Shockwave Medical (SWAV) 10-Q 8 May 23 2023 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2023	May 02, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2023
Document Transition Report	false
Entity File Number	001-38829
Entity Registrant Name	Shockwave Medical, Inc.
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
Title of 12(b) Security	Shockwave Medical, Inc., common stock, par value $0.001 per share
Trading Symbol	SWAV
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		36,626,211
Entity Central Index Key	0001642545
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q1
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
CURRENT ASSETS:
Cash and cash equivalents	$ 280,932	$ 156,586	[1]
Short-term investments	135,929	147,907	[1]
Accounts receivable, net	84,309	71,366	[1]
Inventory	83,256	75,112	[1]
Prepaid expenses and other current assets	6,399	8,292	[1]
Total current assets	590,825	459,263	[1]
Operating lease right-of-use assets	31,623	32,365	[1]
Property and equipment, net	54,057	48,152	[1]
Equity method investment	2,689	3,512	[1]
Deferred tax assets	97,941	97,568
Other assets	6,112	5,229	[1]
TOTAL ASSETS	783,247	646,089	[1]
CURRENT LIABILITIES:
Accounts payable	11,050	6,721	[1]
Debt, current portion	80,000	0	[1]
Accrued liabilities	49,640	55,375	[1]
Lease liability, current portion	1,308	1,278	[1]
Total current liabilities	141,998	63,374	[1]
Lease liability, noncurrent portion	34,058	34,928	[1]
Debt, noncurrent portion	24,231	24,198	[1]
Related party contract liability, noncurrent portion	12,273	12,273	[1]
TOTAL LIABILITIES	212,560	134,773	[1]
STOCKHOLDERS’ EQUITY:
Preferred stock	0	0	[1]
Common stock	37	36	[1]
Additional paid-in capital	568,705	548,960	[1]
Accumulated other comprehensive loss	(367)	(867)	[1]
Retained earnings (accumulated deficit)	2,312	(36,813)	[1]
TOTAL STOCKHOLDERS’ EQUITY	570,687	511,316	[1]
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$ 783,247	$ 646,089	[1]
[1]The condensed consolidated balance sheet as of December 31, 2022 is derived from the audited consolidated financial statements as of that date.

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Revenue:
Product revenue	$ 161,066,000	$ 93,631,000
Cost of revenue:
Cost of product revenue	21,066,000	12,890,000
Gross profit	140,000,000	80,741,000
Operating expenses:
Research and development	26,971,000	17,019,000
Sales and marketing	54,011,000	35,961,000
General and administrative	19,204,000	12,389,000
Total operating expenses	100,186,000	65,369,000
Income from operations	39,814,000	15,372,000
Loss from equity method investment	(823,000)	(47,000)
Interest expense	(636,000)	(297,000)
Other income (expense), net	2,382,000	(310,000)
Net income before taxes	40,737,000	14,718,000
Income tax expense	1,612,000	197,000
Net income	39,125,000	14,521,000
Other comprehensive income (loss):
Unrealized gain (loss) on available-for-sale securities	505,000	(815,000)
Adjustment for net gain realized and included in other income	(5,000)	0
Total comprehensive income	$ 39,625,000	$ 13,706,000
Net income per share
Basic (USD per share)	$ 1.07	$ 0.41
Diluted (USD per share)	$ 1.03	$ 0.39
Denominator:
Basic (in shares)	36,427,263	35,587,337
Diluted (in shares)	37,979,448	37,623,477
Type of Revenue [Extensible List]	Product [Member]	Product [Member]
Type of Cost, Good Or Service [Extensible List]	Product [Member]	Product [Member]

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity - USD ($)	Total		Common Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Income	Accumulated Deficit
Beginning balance, shares (in shares) at Dec. 31, 2021			35,444,472,000
Beginning balance at Dec. 31, 2021	$ 241,830,000		$ 35,000	$ 494,806,000	$ (202,000)	$ (252,809,000)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options (in shares)			54,913,000
Exercise of stock options	391,000		$ 1,000	390,000
Unrealized gain on available-for-sale securities, net of tax	(815,000)				(815,000)
Adjustment for net gain realized and included in other income	0
Issuance of common stock under employee stock purchase plan (in shares)			14,172,000
Issuance of common stock under employee stock purchase plan	2,135,000			2,135,000
Issuance of common stock in connection with vesting of restricted stock (in shares)			210,835,000
Taxes withheld on net settled vesting of restricted stock units (in shares)			(31,000)
Restricted Stock, Value, Shares Issued Net of Tax Withholdings	(6,000)			(6,000)
Stock-based compensation	9,767,000			9,767,000
Net income (loss)	14,521,000					14,521,000
Ending balance, shares (in shares) at Mar. 31, 2022			35,724,361,000
Ending balance at Mar. 31, 2022	267,823,000		$ 36,000	507,092,000	(1,017,000)	(238,288,000)
Beginning balance, shares (in shares) at Dec. 31, 2022			36,235,546,000
Beginning balance at Dec. 31, 2022	$ 511,316,000	[1]	$ 36,000	548,960,000	(867,000)	(36,813,000)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options (in shares)	77,230,000		77,230,000
Exercise of stock options	$ 320,000		$ 1,000	319,000
Unrealized gain on available-for-sale securities, net of tax	505,000				505,000
Adjustment for net gain realized and included in other income	(5,000)				(5,000)
Issuance of common stock under employee stock purchase plan (in shares)			19,124,000
Issuance of common stock under employee stock purchase plan	3,092,000			3,092,000
Issuance of common stock in connection with vesting of restricted stock (in shares)			257,624,000
Taxes withheld on net settled vesting of restricted stock units (in shares)			(19,000)
Restricted Stock, Value, Shares Issued Net of Tax Withholdings	(3,000)			(3,000)
Stock-based compensation	16,337,000			16,337,000
Net income (loss)	39,125,000					39,125,000
Ending balance, shares (in shares) at Mar. 31, 2023			36,589,505,000
Ending balance at Mar. 31, 2023	$ 570,687,000		$ 37,000	$ 568,705,000	$ (367,000)	$ 2,312,000
[1]The condensed consolidated balance sheet as of December 31, 2022 is derived from the audited consolidated financial statements as of that date.

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income (loss)	$ 39,125,000	$ 14,521,000
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	1,708,000	953,000
Loss from equity method investment	823,000	47,000
Stock-based compensation	15,967,000	9,510,000
Non-cash lease expense	748,000	767,000
Amortization of premium and discount on available-for-sale securities	(718,000)	210,000
Loss on write down of fixed assets	11,000	0
Deferred income taxes	(547,000)	0
Amortization of debt issuance costs	33,000	153,000
Foreign currency remeasurement	(689,000)	0
Changes in operating assets and liabilities:
Accounts receivable	(13,004,000)	(10,407,000)
Inventory	(7,757,000)	(10,090,000)
Prepaid expenses and other current assets	1,896,000	600,000
Other assets	(861,000)	(119,000)
Accounts payable	4,734,000	4,911,000
Accrued and other current liabilities	(6,661,000)	(9,051,000)
Lease liabilities	(846,000)	(68,000)
Net cash provided by operating activities	33,962,000	1,937,000
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchase of available-for-sale securities	(21,130,000)	(42,128,000)
Proceeds from maturities of available-for-sale securities	34,500,000	18,000,000
Purchase of property and equipment	(7,188,000)	(3,286,000)
Net cash provided by (used in) investing activities	6,182,000	(27,414,000)
CASH FLOWS FROM FINANCING ACTIVITIES:
Payments of taxes withheld on net settled vesting of restricted stock units	(3,000)	(6,000)
Proceeds from stock option exercises	320,000	391,000
Proceeds from issuance of common stock under employee stock purchase plan	3,092,000	2,135,000
Proceeds from debt financing, net of issuance costs	80,000,000	0
Net cash provided by financing activities	83,409,000	2,520,000
Effect of exchange rate changes on cash and cash equivalents	792,000	0
Net increase (decrease) in cash, cash equivalents and restricted cash	124,345,000	(22,957,000)
Cash, cash equivalents and restricted cash at beginning of period	158,302,000	90,874,000
Cash, cash equivalents and restricted cash equivalents at end of period	282,647,000	67,917,000
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION:
Interest paid	424,000	144,000
Income tax paid	322,000	78,000
NON-CASH INVESTING AND FINANCING ACTIVITIES:
Property and equipment purchases included in accounts payable and accrued liabilities	$ 6,162,000	$ 3,159,000

Organization and Basis of Prese

Organization and Basis of Presentation	3 Months Ended
	Mar. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Basis of Presentation	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 h as eleven wholly-owned foreign subsidiaries as of March 31, 2023 . The unaudited condensed financial statements include the accounts of Shockwave Medical, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation. As of March 31, 2023, the Company had cash, cash equivalents and short-term investments of $416.9 million, which are available to fund future working capital requirements, investments, acquisitions, or repayments of credit facilities. The Company believes that its cash, cash equivalents, and short-term investments as of March 31, 2023, 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, and the timing and cost of establishing additional sales and marketing capabilities and the scope. Risk and Uncertainties The Company is subject to continuing risks and uncertainties in connection with the current macroeconomic environment, including inflation, rising interest rates, and instability in the global banking system, geopolitical factors, including the ongoing conflict between Russia and Ukraine and the responses thereto, supply chain disruptions and the remaining effects of the COVID-19 pandemic . The Company is closely monitoring the impact of these factors on all aspects of its business, including the impacts on its customers, patients, employees, suppliers, vendors, business partners and distribution channels. In particular, while the Company has not experienced material disruptions in its supply chain to date, the Company has been and continues to be impacted by disruptions in the operations of certain of its third-party suppliers, resulting in increased lead-times, higher component costs and lower allocations for the purchase of some components. In certain cases, the Company has incurred higher logistical expenses. The Company is continuing to work closely with its manufacturing partners and suppliers to source key components and maintain appropriate inventory levels to meet customer demand. The Company’s future results of operations and liquidity could be adversely impacted by a variety of factors, including those discussed in the section titled “Risk Factors” of the Company’s Annual Report on Form 10-K for the year ended December 31, 2022 , filed with the SEC on February 27, 2023 (the “2022 Annual Report”), together with any updates in the section titled “Risk Factors” in this Quarterly Report on Form 10-Q. As of the date of issuance of these condensed consolidated financial statements, the extent to which the current macroeconomic environment and the COVID-19 pandemic may materially impact the Company’s financial condition, liquidity, or results of operations remains uncertain.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	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 months ended March 31, 2023 are not necessarily indicative of the results to be expected for the year ending December 31, 2023 or for any other future annual or interim period. The condensed consolidated balance sheet as of December 31, 2022 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 2022 Annual Report. 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. The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated statements of cash flows: March 31, March 31, (in thousands) Cash and cash equivalents $ 280,932 $ 66,252 Restricted cash 1,715 1,665 Total cash, cash equivalents, and restricted cash $ 282,647 $ 67,917 Restricted cash as of March 31, 2023 and December 31, 2022 relates to letters of credit established for real property leases relating to the Company’s office buildings, and is recorded as other assets on the condensed consolidated balance sheets. See Note 12 for a discussion of the Company’s subsequent payments related to the acquisition of Neovasc, Inc. and the repayment of the credit drawn on March 16, 2023 under the Credit Agreement. 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 sheets. The Company records its proportionate share of the underlying income or loss which is recognized in earnings or loss from the equity method investment. The Company eliminates a portion of intra-entity profit to the extent the goods sold by the Company have not yet been sold through by the equity method investee to an end customer at the end of the reporting period. The profit earned by the Company from the equity method investee for items not yet sold through is eliminated through equity method earnings or loss which is recognized in income (loss) from equity method investment. The Company assesses its equity method investment for impairment when events or circumstances suggest that the carrying amount of the investment may be impaired. The Company considers 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. Revenue To determine revenue recognition for arrangements that an entity determines are within the scope of Topic 606, Revenue from Contracts with Customers, the Company performs the following five steps: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies a performance obligation. 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 has 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 generally 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 the Company’s functional intellectual property with a customer, the Company considers 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 were recognized for the three months ended March 31, 2023 and 2022. Stock-Based Compensation

Financial Instruments and Fair

Financial Instruments and Fair Value Measurements	3 Months Ended
	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Financial Instruments and Fair Value Measurements	Financial Instruments and Fair Value Measurements The following tables summarize the Company’s financial assets measured at fair value on a recurring basis by level within the fair value hierarchy: March 31, 2023 Level 1 Level 2 Level 3 Total (in thousands) Assets: U.S. Treasury securities $ 95,282 $ — $ — $ 95,282 Money market funds 10,070 — — 10,070 Commercial paper — 8,139 — 8,139 Corporate bonds — 20,688 — 20,688 U.S. agency securities — 11,820 — 11,820 Total assets $ 105,352 $ 40,647 $ — $ 145,999 December 31, 2022 Level 1 Level 2 Level 3 Total (in thousands) Assets: U.S. Treasury securities $ 111,631 $ — $ — $ 111,631 Money market funds 12,076 — — 12,076 Commercial paper — 8,039 — 8,039 Corporate bonds — 18,808 — 18,808 U.S. agency securities — 9,429 — 9,429 Total assets $ 123,707 $ 36,276 $ — $ 159,983

Cash Equivalents and Short-Term

Cash Equivalents and Short-Term Investments	3 Months Ended
	Mar. 31, 2023
Cash and Cash Equivalents [Abstract]
Cash Equivalents and Short-Term Investments	Cash Equivalents and Short-Term Investments The following is a summary of the Company’s cash equivalents and short-term investments: March 31, 2023 Amortized Unrealized Unrealized Fair Value (in thousands) U.S. Treasury securities $ 95,784 $ 18 $ (520) $ 95,282 Money market funds 10,070 — — 10,070 Commercial paper 8,140 1 (2) 8,139 Corporate bonds 20,685 22 (19) 20,688 U.S. agency securities 11,804 16 — 11,820 Total $ 146,483 $ 57 $ (541) $ 145,999 Reported as: Cash equivalents $ 10,070 Short-term investments 135,929 Total $ 145,999 December 31, 2022 Amortized Unrealized Unrealized Fair Value (in thousands) U.S. Treasury securities $ 112,719 $ 3 $ (1,091) $ 111,631 Money market funds 12,076 — — 12,076 Commercial paper 8,039 — — 8,039 Corporate bonds 18,876 8 (76) 18,808 U.S. agency securities 9,432 4 (7) 9,429 Total $ 161,142 $ 15 $ (1,174) $ 159,983 Reported as: Cash equivalents $ 12,076 Short-term investments 147,907 Total $ 159,983 There were $76.4 million and $123.8 million of investments in unrealized loss positions of $0.5 million and $1.2 million as of March 31, 2023 and December 31, 2022, respectively. During the three months ended March 31, 2023 and 2022, the Company did not record any other-than-temporary impairment charges on its available-for-sale securities. Based on the Company’s procedures under the expected credit loss model, including an assessment of unrealized losses on the portfolio, the Company concluded that the unrealized losses for its marketable securities were not attributable to credit and therefore an allowance for credit losses for these securities has not been recorded as of March 31, 2023 and December 31, 2022. Also, based on the scheduled maturities of the investments, the Company was more likely than not to hold these investments for a period of time sufficient for a recovery of the Company’s cost basis. For the three months ended March 31, 2023 and 2022, the Company recognized $5,000 and nil in realized gains on cash equivalents and short-term investments. The remaining contractual maturities of the Company’s cash equivalents and short-term investments were as follows: March 31, Fair Value (in thousands) Money market funds $ 10,070 One year or less 112,680 Greater than one year and less than two years 23,249 Total $ 145,999

Balance Sheet Components

Balance Sheet Components	3 Months Ended
	Mar. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Balance Sheet Components	Balance Sheet Components Inventory Inventory consists of the following: March 31, December 31, (in thousands) Raw material $ 21,504 $ 18,456 Work in progress 10,722 7,666 Finished goods 50,737 48,735 Consigned inventory 293 255 Total inventory $ 83,256 $ 75,112 Accrued Liabilities Accrued liabilities consist of the following: March 31, December 31, (in thousands) Employee compensation $ 22,070 $ 32,885 Asset purchases 6,882 4,600 Research and development costs 4,118 4,007 Professional services 3,862 4,044 Excise, sales, income and other taxes 5,123 4,036 Other 7,585 5,803 Total accrued liabilities $ 49,640 $ 55,375

Term Notes

Term Notes	3 Months Ended
	Mar. 31, 2023
Debt Disclosure [Abstract]
Term Notes	Debt On October 19, 2022, the Company entered into a Credit Agreement (the “Credit Agreement”) with Wells Fargo Bank, National Association, as administrative agent, Wells Fargo Bank, National Association, as swingline lender and an issuing lender, Wells Fargo Securities, LLC and Silicon Valley Bank, as joint lead arrangers and joint bookrunners, Silicon Valley Bank, as syndication agent, and the several lenders party thereto. The Credit Agreement provides for a revolving credit facility in an aggregate principal amount of $175 million with the right to request increases to the revolving commitments (subject to certain conditions) of up to the greater of (x) $100 million or (y) the Company’s consolidated EBITDA for the four fiscal quarter period most recently ended prior to the date of such increase. Concurrent with entering into the Credit Agreement, the Company drew down $25.0 million. On March 16, 2023, the Company drew down an additional $80.0 million under the Credit Agreement. See Note 12 for a discussion of the Company’s subsequent payment of the additional $80.0 million drawn under the Credit Agreement. The revolving credit facility accrues for interest, at the election of the Company, at (A) the Base Rate (as defined below) plus a margin ranging from 0% to 1% depending on the Company's Consolidated Total Net Leverage Ratio (as defined in the Credit Agreement) (which rate is currently 0%) or (B) the applicable secured overnight financing rate (“SOFR”) plus a margin from 1% to 2%, depending on the Company's Consolidated Total Net Leverage Ratio (which rate is currently 1%). Base Rate means, at any time, the highest of (a) the Wells Fargo Bank, National Association's announced prime rate, (b) the federal funds rate plus 0.5% and (c) Term SOFR for a one-month tenor in effect on such day plus 1%. The Credit Agreement matures on October 19, 2027. The interest rate was 5.6% as of March 31, 2023. The Company recorded interest expense of $0.6 million and $0.3 million for the three months ended March 31, 2023 and 2022, respectively. Debt and debt issuance costs are as follows: March 31, December 31, (in thousands) Principal amount of debt $ 105,000 $ 25,000 Debt issuance costs (769) (802) Debt 104,231 24,198 Less: debt, current portion (80,000) — Debt, noncurrent portion $ 24,231 $ 24,198

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2023
Share-Based Payment Arrangement [Abstract]
Stock-Based Compensation	Stock-Based Compensation Total stock-based compensation was as follows: Three Months Ended 2023 2022 (in thousands) Cost of product revenue $ 954 $ 653 Research and development 3,795 2,238 Sales and marketing 6,466 3,932 General and administrative 4,752 2,687 Total stock-based compensation $ 15,967 $ 9,510 Stock-based compensation of $0.4 million and $0.3 million was capitalized into inventory for the three months ended March 31, 2023 and 2022, 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 Company's Board of Directors (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 Company's initial public offering (the “IPO”). As a result, effective as of March 6, 2019, the Company may not grant any additional awards under the 2009 Plan. The 2009 Plan will continue to govern outstanding equity awards granted thereunder. The Company initially reserved 2,000,430 shares of common stock for the issuance of a variety of awards under the 2019 Plan, including stock options, stock appreciation rights, awards of restricted stock and awards of restricted stock units (“RSUs”). 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 Board. As of March 31, 2023, there were 3,765,125 shares available for issuance under the 2019 Plan. Stock Options Option activity under the 2009 Plan and 2019 Plan is set forth below: Number Weighted- Weighted- Aggregate (in years) (in thousands) Balance, December 31, 2022 1,122,009 $ 5.87 4.60 $ 224,115 Awards authorized — Options exercised (77,230) 4.12 Options cancelled (6,133) 2.41 Balance, March 31, 2023 1,038,646 $ 6.02 4.41 $ 218,961 Vested and exercisable, 1,038,503 $ 6.01 4.41 $ 218,935 Vested and expected to vest, 1,038,646 $ 6.02 4.41 $ 218,961 Restricted Stock Units RSUs are share awards that entitle the holder to receive freely tradable shares of the Company’s common stock upon vesting. 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. RSUs generally vest over a four-year period with straight-line quarterly vesting with a one year cliff or straight-line annual vesting, provided the employee remains continuously employed with the Company. The fair value of RSUs is equal to the closing price of the Company’s common stock on the grant date. In February 2022 and 2023, the Company granted performance-based restricted stock units (“PRSUs”) to certain key executives. The vesting of these PRSUs is dependent on the achievement of certain performance targets related to the Company’s compound annual growth rate of revenue over a two three RSU and PRSU activity under the 2019 Plan is set forth below. Grant activity for all PRSUs is disclosed at target (100%): Restricted Stock Units Performance-Based Restricted Stock Units Number Weighted- Number Weighted- Balance, December 31, 2022 1,125,991 $ 127.39 38,797 $ 165.74 RSUs granted 293,007 191.06 29,473 191.36 RSUs forfeited (19,803) 145.72 (175) 278.52 RSUs vested (257,624) 97.37 — — Balance, March 31, 2023 1,141,571 150.18 68,095 176.54 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 of the Board, in its sole discretion. The fair value of the ESPP shares is estimated using the Black-Scholes option pricing model. The Company recorded $1.3 million and $0.4 million of stock-based compensation expense related to the ESPP for the three months ended March 31, 2023 and 2022, respectively. At March 31, 2023, a total of 1,540,527 shares were available for issuance under the ESPP.

Net Income (Loss) Per Share

Net Income (Loss) Per Share	3 Months Ended
	Mar. 31, 2023
Earnings Per Share [Abstract]
Net Income (Loss) Per Share	Net Income Per Share The components of basic and diluted net income per share were as follows (in thousands, except share and per share amounts): Three Months Ended 2023 2022 Numerator: Net income $ 39,125 $ 14,521 Denominator: Basic: Weighted average number of common shares outstanding - basic 36,427,263 35,587,337 Diluted: Weighted average number of common shares outstanding - basic 36,427,263 35,587,337 Dilutive effect of outstanding common stock options 1,039,985 1,437,748 Dilutive effect of restricted stock units 510,340 597,817 Dilutive effect of common stock pursuant to employee stock purchase plan 1,860 575 Weighted average number of common shares outstanding - diluted 37,979,448 37,623,477 Net income per share: Basic $ 1.07 $ 0.41 Diluted $ 1.03 $ 0.39

Revenue

Revenue	3 Months Ended
	Mar. 31, 2023
Disaggregation of Revenue [Abstract]
Revenue	Revenue The following table represents the Company’s product revenue based on product line: Three Months Ended 2023 2022 (in thousands) Coronary $ 113,875 $ 70,337 Peripheral 46,130 22,852 Other 1,061 442 Product revenue $ 161,066 $ 93,631 Coronary product revenue encompasses sales of the Company’s C 2 catheter and C 2+ catheter. Peripheral product revenue encompasses sales of the Company’s M 5 catheter, M 5+ catheter, S 4 IVL catheter, and L 6 IVL catheter. Other product revenue encompasses sales of the Company’s generators and related accessories. The following table represents the Company’s product revenue based on the location to which the product is shipped: Three Months Ended 2023 2022 (in thousands) United States $ 131,623 $ 78,519 Europe 16,234 12,067 All other countries 13,209 3,045 Product revenue $ 161,066 $ 93,631

Equity Method Investments

Equity Method Investments	3 Months Ended
	Mar. 31, 2023
Equity Method Investments and Joint Ventures [Abstract]
Equity Method Investments	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 (the “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 the 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 the total equity of the JV, to Genesis in exchange for a cash contribution of $15.0 million, of which 50% was due upon signing and the remaining 50% was due within one year of signing, and (ii) 45,000 ordinary shares, which represents 45% of the total equity of the JV, to the Company as consideration for the Shockwave License Agreement (the “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 or a PRC subsidiary of the JV for commercialization and distribution in the PRC. In May 2022, the JV obtained regulatory approval from the China National Medical Products Administration to sell the Company-manufactured Shockwave IVL System with the Shockwave C 2 catheter, M 5 catheter and S 4 catheter in the PRC. The Company has accounted for its investment in the JV under the equity method of accounting. As of March 31, 2023, the carrying value of the Company’s investment in the JV was $2.7 million and the Company owned a 45% interest in the entity. During the three months ended March 31, 2023, the Company continued to recognize product revenue on sales to the JV and eliminate a portion of intra-entity profit to the extent the goods have not yet either been consumed by the JV for use in clinical trials, or sold by the JV to an end customer at the end of the reporting period. The profit earned by the Company from the JV for items not yet sold through to an end customer is eliminated through equity method earnings or loss which is recognized in income (loss) from equity method investment. The Company’s product revenue for products sold to the JV during the three months ended March 31, 2023 and related accounts receivable from the JV as of March 31, 2023 were immaterial. Intra-entity profit, which was recorded as a reduction to equity method investment as of and for the three months ended March 31, 2023, was also immaterial. For the three months ended March 31, 2023 and 2022, the Company’s loss from the equity method was $0.8 million and $47,000, respectively. 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 that were issued at the formation of the JV. As of March 31, 2023, the 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 for the JV manufactured product from the China National Medical Products Administration.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Income Tax Disclosure	Income Taxes On a quarterly basis, the Company provides for income taxes based upon an estimated annual effective income tax rate, adjusted for discrete items. The Company recognized income tax expense of $1.6 million and $0.2 million for the three months ended March 31, 2023 and 2022, respectively, representing an effective tax rate of 3.96% and 1.34%, respectively. The year-over-year increase in tax expense for the three-month period ended March 31, 2023 was primarily due to the valuation allowance on the U.S. federal and other-than-California state deferred tax assets as of March 31, 2022, which was released in the fourth quarter of fiscal year 2022. For the three months ended March 31, 2023, the effective tax rate differed from the U.S. federal statutory rate primarily due to stock-based compensation for tax purposes and research credits. For the three months ended March 31, 2022, the effective tax rate differed from the U.S. federal statutory rate primarily due to the valuation allowance on the U.S. deferred tax assets. The Company’s effective tax rate may be subject to fluctuation due to several factors, including the Company’s ability to accurately predict the pre-tax earnings in the various jurisdictions, valuation allowances against deferred tax assets, the recognition or de-recognition of tax benefits related to uncertain tax positions and the effects of tax law changes. During the fourth quarter of 2022, the Company determined that the positive evidence overcame any negative evidence, primarily due to the Company ’ s transition from a cumulative loss in recent years to cumulative income in 2022 and concluded that it was more likely than not that the U.S. federal and other-than-California state deferred tax assets were realizable. As a result, the Company released the valuation allowance against all of the U.S. federal deferred tax assets and other-than-California state deferred tax assets during the fourth quarter of fiscal year 2022.

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2023
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events Acquisition of Neovasc, Inc. On April 11, 2023, the Company completed the previously announced acquisition of Neovasc Inc. (“Neovasc”), a corporation existing under the Canada Business Corporations Act, in accordance with the Arrangement Agreement (the “Arrangement Agreement”). Pursuant to the Arrangement Agreement, the Company acquired all of the issued and outstanding common shares of Neovasc and Neovasc became a wholly owned subsidiary of the Company by means of a plan of arrangement under the Canada Business Corporations Act. Each common share of Neovasc that was issued and outstanding immediately prior to April 11, 2023 was transferred to the Company in exchange for $27.25 per share in cash and one contingent value right entitling the holder to receive up to $12.00 per share in cash, with such receipt and amount contingent on whether the U.S. Food and Drug Administration grants marketing approval for the device known as the Neovasc Reducer for the treatment of angina within specified timeframes set forth in the Arrangement Agreement Since the completion of the acquisition, the Company has paid a total of $107.2 million to Neovasc shareholders. Pay-off of Credit Agreement Draw On April 26, 2023, the Company repaid the $80.0 million drawn under the Credit Agreement in March 2023.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation 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, 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.
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 sheets. The Company records its proportionate share of the underlying income or loss which is recognized in earnings or loss from the equity method investment. The Company eliminates a portion of intra-entity profit to the extent the goods sold by the Company have not yet been sold through by the equity method investee to an end customer at the end of the reporting period. The profit earned by the Company from the equity method investee for items not yet sold through is eliminated through equity method earnings or loss which is recognized in income (loss) from equity method investment. The Company assesses its equity method investment for impairment when events or circumstances suggest that the carrying amount of the investment may be impaired. The Company considers 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.
Revenue	Revenue To determine revenue recognition for arrangements that an entity determines are within the scope of Topic 606, Revenue from Contracts with Customers, the Company performs the following five steps: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies a performance obligation. 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 has 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 generally 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 the Company’s functional intellectual property with a customer, the Company considers 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 were recognized for the three months ended March 31, 2023 and 2022.
Share-based Payment Arrangement	Stock-Based CompensationThe Company accounts for share-based payments at fair value. The fair value of stock options is measured using the Black-Scholes option-pricing model. For share-based awards that vest subject to the satisfaction of a service requirement, the fair value measurement date for stock-based compensation awards is the date of grant and the expense is recognized on a straight-line basis, over the vesting period. For share-based awards that vest upon the satisfaction of a performance target, the related compensation cost is recognized over the requisite service period based on the expected achievement of the performance target. The Company accounts for forfeitures as they occur.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Restrictions on Cash and Cash Equivalents	March 31, March 31, (in thousands) Cash and cash equivalents $ 280,932 $ 66,252 Restricted cash 1,715 1,665 Total cash, cash equivalents, and restricted cash $ 282,647 $ 67,917
Schedule of Cash and Cash Equivalents	March 31, March 31, (in thousands) Cash and cash equivalents $ 280,932 $ 66,252 Restricted cash 1,715 1,665 Total cash, cash equivalents, and restricted cash $ 282,647 $ 67,917

Financial Instruments and Fai_2

Financial Instruments and Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Schedule of Financial Assets and Liabilities Measured at Fair Value	The following tables summarize the Company’s financial assets measured at fair value on a recurring basis by level within the fair value hierarchy: March 31, 2023 Level 1 Level 2 Level 3 Total (in thousands) Assets: U.S. Treasury securities $ 95,282 $ — $ — $ 95,282 Money market funds 10,070 — — 10,070 Commercial paper — 8,139 — 8,139 Corporate bonds — 20,688 — 20,688 U.S. agency securities — 11,820 — 11,820 Total assets $ 105,352 $ 40,647 $ — $ 145,999 December 31, 2022 Level 1 Level 2 Level 3 Total (in thousands) Assets: U.S. Treasury securities $ 111,631 $ — $ — $ 111,631 Money market funds 12,076 — — 12,076 Commercial paper — 8,039 — 8,039 Corporate bonds — 18,808 — 18,808 U.S. agency securities — 9,429 — 9,429 Total assets $ 123,707 $ 36,276 $ — $ 159,983

Cash Equivalents and Short-Te_2

Cash Equivalents and Short-Term Investments (Tables)	3 Months Ended
	Mar. 31, 2023
Cash and Cash Equivalents [Abstract]
Summary of Cash Equivalents and Short-Term Investments	The following is a summary of the Company’s cash equivalents and short-term investments: March 31, 2023 Amortized Unrealized Unrealized Fair Value (in thousands) U.S. Treasury securities $ 95,784 $ 18 $ (520) $ 95,282 Money market funds 10,070 — — 10,070 Commercial paper 8,140 1 (2) 8,139 Corporate bonds 20,685 22 (19) 20,688 U.S. agency securities 11,804 16 — 11,820 Total $ 146,483 $ 57 $ (541) $ 145,999 Reported as: Cash equivalents $ 10,070 Short-term investments 135,929 Total $ 145,999 December 31, 2022 Amortized Unrealized Unrealized Fair Value (in thousands) U.S. Treasury securities $ 112,719 $ 3 $ (1,091) $ 111,631 Money market funds 12,076 — — 12,076 Commercial paper 8,039 — — 8,039 Corporate bonds 18,876 8 (76) 18,808 U.S. agency securities 9,432 4 (7) 9,429 Total $ 161,142 $ 15 $ (1,174) $ 159,983 Reported as: Cash equivalents $ 12,076 Short-term investments 147,907 Total $ 159,983
Summary of Remaining Contractual Maturities for Available-for-sale Securities	The remaining contractual maturities of the Company’s cash equivalents and short-term investments were as follows: March 31, Fair Value (in thousands) Money market funds $ 10,070 One year or less 112,680 Greater than one year and less than two years 23,249 Total $ 145,999

Balance Sheet Components (Table

Balance Sheet Components (Tables)	3 Months Ended
	Mar. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Inventory	Inventory consists of the following: March 31, December 31, (in thousands) Raw material $ 21,504 $ 18,456 Work in progress 10,722 7,666 Finished goods 50,737 48,735 Consigned inventory 293 255 Total inventory $ 83,256 $ 75,112
Schedule of Accrued Liabilities	Accrued liabilities consist of the following: March 31, December 31, (in thousands) Employee compensation $ 22,070 $ 32,885 Asset purchases 6,882 4,600 Research and development costs 4,118 4,007 Professional services 3,862 4,044 Excise, sales, income and other taxes 5,123 4,036 Other 7,585 5,803 Total accrued liabilities $ 49,640 $ 55,375

Term Notes (Tables)

Term Notes (Tables)	3 Months Ended
	Mar. 31, 2023
Debt Disclosure [Abstract]
Schedule of Current and Noncurrent Debt and Net Discount or Premium Balances	March 31, December 31, (in thousands) Principal amount of debt $ 105,000 $ 25,000 Debt issuance costs (769) (802) Debt 104,231 24,198 Less: debt, current portion (80,000) — Debt, noncurrent portion $ 24,231 $ 24,198

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2023
Share-Based Payment Arrangement [Abstract]
Schedule of Total Stock-Based Compensation	Total stock-based compensation was as follows: Three Months Ended 2023 2022 (in thousands) Cost of product revenue $ 954 $ 653 Research and development 3,795 2,238 Sales and marketing 6,466 3,932 General and administrative 4,752 2,687 Total stock-based compensation $ 15,967 $ 9,510
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: Number Weighted- Weighted- Aggregate (in years) (in thousands) Balance, December 31, 2022 1,122,009 $ 5.87 4.60 $ 224,115 Awards authorized — Options exercised (77,230) 4.12 Options cancelled (6,133) 2.41 Balance, March 31, 2023 1,038,646 $ 6.02 4.41 $ 218,961 Vested and exercisable, 1,038,503 $ 6.01 4.41 $ 218,935 Vested and expected to vest, 1,038,646 $ 6.02 4.41 $ 218,961
Schedule of RSU Activity under 2019 Plan	RSU and PRSU activity under the 2019 Plan is set forth below. Grant activity for all PRSUs is disclosed at target (100%): Restricted Stock Units Performance-Based Restricted Stock Units Number Weighted- Number Weighted- Balance, December 31, 2022 1,125,991 $ 127.39 38,797 $ 165.74 RSUs granted 293,007 191.06 29,473 191.36 RSUs forfeited (19,803) 145.72 (175) 278.52 RSUs vested (257,624) 97.37 — — Balance, March 31, 2023 1,141,571 150.18 68,095 176.54

Net Income (Loss) Per Share (Ta

Net Income (Loss) Per Share (Tables)	3 Months Ended
	Mar. 31, 2023
Earnings Per Share [Abstract]
Components of Basic and Diluted Net Income (Loss) Per Share	The components of basic and diluted net income per share were as follows (in thousands, except share and per share amounts): Three Months Ended 2023 2022 Numerator: Net income $ 39,125 $ 14,521 Denominator: Basic: Weighted average number of common shares outstanding - basic 36,427,263 35,587,337 Diluted: Weighted average number of common shares outstanding - basic 36,427,263 35,587,337 Dilutive effect of outstanding common stock options 1,039,985 1,437,748 Dilutive effect of restricted stock units 510,340 597,817 Dilutive effect of common stock pursuant to employee stock purchase plan 1,860 575 Weighted average number of common shares outstanding - diluted 37,979,448 37,623,477 Net income per share: Basic $ 1.07 $ 0.41 Diluted $ 1.03 $ 0.39

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2023
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 2023 2022 (in thousands) Coronary $ 113,875 $ 70,337 Peripheral 46,130 22,852 Other 1,061 442 Product revenue $ 161,066 $ 93,631 Three Months Ended 2023 2022 (in thousands) United States $ 131,623 $ 78,519 Europe 16,234 12,067 All other countries 13,209 3,045 Product revenue $ 161,066 $ 93,631

Organization and Basis of Pre_2

Organization and Basis of Presentation - Additional Information (Details) $ in Millions	Mar. 31, 2023 USD ($) subsidiary
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of foreign subsidiaries | subsidiary	11
Cash, cash equivalents and short-term investments | $	$ 416.9

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Schedule of Reconciliation of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022	[1]	Mar. 31, 2022
Accounting Policies [Abstract]
Cash and cash equivalents	$ 280,932	$ 156,586		$ 66,252
Restricted cash	1,715			1,665
Total cash, cash equivalents, and restricted cash	$ 282,647			$ 67,917
[1]The condensed consolidated balance sheet as of December 31, 2022 is derived from the audited consolidated financial statements as of that date.

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Additional Information (Details)	3 Months Ended
	Mar. 31, 2023 USD ($)
Accounting Policies [Abstract]
Notice period for cancellation of agreement	30 days
Revenue recognized	$ 0

Financial Instruments and Fai_3

Financial Instruments and Fair Value Measurements - Schedule of Financial Assets and Liabilities Measured at Fair Value (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Assets:
Unrealized Gains	$ 57	$ 15
US Government Agencies Debt Securities | Level 1
Assets:
Total assets	0	0
US Government Agencies Debt Securities | Level 2
Assets:
Total assets	11,820	9,429
Recurring
Assets:
Total assets	145,999	159,983
Recurring | Level 1
Assets:
Total assets	105,352	123,707
Recurring | Level 2
Assets:
Total assets	40,647	36,276
Recurring | Level 3
Assets:
Total assets	0	0
Recurring | U.S. Treasury securities
Assets:
Total assets	95,282	111,631
Recurring | U.S. Treasury securities | Level 1
Assets:
Total assets	95,282	111,631
Recurring | U.S. Treasury securities | Level 2
Assets:
Total assets	0	0
Recurring | U.S. Treasury securities | Level 3
Assets:
Total assets	0	0
Recurring | Money market funds
Assets:
Total assets	10,070	12,076
Recurring | Money market funds | Level 1
Assets:
Total assets	10,070	12,076
Recurring | Money market funds | Level 2
Assets:
Total assets	0	0
Recurring | Money market funds | Level 3
Assets:
Total assets	0	0
Recurring | Commercial paper
Assets:
Total assets	8,139	8,039
Recurring | Commercial paper | Level 1
Assets:
Total assets	0	0
Recurring | Commercial paper | Level 2
Assets:
Total assets	8,139	8,039
Recurring | Commercial paper | Level 3
Assets:
Total assets	0	0
Recurring | Corporate bonds
Assets:
Total assets	20,688	18,808
Recurring | Corporate bonds | Level 1
Assets:
Total assets	0	0
Recurring | Corporate bonds | Level 2
Assets:
Total assets	20,688	18,808
Recurring | Corporate bonds | Level 3
Assets:
Total assets	0	0
Recurring | US Government Agencies Debt Securities
Assets:
Total assets	11,820	9,429
Recurring | US Government Agencies Debt Securities | Level 3
Assets:
Total assets	$ 0	$ 0

Cash Equivalents and Short-Te_3

Cash Equivalents and Short-Term Investments - Summary of Cash Equivalents and Short-Term Investments (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Cash And Cash Equivalents [Line Items]
Money market funds	$ 10,070	$ 12,076
Cash equivalents and short-term investments, amortized cost basis	146,483	161,142
Unrealized Gains	57	15
Unrealized Losses	(541)	(1,174)
Short-term investments, fair value	11,820	9,429
Cash equivalents and short-term investments, fair value	145,999	159,983
Short-term investments	135,929	147,907	[1]
U.S. Treasury securities
Cash And Cash Equivalents [Line Items]
Short-term investments, amortized cost basis	95,784	112,719
Unrealized Gains	18	3
Unrealized Losses	(520)	(1,091)
Short-term investments, fair value	95,282	111,631
Money market funds
Cash And Cash Equivalents [Line Items]
Money market funds	10,070	12,076
Corporate Bond Securities
Cash And Cash Equivalents [Line Items]
Short-term investments, amortized cost basis	20,685	18,876
Unrealized Gains	22	8
Unrealized Losses	(19)	(76)
Short-term investments, fair value	20,688	18,808
Commercial paper
Cash And Cash Equivalents [Line Items]
Short-term investments, amortized cost basis	8,140	8,039
Unrealized Gains	1	0
Unrealized Losses	(2)	0
Short-term investments, fair value	8,139	8,039
US Government Agencies Debt Securities
Cash And Cash Equivalents [Line Items]
Short-term investments, amortized cost basis	11,804	9,432
Unrealized Gains	16	4
Unrealized Losses	$ 0	$ (7)
[1]The condensed consolidated balance sheet as of December 31, 2022 is derived from the audited consolidated financial statements as of that date.

Cash Equivalents and Short-Te_4

Cash Equivalents and Short-Term Investments - Summary of Remaining Contractual Maturities for Available-for-sale Securities (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Cash and Cash Equivalents [Abstract]
Money market funds	$ 10,070	$ 12,076
One year or less	112,680
Greater than one year and less than two years	23,249
Total	$ 145,999

Cash Equivalents and Short-Te_5

Cash Equivalents and Short-Term Investments - Narrative (Details) - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Cash and Cash Equivalents [Abstract]
Debt Securities, Available-for-Sale, Unrealized Loss Position	$ 76,400,000		$ 123,800,000
Debt Securities, Available-for-Sale, Continuous Unrealized Loss Position, 12 Months or Longer, Accumulated Loss	500,000		$ 1,200,000
Adjustment for net gain realized and included in other income	$ 5,000	$ 0

Balance Sheet Components - Sche

Balance Sheet Components - Schedule of Inventory (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Raw material	$ 21,504	$ 18,456
Work in progress	10,722	7,666
Finished goods	50,737	48,735
Consigned inventory	293	255
Total inventory	$ 83,256	$ 75,112	[1]
[1]The condensed consolidated balance sheet as of December 31, 2022 is derived from the audited consolidated financial statements as of that date.

Balance Sheet Components - Sc_2

Balance Sheet Components - Schedule of Accrued Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Employee compensation	$ 22,070	$ 32,885
Research and development costs	4,118	4,007
Asset purchases	6,882	4,600
Professional services	3,862	4,044
Excise, sales, income and other taxes	5,123	4,036
Other	7,585	5,803
Total accrued liabilities	$ 49,640	$ 55,375	[1]
[1]The condensed consolidated balance sheet as of December 31, 2022 is derived from the audited consolidated financial statements as of that date.

Term Notes - Additional Informa

Term Notes - Additional Information (Details) - USD ($)				3 Months Ended
	Apr. 26, 2023	Mar. 16, 2023	Oct. 19, 2022	Mar. 31, 2023	Mar. 31, 2022
Debt Instrument [Line Items]
Interest Expense				$ 636,000	$ 297,000
Subsequent Event | Loan and Security Agreement
Debt Instrument [Line Items]
Debt extinguished	$ 80,000,000
Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Proceeds of supplemental term loan		$ 80,000,000
Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity			$ 175,000,000
Incremental revolving commitments, maximum			100,000,000
Proceeds of supplemental term loan			$ 25,000,000
Line of Credit Facility, Interest Rate at Period End				5.60%
Secured Overnight Financing Rate (SOFR) | Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Debt interest rate basis			1%
Fed Funds Effective Rate Overnight Index Swap Rate | Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Debt interest rate basis			0.50%
Minimum | Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Debt interest rate basis			0%
Minimum | Base Rate | Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Debt interest rate basis			0%
Minimum | Secured Overnight Financing Rate (SOFR) | Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Debt interest rate basis			1%
Maximum | Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Debt interest rate basis			1%
Maximum | Base Rate | Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Debt interest rate basis			1%
Maximum | Secured Overnight Financing Rate (SOFR) | Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Debt interest rate basis			2%

Term Notes - Schedule of Curren

Term Notes - Schedule of Current and Noncurrent Debt and Net Discount or Premium Balances (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Debt Instrument, Periodic Payment [Abstract]
Principal amount of debt	$ 105,000	$ 25,000
Debt issuance costs	(769)	(802)
Debt	104,231	24,198
Less: debt, current portion	(80,000)	0
Debt, noncurrent portion	$ 24,231	$ 24,198

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Total Stock-Based Compensation (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	$ 15,967	$ 9,510
Cost of product revenue
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	954	653
Research and development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	3,795	2,238
Sales and marketing
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	6,466	3,932
General and administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation	$ 4,752	$ 2,687

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Details) - USD ($) $ in Thousands	1 Months Ended	3 Months Ended
	Feb. 28, 2019	Mar. 31, 2023	Mar. 31, 2022	Mar. 06, 2019
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation expenses capitalized amount		$ 400	$ 300
Common stock reserved for issuance (in shares)	2,000,430
Maximum period of automatic annual increase in common stock reserved for issuance	10 years
Automatic annual increase in common stock reserved for issuance	3%
Shares available for issuance (in shares)		3,765,125
Stock-based compensation expense		$ 15,967	9,510
Employee Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock reserved for issuance (in shares)				300,650
Shares available for issuance (in shares)		1,540,527
Purchase shares of common stock, price per share, percentage of fair market value		85%
Stock-based compensation expense		$ 1,300	$ 400
Performance-Based Restricted Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting percentage		100%
Performance-Based Restricted Stock Units | Minimum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period		2 years
Vesting percentage		0%
Performance-Based Restricted Stock Units | Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period		3 years
Vesting percentage		200%

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Number of Shares
Balance beginning of period (in shares)	1,122,009,000
Options exercised (in shares)	77,230,000
Options cancelled (in shares)	(6,133,000)
Balance end of period (in shares)	1,038,646,000	1,122,009,000
Vested and exercisable shares (in shares)	1,038,503,000
Vested and expected to vest shares (in shares)	1,038,646,000
Weighted- Average Exercise Price Per Share
Beginning balance of period (USD per share)	$ 5,870
Options exercised (USD per share)	4,120
Options cancelled (USD per share)	2,410
Ending balance of period (USD per share)	6,020	$ 5,870
Vested and exercisable shares (USD per share)	6,010
Vested and expected to vest shares (USD per share)	$ 6,020
Weighted- Average Remaining Term
Balance (USD per share)	4 years 4 months 28 days	4 years 7 months 6 days
Vested and exercisable, March 31, 2023	4 years 4 months 28 days
Vested and expected to vest,  March 31, 2023	4 years 4 months 28 days
Aggregate Intrinsic Value
Balance	$ 218,961	$ 224,115
Vested and exercisable, March 31, 2023	218,935
Vested and expected to vest,  March 31, 2023	$ 218,961

Stock-Based Compensation - Sc_3

Stock-Based Compensation - Schedule of RSU Activity (Details)	3 Months Ended
	Mar. 31, 2023 $ / shares shares
Restricted Stock Units
Number of Shares
Beginning balance of period (in shares) | shares	1,125,991,000
RSUs granted (in shares) | shares	293,007,000
RSUs forfeited (in shares) | shares	(19,803,000)
RSUs vested (in shares) | shares	(257,624,000)
Ending balance of period (in shares) | shares	1,141,571,000
Weighted-Average Grant Date Fair Value Per Share
Beginning balance of period (USD per share) | $ / shares	$ 127,390
RSUs granted (USD per share) | $ / shares	191,060
RSUs forfeited (USD per share) | $ / shares	145,720
RSUs vested (USD per share) | $ / shares	97,370
Ending balance of period (USD per share) | $ / shares	$ 150,180
Performance-Based Restricted Stock Units
Number of Shares
Beginning balance of period (in shares) | shares	38,797,000
RSUs granted (in shares) | shares	29,473,000
RSUs forfeited (in shares) | shares	(175,000)
RSUs vested (in shares) | shares	0
Ending balance of period (in shares) | shares	68,095,000
Weighted-Average Grant Date Fair Value Per Share
Beginning balance of period (USD per share) | $ / shares	$ 165,740
RSUs granted (USD per share) | $ / shares	191,360
RSUs forfeited (USD per share) | $ / shares	278,520
RSUs vested (USD per share) | $ / shares	0
Ending balance of period (USD per share) | $ / shares	$ 176,540

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
	Mar. 31, 2023	Mar. 31, 2022
Numerator:
Net income (loss)	$ 39,125	$ 14,521
Denominator:
Basic (in shares)	36,427,263	35,587,337
Diluted (in shares)	37,979,448	37,623,477
Net income per share:
Basic (USD per share)	$ 1.07	$ 0.41
Diluted (USD per share)	$ 1.03	$ 0.39
Stock Options
Denominator:
Dilutive effect of share-based payment arrangements (in shares)	1,039,985	1,437,748
Restricted Stock Units
Denominator:
Dilutive effect of share-based payment arrangements (in shares)	510,340	597,817
Employee Stock
Denominator:
Dilutive effect of share-based payment arrangements (in shares)	1,860	575

Revenue - Schedule of Product R

Revenue - Schedule of Product Revenue Based on Product Line (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Disaggregation Of Revenue [Line Items]
Product revenue	$ 161,066	$ 93,631
Coronary
Disaggregation Of Revenue [Line Items]
Product revenue	113,875	70,337
Peripheral
Disaggregation Of Revenue [Line Items]
Product revenue	46,130	22,852
Other
Disaggregation Of Revenue [Line Items]
Product revenue	$ 1,061	$ 442

Revenue - Schedule of Product_2

Revenue - Schedule of Product Revenue Based on Location (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Disaggregation Of Revenue [Line Items]
Product revenue	$ 161,066	$ 93,631
United States
Disaggregation Of Revenue [Line Items]
Product revenue	131,623	78,519
Europe
Disaggregation Of Revenue [Line Items]
Product revenue	16,234	12,067
All other countries
Disaggregation Of Revenue [Line Items]
Product revenue	$ 13,209	$ 3,045

Equity Method Investments - Add

Equity Method Investments - Additional Information (Details) - USD ($)		3 Months Ended
	Mar. 19, 2021	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022	[1]
Schedule Of Equity Method Investments [Line Items]
Equity method investment		$ 2,689,000		$ 3,512,000
Loss from equity method investment		823,000	$ 47,000
Related party contract liability, noncurrent portion		12,273,000		$ 12,273,000
Joint Venture
Schedule Of Equity Method Investments [Line Items]
Percentage of equity stake received	45%
Related party transaction. transaction price	$ 12,300,000
Related party contract liability, noncurrent portion	$ 12,300,000
JV Agreement with Genesis MedTech
Schedule Of Equity Method Investments [Line Items]
Equity method investment		$ 2,700,000
JV Agreement with Genesis MedTech | Share Subscription Agreement
Schedule Of Equity Method Investments [Line Items]
Ordinary shares issued (in shares)	54,900
Equity percentage	55%
Cash contribution from exchange of equity	$ 15,000,000
Percentage of cash contribution received from exchange of equity upon signing of agreement	50%
Percentage of cash contribution receivable from exchange of equity within one year	50%
JV Agreement with Genesis MedTech | License Agreement
Schedule Of Equity Method Investments [Line Items]
Ordinary shares issued (in shares)	45,000
Equity percentage	45%
[1]The condensed consolidated balance sheet as of December 31, 2022 is derived from the audited consolidated financial statements as of that date.

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Tax Disclosure [Abstract]
Income tax expense	$ 1,612	$ 197
Federal statutory income tax rate	3.96%	1.34%

Subsequent Events (Details)

Subsequent Events (Details) - USD ($) $ / shares in Units, $ in Millions				1 Months Ended
	Apr. 26, 2023	Apr. 11, 2023	Mar. 16, 2023	May 03, 2023
Revolving Credit Facility | Line of Credit
Subsequent Event [Line Items]
Proceeds of supplemental term loan			$ 80
Subsequent Event | Loan and Security Agreement
Subsequent Event [Line Items]
Debt extinguished	$ 80
Subsequent Event | Neovasc Inc
Subsequent Event [Line Items]
Business Acquisition, Share Price		$ 27.25
Payments to Acquire Businesses, Gross				$ 107.2
Subsequent Event | Neovasc Inc | Business Combination, Contingent Consideration Arrangements, Maximum Value Per Share
Subsequent Event [Line Items]
business combination, contingent consideration, per share		$ 12