (2,474) (868) (3,342) Net current-year other comprehensive income (loss) 860 403 1,263 (2,474) (868) (3,342) Balance, end of the period $ (2,640) $ (4,221) $ (6,861) $ (3,069) $ (2,903) $ (5,972)

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Income Taxes	11. Income Taxes The Company’s income tax expense (benefit), deferred tax assets and liabilities, and reserves for unrecognized tax benefits reflect management’s best assessment of estimated current and future taxes to be paid. The Company is subject to income taxes in both the United States and foreign jurisdictions. Significant judgment and estimates are required in determining the consolidated income tax expense (benefit). During interim periods, the Company generally utilizes the estimated annual effective tax rate (“AETR”) method which involves the use of forecasted information. Under the AETR method, the provision is calculated by applying the estimated AETR for the full fiscal year to “ordinary” income or loss (pretax income or loss excluding unusual or infrequently occurring discrete items) for the reporting period. Jurisdictions with tax assets for which the Company believes a tax benefit cannot be realized are excluded from the computation of its AETR. The Company’s provision for income taxes for the three months ended March 31, 2023 was $0.1 million, which was primarily due to tax expenses attributable to its worldwide profits offset by excess tax benefits from stock-based compensation attributable to its U.S. jurisdiction. The Company’s benefit from income taxes for the three months ended March 31, 2022 was $5.2 million, which was primarily due to tax benefits attributable to its worldwide losses combined with excess tax benefits from stock-based compensation attributable to its U.S. jurisdiction. The Company’s effective tax rate was 1.0% for the three months ended March 31, 2023, compared to 101.5% for the three months ended March 31, 2022. The Company’s change in effective tax rate was primarily attributable to small tax expenses over relatively large worldwide profits for the three months ended March 31, 2023, when compared to large tax benefits over relatively small worldwide losses for the three months ended March 31, 2022. Significant domestic deferred tax assets (“DTAs”) were generated in recent years, primarily due to excess tax benefits from stock option exercises and vesting of restricted stock units. The Company evaluates all available positive and negative evidence, objective and subjective in nature, in each reporting period to determine if sufficient taxable income will be generated to realize the benefits of its DTAs and, if not, a valuation allowance to reduce the DTAs is recorded. As of March 31, 2023 and 2022, the Company maintains a valuation allowance against its Federal Research and Development Tax Credit DTAs as the Company could not conclude at the required more-likely-than-not level of certainty, that the benefit of these tax attributes would be realized prior to expiration. The Company intends to continue maintaining this full valuation allowance until there is sufficient evidence to reverse it. However, considering current earnings and anticipated future earnings, as well as the impact of IRC Section 174 requiring qualified research expenditures to be capitalized and amortized over 5 or 15 years, the Company anticipates net operating loss (“NOL”) utilization may be accelerated. As a consequence, the Company believes there is a reasonable possibility that sufficient positive evidence may become available to conclude this valuation allowance may no longer be needed within the next 12 months. Release of the valuation allowance will result in the recognition of Federal Research and Development Tax Credit DTAs and a decrease to income tax expenses for the period in which the release is recorded. The exact timing and amount of the valuation allowance release are highly dependent on the level of taxable income in future years. The Company will continue to closely monitor the need for this valuation allowance in each subsequent reporting period. As of March 31, 2023 and 2022, the company maintains a full valuation allowance against its California DTAs as the Company does not expect to generate sufficient future taxable income in California to realize the tax benefit due to the computation of California taxes under the single sales factor and non-conformity of the Section 174 capitalization rule.

Net Income per Share

Net Income per Share	3 Months Ended
	Mar. 31, 2023
Earnings Per Share [Abstract]
Net income per Share	12. Net Income per Share The Company computed basic net income per share based on the weighted average number of shares of common stock outstanding during the period. The Company computed diluted net income per share based on the weighted average number of shares of common stock outstanding plus potentially dilutive common stock equivalents outstanding during the period using the treasury stock method. For the purposes of this calculation, stock options, restricted stock units and stock sold through the Company’s employee stock purchase plan are considered common stock equivalents. A reconciliation of the numerator and denominator used in the calculation of the basic and diluted net income per share is as follows (in thousands, except share and per share amounts): Three Months Ended March 31, 2023 2022 Numerator: Net income $ 8,562 $ 79 Denominator: Weighted average shares used to compute net income attributable to common stockholders: Basic 38,186,342 37,646,122 Potential dilutive stock-based options and awards 889,046 1,062,535 Diluted 39,075,388 38,708,657 Net income per share: Basic $ 0.22 $ 0.00 Diluted $ 0.22 $ 0.00 For the three months ended March 31, 2023 and 2022, outstanding stock-based awards of 26 thousand and 123 thousand shares, respectively, were excluded from the computation of diluted net income per share because their effect would have been anti-dilutive.

Revenues

Revenues	3 Months Ended
	Mar. 31, 2023
Revenue from Contract with Customer [Abstract]
Revenues	13. Revenues Revenue Recognition Revenue is recognized in an amount that reflects the consideration the Company expects to be entitled to in exchange for goods or services. All revenue recognized in the condensed consolidated statements of operations is considered to be revenue from contracts with customers. The following table presents the Company’s revenues disaggregated by geography, based on the destination to which the Company ships its products, for the three months ended March 31, 2023 and 2022 (in thousands): Three Months Ended March 31, 2023 2022 United States $ 171,879 $ 144,308 International 69,519 59,587 Total $ 241,398 $ 203,895 The following table presents the Company’s revenues disaggregated by product category for the three months ended March 31, 2023 and 2022 (in thousands): Three Months Ended March 31, 2023 2022 Vascular $ 142,849 $ 122,809 Neuro 98,549 81,086 Total $ 241,398 $ 203,895 China Distribution and Technology Licensing Agreement In December 2020, the Company entered into a distribution and technology licensing arrangement with its existing distribution partner in China. In addition to modifying the Company’s standard distribution agreement with its partner in China, the Company agreed to license the technology for certain products to its partner in China to permit the manufacturing and commercialization of such products in China as well as provide certain regulatory support. During the three months ended March 31, 2022, the Company further amended the distribution agreement and entered into an additional license agreement, pursuant to which the Company agreed to license the technology for additional products to its partner in China on substantially the same terms as the existing license agreement. Apart from the standard distribution agreement, the Company will receive fixed payments upon transferring its distinct licensed technology and providing related regulatory support and royalty payments on the down-stream sale of the licensed products. Performance Obligations Delivery of products - The Company’s contracts with customers typically contain a single performance obligation, delivery of the Company’s products. Satisfaction of that performance obligation occurs when control of the promised goods transfers to the customer, which is generally upon shipment for non-consignment sale agreements and upon utilization for consignment sale agreements. Payment terms - The Company’s payment terms vary by the type and location of our customer. The timing between fulfillment of performance obligations and when payment is due is not significant and does not give rise to financing transactions. The Company did not have any contracts with significant financing components as of March 31, 2023. Product returns - The Company may allow customers to return products purchased at the Company’s discretion. The Company estimates the amount of its product sales that may be returned by its customers and records this estimate as a reduction of revenue in the period in which the related product revenue is recognized. The Company currently estimates product return liabilities using its own historic sales information, trends, industry data, and other relevant data points. Warranties - The Company offers its standard warranty to all customers and it is not available for sale on a standalone basis. The Company’s standard warranty represents its guarantee that its products function as intended, are free from defects, and comply with agreed-upon specifications and quality standards. This assurance does not constitute a service and is not a separate performance obligation. Transaction Price Revenue is recorded at the net sales price, which includes estimates of variable consideration such as product returns utilizing historical return rates, rebates, discounts, and other adjustments to net revenue. To the extent the transaction price includes variable consideration, the Company estimates the amount of variable consideration that should be included in the transaction price. When determining if variable consideration should be constrained, management considers whether there are factors that could result in a significant reversal of revenue and the likelihood of a potential reversal. Variable consideration is included in revenue only to the extent that it is probable that a significant reversal of the revenue recognized will not occur when the uncertainty associated with the variable consideration is subsequently resolved. These estimates are reassessed each reporting period. During the three months ended March 31, 2023, the Company made no material changes in estimates for variable consideration. When the Company performs shipping and handling activities after control of goods is transferred to the customer, they are considered as fulfillment activities, and costs are accrued for when the related revenue is recognized. Taxes collected from customers relating to product sales and remitted to governmental authorities are excluded from revenues. Contract liabilities, net The following information summarizes the Company’s contract assets and liabilities, net as of March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 December 31, 2022 Contract liabilities, net $ 8,297 $ 8,783 Contract liabilities represents amounts that the Company has already invoiced and are ultimately expected to be recognized as revenue, but for which not all revenue recognition criteria have been met and is recognized as the associated performance obligations are satisfied. Contract assets for the periods presented primarily represent the difference between the revenue that was recognized based on the relative standalone selling price of the related performance obligations satisfied and the contractual billing terms in the arrangements. Revenue recognized during the three months ended March 31, 2023 relating to contract liabilities as of December 31, 2022 was $0.5 million.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation and Consolidation The accompanying condensed consolidated balance sheet as of March 31, 2023, the condensed consolidated statements of operations, the condensed consolidated statements of comprehensive income (loss), and the condensed consolidated statements of stockholders’ equity for the three months ended March 31, 2023 and 2022, and the condensed consolidated statements of cash flows for the three months ended March 31, 2023 and 2022 are unaudited. The unaudited condensed consolidated financial statements included herein have been prepared by the Company in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) and the applicable rules and regulations of the U.S. Securities and Exchange Commission (the “SEC”) for interim financial information. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. The condensed consolidated balance sheet data as of December 31, 2022 was derived from the audited financial statements as of that date. The unaudited condensed consolidated financial statements have been prepared on the same basis as the audited consolidated financial statements and, in the opinion of management, reflect all adjustments of a normal recurring nature considered necessary to state fairly the Company’s financial position as of March 31, 2023, the results of its operations for the three months ended March 31, 2023 and 2022, the changes in its comprehensive income (loss) and stockholders’ equity for the three months ended March 31, 2023 and 2022, and its cash flows for the three months ended March 31, 2023 and 2022. The results for the three months ended March 31, 2023 are not necessarily indicative of the results that may be expected for the year ending December 31, 2023 or for any other future annual or interim period. The information included in this Quarterly Report on Form 10-Q should be read in conjunction with the audited consolidated financial statements and notes thereto for the fiscal year ended December 31, 2022, included in the Company’s Annual Report on Form 10-K. There have been no changes to the Company’s significant accounting policies during the three months ended March 31, 2023, as compared to the significant accounting policies described in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022, except for the granting of restricted stock units with performance conditions to senior management during the three months ended March 31, 2023. Refer to Note “9. Stockholders’ Equity” for information on the Company’s accounting policy.
Consolidation	The condensed consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities and equity accounts; disclosure of contingent assets and liabilities at the date of the financial statements; and the reported amounts of revenues and expenses during the reporting period. On an ongoing basis, the Company evaluates its estimates, including those related to marketable investments, allowances for credit losses, the amount of variable consideration included in the transaction price, warranty reserve, valuation of inventories, useful lives of property and equipment, intangibles, operating and financing lease right-of-use (“ROU”) assets and liabilities, income taxes, contingent consideration and other contingencies, including the probability of achieving performance targets associated with equity awards with performance conditions, among others. The Company bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which
Segments	Segments The Company determined its operating segment on the same basis that it uses to evaluate its performance internally. The Company has one business activity: the design, development, manufacturing and marketing of innovative medical products, and operates as one operating segment. The Company’s chief operating decision-maker, its Chief Executive Officer, reviews its consolidated operating results for the purpose of allocating resources and evaluating financial performance.
Marketable Investments	Marketable InvestmentsThe Company’s marketable investments have been classified and accounted for as available-for-sale.
Performance Shares	The fair value of these PSUs is based on the closing price of the Company's common stock on the date of grant. Stock-based compensation costs associated with these PSUs are recognized over the requisite service period of 4.25 years using graded vesting which results in more accelerated expense recognition compared to traditional time-based vesting over the same vesting period. Each reporting period, the Company monitors the probability of achieving the performance targets and may adjust periodic stock-based compensation expense based on its determination of the likelihood of achieving these performance targets and the estimated number of shares of common stock that will vest. The actual number of PSUs awarded is based on the actual performance during the performance period compared to the performance targets.

Investments and Fair Value of_2

Investments and Fair Value of Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Schedule of Marketable Investments	The following table presents the Company’s marketable investments as of March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 Securities with net gains or losses in accumulated other comprehensive income (loss) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Allowance Fair Value U.S. treasury $ 11,987 $ — $ (321) $ — $ 11,666 U.S. agency and government sponsored securities 6,998 — (102) — 6,896 U.S. states and municipalities 13,355 — (358) — 12,997 Corporate bonds 74,710 — (1,860) — 72,850 Total $ 107,050 $ — $ (2,641) $ — $ 104,409 December 31, 2022 Securities with net gains or losses in accumulated other comprehensive income (loss) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Allowance Fair Value U.S. treasury $ 14,482 $ — $ (478) $ — $ 14,004 U.S. agency and government sponsored securities 6,999 — (176) — 6,823 U.S. states and municipalities 23,460 — (501) — 22,959 Corporate bonds 76,731 — (2,345) — 74,386 Total $ 121,672 $ — $ (3,500) $ — $ 118,172
Debt Securities, Available-for-sale, Unrealized Loss Position, Fair Value	The following tables present the gross unrealized losses and the fair value for those marketable investments that were in an unrealized loss position for less than twelve months or for twelve months or more as of March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 Less than 12 months 12 months or more Total Fair Value Gross Unrealized Losses Fair Value Gross Unrealized Losses Fair Value Gross Unrealized Losses U.S. treasury $ — $ — $ 11,666 $ (321) $ 11,666 $ (321) U.S. agency and government sponsored securities — — 6,896 (102) 6,896 (102) U.S. states and municipalities — — 12,997 (358) 12,997 (358) Corporate bonds 10,812 (77) 62,038 (1,783) 72,850 (1,860) Total $ 10,812 $ (77) $ 93,597 $ (2,564) $ 104,409 $ (2,641) December 31, 2022 Less than 12 months 12 months or more Total Fair Value Gross Unrealized Losses Fair Value Gross Unrealized Losses Fair Value Gross Unrealized Losses U.S. treasury — — 14,004 (478) 14,004 (478) U.S. agency and government sponsored securities — — 6,823 (176) 6,823 (176) U.S. states and municipalities 4,567 (68) 13,772 (433) 18,339 (501) Corporate bonds 15,327 (101) 59,059 (2,244) 74,386 (2,345) Total $ 19,894 $ (169) $ 93,658 $ (3,331) $ 113,552 $ (3,500)
Schedule of Contractual Maturities of Marketable Investments	The following table presents the contractual maturities of the Company’s marketable investments as of March 31, 2023 (in thousands): March 31, 2023 Amortized Cost Fair Value Due in less than one year $ 66,527 $ 65,133 Due in one to five years 40,523 39,276 Total $ 107,050 $ 104,409
Schedule of Fair Value of Assets and Liabilities	The following tables set forth the Company’s financial assets measured at fair value by level within the fair value hierarchy as of March 31, 2023 and December 31, 2022 (in thousands): As of March 31, 2023 Level 1 Level 2 Level 3 Fair Value Financial Assets Cash equivalents: Money market funds $ 32,384 $ — $ — $ 32,384 Marketable investments: U.S. treasury 11,666 — — 11,666 U.S. agency and government sponsored securities — 6,896 — 6,896 U.S. states and municipalities — 12,997 — 12,997 Corporate bonds — 72,850 — 72,850 Total $ 44,050 $ 92,743 $ — $ 136,793 As of December 31, 2022 Level 1 Level 2 Level 3 Fair Value Financial Assets Cash equivalents: Money market funds $ 21,521 $ — $ — $ 21,521 Marketable investments: U.S. treasury 14,004 — — 14,004 U.S. agency and government sponsored securities — 6,823 — 6,823 U.S. states and municipalities — 22,959 — 22,959 Corporate bonds — 74,386 — 74,386 Total $ 35,525 $ 104,168 $ — $ 139,693

Balance Sheet Components Balanc

Balance Sheet Components Balance Sheet Components (Tables)	3 Months Ended
	Mar. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Inventories	The following table shows the components of inventories as of March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 December 31, 2022 Raw materials $ 90,980 $ 90,786 Work in process 32,761 26,793 Finished goods 220,301 216,427 Inventories $ 344,042 $ 334,006
Schedule of Accrued Liabilities	The following table shows the components of accrued liabilities as of March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 December 31, 2022 Payroll and employee-related cost $ 59,685 $ 60,480 Accrued expenses 11,147 10,902 Deferred revenue 9,114 9,158 Other accrued liabilities 25,923 25,760 Total accrued liabilities $ 105,869 $ 106,300
Schedule of Estimated Product Warranty Accrual	The following table shows the changes in the Company’s estimated product warranty accrual, included in accrued liabilities, for the three months ended March 31, 2023 and twelve months ended December 31, 2022, respectively (in thousands): March 31, 2023 December 31, 2022 Balance at the beginning of the period $ 5,370 $ 4,310 Accruals of warranties issued 500 2,451 Settlements of warranty claims (282) (1,391) Balance at the end of the period $ 5,588 $ 5,370

Intangible Assets Intangible As

Intangible Assets Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2023
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Schedule of Finite-lived Intangible Assets	The following tables present details of the Company’s acquired finite-lived intangible assets as of March 31, 2023 and December 31, 2022 (in thousands, except weighted-average amortization period): As of March 31, 2023 Weighted-Average Amortization Period Gross Carrying Amount Accumulated Amortization Net Finite-lived intangible assets: Developed technology 8.8 years $ 83,289 $ (12,495) $ 70,794 Customer relationships 15.0 years 6,484 (2,485) 3,999 Trade secrets and processes 20.0 years 5,256 (1,380) 3,876 Total intangible assets 9.6 years $ 95,029 $ (16,360) $ 78,669 As of December 31, 2022 Weighted-Average Gross Carrying Amount Accumulated Amortization Net Finite-lived intangible assets: Developed technology 8.8 years $ 83,289 $ (10,113) $ 73,176 Customer relationships 15.0 years 6,383 (2,340) 4,043 Trade secrets and processes 20.0 years 5,256 (1,314) 3,942 Other 5.0 years 1,646 (1,646) — Total intangible assets 9.6 years $ 96,574 $ (15,413) $ 81,161
Finite-lived Intangible Assets Amortization Expense	The following table presents the amortization expense recorded related to the Company’s finite-lived intangible assets for the three months ended March 31, 2023 and 2022 (in thousands): Three Months Ended March 31, 2023 2022 Cost of revenue $ 66 $ 66 Sales, general and administrative 2,486 1,982 Total $ 2,552 $ 2,048

Goodwill (Tables)

Goodwill (Tables)	3 Months Ended
	Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The following table presents the changes in goodwill during the three months ended March 31, 2023 (in thousands): Total Company Balance as of December 31, 2022 $ 166,046 Foreign currency translation 115 Balance as of March 31, 2023 $ 166,161

Stockholder's Equity (Tables)

Stockholder's Equity (Tables)	3 Months Ended
	Mar. 31, 2023
Share-Based Payment Arrangement [Abstract]
Schedule of Stock-based Compensation Expense	The following table sets forth the stock-based compensation expense included in the Company’s condensed consolidated statements of operations for the three months ended March 31, 2023 and 2022 (in thousands): Three Months Ended March 31, 2023 2022 Cost of revenue $ 1,191 $ 856 Research and development 2,278 1,386 Sales, general and administrative 9,297 6,651 Total $ 12,766 $ 8,893

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Income (Loss) (Tables)	3 Months Ended
	Mar. 31, 2023
Equity [Abstract]
Schedule of Accumulated Other Comprehensive Income (Loss)	The following table summarizes the changes in the accumulated balances during the period and includes information regarding the manner in which the reclassifications out of accumulated other comprehensive income (loss) into earnings affect the Company’s condensed consolidated statements of operations and condensed consolidated statements of comprehensive income (loss) (in thousands): Three Months Ended March 31, 2023 Three Months Ended March 31, 2022 Marketable Currency Translation Total Marketable Currency Translation Total Balance, beginning of the period $ (3,500) $ (4,624) $ (8,124) $ (595) $ (2,035) $ (2,630) Other comprehensive income (loss) before reclassifications: Unrealized gains (losses) — marketable investments 860 — 860 (2,474) — (2,474) Foreign currency translation gains (losses) — 403 403 — (868) (868) Net of tax 860 403 1,263 (2,474) (868) (3,342) Net current-year other comprehensive income (loss) 860 403 1,263 (2,474) (868) (3,342) Balance, end of the period $ (2,640) $ (4,221) $ (6,861) $ (3,069) $ (2,903) $ (5,972)

Net Income per Share (Tables)

Net Income per Share (Tables)	3 Months Ended
	Mar. 31, 2023
Earnings Per Share [Abstract]
Reconciliation of the Numerator and Denominator used in the Calculation of the Basic and Diluted Earnings per Share	A reconciliation of the numerator and denominator used in the calculation of the basic and diluted net income per share is as follows (in thousands, except share and per share amounts): Three Months Ended March 31, 2023 2022 Numerator: Net income $ 8,562 $ 79 Denominator: Weighted average shares used to compute net income attributable to common stockholders: Basic 38,186,342 37,646,122 Potential dilutive stock-based options and awards 889,046 1,062,535 Diluted 39,075,388 38,708,657 Net income per share: Basic $ 0.22 $ 0.00 Diluted $ 0.22 $ 0.00

Revenues Revenues (Tables)

Revenues Revenues (Tables)	3 Months Ended
	Mar. 31, 2023
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	The following table presents the Company’s revenues disaggregated by geography, based on the destination to which the Company ships its products, for the three months ended March 31, 2023 and 2022 (in thousands): Three Months Ended March 31, 2023 2022 United States $ 171,879 $ 144,308 International 69,519 59,587 Total $ 241,398 $ 203,895 The following table presents the Company’s revenues disaggregated by product category for the three months ended March 31, 2023 and 2022 (in thousands): Three Months Ended March 31, 2023 2022 Vascular $ 142,849 $ 122,809 Neuro 98,549 81,086 Total $ 241,398 $ 203,895
Summary of Contract Assets and Liabilities	The following information summarizes the Company’s contract assets and liabilities, net as of March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 December 31, 2022 Contract liabilities, net $ 8,297 $ 8,783

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Disclosures (Details)	3 Months Ended
	Mar. 31, 2023 activity segment
Accounting Policies [Abstract]
Number of business activities | activity	1
Number of operating segments | segment	1

Investments and Fair Value of_3

Investments and Fair Value of Financial Instruments - Gains and Losses of Marketable Investments (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 107,050	$ 121,672
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(2,641)	(3,500)
Allowance for Credit Loss	0	0
Fair Value	104,409	118,172
U.S. treasury
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	11,987	14,482
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(321)	(478)
Allowance for Credit Loss	0	0
Fair Value	11,666	14,004
U.S. agency and government sponsored securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	6,998	6,999
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(102)	(176)
Allowance for Credit Loss	0	0
Fair Value	6,896	6,823
U.S. states and municipalities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	13,355	23,460
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(358)	(501)
Allowance for Credit Loss	0	0
Fair Value	12,997	22,959
Corporate bonds
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	74,710	76,731
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(1,860)	(2,345)
Allowance for Credit Loss	0	0
Fair Value	$ 72,850	$ 74,386

Investments and Fair Value of_4

Investments and Fair Value of Financial Instruments - Narrative (Details) - USD ($)	3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Gross Unrealized Losses	$ (2,641,000)	$ (3,500,000)
Allowance for credit loss	$ 0

Investments and Fair Value of_5

Investments and Fair Value of Financial Instruments - Marketable Securities in an Unrealized Loss Position (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Less than 12 months: Fair Value	$ 10,812	$ 19,894
Less than 12 months: Gross Unrealized Losses	(77)	(169)
12 Months of more: Fair Value	93,597	93,658
12 months or more: Gross Unrealized Losses	(2,564)	(3,331)
Total: Fair Value	104,409	113,552
Total: Gross Unrealized Losses	(2,641)	(3,500)
U.S. treasury
Debt Securities, Available-for-sale [Line Items]
Less than 12 months: Fair Value	0	0
Less than 12 months: Gross Unrealized Losses	0	0
12 Months of more: Fair Value	11,666	14,004
12 months or more: Gross Unrealized Losses	(321)	(478)
Total: Fair Value	11,666	14,004
Total: Gross Unrealized Losses	(321)	(478)
U.S. agency and government sponsored securities
Debt Securities, Available-for-sale [Line Items]
Less than 12 months: Fair Value	0	0
Less than 12 months: Gross Unrealized Losses	0	0
12 Months of more: Fair Value	6,896	6,823
12 months or more: Gross Unrealized Losses	(102)	(176)
Total: Fair Value	6,896	6,823
Total: Gross Unrealized Losses	(102)	(176)
U.S. states and municipalities
Debt Securities, Available-for-sale [Line Items]
Less than 12 months: Fair Value	0	4,567
Less than 12 months: Gross Unrealized Losses	0	(68)
12 Months of more: Fair Value	12,997	13,772
12 months or more: Gross Unrealized Losses	(358)	(433)
Total: Fair Value	12,997	18,339
Total: Gross Unrealized Losses	(358)	(501)
Corporate bonds
Debt Securities, Available-for-sale [Line Items]
Less than 12 months: Fair Value	10,812	15,327
Less than 12 months: Gross Unrealized Losses	(77)	(101)
12 Months of more: Fair Value	62,038	59,059
12 months or more: Gross Unrealized Losses	(1,783)	(2,244)
Total: Fair Value	72,850	74,386
Total: Gross Unrealized Losses	$ (1,860)	$ (2,345)

Investments and Fair Value of_6

Investments and Fair Value of Financial Instruments - Contractual Maturities of Marketable Investments (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Amortized Cost
Due in less than one year	$ 66,527
Due in one to five years	40,523
Total	107,050	$ 121,672
Fair Value
Due in less than one year	65,133
Due in one to five years	39,276
Total	$ 104,409	$ 118,172

Investments and Fair Value of_7

Investments and Fair Value of Financial Instruments - Financial Assets and Liabilities Measured at Fair Value (Details) - Recurring - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Financial Assets
Assets, Fair Value Disclosure	$ 136,793	$ 139,693
U.S. treasury
Financial Assets
Marketable investments	11,666	14,004
U.S. agency and government sponsored securities
Financial Assets
Marketable investments	6,896	6,823
U.S. states and municipalities
Financial Assets
Marketable investments	12,997	22,959
Corporate bonds
Financial Assets
Marketable investments	72,850	74,386
Money market funds
Financial Assets
Cash equivalents	32,384	21,521
Level 1
Financial Assets
Assets, Fair Value Disclosure	44,050	35,525
Level 1 | U.S. treasury
Financial Assets
Marketable investments	11,666	14,004
Level 1 | U.S. agency and government sponsored securities
Financial Assets
Marketable investments	0	0
Level 1 | U.S. states and municipalities
Financial Assets
Marketable investments	0	0
Level 1 | Corporate bonds
Financial Assets
Marketable investments	0	0
Level 1 | Money market funds
Financial Assets
Cash equivalents	32,384	21,521
Level 2
Financial Assets
Assets, Fair Value Disclosure	92,743	104,168
Level 2 | U.S. treasury
Financial Assets
Marketable investments	0	0
Level 2 | U.S. agency and government sponsored securities
Financial Assets
Marketable investments	6,896	6,823
Level 2 | U.S. states and municipalities
Financial Assets
Marketable investments	12,997	22,959
Level 2 | Corporate bonds
Financial Assets
Marketable investments	72,850	74,386
Level 2 | Money market funds
Financial Assets
Cash equivalents	0	0
Level 3
Financial Assets
Assets, Fair Value Disclosure	0	0
Level 3 | U.S. treasury
Financial Assets
Marketable investments	0	0
Level 3 | U.S. agency and government sponsored securities
Financial Assets
Marketable investments	0	0
Level 3 | U.S. states and municipalities
Financial Assets
Marketable investments	0	0
Level 3 | Corporate bonds
Financial Assets
Marketable investments	0	0
Level 3 | Money market funds
Financial Assets
Cash equivalents	$ 0	$ 0

Balance Sheet Components - Inve

Balance Sheet Components - Inventories (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Raw materials	$ 90,980	$ 90,786
Work in process	32,761	26,793
Finished goods	220,301	216,427
Inventories	$ 344,042	$ 334,006

Balance Sheet Components - Accr

Balance Sheet Components - Accrued Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Payroll and employee-related cost	$ 59,685	$ 60,480
Accrued expenses	11,147	10,902
Deferred revenue	9,114	9,158
Other accrued liabilities	25,923	25,760
Total accrued liabilities	$ 105,869	$ 106,300

Balance Sheet Components - Prod

Balance Sheet Components - Product Warranty (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Product Warranty, Increase (Decrease) [Roll Forward]
Balance at the beginning of the period	$ 5,370	$ 4,310
Accruals of warranties issued	500	2,451
Settlements of warranty claims	(282)	(1,391)
Balance at the end of the period	$ 5,588	$ 5,370

Intangible Assets - Intangible

Intangible Assets - Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Period	9 years 7 months 6 days		9 years 7 months 6 days
Finite lived intangible assets: gross carrying amount	$ 95,029		$ 96,574
Accumulated amortization	(16,360)		(15,413)
Finite lived intangible assets: net	78,669		81,161
Intangible assets, net	78,669		$ 81,161
Total amortization of finite lived intangible assets	$ 2,552	$ 2,048
Developed technology
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Period	8 years 9 months 18 days		8 years 9 months 18 days
Finite lived intangible assets: gross carrying amount	$ 83,289		$ 83,289
Accumulated amortization	(12,495)		(10,113)
Finite lived intangible assets: net	$ 70,794		$ 73,176
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Period	15 years		15 years
Finite lived intangible assets: gross carrying amount	$ 6,484		$ 6,383
Accumulated amortization	(2,485)		(2,340)
Finite lived intangible assets: net	$ 3,999		$ 4,043
Trade secrets and processes
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Period	20 years		20 years
Finite lived intangible assets: gross carrying amount	$ 5,256		$ 5,256
Accumulated amortization	(1,380)		(1,314)
Finite lived intangible assets: net	3,876		$ 3,942
Other
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Period			5 years
Finite lived intangible assets: gross carrying amount			$ 1,646
Accumulated amortization			(1,646)
Finite lived intangible assets: net			$ 0
Cost of revenue
Finite-Lived Intangible Assets [Line Items]
Total amortization of finite lived intangible assets	66	66
Sales, general and administrative
Finite-Lived Intangible Assets [Line Items]
Total amortization of finite lived intangible assets	$ 2,486	$ 1,982

Goodwill (Details)

Goodwill (Details)	3 Months Ended
	Mar. 31, 2023 USD ($)
Goodwill [Roll Forward]
Goodwill	$ 166,046,000
Foreign currency translation and other adjustments	115,000
Goodwill	166,161,000
Goodwill impairment	$ 0

Debt (Details)

Debt (Details) - Revolving Credit Facility - USD ($)	3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022	Apr. 24, 2020
Line of Credit Facility [Line Items]
Borrowing capacity			$ 100,000,000
Line of credit, increase limit			$ 150,000,000
Borrowings outstanding	$ 0	$ 0
Bank Of America And Citibank | Line of Credit
Line of Credit Facility [Line Items]
Line of credit facility, unused capacity, commitment fee percentage	0.35%

Commitments and Contingencies -

Commitments and Contingencies - Royalty Obligations (Details) - USD ($) $ in Millions	1 Months Ended	3 Months Ended
	Jul. 31, 2019	Mar. 31, 2023	Mar. 31, 2022
Cost of revenue
Other Commitments [Line Items]
Royalty expense		$ 0.7	$ 0.6
Royalty Agreement, March 2005
Other Commitments [Line Items]
Extended term of agreement	10 years
Increase in minimum annual royalty payments	$ 0.2
Minimum quarterly royalty payments		$ 0.3
Royalty Agreement, April 2012
Other Commitments [Line Items]
Royalty as a percent of sales		5%
Term of agreement		15 years

Stockholder's Equity - Stock-ba

Stockholder's Equity - Stock-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation expense	$ 12,766	$ 8,893
Share-based compensation expense, capitalized in inventory	2,200		$ 2,200
NonPerformanceShares [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Unrecognized compensation cost related to unvested share-based compensation arrangements	$ 76,400
Unrecognized compensation cost, expected recognition period (in years)	3 years
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Award requisite service period	4 years 3 months
Unrecognized compensation cost related to unvested share-based compensation arrangements	$ 18,500
Unrecognized compensation cost, expected recognition period (in years)	4 years
Cost of revenue
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation expense	$ 1,191	856
Research and development
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation expense	2,278	1,386
Sales, general and administrative
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation expense	$ 9,297	$ 6,651

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	$ 998,858	$ 953,927
Other comprehensive income (loss) before reclassifications:
Total other comprehensive (loss) income, net of tax	1,263	(3,342)
Ending balance	1,024,469	959,302
Marketable Investments
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(3,500)	(595)
Other comprehensive income (loss) before reclassifications:
Other comprehensive income before reclassifications	860	(2,474)
Foreign currency translation gains (losses)	0	0
Net of tax	860	(2,474)
Total other comprehensive (loss) income, net of tax	860	(2,474)
Ending balance	(2,640)	(3,069)
Currency Translation Adjustments
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(4,624)	(2,035)
Other comprehensive income (loss) before reclassifications:
Other comprehensive income before reclassifications	0	0
Foreign currency translation gains (losses)	403	(868)
Net of tax	403	(868)
Total other comprehensive (loss) income, net of tax	403	(868)
Ending balance	(4,221)	(2,903)
Total
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(8,124)	(2,630)
Other comprehensive income (loss) before reclassifications:
Other comprehensive income before reclassifications	860	(2,474)
Foreign currency translation gains (losses)	403	(868)
Net of tax	1,263	(3,342)
Total other comprehensive (loss) income, net of tax	1,263	(3,342)
Ending balance	$ (6,861)	$ (5,972)

Income Taxes Income Taxes (Deta

Income Taxes Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Tax Disclosure [Abstract]
Provision for (benefit from) income taxes	$ 90	$ (5,183)
Effective tax rate	(1.00%)	101.50%

Net Income per Share - Basic an

Net Income per Share - Basic and Diluted Earnings per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Numerator:
Net income	$ 8,562	$ 79
Weighted average shares used to compute net income attributable to common stockholders:
Basic (in shares)	38,186,342	37,646,122
Potential dilutive stock-based options and awards (in shares)	889,046	1,062,535
Diluted (in shares)	39,075,388	38,708,657
Net income per share:
Basic (in dollars per share)	$ 0.22	$ 0
Diluted (in dollars per share)	$ 0.22	$ 0

Net Income per Share - Antidilu

Net Income per Share - Antidilutive Securities (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Earnings Per Share [Abstract]
Antidilutive securities excluded from the computation of earnings per share (in shares)	26	123

Revenues - Disaggregation of Re

Revenues - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	$ 241,398	$ 203,895
United States
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	171,879	144,308
International
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	69,519	59,587
Neuro
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	98,549	81,086
Vascular
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	$ 142,849	$ 122,809

Revenues - Summary of Contract

Revenues - Summary of Contract Assets and Liabilities (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Contract liabilities, net	$ 8,297	$ 8,783
Revenue recognized relating to contract liabilities	$ 500