Shockwave Medical (SWAV) 10-Q 10 May 21 2021 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2021	May 06, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2021
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1
Trading Symbol	SWAV
Entity Registrant Name	Shockwave Medical, Inc.
Entity Central Index Key	0001642545
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		34,983,062
Entity Shell Company	false
Entity Current Reporting Status	Yes
Entity File Number	001-38829
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	27-0494101
Entity Address, Address Line One	5403 Betsy Ross Drive
Entity Address, City or Town	Santa Clara
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	95054
City Area Code	510
Local Phone Number	279-4262
Document Quarterly Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Title of 12(b) Security	Shockwave Medical, Inc., common stock, parvalue $0.001 per share
Security Exchange Name	NASDAQ

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
CURRENT ASSETS:
Cash and cash equivalents	$ 57,006	$ 50,423
Short-term investments	120,422	151,931
Accounts receivable, net	19,613	11,689
Inventory	33,538	29,859
Prepaid expenses and other current assets	2,533	2,398
Total current assets	233,112	246,300
Operating lease right-of-use assets	7,211	7,568
Property and equipment, net	20,233	16,362
Equity method investment	6,750
Other assets	1,764	1,812
TOTAL ASSETS	269,070	272,042
CURRENT LIABILITIES:
Accounts payable	3,728	1,466
Term notes, current portion	4,950	3,300
Accrued liabilities	23,918	19,942
Lease liability, current portion	898	873
Total current liabilities	33,494	25,581
Lease liability, noncurrent portion	7,213	7,488
Term notes, noncurrent portion	11,836	13,319
Related party contract liability, noncurrent portion	12,273
TOTAL LIABILITIES	64,816	46,388
STOCKHOLDERS’ EQUITY:
Preferred stock
Common stock	35	35
Additional paid-in capital	471,477	469,283
Accumulated other comprehensive income	16	9
Accumulated deficit	(267,274)	(243,673)
TOTAL STOCKHOLDERS’ EQUITY	204,254	225,654
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$ 269,070	$ 272,042

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Revenue:
Product revenue	$ 31,900	$ 15,197
Type of Revenue [Extensible List]	us-gaap:ProductMember	us-gaap:ProductMember
Cost of revenue:
Cost of product revenue	$ 7,892	$ 5,651
Type of Cost, Good Or Service [Extensible List]	us-gaap:ProductMember	us-gaap:ProductMember
Gross profit	$ 24,008	$ 9,546
Operating expenses:
Research and development	10,277	11,890
Sales and marketing	23,992	10,411
General and administrative	7,226	6,224
Total operating expenses	41,495	28,525
Loss from operations	(17,487)	(18,979)
Share in net loss of equity method investment	(5,523)
Interest expense	(312)	(277)
Other income (expense), net	(235)	504
Net loss before taxes	(23,557)	(18,752)
Income tax provision	44	23
Net loss	(23,601)	(18,775)
Unrealized gain on available-for-sale securities	7	68
Total comprehensive loss	$ (23,594)	$ (18,707)
Net loss per share, basic and diluted	$ (0.68)	$ (0.59)
Shares used in computing net loss per share, basic and diluted	34,797,400	31,644,041

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity (Unaudited) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Income	Accumulated Deficit
Beginning balance at Dec. 31, 2019	$ 192,653	$ 31	$ 370,561	$ 35	$ (177,974)
Beginning balance, Shares at Dec. 31, 2019		31,446,787
Exercise of stock options	1,113	$ 1	1,112
Exercise of stock options, Shares		356,128
Unrealized gain on available-for- sale securities	68			68
Issuance of common stock under employee stock purchase plan	842		842
Issuance of common stock under employee stock purchase plan, Share		24,691
Stock-based compensation	1,871		1,871
Net loss	(18,775)				(18,775)
Ending balance at Mar. 31, 2020	177,772	$ 32	374,386	103	(196,749)
Beginning balance, shares at Mar. 31, 2020		31,827,606
Beginning balance at Dec. 31, 2020	225,654	$ 35	469,283	9	(243,673)
Beginning balance, Shares at Dec. 31, 2020		34,684,337
Exercise of stock options	$ 773		773
Exercise of stock options, Shares	159,325	159,325
Unrealized gain on available-for- sale securities	$ 7			7
Issuance of common stock under employee stock purchase plan	1,141		1,141
Issuance of common stock under employee stock purchase plan, Share		20,594
Issuance of common stock in connection with vesting of restricted stock units, Shares		107,237
Taxes withheld on net settled vesting of restricted stock units	(5,114)		(5,114)
Taxes withheld on net settled vesting of restricted stock units, shares		(42,529)
Stock-based compensation	5,394		5,394
Net loss	(23,601)				(23,601)
Ending balance at Mar. 31, 2021	$ 204,254	$ 35	$ 471,477	$ 16	$ (267,274)
Beginning balance, shares at Mar. 31, 2021		34,928,964

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
CASH FLOWS FROM OPERATING ACTIVITIES:
Net loss	$ (23,601)	$ (18,775)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	721	426
Share in net loss of equity method investment	5,523
Stock-based compensation	5,139	1,871
Amortization of right-of-use assets	405	369
Accretion of discount on available-for-sale securities	379	114
Amortization of debt issuance costs	167	153
Changes in operating assets and liabilities:
Accounts receivable	(7,924)	(434)
Inventory	(3,308)	(3,807)
Prepaid expenses and other current assets	(135)	(1,588)
Other assets	48	(47)
Accounts payable	1,782	(542)
Accrued and other current liabilities	3,799	(1,855)
Lease liabilities	(298)	(74)
Net cash used in operating activities	(17,303)	(24,189)
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchase of available-for-sale securities	(15,263)	(16,020)
Proceeds from maturities of available-for-sale securities	46,400	25,000
Purchase of property and equipment	(4,051)	(4,655)
Net cash provided by investing activities	27,086	4,325
CASH FLOWS FROM FINANCING ACTIVITIES:
Payments of offering costs		(179)
Principal payments of term loan		(1,111)
Net proceeds from term loan		3,265
Payments of taxes withheld on net settled vesting of restricted stock units	(5,114)
Proceeds from stock option exercises	773	1,113
Proceeds from issuance of common stock under employee stock purchase plan	1,141	842
Net cash (used in) provided by financing activities	(3,200)	3,930
Net increase (decrease) in cash, cash equivalents and restricted cash	6,583	(15,934)
Cash, cash equivalents and restricted cash at beginning of period	51,873	140,495
Cash, cash equivalents and restricted cash equivalents at end of period	58,456	124,561
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION:
Interest paid	144	108
Income tax paid	15
NON-CASH INVESTING AND FINANCING ACTIVITIES:
Right-of-use asset obtained in exchange for lease liability	48	39
Property and equipment purchases included in accounts payable and accrued liabilities	3,104	4,036
Equity method investment obtained in exchange for related party contract liability	12,273
Transfer of fixed assets to inventory	$ 116	$ 40

Organization and Basis of Prese

Organization and Basis of Presentation	3 Months Ended
	Mar. 31, 2021
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Organization and Basis of Presentation	1. Organization and Basis of Presentation Shockwave Medical, Inc. (the “Company”) was incorporated on June 17, 2009. The Company is primarily engaged in the development of Intravascular Lithotripsy (“IVL”) technology for the treatment of calcified plaque in patients with peripheral vascular, coronary vascular, and heart valve disease. Built on a balloon catheter platform, the IVL technology uses lithotripsy to disrupt both superficial and deep vascular calcium, while minimizing soft tissue injury, and an integrated angioplasty balloon to dilate blockages at low pressures, restoring blood flow. In 2016, the Company began commercial and manufacturing operations, and began selling catheters based on the IVL technology. The Company’s headquarters are in Santa Clara, California. The Company is located and operates primarily in the United States and has subsidiaries in Germany, the United Kingdom, Japan and France. Need for Additional Capital The Company has incurred significant losses and has negative cash flows from operations. As of March 31, 2021, the Company had an accumulated deficit of $267.3 million. Management expects to continue to incur additional substantial losses for the foreseeable future. As of March 31, 2021, the Company had cash, cash equivalents and short-term investments of $177.4 million, which are available to fund future operations. The Company believes that its cash, cash equivalents and short-term investments as of March 31, 2021, will be sufficient for the Company to continue as a going concern for at least 12 months from the date the unaudited condensed consolidated financial statements are filed with the Securities and Exchange Commission (“SEC”). Risk and Uncertainties The Company is subject to continuing risks and uncertainties as a result of the COVID-19 pandemic, and is closely monitoring the impact of the pandemic on all aspects of its business, including the impacts on its customers, patients that would benefit from procedures utilizing the Company’s products, employees, suppliers, vendors, business partners and distribution channels. Economies worldwide continue to be negatively impacted by the COVID-19 pandemic, in particular with recurrent outbreaks and mutations of the virus, despite advances in vaccines, and we anticipate these disruptions will continue. As such he Company's future results of operations and liquidity could be adversely impacted by a variety of factors related to the COVID-19 pandemic, including those discussed in the section entitled “ Risk Factors ” of the Company’s Annual Report on Form 10-K for the year ended December 31, 2020. As of the date of issuance of these condensed consolidated financial statements, the extent to which the COVID-19 pandemic may materially impact the Company's financial condition, liquidity, or results of operations remains uncertain

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2021
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States (“GAAP”) and applicable rules and regulations of SEC regarding interim financial reporting. The unaudited interim condensed consolidated financial statements have been prepared on the same basis as the annual consolidated financial statements and, in the opinion of management, reflect all adjustments, which include only normal recurring adjustments, necessary to present fairly the Company’s consolidated financial position, results of operations and cash flows. The results of operations for the three months ended March 31, 2021 are not necessarily indicative of the results to be expected for the year ending December 31, 2021 or for any other future annual or interim period. The condensed consolidated balance sheet as of December 31, 2020 included herein was derived from the audited financial statements as of that date. The unaudited condensed consolidated financial statements should be read in conjunction with the Company’s audited consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020, filed with the SEC on February 26, 2021. Cash, Cash Equivalents, and Restricted Cash The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sum to the total of the same amounts shown in the condensed consolidated statements of cash flows: March 31, 2021 December 31, 2020 (in thousands) Cash and cash equivalents $ 57,006 $ 50,423 Restricted cash 1,450 1,450 Total cash, cash equivalents, and restricted cash $ 58,456 $ 51,873 Equity Method Investments Entities which the Company has significant influence over activities of the entity, but does not control, are accounted for under the equity method of accounting in accordance with Topic 323, Investments - Equity Method and Joint Ventures . The Company’s carrying value in the equity method investment is reported as equity method investment on the Company’s consolidated balance sheet. The Company records its proportionate of the underlying income or loss which is recognized in share in net loss of equity method investment. For the three months ended, March 31, 2021, the Company’s share in the losses incurred by the equity method investee was $5.5 million. The Company eliminates any intra-entity profits to the extent of the Company’s beneficial interest. We assess our equity method investment for impairment when events or circumstances suggest that the carrying amount of the investment may be impaired. We consider all available evidenced in assessing whether a decline in fair value is other than temporary. If the decline in fair value is determined to be other than temporary, the difference between the carrying amount of the investment and estimated fair value is recognized as an impairment charge. Fair Value of Financial Instruments The Company’s cash and cash equivalents, restricted cash, short-term investments, accounts receivable, accounts payable and accrued liabilities approximate their fair value due to their short maturities. Management believes that its term notes bear interest at the prevailing market rates for instruments with similar characteristics; accordingly, the carrying value of this instrument approximates its fair value. The Company utilizes valuation techniques that maximize the use of observable inputs and minimize the use of unobservable inputs to the extent possible. The Company determines the fair value of its financial instruments based on assumptions that market participants would use in pricing an asset or liability in the principal or most advantageous market. When considering market participant assumptions in fair value measurements, the following fair value hierarchy distinguishes between observable and unobservable inputs, which are categorized in one of the following levels: Level 1 – Inputs are unadjusted, quoted prices in active markets for identical assets or liabilities at the measurement date; Level 2 – Inputs are observable, unadjusted quoted prices in active markets for similar assets or liabilities, unadjusted quoted prices for identical or similar assets or liabilities 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 related assets or liabilities; and Level 3 – Unobservable inputs that are significant to the measurement of the fair value of the assets or liabilities that are supported by little or no market data. Revenue To determine revenue recognition for arrangements that an entity determines are within the scope of Topic 606, Revenue from Contracts with Customers Product Revenue The Company records product revenue primarily from the sale of its IVL catheters. The Company sells its products to hospitals, primarily through direct sales representatives, as well as through distributors in selected international markets. Additionally, a significant portion of the Company’s revenue is generated through a consignment model under which inventory is maintained at hospitals. Product revenue is recognized when a customer obtains control of promised goods or services, in an amount that reflects the consideration which the entity expects to receive in exchange for those goods or services. For products sold through direct sales representatives, control is transferred upon delivery to customers. For products sold to distributors internationally and products sold to customers that utilize stocking orders, control is transferred upon shipment or delivery to the customer’s named location, based on the contractual shipping terms. For consignment inventory, control is transferred at the time the IVL catheters are consumed in a procedure. The Company elected to account for shipping and handling activities that occur after the customer has obtained control as a fulfillment activity, and not a separate performance obligation. The Company may provide for the use of an IVL generator and connector cable under an agreement to customers at no charge to facilitate use of the IVL catheters. These agreements do not contain contractually enforceable minimum commitments and are generally cancellable by either party with 30 days’ notice. License Revenue For arrangements that contain a license of our functional intellectual property with a customer, we consider whether the license grant is distinct from other performance obligations in the arrangement. A license grant of functional intellectual property is generally considered to be capable of being distinct if a customer can benefit from the license on its own or together with other readily available resources. License revenue for licenses of functional intellectual property is recognized at a point in time when the Company satisfies its performance obligation of transferring the license to the customer. Consideration received in advance of the satisfaction of a performance obligation is recognized as a contract liability. No license revenues have been recognized for the three months ended March 31, 2021.

Financial Instruments and Fair

Financial Instruments and Fair Value Measurements	3 Months Ended
	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Financial Instruments and Fair Value Measurements	3. Financial Instruments and Fair Value Measurements The following tables summarize the Company’s financial assets and liabilities measured at fair value on a recurring basis by level within the fair value hierarchy: March 31, 2021 Level 1 Level 2 Level 3 Total (in thousands) Assets: U.S. Treasury securities $ 90,974 $ — $ — $ 90,974 Money market funds 49,008 — — 49,008 Commercial paper — 24,178 — 24,178 Corporate bonds — 5,270 — 5,270 Total assets $ 139,982 $ 29,448 $ — $ 169,430 December 31, 2020 Level 1 Level 2 Level 3 Total (in thousands) Assets: U.S. Treasury securities $ 126,363 $ — $ — $ 126,363 Money market funds 35,053 — — $ 35,053 Commercial paper — 31,968 — $ 31,968 Total assets $ 161,416 $ 31,968 $ — $ 193,384

Cash Equivalents and Short-Term

Cash Equivalents and Short-Term Investments	3 Months Ended
	Mar. 31, 2021
Cash And Cash Equivalents [Abstract]
Cash Equivalents and Short-Term Investments	4. Cash Equivalents and Short-Term Investments The following is a summary of the Company’s cash equivalents and short-term investments: March 31, 2021 Amortized Cost Basis Unrealized Gains Unrealized Losses Fair Value (in thousands) U.S. Treasury securities $ 90,953 $ 21 $ — $ 90,974 Money market funds 49,008 — — 49,008 Commercial paper 24,178 — — 24,178 Corporate bonds 5,275 — (5 ) 5,270 Total $ 169,414 $ 21 $ (5 ) $ 169,430 Reported as: Cash equivalents $ 49,008 Short-term investments 120,422 Total $ 169,430 December 31, 2020 Amortized Cost Basis Unrealized Gains Unrealized Losses Fair Value (in thousands) U.S. Treasury securities $ 126,354 $ 11 $ (2 ) $ 126,363 Money market funds 35,053 — — 35,053 Commercial paper 31,968 — — 31,968 Total $ 193,375 $ 11 $ (2 ) $ 193,384 Reported as: Cash equivalents $ 41,453 Short-term investments 151,931 Total $ 193,384 The C ompany recognized

Balance Sheet Components

Balance Sheet Components	3 Months Ended
	Mar. 31, 2021
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Balance Sheet Components	5. Balance Sheet Components Inventory Inventory consists of the following: March 31, December 31, 2021 2020 (in thousands) Raw material $ 6,265 $ 4,995 Work in progress 7,233 6,051 Finished goods 18,345 16,952 Consigned inventory 1,695 1,861 Total inventory $ 33,538 $ 29,859 Accrued Liabilities Accrued liabilities consist of the following: March 31, December 31, 2021 2020 (in thousands) Accrued employee compensation 13,094 10,885 Accrued research and development costs 3,558 3,057 Accrued asset purchases 3,154 2,527 Accrued professional services 1,338 1,325 Other 2,774 2,148 Total accrued liabilities $ 23,918 $ 19,942

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2021
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-Based Compensation	6. Stock-Based Compensation Total stock-based compensation was as follows: Three Months March 31, 2021 2020 (in thousands) Cost of product revenue $ 138 $ 161 Research and development 1,167 488 Sales and marketing 2,057 559 General and administrative 1,777 663 Total stock-based compensation $ 5,139 $ 1,871 Stock-based compensation of $255,000 was capitalized into inventory for the three months ended March 31, 2021. No material stock-based compensation was capitalized into inventory for the three months ended March 31, 2020. Stock-based compensation capitalized into inventory is recognized as cost of product revenue when the related product is sold. 2009 Equity Incentive Plan and 2019 Equity Incentive Plan On June 17, 2009, the Company adopted the 2009 Equity Incentive Plan (the “2009 Plan”) under which the Board had the authority to issue stock options to employees, directors, and consultants. In February 2019, the Company adopted the 2019 Stock Option and Incentive Plan (the “2019 Plan”), which became effective in connection with the Company’s initial public offering (the “IPO”). As a result, effective as of March 6, 2019, the Company may not grant any additional awards under the 2009 Plan. The 2009 Plan will continue to govern outstanding equity awards granted thereunder. The Company initially reserved 2,000,430 shares of common stock for the issuance of a variety of awards under the 2019 Plan, including stock options, stock appreciation rights, awards of restricted stock and awards of restricted stock units In addition, the number of shares of common stock reserved for issuance under the 2019 Plan automatically increases on the first day of January for a period of up to ten years, which commenced on January 1, 2020, in an amount equal to 3% of the total number of shares of the Company’s capital stock outstanding on the last day of the preceding year, or a lesser number of shares determined by the Company’s board of directors. Stock Options Option activity under the 2009 Plan and 2019 Plan is set forth below: Shares Available for Grant Number of Shares Weighted- Average Exercise Price Per Share Weighted- Average Remaining Term Aggregate Intrinsic Value (in years) (in thousands) Balance, December 31, 2020 2,689,624 2,087,202 $ 5.92 6.77 $ 204,137 Awards authorized 1,040,530 — Options exercised — (159,325 ) 4.85 Options cancelled 615 (615 ) 4.03 Balance, March 31, 2021 3,730,769 1,927,262 $ 6.00 6.54 $ 239,473 Vested and exercisable, March 31, 2021 1,399,252 $ 4.91 6.21 $ 175,391 Vested and expected to vest, March 31, 2021 1,927,262 $ 6.00 6.54 $ 239,473 Restricted Stock Units Restricted stock units (“RSUs”) are share awards that entitle the holder to receive freely tradable shares of the Company’s common stock upon vesting. The RSUs cannot be transferred and the awards are subject to forfeiture if the holder’s employment terminates prior to the release of the vesting restrictions. The RSUs generally vest over a four-year RSU activity under the 2019 Plan is set forth below : Number of Shares Weighted- Average Grant Date Fair Value Per Share Balance, December 31, 2020 859,577 $ 48.50 RSUs granted 431,365 119.13 RSUs forfeited (9,733 ) 53.03 RSUs vested (107,237 ) 42.16 Balance, March 31, 2021 1,173,972 $ 75.00 Employee Share Purchase Plan (ESPP) In February 2019, the Company adopted the 2019 Employee Stock Purchase Plan (“ESPP”), which became effective with in connection with the Company’s IPO, on March 6, 2019. The Company initially reserved 300,650 shares of common stock for purchase under the ESPP. Each offering under the ESPP to Company employees to purchase stock under the ESPP begins on each September 1 and March 1 and ends on the following February 28 or 29 and August 31, respectively. The fair value of the ESPP shares is estimated using the Black-Scholes option pricing model. The Company recorded $267,000 and $191,000 of stock-based compensation expense related to the ESPP for the three months ended March 31, 2021 and 2020, respectively. At March 31, 2021, a total of 888,735 shares were available for issuance under the ESPP.

Net Loss Per Share

Net Loss Per Share	3 Months Ended
	Mar. 31, 2021
Earnings Per Share [Abstract]
Net Loss Per Share	7. Net Loss Per Share The following outstanding potentially dilutive common stock equivalents have been excluded from the calculation of diluted net loss per share for the periods presented due to their anti-dilutive effect: March 31, 2021 2020 Common stock options issued and outstanding 1,927,262 2,945,534 Restricted stock units 1,173,972 722,409 Employee stock purchase plan 2,951 6,468 Total 3,104,185 3,674,411

Revenue

Revenue	3 Months Ended
	Mar. 31, 2021
Disaggregation Of Revenue [Abstract]
Revenue	8. Revenue Disaggregation of revenue The following table represents the Company’s product revenue based on product line: Three Months Ended March 31, 2021 2020 (in thousands) Peripheral $ 16,141 $ 9,081 Coronary 15,308 5,767 Other 451 349 Product revenue $ 31,900 $ 15,197 Peripheral product revenue encompasses sales of the Company’s M 5 4 2 The following table represents the Company’s product revenue based on the location to which the product is shipped: Three Months Ended March 31, 2021 2020 (in thousands) United States $ 21,045 $ 7,769 Germany 1,311 911 Rest of Europe 6,911 5,108 All other countries 2,633 1,409 Product revenue $ 31,900 $ 15,197

Equity Method Investments

Equity Method Investments	3 Months Ended
	Mar. 31, 2021
Equity Method Investments And Joint Ventures [Abstract]
Equity Method Investments	9. Equity Method Investments Genesis Shockwave Private Limited On March 19, 2021, the Company entered into the Joint Venture Deed (or “JV Agreement”) with Genesis MedTech International Private Limited (“Genesis”) to establish a long-term strategic partnership to develop, manufacture and commercialize certain of Shockwave’s interventional products in the People’s Republic of China, excluding the Special Administrative Regions of Hong Kong and Macau (“PRC”). Under the JV Agreement, Genesis Shockwave Private Ltd. (the “JV”) was formed under the laws of Singapore to serve as a joint venture of Genesis and the Company for the purpose of establishing and managing such a strategic partnership. On the same date, Genesis and the Company entered into a Share Subscription Agreement pursuant to which, among other things, the JV issued (i) 54,900 ordinary shares which represents 55% of total equity of the JV, to Genesis in exchange for a cash contribution of $15.0 million, of which 50% was paid upon signing and the remaining 50% will be due within one year of signing, and (ii) 45,000 ordinary shares which represents 45% of total equity, to the Company as consideration for the Shockwave License Agreement (or “License Agreement”). Under the License Agreement, the Company has agreed to contribute to the JV an exclusive license under certain of the Company’s intellectual property rights to develop, manufacture, distribute and commercialize certain products in the PRC and is entitled to receive royalties on the sales of the licensed products in the PRC. Further, the Company entered into a Distribution Agreement, pursuant to which the Company has agreed to sell certain Shockwave-manufactured products to the JV and/or a to-be formed PRC subsidiary of the JV for commercialization and distribution in the PRC. The Company has accounted for its investment in the JV under the equity method of accounting. The Company’s share of losses generated by the JV for the three months ended March 31, 2021 was $5.5 million, which was recorded in share in net loss of equity method investment. The JV has not generated any revenues to date. The following table summarizes the unaudited balance sheet for the JV: March 31, 2021 Balance sheet: (in thousands) Current assets $ 14,994 Total assets 14,994 Total liabilities — Net assets $ 14,994 Upon execution of the License Agreement, on March 19, 2021, the Company received a 45% equity stake in the JV. The Company determined that the JV met the definition of a customer under Topic 606, and that the promised goods and services of the contribution of the license of intellectual property and associated manufacturing technology transfer to the JV were considered to be a single performance obligation. The transaction price of $12.3 million was estimated by reference to the cash value of the shares which were issued at the formation of the JV. As of March 31, 2021, the contribution of the license of intellectual property and associated manufacturing technology transfer to the JV has not yet been completed. The Company recorded a related party contract liability, non-current, of $12.3 million for the outstanding performance obligation.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2021
Accounting Policies [Abstract]
Risk and Uncertainties	Risk and Uncertainties The Company is subject to continuing risks and uncertainties as a result of the COVID-19 pandemic, and is closely monitoring the impact of the pandemic on all aspects of its business, including the impacts on its customers, patients that would benefit from procedures utilizing the Company’s products, employees, suppliers, vendors, business partners and distribution channels. Economies worldwide continue to be negatively impacted by the COVID-19 pandemic, in particular with recurrent outbreaks and mutations of the virus, despite advances in vaccines, and we anticipate these disruptions will continue. As such he Company's future results of operations and liquidity could be adversely impacted by a variety of factors related to the COVID-19 pandemic, including those discussed in the section entitled “ Risk Factors ” of the Company’s Annual Report on Form 10-K for the year ended December 31, 2020. As of the date of issuance of these condensed consolidated financial statements, the extent to which the COVID-19 pandemic may materially impact the Company's financial condition, liquidity, or results of operations remains uncertain
Basis of Presentation	Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States (“GAAP”) and applicable rules and regulations of SEC regarding interim financial reporting. The unaudited interim condensed consolidated financial statements have been prepared on the same basis as the annual consolidated financial statements and, in the opinion of management, reflect all adjustments, which include only normal recurring adjustments, necessary to present fairly the Company’s consolidated financial position, results of operations and cash flows. The results of operations for the three months ended March 31, 2021 are not necessarily indicative of the results to be expected for the year ending December 31, 2021 or for any other future annual or interim period. The condensed consolidated balance sheet as of December 31, 2020 included herein was derived from the audited financial statements as of that date. The unaudited condensed consolidated financial statements should be read in conjunction with the Company’s audited consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020, filed with the SEC on February 26, 2021.
Cash, Cash Equivalents and Restricted Cash	Cash, Cash Equivalents, and Restricted Cash The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sum to the total of the same amounts shown in the condensed consolidated statements of cash flows: March 31, 2021 December 31, 2020 (in thousands) Cash and cash equivalents $ 57,006 $ 50,423 Restricted cash 1,450 1,450 Total cash, cash equivalents, and restricted cash $ 58,456 $ 51,873
Equity Method Investments	Equity Method Investments Entities which the Company has significant influence over activities of the entity, but does not control, are accounted for under the equity method of accounting in accordance with Topic 323, Investments - Equity Method and Joint Ventures . The Company’s carrying value in the equity method investment is reported as equity method investment on the Company’s consolidated balance sheet. The Company records its proportionate of the underlying income or loss which is recognized in share in net loss of equity method investment. For the three months ended, March 31, 2021, the Company’s share in the losses incurred by the equity method investee was $5.5 million. The Company eliminates any intra-entity profits to the extent of the Company’s beneficial interest. We assess our equity method investment for impairment when events or circumstances suggest that the carrying amount of the investment may be impaired. We consider all available evidenced in assessing whether a decline in fair value is other than temporary. If the decline in fair value is determined to be other than temporary, the difference between the carrying amount of the investment and estimated fair value is recognized as an impairment charge.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The Company’s cash and cash equivalents, restricted cash, short-term investments, accounts receivable, accounts payable and accrued liabilities approximate their fair value due to their short maturities. Management believes that its term notes bear interest at the prevailing market rates for instruments with similar characteristics; accordingly, the carrying value of this instrument approximates its fair value. The Company utilizes valuation techniques that maximize the use of observable inputs and minimize the use of unobservable inputs to the extent possible. The Company determines the fair value of its financial instruments based on assumptions that market participants would use in pricing an asset or liability in the principal or most advantageous market. When considering market participant assumptions in fair value measurements, the following fair value hierarchy distinguishes between observable and unobservable inputs, which are categorized in one of the following levels: Level 1 – Inputs are unadjusted, quoted prices in active markets for identical assets or liabilities at the measurement date; Level 2 – Inputs are observable, unadjusted quoted prices in active markets for similar assets or liabilities, unadjusted quoted prices for identical or similar assets or liabilities 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 related assets or liabilities; and Level 3 – Unobservable inputs that are significant to the measurement of the fair value of the assets or liabilities that are supported by little or no market data.
Revenue	Revenue To determine revenue recognition for arrangements that an entity determines are within the scope of Topic 606, Revenue from Contracts with Customers Product Revenue The Company records product revenue primarily from the sale of its IVL catheters. The Company sells its products to hospitals, primarily through direct sales representatives, as well as through distributors in selected international markets. Additionally, a significant portion of the Company’s revenue is generated through a consignment model under which inventory is maintained at hospitals. Product revenue is recognized when a customer obtains control of promised goods or services, in an amount that reflects the consideration which the entity expects to receive in exchange for those goods or services. For products sold through direct sales representatives, control is transferred upon delivery to customers. For products sold to distributors internationally and products sold to customers that utilize stocking orders, control is transferred upon shipment or delivery to the customer’s named location, based on the contractual shipping terms. For consignment inventory, control is transferred at the time the IVL catheters are consumed in a procedure. The Company elected to account for shipping and handling activities that occur after the customer has obtained control as a fulfillment activity, and not a separate performance obligation. The Company may provide for the use of an IVL generator and connector cable under an agreement to customers at no charge to facilitate use of the IVL catheters. These agreements do not contain contractually enforceable minimum commitments and are generally cancellable by either party with 30 days’ notice. License Revenue For arrangements that contain a license of our functional intellectual property with a customer, we consider whether the license grant is distinct from other performance obligations in the arrangement. A license grant of functional intellectual property is generally considered to be capable of being distinct if a customer can benefit from the license on its own or together with other readily available resources. License revenue for licenses of functional intellectual property is recognized at a point in time when the Company satisfies its performance obligation of transferring the license to the customer. Consideration received in advance of the satisfaction of a performance obligation is recognized as a contract liability. No license revenues have been recognized for the three months ended March 31, 2021.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2021
Accounting Policies [Abstract]
Schedule of Reconciliation of Cash, Cash Equivalents and Restricted Cash	The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sum to the total of the same amounts shown in the condensed consolidated statements of cash flows: March 31, 2021 December 31, 2020 (in thousands) Cash and cash equivalents $ 57,006 $ 50,423 Restricted cash 1,450 1,450 Total cash, cash equivalents, and restricted cash $ 58,456 $ 51,873

Financial Instruments and Fai_2

Financial Instruments and Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Schedule of Financial Assets and Liabilities Measured at Fair Value	The following tables summarize the Company’s financial assets and liabilities measured at fair value on a recurring basis by level within the fair value hierarchy: March 31, 2021 Level 1 Level 2 Level 3 Total (in thousands) Assets: U.S. Treasury securities $ 90,974 $ — $ — $ 90,974 Money market funds 49,008 — — 49,008 Commercial paper — 24,178 — 24,178 Corporate bonds — 5,270 — 5,270 Total assets $ 139,982 $ 29,448 $ — $ 169,430 December 31, 2020 Level 1 Level 2 Level 3 Total (in thousands) Assets: U.S. Treasury securities $ 126,363 $ — $ — $ 126,363 Money market funds 35,053 — — $ 35,053 Commercial paper — 31,968 — $ 31,968 Total assets $ 161,416 $ 31,968 $ — $ 193,384

Cash Equivalents and Short-Te_2

Cash Equivalents and Short-Term Investments (Tables)	3 Months Ended
	Mar. 31, 2021
Cash And Cash Equivalents [Abstract]
Summary of Cash Equivalents and Short-Term Investments	The following is a summary of the Company’s cash equivalents and short-term investments: March 31, 2021 Amortized Cost Basis Unrealized Gains Unrealized Losses Fair Value (in thousands) U.S. Treasury securities $ 90,953 $ 21 $ — $ 90,974 Money market funds 49,008 — — 49,008 Commercial paper 24,178 — — 24,178 Corporate bonds 5,275 — (5 ) 5,270 Total $ 169,414 $ 21 $ (5 ) $ 169,430 Reported as: Cash equivalents $ 49,008 Short-term investments 120,422 Total $ 169,430 December 31, 2020 Amortized Cost Basis Unrealized Gains Unrealized Losses Fair Value (in thousands) U.S. Treasury securities $ 126,354 $ 11 $ (2 ) $ 126,363 Money market funds 35,053 — — 35,053 Commercial paper 31,968 — — 31,968 Total $ 193,375 $ 11 $ (2 ) $ 193,384 Reported as: Cash equivalents $ 41,453 Short-term investments 151,931 Total $ 193,384

Balance Sheet Components (Table

Balance Sheet Components (Tables)	3 Months Ended
	Mar. 31, 2021
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Schedule of Inventory	Inventory consists of the following: March 31, December 31, 2021 2020 (in thousands) Raw material $ 6,265 $ 4,995 Work in progress 7,233 6,051 Finished goods 18,345 16,952 Consigned inventory 1,695 1,861 Total inventory $ 33,538 $ 29,859
Schedule of Accrued Liabilities	Accrued liabilities consist of the following: March 31, December 31, 2021 2020 (in thousands) Accrued employee compensation 13,094 10,885 Accrued research and development costs 3,558 3,057 Accrued asset purchases 3,154 2,527 Accrued professional services 1,338 1,325 Other 2,774 2,148 Total accrued liabilities $ 23,918 $ 19,942

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2021
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Schedule of Total Stock-Based Compensation	Total stock-based compensation was as follows: Three Months March 31, 2021 2020 (in thousands) Cost of product revenue $ 138 $ 161 Research and development 1,167 488 Sales and marketing 2,057 559 General and administrative 1,777 663 Total stock-based compensation $ 5,139 $ 1,871
Schedule of Option Activity under 2009 Plan and 2019 Plan	Stock Options Option activity under the 2009 Plan and 2019 Plan is set forth below: Shares Available for Grant Number of Shares Weighted- Average Exercise Price Per Share Weighted- Average Remaining Term Aggregate Intrinsic Value (in years) (in thousands) Balance, December 31, 2020 2,689,624 2,087,202 $ 5.92 6.77 $ 204,137 Awards authorized 1,040,530 — Options exercised — (159,325 ) 4.85 Options cancelled 615 (615 ) 4.03 Balance, March 31, 2021 3,730,769 1,927,262 $ 6.00 6.54 $ 239,473 Vested and exercisable, March 31, 2021 1,399,252 $ 4.91 6.21 $ 175,391 Vested and expected to vest, March 31, 2021 1,927,262 $ 6.00 6.54 $ 239,473
Schedule of RSU Activity under 2019 Plan	RSU activity under the 2019 Plan is set forth below : Number of Shares Weighted- Average Grant Date Fair Value Per Share Balance, December 31, 2020 859,577 $ 48.50 RSUs granted 431,365 119.13 RSUs forfeited (9,733 ) 53.03 RSUs vested (107,237 ) 42.16 Balance, March 31, 2021 1,173,972 $ 75.00

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	3 Months Ended
	Mar. 31, 2021
Earnings Per Share [Abstract]
Summary of Outstanding Potentially Dilutive Common Stock Equivalents Excluded from Calculation of Diluted Net Loss Per Share	The following outstanding potentially dilutive common stock equivalents have been excluded from the calculation of diluted net loss per share for the periods presented due to their anti-dilutive effect: March 31, 2021 2020 Common stock options issued and outstanding 1,927,262 2,945,534 Restricted stock units 1,173,972 722,409 Employee stock purchase plan 2,951 6,468 Total 3,104,185 3,674,411

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2021
Disaggregation Of Revenue [Abstract]
Schedule of Product Revenue Based on Product Line and Location	Disaggregation of revenue The following table represents the Company’s product revenue based on product line: Three Months Ended March 31, 2021 2020 (in thousands) Peripheral $ 16,141 $ 9,081 Coronary 15,308 5,767 Other 451 349 Product revenue $ 31,900 $ 15,197 Peripheral product revenue encompasses sales of the Company’s M 5 4 2 The following table represents the Company’s product revenue based on the location to which the product is shipped: Three Months Ended March 31, 2021 2020 (in thousands) United States $ 21,045 $ 7,769 Germany 1,311 911 Rest of Europe 6,911 5,108 All other countries 2,633 1,409 Product revenue $ 31,900 $ 15,197

Equity Method Investments (Tabl

Equity Method Investments (Tables)	3 Months Ended
	Mar. 31, 2021
Equity Method Investments And Joint Ventures [Abstract]
Summary of Unaudited Balance Sheet	The following table summarizes the unaudited balance sheet for the JV: March 31, 2021 Balance sheet: (in thousands) Current assets $ 14,994 Total assets 14,994 Total liabilities — Net assets $ 14,994

Organization and Basis of Pre_2

Organization and Basis of Presentation - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Dec. 31, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Entity incorporation, date of incorporation	Jun. 17, 2009
Accumulated deficit	$ (267,274)	$ (243,673)
Cash, cash equivalents and short-term investments	$ 177,400

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Schedule of Reconciliation of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020	Dec. 31, 2019
Accounting Policies [Abstract]
Cash and cash equivalents	$ 57,006	$ 50,423
Restricted cash	1,450	1,450
Total cash, cash equivalents, and restricted cash	$ 58,456	$ 51,873	$ 124,561	$ 140,495

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Additional Information (Details) - USD ($)	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Summary Of Significant Accounting Policies [Line Items]
Share in the losses incurred by the equity method investee	$ 5,523,000
Notice period for cancellation of agreement	30 days
Revenue	$ 31,900,000	$ 15,197,000
License
Summary Of Significant Accounting Policies [Line Items]
Revenue	$ 0

Financial Instruments and Fai_3

Financial Instruments and Fair Value Measurements - Schedule of Financial Assets and Liabilities Measured at Fair Value (Details) - Recurring - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Assets:
Total assets	$ 169,430	$ 193,384
Level 1
Assets:
Total assets	139,982	161,416
Level 2
Assets:
Total assets	29,448	31,968
U.S. Treasury Securities
Assets:
Total assets	90,974	126,363
U.S. Treasury Securities | Level 1
Assets:
Total assets	90,974	126,363
Money Market Funds
Assets:
Total assets	49,008	35,053
Money Market Funds | Level 1
Assets:
Total assets	49,008	35,053
Commercial Paper
Assets:
Total assets	24,178	31,968
Commercial Paper | Level 2
Assets:
Total assets	24,178	$ 31,968
Corporate Bonds
Assets:
Total assets	5,270
Corporate Bonds | Level 2
Assets:
Total assets	$ 5,270

Cash Equivalents and Short-Te_3

Cash Equivalents and Short-Term Investments - Summary of Cash Equivalents and Short-Term Investments (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Cash And Cash Equivalents [Line Items]
Cash equivalents, Fair Value	$ 49,008	$ 41,453
Cash equivalents and short-term investments, Amortized cost Basis	169,414	193,375
Cash equivalents and short-term investments, Unrealized Gains	21	11
Cash equivalents and short-term investments, Unrealized losses	(5)	(2)
Cash equivalents and short-term investments, Fair Value	169,430	193,384
Short-term investments	120,422	151,931
U.S. Treasury Securities
Cash And Cash Equivalents [Line Items]
Short-term investments Amortized Cost Basis	90,953	126,354
Short-term investments Unrealized Gains	21	11
Short-term investments Unrealized Losses		(2)
Short-term investments, Fair Value	90,974	126,363
Money Market Funds
Cash And Cash Equivalents [Line Items]
Cash equivalents Amortized Cost Basis	49,008	35,053
Cash equivalents, Fair Value	49,008	35,053
Commercial Paper
Cash And Cash Equivalents [Line Items]
Short-term investments Amortized Cost Basis	24,178	31,968
Short-term investments, Fair Value	24,178	$ 31,968
Corporate Bonds
Cash And Cash Equivalents [Line Items]
Short-term investments Amortized Cost Basis	5,275
Short-term investments Unrealized Losses	(5)
Short-term investments, Fair Value	$ 5,270

Cash Equivalents and Short-Te_4

Cash Equivalents and Short-Term Investments - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2021
Maximum
Cash And Cash Equivalents [Line Items]
Available for sale securities remaining contractual maturities	1 year

Balance Sheet Components - Sche

Balance Sheet Components - Schedule of Inventory (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Inventory Disclosure [Abstract]
Raw material	$ 6,265	$ 4,995
Work in progress	7,233	6,051
Finished goods	18,345	16,952
Consigned inventory	1,695	1,861
Total inventory	$ 33,538	$ 29,859

Balance Sheet Components - Sc_2

Balance Sheet Components - Schedule of Accrued Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Payables And Accruals [Abstract]
Accrued employee compensation	$ 13,094	$ 10,885
Accrued research and development costs	3,558	3,057
Accrued asset purchases	3,154	2,527
Accrued professional services	1,338	1,325
Other	2,774	2,148
Total accrued liabilities	$ 23,918	$ 19,942

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Total Stock-Based Compensation (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	$ 5,139	$ 1,871
Cost of Product Revenue
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	138	161
Research and Development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	1,167	488
Sales and Marketing
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	2,057	559
General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	$ 1,777	$ 663

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Details) - USD ($)	1 Months Ended	3 Months Ended
	Feb. 28, 2019	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020	Mar. 06, 2019
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation expenses capitalized amount		$ 255,000	$ 0
Shares available for issuance		3,730,769		2,689,624
Stock-based compensation		$ 5,139,000	1,871,000
Restricted Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period		4 years
Cliff vesting, percentage		25.00%
Share-based compensation vesting rights, terms		The RSUs generally vest over a four-year period with straight-line vesting and a 25% one-year cliff or over a three-year period in equal amounts on a semi-annual basis,
2019 Stock Option and Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock reserved for issuance	2,000,430
Maximum period of automatic annual increase in common stock reserved for issuance	10 years
Automatic annual increase in common stock reserved for issuance	3.00%
Shares available for issuance		3,730,769
2019 Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock reserved for issuance					300,650
Shares available for issuance		888,735
Purchase shares of common stock, price per share, percentage of fair market value		85.00%
Stock-based compensation		$ 267,000	$ 191,000

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of Option Activity under 2009 Plan and 2019 Plan (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2021	Dec. 31, 2020
Shares Available for Grant
Shares Available for Grant, Beginning balance	2,689,624
Shares Available for Grant, Awards authorized	1,040,530
Shares Available for Grant, Options cancelled	615
Shares Available for Grant, Ending balance	3,730,769	2,689,624
Number of Shares
Number of Shares, Beginning balance	2,087,202
Number of Shares, Options exercised	(159,325)
Number of Shares, Options cancelled	(615)
Number of Shares, Ending balance	1,927,262	2,087,202
Number of Shares, Vested and exercisable	1,399,252
Number of Shares, Vested and expected to vest	1,927,262
Weighted-Average Exercise Price Per Share
Weighted-Average Exercise Price Per Share, Beginning balance	$ 5.92
Weighted-Average Exercise Price Per Share, Options exercised	4.85
Weighted-Average Exercise Price Per Share, Options cancelled	4.03
Weighted-Average Exercise Price Per Share, Ending balance	6	$ 5.92
Weighted-Average Exercise Price Per Share, Vested and exercisable	4.91
Weighted-Average Exercise Price Per Share, Vested and expected to vest	$ 6
Weighted-Average Remaining Term
Weighted-Average Remaining Term, Balance	6 years 6 months 14 days	6 years 9 months 7 days
Weighted-Average Remaining Term, Vested and exercisable	6 years 2 months 15 days
Weighted-Average Remaining Term, Vested and expected to vest	6 years 6 months 14 days
Aggregate Intrinsic Value
Aggregate Intrinsic Value, Balance	$ 239,473	$ 204,137
Aggregate Intrinsic Value, Vested and exercisable	175,391
Aggregate Intrinsic Value, Vested and expected to vest	$ 239,473

Stock-Based Compensation - Sc_3

Stock-Based Compensation - Schedule of RSU Activity under 2019 Plan (Detail) - Restricted Stock Units	3 Months Ended
	Mar. 31, 2021$ / sharesshares
Number of Shares
Number of Shares, Beginning balance | shares	859,577
Number of Shares, RSUs granted | shares	431,365
Number of Shares, RSUs forfeited | shares	(9,733)
Number of Shares, RSUs vested | shares	107,237
Number of Shares, Ending balance | shares	1,173,972
Weighted-Average Grant Date Fair Value Per Share
Weighted-Average Grant Date Fair Value Per Share, Beginning balance | $ / shares	$ 48.50
Weighted-Average Grant Date Fair Value Per Share, RSUs granted | $ / shares	119.13
Weighted-Average Grant Date Fair Value Per Share, RSUs forfeited | $ / shares	53.03
Weighted-Average Grant Date Fair Value Per Share, RSUs vested | $ / shares	42.16
Weighted-Average Grant Date Fair Value Per Share, Ending balance | $ / shares	$ 75

Net Loss Per Share - Summary of

Net Loss Per Share - Summary of Outstanding Potentially Dilutive Common Stock Equivalents Excluded from Calculation of Diluted Net Loss Per Share (Details) - shares	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted net loss per share	3,104,185	3,674,411
Common Stock Options Issued and Outstanding
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted net loss per share	1,927,262	2,945,534
Restricted Stock Units
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted net loss per share	1,173,972	722,409
Employee Stock Purchase Plan
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted net loss per share	2,951	6,468

Revenue - Schedule of Product R

Revenue - Schedule of Product Revenue Based on Product Line and Location (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Disaggregation Of Revenue [Line Items]
Product revenue	$ 31,900	$ 15,197
United States
Disaggregation Of Revenue [Line Items]
Product revenue	21,045	7,769
Germany
Disaggregation Of Revenue [Line Items]
Product revenue	1,311	911
Rest of Europe
Disaggregation Of Revenue [Line Items]
Product revenue	6,911	5,108
All Other Countries
Disaggregation Of Revenue [Line Items]
Product revenue	2,633	1,409
Peripheral
Disaggregation Of Revenue [Line Items]
Product revenue	16,141	9,081
Coronary
Disaggregation Of Revenue [Line Items]
Product revenue	15,308	5,767
Other
Disaggregation Of Revenue [Line Items]
Product revenue	$ 451	$ 349

Equity Method Investments - Add

Equity Method Investments - Additional Information (Details) - USD ($) $ in Thousands	Mar. 19, 2021	Mar. 31, 2021
Schedule Of Equity Method Investments [Line Items]
Share in net loss of equity method investment		$ 5,523
Related party contract liability, noncurrent portion		12,273
Joint Venture
Schedule Of Equity Method Investments [Line Items]
Percentage of equity stake received	45.00%
Related party transaction. transaction price	$ 12,300
Related party contract liability, noncurrent portion		$ 12,300
JV Agreement with Genesis MedTech | Share Subscription Agreement
Schedule Of Equity Method Investments [Line Items]
Ordinary shares issued	54,900
Equity percentage	55.00%
Cash contribution from exchange of equity	$ 15,000
Percentage of cash contribution received from exchange of equity upon signing of agreement	50.00%
Percentage of cash contribution receivable from exchange of equity within one year	50.00%
JV Agreement with Genesis MedTech | License Agreement
Schedule Of Equity Method Investments [Line Items]
Ordinary shares issued	45,000
Equity percentage	45.00%

Equity Method Investments - Sum

Equity Method Investments - Summary of Unaudited Balance Sheet (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Balance sheet:
Current assets	$ 233,112	$ 246,300
TOTAL ASSETS	269,070	272,042
Total liabilities	64,816	$ 46,388
JV Agreement with Genesis MedTech
Balance sheet:
Current assets	14,994
TOTAL ASSETS	14,994
Net assets	$ 14,994