Shockwave Medical (SWAV) 10-Q 8 Nov 21 2021 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2021	Nov. 02, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2021
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
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		35,304,469
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, par value $0.001 per share
Security Exchange Name	NASDAQ

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
CURRENT ASSETS:
Cash and cash equivalents	$ 91,195	$ 50,423
Short-term investments	91,759	151,931
Accounts receivable, net	29,966	11,689
Inventory	38,744	29,859
Prepaid expenses and other current assets	4,364	2,398
Total current assets	256,028	246,300
Operating lease right-of-use assets	11,790	7,568
Property and equipment, net	23,085	16,362
Equity method investment	6,408
Other assets	1,684	1,812
TOTAL ASSETS	298,995	272,042
CURRENT LIABILITIES:
Accounts payable	3,632	1,466
Term notes, current portion	2,750	3,300
Accrued liabilities	33,017	19,942
Lease liability, current portion	867	873
Total current liabilities	40,266	25,581
Lease liability, noncurrent portion	11,939	7,488
Term notes, noncurrent portion	14,226	13,319
Related party contract liability, noncurrent portion	12,273
TOTAL LIABILITIES	78,704	46,388
STOCKHOLDERS’ EQUITY:
Preferred stock
Common stock	35	35
Additional paid-in capital	486,014	469,283
Accumulated other comprehensive income (loss)	(7)	9
Accumulated deficit	(265,751)	(243,673)
TOTAL STOCKHOLDERS’ EQUITY	220,291	225,654
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$ 298,995	$ 272,042

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenue:
Product revenue	$ 65,155	$ 19,590	$ 152,963	$ 45,073
Type of Revenue [Extensible List]	us-gaap:ProductMember	us-gaap:ProductMember	us-gaap:ProductMember	us-gaap:ProductMember
Cost of revenue:
Cost of product revenue	$ 10,949	$ 5,277	$ 28,775	$ 14,520
Type of Cost, Good Or Service [Extensible List]	us-gaap:ProductMember	us-gaap:ProductMember	us-gaap:ProductMember	us-gaap:ProductMember
Gross profit	$ 54,206	$ 14,313	$ 124,188	$ 30,553
Operating expenses:
Research and development	13,735	7,891	35,827	27,882
Sales and marketing	28,393	13,619	78,098	35,236
General and administrative	9,265	5,610	25,117	17,232
Total operating expenses	51,393	27,120	139,042	80,350
Income (loss) from operations	2,813	(12,807)	(14,854)	(49,797)
Share in net loss of equity method investment	(342)		(5,865)
Interest expense	(165)	(314)	(795)	(897)
Other income (expense), net	(280)	218	(369)	942
Net income (loss) before taxes	2,026	(12,903)	(21,883)	(49,752)
Income tax provision	78	29	195	73
Net income (loss)	1,948	(12,932)	(22,078)	(49,825)
Other comprehensive income (loss):
Unrealized gain/(loss) on available-for-sale securities	(17)		(16)	(14)
Adjustment for net gain realized and included in other income, net		(21)		(21)
Total other comprehensive income (loss)	(17)	(21)	(16)	(35)
Total comprehensive income (loss)	$ 1,931	$ (12,953)	$ (22,094)	$ (49,860)
Net income (loss) per share
Basic	$ 0.06	$ (0.38)	$ (0.63)	$ (1.53)
Diluted	$ 0.05	$ (0.38)	$ (0.63)	$ (1.53)
Shares used in computing net income (loss) per share
Basic	35,207,276	34,078,726	35,013,072	32,631,715
Diluted	37,567,176	34,078,726	35,013,072	32,631,715

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity (Unaudited) - USD ($) $ in Thousands	Total	Public Offering	Common Stock	Common StockPublic Offering	Additional Paid-In Capital	Additional Paid-In CapitalPublic Offering	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 (loss) 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 income (loss)	(18,775)							(18,775)
Ending balance at Mar. 31, 2020	177,772		$ 32		374,386		103	(196,749)
Ending balance, shares at Mar. 31, 2020			31,827,606
Beginning balance at Dec. 31, 2019	192,653		$ 31		370,561		35	(177,974)
Beginning balance, Shares at Dec. 31, 2019			31,446,787
Net gain reclassified from accumulated other comprehensive income	(21)
Net income (loss)	(49,825)
Ending balance at Sep. 30, 2020	237,047		$ 34		464,812			(227,799)
Ending balance, shares at Sep. 30, 2020			34,236,165
Beginning balance at Mar. 31, 2020	177,772		$ 32		374,386		103	(196,749)
Beginning balance, Shares at Mar. 31, 2020			31,827,606
Exercise of stock options	480				480
Exercise of stock options, Shares			137,178
Unrealized gain (loss) on available-for- sale securities	(82)						(82)
Issuance of common stock in connection with public offering, net of issuance costs		$ 83,382		$ 2		$ 83,380
Issuance of common stock in connection with initial/public offering, Shares				1,955,000
Restricted stock units withheld in net settlement for tax	(616)				(616)
Restricted stock units withheld in net settlement for tax, Shares			(15,456)
Issuance of common stock in connection with vesting of restricted stock, Shares			41,229
Stock-based compensation	2,605				2,605
Net income (loss)	(18,118)							(18,118)
Ending balance at Jun. 30, 2020	245,423		$ 34		460,235		21	(214,867)
Ending balance, shares at Jun. 30, 2020			33,945,557
Exercise of stock options	993				993
Exercise of stock options, Shares			254,523
Issuance of common stock under employee stock purchase plan	953				953
Issuance of common stock under employee stock purchase plan, Share			27,921
Issuance of common stock in connection with public offering, net of issuance costs	(14)				(14)
Restricted stock units withheld in net settlement for tax	(246)				(246)
Restricted stock units withheld in net settlement for tax, Shares			(4,611)
Issuance of common stock in connection with vesting of restricted stock, Shares			12,775
Stock-based compensation	2,891				2,891
Net gain reclassified from accumulated other comprehensive income	(21)						(21)
Net income (loss)	(12,932)							(12,932)
Ending balance at Sep. 30, 2020	237,047		$ 34		464,812			(227,799)
Ending balance, shares at Sep. 30, 2020			34,236,165
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
Unrealized gain (loss) 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
Restricted stock units withheld in net settlement for tax	(5,114)				(5,114)
Restricted stock units withheld in net settlement for tax, Shares			(42,529)
Issuance of common stock in connection with vesting of restricted stock, Shares			107,237
Stock-based compensation	5,394				5,394
Net income (loss)	(23,601)							(23,601)
Ending balance at Mar. 31, 2021	204,254		$ 35		471,477		16	(267,274)
Ending balance, shares at Mar. 31, 2021			34,928,964
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, Shares	431,041
Net income (loss)	$ (22,078)
Ending balance at Sep. 30, 2021	220,291		$ 35		486,014		(7)	(265,751)
Ending balance, shares at Sep. 30, 2021			35,294,952
Beginning balance at Mar. 31, 2021	204,254		$ 35		471,477		16	(267,274)
Beginning balance, Shares at Mar. 31, 2021			34,928,964
Exercise of stock options	1,085				1,085
Exercise of stock options, Shares			149,101
Unrealized gain (loss) on available-for- sale securities	(6)						(6)
Restricted stock units withheld in net settlement for tax	(3,223)				(3,223)
Restricted stock units withheld in net settlement for tax, Shares			(20,537)
Issuance of common stock in connection with vesting of restricted stock, Shares			71,761
Stock-based compensation	6,662				6,662
Net income (loss)	(425)							(425)
Ending balance at Jun. 30, 2021	208,347		$ 35		476,001		10	(267,699)
Ending balance, shares at Jun. 30, 2021			35,129,289
Exercise of stock options	691				691
Exercise of stock options, Shares			122,615
Unrealized gain (loss) on available-for- sale securities	(17)						(17)
Issuance of common stock under employee stock purchase plan	1,696				1,696
Issuance of common stock under employee stock purchase plan, Share			16,239
Issuance of common stock in connection with vesting of restricted stock, Shares			26,809
Stock-based compensation	7,626				7,626
Net income (loss)	1,948							1,948
Ending balance at Sep. 30, 2021	$ 220,291		$ 35		$ 486,014		$ (7)	$ (265,751)
Ending balance, shares at Sep. 30, 2021			35,294,952

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Stockholders' Equity (Unaudited) (Parenthetical) $ in Millions	3 Months Ended
	Jun. 30, 2020USD ($)
Public Offering
Issuance costs	$ 6.1

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income (loss)	$ (22,078)	$ (49,825)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	2,685	1,361
Share in net loss of equity method investment	5,865
Stock-based compensation	19,049	7,108
Amortization of right-of-use assets	1,184	1,105
Accretion of discount on available-for-sale securities	1,022	289
Loss on write down of fixed assets		97
Amortization of debt issuance costs	357	478
Changes in operating assets and liabilities:
Accounts receivable	(18,277)	(3,334)
Inventory	(7,982)	(16,338)
Prepaid expenses and other current assets	(1,966)	(1,136)
Other assets	128	(161)
Accounts payable	2,168	(776)
Accrued and other current liabilities	13,011	2,841
Lease liabilities	(961)	(494)
Net cash used in operating activities	(5,795)	(58,785)
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchase of available-for-sale securities	(75,566)	(16,020)
Proceeds from maturities of available-for-sale securities	134,700	72,000
Purchase of property and equipment	(9,616)	(9,846)
Net cash provided by investing activities	49,518	46,134
CASH FLOWS FROM FINANCING ACTIVITIES:
Payments of offering costs		(179)
Proceed from issuance of common stock from public offering, net of issuance cost paid		83,368
Payments of taxes withheld on net settled vesting of restricted stock units	(8,337)	(862)
Principal payments of term loan		(1,111)
Net proceeds from term loan		3,265
Proceeds from stock option exercises	2,549	2,586
Proceeds from issuance of common stock under employee stock purchase plan	2,837	1,795
Net cash provided by (used in) financing activities	(2,951)	88,862
Net increase in cash, cash equivalents and restricted cash	40,772	76,211
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	92,645	216,706
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION:
Interest paid	440	403
Income tax paid	114	22
NON-CASH INVESTING AND FINANCING ACTIVITIES:
Right-of-use asset obtained in exchange for lease liability	5,406	121
Property and equipment purchases included in accounts payable and accrued liabilities	2,510	233
Equity method investment obtained in exchange for related party contract liability	12,273
Transfer of fixed assets to inventory	$ 270	$ 197

Organization and Basis of Prese

Organization and Basis of Presentation	9 Months Ended
	Sep. 30, 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 to date, and as of September 30, 2021, had an accumulated deficit of $265.8 million. Although the Company had positive net income for the quarter ended September 30, 2021, it had a net loss for the nine months ended September 30, 2021. The Company may continue to incur losses in the future, which may vary significantly from period to period. The Company expects to continue to incur significant expenses as it (i) expands its marketing efforts to increase adoption of its products, (ii) expands existing relationships with its customers, (iii) obtains regulatory clearances or approvals for its planned or future products, (iv) conducts clinical trials on its existing and planned or future products, and (v) develops new products or adds new features to its existing products. The Company will need to continue to generate significant revenue in order to sustain profitability as it continues to grow its business. Even if it achieves profitability for any period, the Company cannot be sure that it will remain profitable for any substantial period of time. As of September 30, 2021, the Company had cash, cash equivalents and short-term investments of $183.0 million, which are available to fund future operations. The Company believes that its cash and cash equivalents as of September 30, 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”). The Company’s future capital requirements will depend on many factors, including its growth rate, the timing and extent of its spending to support research and development activities, the timing and cost of establishing additional sales and marketing capabilities and the scope, duration and continuing impact of the COVID-19 pandemic. 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. Specifically, the Company has recently seen some disruptions in the operations of certain of its third-party suppliers, resulting in increased lead-times, higher component costs and lower allocations for our purchase of some components and, in certain cases, requiring the Company to procure materials from alternate suppliers or incur higher logistical expenses. The Company is continuing to work closely with its manufacturing partners and suppliers to enable the Company to source key components and maintain appropriate inventory levels to meet customer demand. The Company, however, has not experienced material disruptions in its supply chain to date. Economies worldwide continue to be negatively impacted by the COVID-19 pandemic and the Company anticipates these disruptions will continue. As such the 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	9 Months Ended
	Sep. 30, 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 the 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 and nine months ended September 30 , 202 1 are not necessarily indicative of the results to be expected for the year ending December 31, 202 1 or for any other future annual or interim period. The condensed consolidated balance sheet as of December 31, 20 20 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, 20 20 , filed with the SEC on February 26 , 202 1 . Cash, Cash Equivalents, and Restricted Cash The Company considers all highly liquid investments purchased with original maturities of three months or less from the purchase date to be cash equivalents. Cash equivalents consist primarily of amounts invested in money market accounts. Restricted cash as of September 30, 2021 and December 31, 2020 relates to a letter of credit established for the Company’s office lease and is recorded as other assets on the condensed consolidated balance sheets. 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: September 30, 2021 December 31, 2020 (in thousands) Cash and cash equivalents $ 91,195 $ 50,423 Restricted cash 1,450 1,450 Total cash, cash equivalents, and restricted cash $ 92,645 $ 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 and nine months ended September 30, 2021, the Company’s share in the losses incurred by the equity method investee was $0.3 and $ 5.9 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 evidence 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 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 and nine months ended September 30, 2021.

Financial Instruments and Fair

Financial Instruments and Fair Value Measurements	9 Months Ended
	Sep. 30, 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: September 30, 2021 Level 1 Level 2 Level 3 Total (in thousands) Assets: U.S. Treasury securities $ 65,235 $ — $ — $ 65,235 Money market funds 67,705 — — 67,705 Commercial paper — 21,385 — 21,385 Corporate bonds — 5,139 — 5,139 Total assets $ 132,940 $ 26,524 $ — $ 159,464 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	9 Months Ended
	Sep. 30, 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: September 30, 2021 Amortized Cost Basis Unrealized Gains Unrealized Losses Fair Value (in thousands) U.S. Treasury securities $ 65,242 $ 2 $ (9 ) $ 65,235 Money market funds 67,705 — — 67,705 Commercial paper 21,385 — — $ 21,385 Corporate bonds 5,139 — — 5,139 Total $ 159,471 $ 2 $ (9 ) $ 159,464 Reported as: Cash equivalents $ 67,705 Short-term investments 91,759 Total $ 159,464 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 Company recognized no material gains or losses on its cash equivalents and short-term investments in the periods presented. The remaining contractual maturities for available-for-sale securities were as follows: September 30, 2021 Fair Value One year or less $ 134,384 Greater than one year and less than two years 25,080 Total $ 159,464

Balance Sheet Components

Balance Sheet Components	9 Months Ended
	Sep. 30, 2021
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Balance Sheet Components	5. Balance Sheet Components Inventory Inventory consists of the following: September 30, December 31, 2021 2020 (in thousands) Raw material $ 6,781 $ 4,995 Work in progress 11,066 6,051 Finished goods 19,000 16,952 Consigned inventory 1,897 1,861 Total inventory $ 38,744 $ 29,859 Accrued Liabilities Accrued liabilities consist of the following: September 30, December 31, 2021 2020 (in thousands) Accrued employee compensation $ 20,713 $ 10,885 Accrued research and development costs 3,839 3,057 Accrued asset purchases 3,451 2,527 Accrued professional services 1,819 1,325 Other 3,195 2,148 Total accrued liabilities $ 33,017 $ 19,942

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2021
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	6. Commitments and Contingencies Operating Leases In May 2018, the Company entered into a lease agreement for office, laboratory, and manufacturing space located at 5403 Betsy Ross Drive in Santa Clara, California, which consists of approximately 35,000 square feet (the “5403 Lease”). The term of the 5403 Lease commenced in September 2018 and ends in August 2022. In connection with the 5403 Lease, the Company maintains a letter of credit for the benefit of the landlord in the amount of $0.5 million, which is secured by restricted cash recorded as other assets on the consolidated balance sheets. In connection with the 5403 Lease, the Company has an operating lease right-of-use asset of $0.7 million as of September 30, 2021 and an aggregate lease liability of $0.8 million on its consolidated balance sheet. The remaining lease term is eleven months. In December 2019, the Company entered into a lease agreement (i) for additional office, laboratory and manufacturing space located at 5353 Betsy Ross Drive in Santa Clara, California, which consists of approximately 50,200 square feet (the “5353 Lease”); and (ii) to modify the terms of the 5403 Lease. The 5403 Lease will continue in its existing terms (and with no changes to its terms, including its base rent) until its expiration on August 31, 2022, at which point the leased space under the 5403 Lease will become subject to the terms of the 5353 Lease. The initial term of the 5353 Lease began in December 2019 and was initially for 96 months. The base rent of the first floor of the premises for the 5353 Betsy Ross building shall be abated for the first 19 months, and the base rent for the second floor of the 5353 Betsy Ross building shall be abated for the first four months. The landlord provided the Company with a tenant improvement allowance of up to $1.8 million for both 5403 and 5353 Betsy Ross buildings. In connection with the 5353 Lease, the Company provided an initial security deposit of $1.0 million in the form of a letter of credit, which is secured by restricted cash recorded as other assets on the consolidated balance sheets. While this amount will increase to $1.5 million on September 1, 2022 when the office, laboratory and manufacturing space of the 5403 Lease is included under the terms of the 5353 Lease, the letter of credit will be reduced annually from and after September 1, 2022 until the expiration of the 5353 Lease. In September 2021, the Company amended the 5353 Lease (the “Amended Lease”), which extended the initial lease terms for both 5403 and 5353 Betsy Ross buildings by approximately 48.5 months to December 31, 2031. The Company accounted for this amendment as a lease modification for the lease of the 5353 Building. As of September 30, 2021, the lease of the 5403 Betsy Ross building under the modified terms has not yet commenced. The Amended Lease also contains an expansion option, which can be exercised after June 1, 2023, to lease an adjacent building consisting of approximately 35,000 square feet. In connection with the lease of the 5353 Betsy Ross building, the Company has recorded an operating lease right-of-use asset of $10.9 million as of September 30, 2021 and an aggregate lease liability of $11.9 million on its consolidated balance sheet. The remaining lease term is ten years and three months. Additionally, in September 2021, the Company entered into a ten-year improvement allowance of up to $ 5.5 million. In connection with the lease, the Company shall provide an initial security deposit of $ 0.2 million in the form of a letter of credit and a prepayment for the same amount which will be applied to the first month’s rent. The lease is due to expire in December 2031 , and contains two optional extension periods of sixty months each at the then fair market rent for the space . As of September 30, 2021, the Company has not taken control of the leased facility and anticipates that it will take control of the leased facility in the fourth quarter of 2021. The Company also leases vehicles for use by certain of its employees. In connection with the vehicle leases, the Company has an operating lease right-of-use asset and an aggregate lease liability of $0.2 million as of September 30, 2021 on its consolidated balance sheet. The weighted average remaining lease term for these vehicle leases is one year and seven months. The weighted average incremental borrowing rate used to measure the operating lease liability is 5.14%. As of September 30, 2021, the Company has no material finance leases. Short-term leases are leases having a term of 12 months or less. The Company recognizes short-term leases on a straight-line basis and does not record a related lease asset or liability for such leases. The following are minimum future rental payments owed under these agreements which have commenced as of September 30, 2021: Year ending December 31, (in thousands) 2021 (remainder) $ 602 2022 2,128 2023 1,535 2024 1,552 2025 1,600 2026 1,643 Thereafter 8,787 Total minimum lease payments $ 17,847 Less: imputed interest and adjustments (5,041 ) Total lease liability $ 12,806 The following are minimum undiscounted future rental payments owed for the modified 5403 Betsy Ross Lease and 3003 Bunker Hill Lease which have not yet commenced as of September 30, 2021: Year ending December 31, (in thousands) 2021 (remainder) $ 215 2022 1,420 2023 3,704 2024 3,815 2025 3,926 2026 4,047 Thereafter 22,004 Total minimum lease payments $ 39,131 Operating lease cost for the three and nine months ended September 30, 2021 and 2020 was $0.5 million and $1.5 million, respectively, and $0.5 million and $1.5 million, respectively.

Term Notes

Term Notes	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Term Notes	7. Term Notes Loan and Security Agreement In February 2018, the Company entered into a Loan and Security Agreement with Silicon Valley Bank (the “Loan and Security Agreement”). The terms of the Loan and Security Agreement included a term loan of $15.0 million and a revolving line of credit of $2.0 million. The term loan was available in two tranches, of which the first tranche of $10.0 million was funded in June 2018 and the second tranche of $5.0 million was funded in December 2018. The term loan accrued interest at a floating per annum rate equal to the greater of (a) the Wall Street Journal prime rate minus 1.75% and (b) 2.75%. There was a final payment equal to 6.75% of the original aggregate principal amount, or $1.0 million, of the term loan advances, which was being accrued over the expected term of the loan using the effective-interest method. In connection with the execution of the Loan and Security Agreement, the Company issued warrants to Silicon Valley Bank to purchase 34,440 shares of the Company’s common stock. Upon issuance, the fair value of the warrants of $0.1 million was recorded as a debt issuance cost. The debt issuance cost was being amortized to interest expense, net over the expected repayment period of the loan. In February 2020, the Company entered into a First Amendment to its Loan and Security Agreement (the “Amended Credit Facility”) to, among other things, refinance its existing term loan, which is accounted for as a modification of the Loan and Security Agreement. Under the Amended Credit Facility, the existing revolving line of credit of $2.0 million was terminated and the termination fee of less than $0.1 million was waived. The Amended Credit Facility provides the Company with a supplemental term loan in the amount of $16.5 million. After repayment of the outstanding amount of the term loan, the Company received net proceeds of $3.3 million, which reflects an additional $4.3 million in principal as of the date of the modification less the final balloon payment fee of $1.0 million. The principal amount outstanding under the supplemental term loan accrues interest at a floating per annum rate equal to the greater of (a) the Prime Rate minus 1.25% and (b) 3.5%. The interest rate was 3.5% as of September 30, 2021. The supplemental term loan matures on December 1, 2023. The Amended Credit Facility provides an interest-only payment period through June 30, 2022. The additional final payment for the Amended Credit Facility is $1.6 million, which will be accrued over the term of the supplemental term loan using an effective interest rate that reflects the revised cash flows of the modified term loan. The supplemental term loan is secured by all of the Company’s assets, excluding intellectual property and certain other assets. The loan contains customary affirmative and restrictive covenants, including with respect to the Company’s ability to enter into fundamental transactions, incur additional indebtedness, grant liens, pay any dividend or make any distributions to its holders, make investments, merge or consolidate with any other person or engage in transactions with the Company’s affiliates, but does not include any financial covenants. Current and noncurrent debt and net discount or premium balances are as follows: September 30, December 31, 2021 2020 (in thousands) Principal amount of term note $ 16,500 $ 16,500 Net premium associated with accretion of final payment, and other debt issuance costs 476 119 Term note, current and noncurrent 16,976 16,619 Less term note, current portion (2,750 ) (3,300 ) Term note, noncurrent portion $ 14,226 $ 13,319 Future minimum payments of principal and estimated payments of interest on the Company’s outstanding variable rate borrowings as of September 30, 2021 are as follows: Year ending December 31: (in thousands) 2021 (remainder) 146 2022 6,045 2023 12,779 Total future payments 18,970 Less amounts representing interest (902 ) Less final payment (1,568 ) Total principal amount of term note payments $ 16,500

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2021
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-Based Compensation	8. Stock-Based Compensation Total stock-based compensation was as follows: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 (in thousands) (in thousands) Cost of product revenue $ 263 $ 162 $ 718 $ 303 Research and development 1,686 631 4,343 1,769 Sales and marketing 3,051 913 7,693 2,309 General and administrative 2,387 1,140 6,295 2,727 Total stock-based compensation $ 7,387 $ 2,846 $ 19,049 $ 7,108 Stock-based compensation of $239,000 and $45,000 was capitalized into inventory for the three months ended September 30, 2021 and 2020, respectively. Stock-based compensation of $633,000 and $259,000 was capitalized into inventory for the nine months ended September 30, 2021 and 2020, respectively. 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 Equity Incentive Plan (the “2019 Plan”), which became effective in connection with the 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 will automatically increase 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 — (431,041 ) 5.91 Options forfeited 15,062 (15,062 ) 9.33 Balance, September 30, 2021 3,745,216 1,641,099 $ 5.88 5.98 $ 328,212 Vested and exercisable, September 30, 2021 1,339,978 $ 4.88 5.72 $ 269,338 Vested and expected to vest, September 30, 2021 1,641,099 $ 5.88 5.98 $ 328,212 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 557,355 137.41 RSUs vested (205,807 ) 42.98 RSUs forfeited (47,266 ) 75.16 Balance, September 30, 2021 1,163,859 $ 90.97 Employee Stock Purchase Plan In February 2019, the Company adopted the 2019 Employee Stock Purchase Plan (“ESPP”), which became effective in connection with the 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. On each purchase date, which falls on the last date of each offering period, ESPP participants will purchase shares of common stock at a price per share equal to 85% of the lesser of (1) the fair market value per share of the common stock on the offering date or (2) the fair market value of the common stock on the purchase date. The occurrence and duration of offering periods under the ESPP are subject to the determinations of the Company’s Compensation Committee, in its sole discretion. The fair value of the ESPP shares is estimated using the Black-Scholes option pricing model. The Company recorded $333,000 and $890,000 of stock-based compensation expense related to the ESPP for the three and nine months ended September 30, 2021, respectively. The Company recorded $118,000 and $516,000 of stock-based compensation expense related to the ESPP for the three and nine months ended September 30, 2020, respectively. At September 30, 2021, a total of 872,496 shares were available for issuance under the ESPP.

Net Income (Loss) Per Share

Net Income (Loss) Per Share	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Net Income (Loss) Per Share	9. Net Income (Loss) Per Share The components of basic and diluted net income (loss) per share are as follows (in thousands, except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Numerator: Net income (loss) $ 1,948 $ (12,932 ) $ (22,078 ) $ (49,825 ) Denominator: Basic: Weighted average number of common shares outstanding - basic 35,207,276 34,078,726 35,013,072 32,631,715 Diluted: Weighted average number of common shares outstanding - basic 35,207,276 34,078,726 35,013,072 32,631,715 Dilutive effect of outstanding common stock options 1,645,968 — — — Dilutive effect of restricted stock units 708,788 — — — Dilutive effect of common stock pursuant to employee stock purchase plan 5,144 — — — Weighted average number of common shares outstanding - diluted 37,567,176 34,078,726 35,013,072 32,631,715 Net income (loss) per share: Basic $ 0.06 $ (0.38 ) $ (0.63 ) $ (1.53 ) Diluted $ 0.05 $ (0.38 ) $ (0.63 ) $ (1.53 ) The following outstanding potentially dilutive common stock equivalents have been excluded from the calculation of diluted net income (loss) per share for the periods presented due to their anti-dilutive effect: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Common stock options issued and outstanding — 2,529,433 1,641,099 2,529,433 Restricted stock units 18,539 798,708 1,163,859 798,708 Employee stock purchase plan 596 3,911 1,976 3,911 Total 19,135 3,332,052 2,806,934 3,332,052

Revenue

Revenue	9 Months Ended
	Sep. 30, 2021
Disaggregation Of Revenue [Abstract]
Revenue	10. Revenue The following table represents the Company’s product revenue based on product line: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 (in thousands) (in thousands) Coronary $ 47,165 $ 6,983 $ 99,175 $ 16,403 Peripheral 17,725 12,337 52,659 27,927 Other 265 270 1,129 743 Product revenue $ 65,155 $ 19,590 $ 152,963 $ 45,073 Coronary product revenue encompasses sales of the Company’s C 2 5 4 The following table represents the Company’s product revenue based on the location to which the product is shipped: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 (in thousands) (in thousands) United States $ 52,771 $ 11,144 $ 116,729 $ 24,450 Europe 8,624 6,370 27,266 15,962 All other countries 3,760 2,076 8,968 4,661 Product revenue $ 65,155 $ 19,590 $ 152,963 $ 45,073

Equity Method Investments

Equity Method Investments	9 Months Ended
	Sep. 30, 2021
Equity Method Investments And Joint Ventures [Abstract]
Equity Method Investments	11. 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 the Company’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 Company-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. As of September 30, 2021, the carrying value of the Company’s investment in the JV was $6.4 million. The Company’s share of losses generated by the JV for the three and nine months ended September 30, 2021 was $0.3 and $5.9 million, respectively, 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: September 30, 2021 Balance sheet: (in thousands) Current assets $ 14,991 Current liabilities (757 ) Net assets $ 14,234 The following table summarizes the unaudited results of operations for the JV: Three Months Ended September 30, Nine Months Ended September 30, 2021 2021 (in thousands) Revenues $ — $ — Loss from operations 758 13,033 Net loss $ 758 $ 13,033 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 September 30, 2021, the contribution of the license of intellectual property and associated manufacturing technology transfer to the JV has not yet been completed. The Company maintains a related party contract liability, noncurrent, of $12.3 million for the outstanding performance obligation. The Company will satisfy the outstanding performance obligation upon the completion of training provided by the Company to the JV, and successful regulatory approval from the PRC National Medical Products Administration.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 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. Specifically, the Company has recently seen some disruptions in the operations of certain of its third-party suppliers, resulting in increased lead-times, higher component costs and lower allocations for our purchase of some components and, in certain cases, requiring the Company to procure materials from alternate suppliers or incur higher logistical expenses. The Company is continuing to work closely with its manufacturing partners and suppliers to enable the Company to source key components and maintain appropriate inventory levels to meet customer demand. The Company, however, has not experienced material disruptions in its supply chain to date. Economies worldwide continue to be negatively impacted by the COVID-19 pandemic and the Company anticipates these disruptions will continue. As such the 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 the 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 and nine months ended September 30 , 202 1 are not necessarily indicative of the results to be expected for the year ending December 31, 202 1 or for any other future annual or interim period. The condensed consolidated balance sheet as of December 31, 20 20 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, 20 20 , filed with the SEC on February 26 , 202 1 .
Cash, Cash Equivalents and Restricted Cash	Cash, Cash Equivalents, and Restricted Cash The Company considers all highly liquid investments purchased with original maturities of three months or less from the purchase date to be cash equivalents. Cash equivalents consist primarily of amounts invested in money market accounts. Restricted cash as of September 30, 2021 and December 31, 2020 relates to a letter of credit established for the Company’s office lease and is recorded as other assets on the condensed consolidated balance sheets. 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: September 30, 2021 December 31, 2020 (in thousands) Cash and cash equivalents $ 91,195 $ 50,423 Restricted cash 1,450 1,450 Total cash, cash equivalents, and restricted cash $ 92,645 $ 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 and nine months ended September 30, 2021, the Company’s share in the losses incurred by the equity method investee was $0.3 and $ 5.9 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 evidence 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 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 and nine months ended September 30, 2021.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 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: September 30, 2021 December 31, 2020 (in thousands) Cash and cash equivalents $ 91,195 $ 50,423 Restricted cash 1,450 1,450 Total cash, cash equivalents, and restricted cash $ 92,645 $ 51,873

Financial Instruments and Fai_2

Financial Instruments and Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 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: September 30, 2021 Level 1 Level 2 Level 3 Total (in thousands) Assets: U.S. Treasury securities $ 65,235 $ — $ — $ 65,235 Money market funds 67,705 — — 67,705 Commercial paper — 21,385 — 21,385 Corporate bonds — 5,139 — 5,139 Total assets $ 132,940 $ 26,524 $ — $ 159,464 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)	9 Months Ended
	Sep. 30, 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: September 30, 2021 Amortized Cost Basis Unrealized Gains Unrealized Losses Fair Value (in thousands) U.S. Treasury securities $ 65,242 $ 2 $ (9 ) $ 65,235 Money market funds 67,705 — — 67,705 Commercial paper 21,385 — — $ 21,385 Corporate bonds 5,139 — — 5,139 Total $ 159,471 $ 2 $ (9 ) $ 159,464 Reported as: Cash equivalents $ 67,705 Short-term investments 91,759 Total $ 159,464 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
Summary of Remaining Contractual Maturities for Available-for-sale Securities	The remaining contractual maturities for available-for-sale securities were as follows: September 30, 2021 Fair Value One year or less $ 134,384 Greater than one year and less than two years 25,080 Total $ 159,464

Balance Sheet Components (Table

Balance Sheet Components (Tables)	9 Months Ended
	Sep. 30, 2021
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Schedule of Inventory	Inventory consists of the following: September 30, December 31, 2021 2020 (in thousands) Raw material $ 6,781 $ 4,995 Work in progress 11,066 6,051 Finished goods 19,000 16,952 Consigned inventory 1,897 1,861 Total inventory $ 38,744 $ 29,859
Schedule of Accrued Liabilities	Accrued liabilities consist of the following: September 30, December 31, 2021 2020 (in thousands) Accrued employee compensation $ 20,713 $ 10,885 Accrued research and development costs 3,839 3,057 Accrued asset purchases 3,451 2,527 Accrued professional services 1,819 1,325 Other 3,195 2,148 Total accrued liabilities $ 33,017 $ 19,942

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2021
Commitments And Contingencies Disclosure [Abstract]
Schedule of Minimum Future Rental Payments	The following are minimum future rental payments owed under these agreements which have commenced as of September 30, 2021: Year ending December 31, (in thousands) 2021 (remainder) $ 602 2022 2,128 2023 1,535 2024 1,552 2025 1,600 2026 1,643 Thereafter 8,787 Total minimum lease payments $ 17,847 Less: imputed interest and adjustments (5,041 ) Total lease liability $ 12,806
Schedule of Minimum Undiscounted Future Rental Payments Not Yet Commenced	The following are minimum undiscounted future rental payments owed for the modified 5403 Betsy Ross Lease and 3003 Bunker Hill Lease which have not yet commenced as of September 30, 2021: Year ending December 31, (in thousands) 2021 (remainder) $ 215 2022 1,420 2023 3,704 2024 3,815 2025 3,926 2026 4,047 Thereafter 22,004 Total minimum lease payments $ 39,131

Term Notes (Tables)

Term Notes (Tables)	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Schedule of Current and Noncurrent Debt and Net Discount or Premium Balances	Current and noncurrent debt and net discount or premium balances are as follows: September 30, December 31, 2021 2020 (in thousands) Principal amount of term note $ 16,500 $ 16,500 Net premium associated with accretion of final payment, and other debt issuance costs 476 119 Term note, current and noncurrent 16,976 16,619 Less term note, current portion (2,750 ) (3,300 ) Term note, noncurrent portion $ 14,226 $ 13,319
Schedule of Future Minimum Payments for Principal and Interest	Future minimum payments of principal and estimated payments of interest on the Company’s outstanding variable rate borrowings as of September 30, 2021 are as follows: Year ending December 31: (in thousands) 2021 (remainder) 146 2022 6,045 2023 12,779 Total future payments 18,970 Less amounts representing interest (902 ) Less final payment (1,568 ) Total principal amount of term note payments $ 16,500

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2021
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Schedule of Total Stock-Based Compensation	Total stock-based compensation was as follows: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 (in thousands) (in thousands) Cost of product revenue $ 263 $ 162 $ 718 $ 303 Research and development 1,686 631 4,343 1,769 Sales and marketing 3,051 913 7,693 2,309 General and administrative 2,387 1,140 6,295 2,727 Total stock-based compensation $ 7,387 $ 2,846 $ 19,049 $ 7,108
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 — (431,041 ) 5.91 Options forfeited 15,062 (15,062 ) 9.33 Balance, September 30, 2021 3,745,216 1,641,099 $ 5.88 5.98 $ 328,212 Vested and exercisable, September 30, 2021 1,339,978 $ 4.88 5.72 $ 269,338 Vested and expected to vest, September 30, 2021 1,641,099 $ 5.88 5.98 $ 328,212
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 557,355 137.41 RSUs vested (205,807 ) 42.98 RSUs forfeited (47,266 ) 75.16 Balance, September 30, 2021 1,163,859 $ 90.97

Net Income (Loss) Per Share (Ta

Net Income (Loss) Per Share (Tables)	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Components of Basic and Diluted Net Income (Loss) Per Share	The components of basic and diluted net income (loss) per share are as follows (in thousands, except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Numerator: Net income (loss) $ 1,948 $ (12,932 ) $ (22,078 ) $ (49,825 ) Denominator: Basic: Weighted average number of common shares outstanding - basic 35,207,276 34,078,726 35,013,072 32,631,715 Diluted: Weighted average number of common shares outstanding - basic 35,207,276 34,078,726 35,013,072 32,631,715 Dilutive effect of outstanding common stock options 1,645,968 — — — Dilutive effect of restricted stock units 708,788 — — — Dilutive effect of common stock pursuant to employee stock purchase plan 5,144 — — — Weighted average number of common shares outstanding - diluted 37,567,176 34,078,726 35,013,072 32,631,715 Net income (loss) per share: Basic $ 0.06 $ (0.38 ) $ (0.63 ) $ (1.53 ) Diluted $ 0.05 $ (0.38 ) $ (0.63 ) $ (1.53 )
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 income (loss) per share for the periods presented due to their anti-dilutive effect: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Common stock options issued and outstanding — 2,529,433 1,641,099 2,529,433 Restricted stock units 18,539 798,708 1,163,859 798,708 Employee stock purchase plan 596 3,911 1,976 3,911 Total 19,135 3,332,052 2,806,934 3,332,052

Revenue (Tables)

Revenue (Tables)	9 Months Ended
	Sep. 30, 2021
Disaggregation Of Revenue [Abstract]
Schedule of Product Revenue Based on Product Line and Location	The following table represents the Company’s product revenue based on product line: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 (in thousands) (in thousands) Coronary $ 47,165 $ 6,983 $ 99,175 $ 16,403 Peripheral 17,725 12,337 52,659 27,927 Other 265 270 1,129 743 Product revenue $ 65,155 $ 19,590 $ 152,963 $ 45,073 Coronary product revenue encompasses sales of the Company’s C 2 5 4 The following table represents the Company’s product revenue based on the location to which the product is shipped: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 (in thousands) (in thousands) United States $ 52,771 $ 11,144 $ 116,729 $ 24,450 Europe 8,624 6,370 27,266 15,962 All other countries 3,760 2,076 8,968 4,661 Product revenue $ 65,155 $ 19,590 $ 152,963 $ 45,073

Equity Method Investments (Tabl

Equity Method Investments (Tables)	9 Months Ended
	Sep. 30, 2021
Equity Method Investments And Joint Ventures [Abstract]
Summary of Unaudited Balance Sheet	The following table summarizes the unaudited balance sheet for the JV: September 30, 2021 Balance sheet: (in thousands) Current assets $ 14,991 Current liabilities (757 ) Net assets $ 14,234
Summary of Unaudited Results of Operations	The following table summarizes the unaudited results of operations for the JV: Three Months Ended September 30, Nine Months Ended September 30, 2021 2021 (in thousands) Revenues $ — $ — Loss from operations 758 13,033 Net loss $ 758 $ 13,033

Organization and Basis of Pre_2

Organization and Basis of Presentation - Additional Information (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Entity incorporation, date of incorporation	Jun. 17, 2009
Accumulated deficit	$ 265,751	$ 243,673
Cash, cash equivalents and short-term investments	$ 183,000

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Schedule of Reconciliation of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020	Sep. 30, 2020	Dec. 31, 2019
Accounting Policies [Abstract]
Cash and cash equivalents	$ 91,195	$ 50,423
Restricted cash	1,450	1,450
Total cash, cash equivalents, and restricted cash	$ 92,645	$ 51,873	$ 216,706	$ 140,495

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Summary Of Significant Accounting Policies [Line Items]
Share in net loss of equity method investment	$ 342,000		$ 5,865,000
Notice period for cancellation of agreement			30 days
Revenue	65,155,000	$ 19,590,000	$ 152,963,000	$ 45,073,000
License
Summary Of Significant Accounting Policies [Line Items]
Revenue	$ 0		$ 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	Sep. 30, 2021	Dec. 31, 2020
Assets:
Total assets	$ 159,464	$ 193,384
Level 1
Assets:
Total assets	132,940	161,416
Level 2
Assets:
Total assets	26,524	31,968
U.S. Treasury Securities
Assets:
Total assets	65,235	126,363
U.S. Treasury Securities | Level 1
Assets:
Total assets	65,235	126,363
Money Market Funds
Assets:
Total assets	67,705	35,053
Money Market Funds | Level 1
Assets:
Total assets	67,705	35,053
Commercial Paper
Assets:
Total assets	21,385	31,968
Commercial Paper | Level 2
Assets:
Total assets	21,385	$ 31,968
Corporate Bonds
Assets:
Total assets	5,139
Corporate Bonds | Level 2
Assets:
Total assets	$ 5,139

Cash Equivalents and Short-Te_3

Cash Equivalents and Short-Term Investments - Summary of Cash Equivalents and Short-Term Investments (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Cash And Cash Equivalents [Line Items]
Cash equivalents, Fair Value	$ 67,705	$ 41,453
Cash equivalents and short-term investments, Amortized Cost Basis	159,471	193,375
Cash equivalents and short-term investments, Unrealized Gains	2	11
Cash equivalents and short-term investments, Unrealized losses	(9)	(2)
Cash equivalents and short-term investments, Fair Value	159,464	193,384
Short-term investments	91,759	151,931
U.S. Treasury Securities
Cash And Cash Equivalents [Line Items]
Short-term investments Amortized Cost Basis	65,242	126,354
Short-term investments Unrealized Gains	2	11
Short-term investments Unrealized Losses	(9)	(2)
Short-term investments, Fair Value	65,235	126,363
Money Market Funds
Cash And Cash Equivalents [Line Items]
Cash equivalents Amortized Cost Basis	67,705	35,053
Cash equivalents, Fair Value	67,705	35,053
Commercial Paper
Cash And Cash Equivalents [Line Items]
Short-term investments Amortized Cost Basis	21,385	31,968
Short-term investments, Fair Value	21,385	$ 31,968
Corporate Bonds
Cash And Cash Equivalents [Line Items]
Short-term investments Amortized Cost Basis	5,139
Short-term investments, Fair Value	$ 5,139

Cash Equivalents and Short-Te_4

Cash Equivalents and Short-Term Investments - Summary of Remaining Contractual Maturities for Available-for-sale Securities (Details) $ in Thousands	Sep. 30, 2021USD ($)
Cash And Cash Equivalents [Abstract]
One year or less	$ 134,384
Greater than one year and less than two years	25,080
Total	$ 159,464

Balance Sheet Components - Sche

Balance Sheet Components - Schedule of Inventory (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Inventory Disclosure [Abstract]
Raw material	$ 6,781	$ 4,995
Work in progress	11,066	6,051
Finished goods	19,000	16,952
Consigned inventory	1,897	1,861
Total inventory	$ 38,744	$ 29,859

Balance Sheet Components - Sc_2

Balance Sheet Components - Schedule of Accrued Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Payables And Accruals [Abstract]
Accrued employee compensation	$ 20,713	$ 10,885
Accrued research and development costs	3,839	3,057
Accrued asset purchases	3,451	2,527
Accrued professional services	1,819	1,325
Other	3,195	2,148
Total accrued liabilities	$ 33,017	$ 19,942

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) $ in Thousands	1 Months Ended			3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2021USD ($)ft²Option	Dec. 31, 2019USD ($)ft²	May 31, 2018ft²	Sep. 30, 2021USD ($)ft²	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)ft²	Sep. 30, 2020USD ($)	Dec. 31, 2019USD ($)ft²	Jun. 01, 2023ft²	Sep. 01, 2022USD ($)	Dec. 31, 2020USD ($)
Loss Contingencies [Line Items]
Operating lease right-of-use asset	$ 11,790			$ 11,790		$ 11,790					$ 7,568
Operating lease liabilities	12,806			12,806		12,806
Operating lease cost				500	$ 1,500	500	$ 1,500
Germany
Loss Contingencies [Line Items]
Operating lease right-of-use asset	200			200		200
Operating lease liabilities	$ 200			$ 200		$ 200
Operating lease, weighted average remaining lease term	1 year 7 months			1 year 7 months		1 year 7 months
Operating lease liability, weighted average incremental borrowing rate						5.14%
5403 Lease | Santa Clara, California
Loss Contingencies [Line Items]
Area of office and laboratory space | ft²			35,000
Lease term expiration month and year			2022-08
Lease commencement date			2018-09
Letter of credit secured by restricted cash	$ 500			$ 500		$ 500
Operating lease right-of-use asset	700			700		700
Operating lease liabilities	800			800		$ 800
Operating lease, remaining lease term						11 months
5403 Lease | Santa Clara, California | Scenario Forecast
Loss Contingencies [Line Items]
Area of office and laboratory space | ft²									35,000
5353 Lease | Santa Clara, California
Loss Contingencies [Line Items]
Area of office and laboratory space | ft²		50,200						50,200
Lease commencement date								2019-12
Operating lease right-of-use asset	10,900			10,900		$ 10,900
Operating lease liabilities	$ 11,900			$ 11,900		$ 11,900
Operating lease, remaining lease term						10 years 3 months
Lease term expiration date		Aug. 31, 2022
Initial term of building		96 months						96 months
Lessee, Operating Lease, Existence of Option to Extend								true
Lease rent abatement term for first building								19 months
Lease rent abatement term for second floor								4 months
Operating lease, extended period	48 months 15 days
Operating lease extended term date	Dec. 31, 2031
Lessee, Operating Lease, Existence of Option to Extend	true
5353 Lease | Santa Clara, California | Scenario Forecast
Loss Contingencies [Line Items]
Letter of credit secured by restricted cash										$ 1,500
5353 Lease | Santa Clara, California | Initial Security Deposit
Loss Contingencies [Line Items]
Letter of credit secured by restricted cash		$ 1,000						$ 1,000
5403 and 5353 Lease | Santa Clara, California | Maximum
Loss Contingencies [Line Items]
Tenant improvements allowance		$ 1,800						$ 1,800
3003 Lease | Santa Clara, California
Loss Contingencies [Line Items]
Area of office and laboratory space | ft²	81,000			81,000		81,000
Lease term expiration month and year	2031-12
Initial term of building	10 years			10 years		10 years
Number of operating lease optional extension | Option	2
Operating lease, optional extension term	60 months
3003 Lease | Santa Clara, California | Initial Security Deposit
Loss Contingencies [Line Items]
Line of credit	$ 200			$ 200		$ 200
Prepayment for rent	200			200		200
3003 Lease | Santa Clara, California | Maximum
Loss Contingencies [Line Items]
Tenant improvements allowance	$ 5,500			$ 5,500		$ 5,500

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Minimum Future Rental Payments (Details) $ in Thousands	Sep. 30, 2021USD ($)
Operating Lease Liabilities Payments Due [Abstract]
2021 (remainder)	$ 602
2022	2,128
2023	1,535
2024	1,552
2025	1,600
2026	1,643
Thereafter	8,787
Total minimum lease payments	17,847
Less: imputed interest and adjustments	(5,041)
Operating lease liabilities	$ 12,806

Commitments and Contingencies_3

Commitments and Contingencies - Schedule of Minimum Undiscounted Future Rental Payments Not Yet Commenced (Details) - 5403 and 3003 Lease $ in Thousands	Sep. 30, 2021USD ($)
Lessee, Operating Lease, Not yet Commenced, Description [Abstract]
2021 (remainder)	$ 215
2022	1,420
2023	3,704
2024	3,815
2025	3,926
2026	4,047
Thereafter	22,004
Total minimum lease payments	$ 39,131

Term Notes - Additional Informa

Term Notes - Additional Information (Details) - USD ($)	Feb. 29, 2020	Sep. 30, 2021	Dec. 31, 2020	Dec. 31, 2018	Jun. 30, 2018	Feb. 28, 2018
Debt Instrument [Line Items]
Debt Amount		$ 16,500,000	$ 16,500,000
Debt, final payment amount		$ 1,568,000
Loan and Security Agreement
Debt Instrument [Line Items]
Debt, final payment as percentage of original aggregate principal amount		6.75%
Debt, final payment amount						$ 1,000,000
Proceeds of supplemental term loan	$ 4,300,000
Debt payments description		The Amended Credit Facility provides an interest-only payment period through June 30, 2022.
Loan and Security Agreement | Supplemental Term Loan
Debt Instrument [Line Items]
Debt Amount	16,500,000
Debt interest rate		3.50%
Debt, final payment amount		$ 1,600,000
Proceeds of supplemental term loan, net of final balloon payment fee	$ 3,300,000
Debt maturity date	Dec. 1, 2023
Loan and Security Agreement | Minimum
Debt Instrument [Line Items]
Debt interest rate		1.75%
Loan and Security Agreement | Minimum | Prime Rate | Supplemental Term Loan
Debt Instrument [Line Items]
Debt interest rate basis	1.25%
Loan and Security Agreement | Maximum
Debt Instrument [Line Items]
Debt interest rate basis		2.75%
Loan and Security Agreement | Maximum | Supplemental Term Loan
Debt Instrument [Line Items]
Debt interest rate	3.50%
Loan and Security Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Termination of line of credit facility	$ 2,000,000
Loan and Security Agreement | Revolving Credit Facility | Maximum
Debt Instrument [Line Items]
Line of credit facility termination fee	$ 100,000
Loan and Security Agreement | Silicon Valley Bank
Debt Instrument [Line Items]
Debt, warrants issued		34,440
Debt, fair value of warrants issued		$ 100,000
Loan and Security Agreement | Silicon Valley Bank | Short Term Notes
Debt Instrument [Line Items]
Debt Amount						15,000,000
Loan and Security Agreement | Silicon Valley Bank | Short Term Notes | Tranche One
Debt Instrument [Line Items]
Debt Amount					$ 10,000,000
Loan and Security Agreement | Silicon Valley Bank | Short Term Notes | Tranche Two
Debt Instrument [Line Items]
Debt Amount				$ 5,000,000
Loan and Security Agreement | Silicon Valley Bank | Revolving Credit Facility
Debt Instrument [Line Items]
Debt Amount						$ 2,000,000

Term Notes - Schedule of Curren

Term Notes - Schedule of Current and Noncurrent Debt and Net Discount or Premium Balances (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Debt Instrument Periodic Payment [Abstract]
Principal amount of term note	$ 16,500	$ 16,500
Net premium associated with accretion of final payment, and other debt issuance costs	476	119
Term note, current and noncurrent	16,976	16,619
Less term note, current portion	(2,750)	(3,300)
Term note, noncurrent portion	$ 14,226	$ 13,319

Term Notes - Schedule of Future

Term Notes - Schedule of Future Minimum and Estimated Payments (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Debt Disclosure [Abstract]
2021 (remainder)	$ 146
2022	6,045
2023	12,779
Total future payments	18,970
Less amounts representing interest	(902)
Less final payment	(1,568)
Total principal amount of term note payments	$ 16,500	$ 16,500

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Total Stock-Based Compensation (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	$ 7,387	$ 2,846	$ 19,049	$ 7,108
Cost of Product Revenue
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	263	162	718	303
Research and Development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	1,686	631	4,343	1,769
Sales and Marketing
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	3,051	913	7,693	2,309
General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	$ 2,387	$ 1,140	$ 6,295	$ 2,727

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Details) - USD ($)	1 Months Ended	3 Months Ended		9 Months Ended
	Feb. 28, 2019	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020	Mar. 06, 2019
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation expenses capitalized amount		$ 239,000	$ 45,000	$ 633,000	$ 259,000
Shares available for issuance		3,745,216		3,745,216		2,689,624
Stock-based compensation				$ 19,049,000	7,108,000
Restricted Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period				4 years
Share-based compensation vesting rights, terms				The RSUs generally vest over a four-year period with straight-line annual vesting,
2019 Equity Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock reserved for issuance	2,000,430
Automatic annual increase in common stock reserved for issuance	3.00%
Maximum period of automatic annual increase in common stock reserved for issuance	10 years
Shares available for issuance		3,745,216		3,745,216
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		872,496		872,496
Purchase shares of common stock, price per share, percentage of fair market value				85.00%
Stock-based compensation		$ 333,000	$ 118,000	$ 890,000	$ 516,000

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of Option Activity under 2009 Plan and 2019 Plan (Details) $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2021USD ($)$ / sharesshares	Dec. 31, 2020USD ($)$ / sharesshares
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 forfeited	15,062
Shares Available for Grant, Ending balance	3,745,216	2,689,624
Number of Shares
Number of Shares, Beginning balance	2,087,202
Number of Shares, Options exercised	(431,041)
Number of Shares, Options forfeited	(15,062)
Number of Shares, Ending balance	1,641,099	2,087,202
Number of Shares, Vested and exercisable	1,339,978
Number of Shares, Vested and expected to vest	1,641,099
Weighted-Average Exercise Price Per Share
Weighted-Average Exercise Price Per Share, Beginning balance | $ / shares	$ 5.92
Weighted-Average Exercise Price Per Share, Options exercised | $ / shares	5.91
Weighted-Average Exercise Price Per Share, Options forfeited | $ / shares	9.33
Weighted-Average Exercise Price Per Share, Ending balance | $ / shares	5.88	$ 5.92
Weighted-Average Exercise Price Per Share, Vested and exercisable | $ / shares	4.88
Weighted-Average Exercise Price Per Share, Vested and expected to vest | $ / shares	$ 5.88
Weighted-Average Remaining Term
Weighted-Average Remaining Term, Balance	5 years 11 months 23 days	6 years 9 months 7 days
Weighted-Average Remaining Term, Vested and exercisable	5 years 8 months 19 days
Weighted-Average Remaining Term, Vested and expected to vest	5 years 11 months 23 days
Aggregate Intrinsic Value
Aggregate Intrinsic Value, Balance | $	$ 328,212	$ 204,137
Aggregate Intrinsic Value, Vested and exercisable | $	269,338
Aggregate Intrinsic Value, Vested and expected to vest | $	$ 328,212

Stock-Based Compensation - Sc_3

Stock-Based Compensation - Schedule of RSU Activity under 2019 Plan (Details) - Restricted Stock Units	9 Months Ended
	Sep. 30, 2021$ / sharesshares
Number of Shares
Number of Shares, Beginning balance | shares	859,577
Number of Shares, RSUs granted | shares	557,355
Number of Shares, RSUs vested | shares	(205,807)
Number of Shares, RSUs forfeited | shares	(47,266)
Number of Shares, Ending balance | shares	1,163,859
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	137.41
Weighted-Average Grant Date Fair Value Per Share, RSUs vested | $ / shares	42.98
Weighted-Average Grant Date Fair Value Per Share, RSUs forfeited | $ / shares	75.16
Weighted-Average Grant Date Fair Value Per Share, Ending balance | $ / shares	$ 90.97

Net Income (Loss) Per Share - C

Net Income (Loss) Per Share - Components of Basic and Diluted Net Income (Loss) Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Numerator:
Net income (loss)	$ 1,948	$ (12,932)	$ (22,078)	$ (49,825)
Basic:
Basic	35,207,276	34,078,726	35,013,072	32,631,715
Shares used in computing net income (loss) per share
Basic	35,207,276	34,078,726	35,013,072	32,631,715
Dilutive effect of outstanding common stock options	1,645,968
Dilutive effect of restricted stock units	708,788
Dilutive effect of common stock pursuant to employee stock purchase plan	5,144
Weighted average number of common shares outstanding - diluted	37,567,176	34,078,726	35,013,072	32,631,715
Net income (loss) per share:
Basic	$ 0.06	$ (0.38)	$ (0.63)	$ (1.53)
Diluted	$ 0.05	$ (0.38)	$ (0.63)	$ (1.53)

Net Income (Loss) Per Share - S

Net Income (Loss) Per Share - Summary of Outstanding Potentially Dilutive Common Stock Equivalents Excluded from Calculation of Diluted Net Income (Loss) Per Share (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted net loss per share	19,135	3,332,052	2,806,934	3,332,052
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		2,529,433	1,641,099	2,529,433
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	18,539	798,708	1,163,859	798,708
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	596	3,911	1,976	3,911

Revenue - Schedule of Product R

Revenue - Schedule of Product Revenue Based on Product Line and Location (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Disaggregation Of Revenue [Line Items]
Product revenue	$ 65,155	$ 19,590	$ 152,963	$ 45,073
United States
Disaggregation Of Revenue [Line Items]
Product revenue	52,771	11,144	116,729	24,450
Europe
Disaggregation Of Revenue [Line Items]
Product revenue	8,624	6,370	27,266	15,962
All Other Countries
Disaggregation Of Revenue [Line Items]
Product revenue	3,760	2,076	8,968	4,661
Coronary
Disaggregation Of Revenue [Line Items]
Product revenue	47,165	6,983	99,175	16,403
Peripheral
Disaggregation Of Revenue [Line Items]
Product revenue	17,725	12,337	52,659	27,927
Other
Disaggregation Of Revenue [Line Items]
Product revenue	$ 265	$ 270	$ 1,129	$ 743

Equity Method Investments - Add

Equity Method Investments - Additional Information (Details) - USD ($) $ in Thousands	Mar. 19, 2021	Sep. 30, 2021	Sep. 30, 2021
Schedule Of Equity Method Investments [Line Items]
Equity method investment		$ 6,408	$ 6,408
Share in net loss of equity method investment		342	5,865
Related party contract liability, noncurrent portion		12,273	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	$ 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	Sep. 30, 2021	Dec. 31, 2020
Balance sheet:
Current assets	$ 256,028	$ 246,300
Current liabilities	(40,266)	$ (25,581)
JV Agreement with Genesis MedTech
Balance sheet:
Current assets	14,991
Current liabilities	(757)
Net assets	$ 14,234

Equity Method Investments - S_2

Equity Method Investments - Summary of Unaudited Results of Operations (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Schedule Of Equity Method Investments [Line Items]
Product revenue	$ 65,155	$ 19,590	$ 152,963	$ 45,073
Loss from operations	2,813	(12,807)	(14,854)	(49,797)
Net income (loss)	1,948	$ (12,932)	(22,078)	$ (49,825)
JV Agreement with Genesis MedTech
Schedule Of Equity Method Investments [Line Items]
Loss from operations	758		13,033
Net income (loss)	$ 758		$ 13,033