Merit Medical Systems (MMSI) 10-Q 26 Oct 23 2023 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2023	Oct. 24, 2023
Cover page.
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2023
Entity File Number	0-18592
Entity Registrant Name	MERIT MEDICAL SYSTEMS INC
Entity Incorporation, State or Country Code	UT
Entity Central Index Key	0000856982
Entity Tax Identification Number	87-0447695
Entity Address, Address Line One	1600 West Merit Parkway
Entity Address, City or Town	South Jordan
Entity Address, State or Province	UT
Entity Address, Postal Zip Code	84095
City Area Code	801
Local Phone Number	253-1600
Title of 12(b) Security	Common Stock, no par value
Trading Symbol	MMSI
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		57,750,462
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 58,673	$ 58,408
Trade receivables - net of allowance for credit losses - 2023 - $8,721 and 2022 - $8,423	167,824	164,677
Other receivables	13,576	12,992
Inventories	303,923	265,991
Prepaid expenses and other current assets	27,954	22,324
Prepaid income taxes	3,936	3,913
Income tax refund receivables	9,432	779
Total current assets	585,318	529,084
Property and equipment:
Land and land improvements	26,017	25,940
Buildings	190,825	189,148
Manufacturing equipment	313,600	299,089
Furniture and fixtures	66,451	61,128
Leasehold improvements	53,208	49,673
Construction-in-progress	60,492	61,269
Total property and equipment	710,593	686,247
Less accumulated depreciation	(327,267)	(303,271)
Property and equipment - net	383,326	382,976
Other assets:
Goodwill	381,052	359,821
Deferred income tax assets	6,438	6,599
Right-of-use operating lease assets	63,633	65,262
Other assets	48,545	44,352
Total other assets	839,861	751,906
Total assets	1,808,505	1,663,966
Current liabilities:
Trade payables	48,862	68,504
Accrued expenses	119,291	123,189
Current portion of long-term debt	3,750	11,250
Short-term operating lease liabilities	11,688	11,005
Income taxes payable	3,542	6,697
Total current liabilities	187,133	220,645
Long-term debt	282,370	186,759
Deferred income tax liabilities	18,458	18,462
Long-term income taxes payable	347	347
Liabilities related to unrecognized tax benefits	1,912	1,912
Deferred compensation payable	15,508	15,264
Deferred credits	1,631	1,708
Long-term operating lease liabilities	57,455	59,736
Other long-term obligations	13,806	14,736
Total liabilities	578,620	519,569
Commitments and contingencies
Stockholders' equity:
Preferred stock - 5,000 shares authorized as of September 30, 2023 and December 31, 2022; no shares issued
Common stock, no par value; 100,000 shares authorized; issued and outstanding as of September 30, 2023 - 57,746 and December 31, 2022 - 57,306	695,181	675,174
Retained earnings	547,555	480,773
Accumulated other comprehensive loss	(12,851)	(11,550)
Total stockholders' equity	1,229,885	1,144,397
Total liabilities and stockholders' equity	1,808,505	1,663,966
Developed technology
Other assets:
Intangible assets	296,349	237,522
Other
Other assets:
Intangible assets	$ 43,844	$ 38,350

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Trade receivables, allowances	$ 8,721	$ 8,423
Stockholders' equity:
Preferred stock shares authorized (in shares)	5,000	5,000
Preferred stock shares issued (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0	$ 0
Common stock shares authorized (in shares)	100,000	100,000
Common stock shares issued (in shares)	57,746	57,306
Common stock shares outstanding (in shares)	57,746	57,306
Developed technology
Other assets:
Intangibles, accumulated amortization	$ 308,889	$ 274,570
Other
Other assets:
Intangibles, accumulated amortization	$ 76,909	$ 69,780

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Net sales	$ 315,230	$ 287,175	$ 932,851	$ 857,566
Cost of sales	173,031	158,602	499,508	473,019
Gross profit	142,199	128,573	433,343	384,547
Operating expenses:
Selling, general and administrative	86,854	89,780	277,925	259,282
Research and development	19,646	19,221	61,089	55,074
Impairment charges			270	1,672
Contingent consideration expense	562	915	2,177	4,702
Acquired in-process research and development			1,550	6,671
Total operating expenses	107,062	109,916	343,011	327,401
Income from operations	35,137	18,657	90,332	57,146
Other income (expense):
Interest income	181	116	533	316
Interest expense	(4,841)	(1,831)	(10,534)	(4,180)
Other income (expense) - net	(255)	660	291	(808)
Total other expense - net	(4,915)	(1,055)	(9,710)	(4,672)
Income before income taxes	30,222	17,602	80,622	52,474
Income tax expense	4,388	2,330	13,840	11,359
Net income	$ 25,834	$ 15,272	$ 66,782	$ 41,115
Earnings per common share
Basic (in dollars per share)	$ 0.45	$ 0.27	$ 1.16	$ 0.73
Diluted (in dollars per share)	$ 0.44	$ 0.27	$ 1.14	$ 0.71
Weighted average shares outstanding
Basic (in shares)	57,682	56,835	57,525	56,707
Diluted (in shares)	58,375	57,586	58,345	57,573

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 25,834	$ 15,272	$ 66,782	$ 41,115
Other comprehensive income:
Cash flow hedges	(539)	3,850	1,192	13,182
Income tax benefit (expense)	129	(942)	(286)	(3,226)
Foreign currency translation adjustment	(2,914)	(9,003)	(2,190)	(18,775)
Income tax benefit (expense)	17	85	(17)	81
Total other comprehensive loss	(3,307)	(6,010)	(1,301)	(8,738)
Total comprehensive income	$ 22,527	$ 9,262	$ 65,481	$ 32,377

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands	Common Stock	Retained Earnings	Accumulated Other Comprehensive Loss	Total
Beginning balance at Dec. 31, 2021	$ 641,533	$ 406,257	$ (7,991)	$ 1,039,799
Beginning balance (in shares) at Dec. 31, 2021	56,570
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		10,545		10,545
Other comprehensive income (loss)			1,338	1,338
Stock-based compensation expense	$ 4,212			4,212
Options exercised	$ 1,320			1,320
Options exercised (in shares)	52
Issuance of common stock under Employee Stock Purchase Plan	$ 320			320
Issuance of common stock under Employee Stock Purchase Plan (in shares)	5
Shares issued from time-vested restricted stock units (in shares)	44
Shares surrendered in exchange for payment of payroll tax liabilities	$ (1,015)			(1,015)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)	(16)
Ending balance at Mar. 31, 2022	$ 646,370	416,802	(6,653)	1,056,519
Ending balance (in shares) at Mar. 31, 2022	56,655
Beginning balance at Dec. 31, 2021	$ 641,533	406,257	(7,991)	1,039,799
Beginning balance (in shares) at Dec. 31, 2021	56,570
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income				41,115
Other comprehensive income (loss)				(8,738)
Shares surrendered in exchange for exercise of stock options				(898)
Ending balance at Sep. 30, 2022	$ 658,198	447,372	(16,729)	1,088,841
Ending balance (in shares) at Sep. 30, 2022	56,918
Beginning balance at Mar. 31, 2022	$ 646,370	416,802	(6,653)	1,056,519
Beginning balance (in shares) at Mar. 31, 2022	56,655
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		15,298		15,298
Other comprehensive income (loss)			(4,066)	(4,066)
Stock-based compensation expense	$ 3,952			3,952
Options exercised	$ 1,303			1,303
Options exercised (in shares)	58
Issuance of common stock under Employee Stock Purchase Plan	$ 301			301
Issuance of common stock under Employee Stock Purchase Plan (in shares)	6
Shares issued from time-vested restricted stock units (in shares)	26
Ending balance at Jun. 30, 2022	$ 651,926	432,100	(10,719)	1,073,307
Ending balance (in shares) at Jun. 30, 2022	56,745
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		15,272		15,272
Other comprehensive income (loss)			(6,010)	(6,010)
Stock-based compensation expense	$ 3,893			3,893
Options exercised	$ 4,141			4,141
Options exercised (in shares)	201
Issuance of common stock under Employee Stock Purchase Plan	$ 246			246
Issuance of common stock under Employee Stock Purchase Plan (in shares)	5
Shares surrendered in exchange for payment of payroll tax liabilities	$ (1,110)			(1,110)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)	(18)
Shares surrendered in exchange for exercise of stock options	$ (898)			(898)
Shares surrendered in exchange for exercise of stock options (in shares)	(15)
Ending balance at Sep. 30, 2022	$ 658,198	447,372	(16,729)	1,088,841
Ending balance (in shares) at Sep. 30, 2022	56,918
Beginning balance at Dec. 31, 2022	$ 675,174	480,773	(11,550)	$ 1,144,397
Beginning balance (in shares) at Dec. 31, 2022	57,306			57,306
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		20,703		$ 20,703
Other comprehensive income (loss)			621	621
Stock-based compensation expense	$ 3,498			3,498
Options exercised	$ 3,726			3,726
Options exercised (in shares)	123
Issuance of common stock under Employee Stock Purchase Plan	$ 302			302
Issuance of common stock under Employee Stock Purchase Plan (in shares)	4
Shares issued from time-vested restricted stock units (in shares)	61
Shares surrendered in exchange for payment of payroll tax liabilities	$ (1,592)			(1,592)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)	(22)
Ending balance at Mar. 31, 2023	$ 681,108	501,476	(10,929)	1,171,655
Ending balance (in shares) at Mar. 31, 2023	57,472
Beginning balance at Dec. 31, 2022	$ 675,174	480,773	(11,550)	$ 1,144,397
Beginning balance (in shares) at Dec. 31, 2022	57,306			57,306
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income				$ 66,782
Other comprehensive income (loss)				(1,301)
Shares surrendered in exchange for exercise of stock options				(5,809)
Ending balance at Sep. 30, 2023	$ 695,181	547,555	(12,851)	$ 1,229,885
Ending balance (in shares) at Sep. 30, 2023	57,746			57,746
Beginning balance at Mar. 31, 2023	$ 681,108	501,476	(10,929)	$ 1,171,655
Beginning balance (in shares) at Mar. 31, 2023	57,472
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		20,245		20,245
Other comprehensive income (loss)			1,385	1,385
Stock-based compensation expense	$ 4,980			4,980
Options exercised	$ 5,154			5,154
Options exercised (in shares)	128
Issuance of common stock under Employee Stock Purchase Plan	$ 281			281
Issuance of common stock under Employee Stock Purchase Plan (in shares)	4
Shares issued from time-vested restricted stock units (in shares)	30
Ending balance at Jun. 30, 2023	$ 691,523	521,721	(9,544)	1,203,700
Ending balance (in shares) at Jun. 30, 2023	57,634
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		25,834		25,834
Other comprehensive income (loss)			(3,307)	(3,307)
Stock-based compensation expense	$ 5,206			5,206
Options exercised	$ 7,555			7,555
Options exercised (in shares)	247
Issuance of common stock under Employee Stock Purchase Plan	$ 237			237
Issuance of common stock under Employee Stock Purchase Plan (in shares)	4
Shares surrendered in exchange for payment of payroll tax liabilities	$ (3,531)			(3,531)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)	(53)
Shares surrendered in exchange for exercise of stock options	$ (5,809)			(5,809)
Shares surrendered in exchange for exercise of stock options (in shares)	(86)
Ending balance at Sep. 30, 2023	$ 695,181	$ 547,555	$ (12,851)	$ 1,229,885
Ending balance (in shares) at Sep. 30, 2023	57,746			57,746

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 66,782	$ 41,115
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	66,359	61,312
Loss on disposition of business		1,389
Loss on sale or abandonment of property and equipment	4,761	196
Write-off of certain intangible assets and other long-term assets	461	1,733
Acquired in-process research and development	1,550	6,671
Amortization of right-of-use operating lease assets	8,621	7,819
Adjustments related to contingent consideration liabilities	2,177	2,888
Amortization of deferred credits	(78)	(81)
Amortization of long-term debt issuance costs	744	453
Stock-based compensation expense	15,346	13,691
Changes in operating assets and liabilities, net of acquisitions and divestitures:
Trade receivables	(3,852)	(9,063)
Other receivables	(1,040)	5,669
Inventories	(34,426)	(30,735)
Prepaid expenses and other current assets	(72)	(4,186)
Prepaid income taxes	(24)
Income tax refund receivables	(8,682)	(1,713)
Other assets	(719)	1,848
Trade payables	(20,332)	9,752
Accrued expenses	(599)	(8,861)
Income taxes payable	(3,431)	(1,374)
Deferred compensation payable	245	(3,325)
Operating lease liabilities	(8,573)	(8,406)
Other long-term obligations	(2,318)	(509)
Total adjustments	16,118	45,168
Net cash, cash equivalents, and restricted cash provided by operating activities	82,900	86,283
Capital expenditures for:
Property and equipment	(27,151)	(32,539)
Intangible assets	(1,756)	(1,909)
Proceeds from the sale of property and equipment	181	63
Payments from disposition of business		(971)
Cash paid in acquisitions, net of cash acquired	(138,278)	(4,712)
Net cash, cash equivalents, and restricted cash used in investing activities	(167,004)	(40,068)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of common stock	11,446	6,733
Proceeds from issuance of long-term debt	480,499	172,336
Payments on long-term debt	(391,624)	(198,593)
Long-term debt issuance costs	(5,240)
Contingent payments related to acquisitions	(3,502)	(32,862)
Payment of taxes related to an exchange of common stock	(5,123)	(2,125)
Net cash, cash equivalents, and restricted cash provided by (used in) financing activities	86,456	(54,511)
Effect of exchange rates on cash, cash equivalents, and restricted cash	(2,181)	(5,862)
Net increase (decrease) in cash, cash equivalents and restricted cash	171	(14,158)
CASH, CASH EQUIVALENTS AND RESTRICTED CASH:
Beginning of period	60,558	67,750
End of period	60,729	53,592
RECONCILIATION OF CASH, CASH EQUIVALENTS AND RESTRICTED CASH TO THE CONSOLIDATED BALANCE SHEETS:
Cash and cash equivalents	58,673	51,481
Restricted cash reported in prepaid expenses and other current assets	$ 2,056	$ 2,111
Restricted Cash and Cash Equivalents, Current, Statement of Financial Position [Extensible Enumeration]	Prepaid Expense and Other Assets, Current	Prepaid Expense and Other Assets, Current
Total cash, cash equivalents and restricted cash	$ 60,729	$ 53,592
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION
Interest (net of capitalized interest of $941 and $565, respectively)	9,572	4,087
Income taxes	24,875	14,013
SUPPLEMENTAL DISCLOSURES OF NON-CASH INVESTING AND FINANCING ACTIVITIES
Property and equipment purchases in accounts payable	4,613	1,899
Acquisition purchases in accrued expenses and other long-term obligations	3,674	4,526
Merit common stock surrendered (86 and 15 shares, respectively) in exchange for exercise of stock options	5,809	898
Right-of-use operating lease assets obtained in exchange for operating lease liabilities	$ 7,560	$ 8,948

CONSOLIDATED STATEMENTS OF CA_2

CONSOLIDATED STATEMENTS OF CASH FLOWS (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Statement of Cash Flows [Abstract]
Net capitalized interest	$ 941	$ 565
Common stock surrendered in exchange for exercise of stock options (in shares)	86	15

Basis of Presentation and Other

Basis of Presentation and Other Items	9 Months Ended
	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Other Items	1. Basis of Presentation and Other Items.

Recently Adopted Financial Acco

Recently Adopted Financial Accounting Standards	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Recently Adopted Financial Accounting Standards	2. Recently Adopted Financial Accounting Standards. In March 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting , which provides temporary optional expedients and exceptions in accounting for modifications of contracts that reference the London interbank offered rate (“LIBOR”) or another reference rate expected to be discontinued as a result of reference rate reform. Entities can elect not to apply certain modification accounting requirements to contracts affected by what the guidance calls “reference rate reform” if certain criteria are met. An entity that makes this election would not have to remeasure the contracts at the modification date or reassess a previous accounting determination. Also, entities can elect various optional expedients that would allow them to continue applying hedge accounting for hedging relationships affected by reference rate reform if certain criteria are met. In December 2022, the FASB issued ASU 2022-06, Deferral of the Sunset Date of Topic 848 , which defers the sunset date of the guidance in ASC 848 to December 31, 2024. During the quarter ended June 30, 2023, we transitioned our interest rate swap agreement to reference the Secured Overnight Financing Rate (“SOFR”) in connection with reference rate reform and adopted certain optional expedients provided in ASU 2020-04 in relation to contract modifications and hedge accounting that allowed us to continue hedge accounting for our interest rate swap cash flow hedges (see Note 9). The adoption of this guidance did not have a material impact on our consolidated financial statements. Recently Issued Accounting Standards. ​

Revenue from Contracts with Cus

Revenue from Contracts with Customers	9 Months Ended
	Sep. 30, 2023
Revenue from Contract with Customer [Abstract]
Revenue from Contracts with Customers	3. Revenue from Contracts with Customers. We recognize revenue when a customer obtains control of promised goods. The amount of revenue recognized reflects the consideration we expect to receive in exchange for these goods. Our revenue recognition policies have not changed from those disclosed in Note 1 to our consolidated financial statements in Item 8 of the 2022 Annual Report on Form 10-K. Disaggregation of Revenue Our revenue is disaggregated based on reporting segment, product category and geographical region. We design, develop, manufacture and market medical products for interventional and diagnostic procedures. For financial reporting purposes, we report our operations in two operating segments: cardiovascular and endoscopy. Our cardiovascular segment consists of four product categories: peripheral intervention, cardiac intervention, custom procedural solutions, and original equipment manufacturer (“OEM”). Within these product categories, we sell a variety of products, including cardiology and radiology devices (which assist in diagnosing and treating coronary arterial disease, peripheral vascular disease and other non-vascular diseases), as well as embolotherapeutic, cardiac rhythm management, electrophysiology, critical care, breast cancer localization and guidance, biopsy, and interventional oncology and spine devices. Our endoscopy segment consists of gastroenterology and pulmonology devices which assist in the palliative treatment of expanding esophageal, tracheobronchial and biliary strictures caused by malignant tumors. The following tables present revenue from contracts with customers by reporting segment, product category and geographical region for the three and nine-month periods ended September 30, 2023 and 2022 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Three Months Ended ​ ​ September 30, 2023 ​ September 30, 2022 ​ United States International Total United States International Total Cardiovascular ​ ​ ​ ​ ​ ​ ​ Peripheral Intervention ​ $ 78,617 ​ $ 49,768 ​ $ 128,385 ​ $ 67,200 ​ $ 43,498 ​ $ 110,698 Cardiac Intervention ​ 36,593 ​ ​ 52,513 ​ 89,106 ​ 33,194 ​ ​ 53,654 ​ 86,848 Custom Procedural Solutions ​ 29,602 ​ ​ 19,022 ​ 48,624 ​ 27,078 ​ ​ 18,614 ​ 45,692 OEM ​ 34,207 ​ ​ 5,762 ​ 39,969 ​ 29,425 ​ ​ 6,286 ​ 35,711 Total ​ 179,019 ​ ​ 127,065 ​ 306,084 ​ 156,897 ​ 122,052 ​ 278,949 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy Devices ​ 8,486 ​ 660 ​ 9,146 ​ 7,674 ​ ​ 552 ​ 8,226 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ $ 187,505 ​ $ 127,725 ​ $ 315,230 ​ $ 164,571 ​ $ 122,604 ​ $ 287,175 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ Nine Months Ended ​ ​ September 30, 2023 ​ September 30, 2022 ​ United States International Total United States International Total Cardiovascular ​ ​ ​ ​ ​ ​ ​ ​ Peripheral Intervention ​ $ 219,257 ​ $ 148,820 ​ $ 368,077 ​ $ 195,095 ​ $ 132,331 ​ $ 327,426 Cardiac Intervention ​ 106,588 ​ ​ 161,621 ​ 268,209 ​ 95,652 ​ 162,257 ​ 257,909 Custom Procedural Solutions ​ 85,556 ​ ​ 60,153 ​ 145,709 ​ 80,951 ​ 60,096 ​ 141,047 OEM ​ 101,341 ​ ​ 21,999 ​ 123,340 ​ 87,269 ​ 18,904 ​ 106,173 Total ​ 512,742 ​ ​ 392,593 ​ 905,335 ​ 458,967 ​ 373,588 ​ 832,555 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy Devices ​ 25,705 ​ 1,811 ​ 27,516 ​ 23,270 ​ 1,741 ​ 25,011 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ $ 538,447 ​ $ 394,404 ​ $ 932,851 ​ $ 482,237 ​ $ 375,329 ​ $ 857,566 ​

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2023
Business Combinations [Abstract]
Acquisitions	4. Acquisitions. On June 8, 2023, we entered into an asset purchase agreement with AngioDynamics, Inc. (“AngioDynamics”) to acquire the assets associated with a portfolio of dialysis catheter products and the BioSentry® Biopsy Tract Sealant System for a purchase price of $100 million. We accounted for this acquisition as a business combination. The sales related to the acquisition have been included in our cardiovascular segment since the acquisition date and were approximately $7.3 and $8.3 million for the three and nine-month periods ended September 30, 2023, respectively. It is not practical to separately report earnings related to the acquisition, as we cannot split out sales costs related solely to the products acquired, principally because our sales representatives sell multiple products within our cardiovascular business segment. Acquisition-related costs associated with the AngioDynamics acquisition, which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were approximately $0.1 million and $4.9 million for the three and nine-month periods ended September 30, 2023, respectively. The purchase price was preliminarily allocated as follows (in thousands): ​ ​ ​ ​ ​ Assets Acquired ​ Prepaid expenses ​ $ 2,000 Inventories ​ 5,254 Property and equipment ​ ​ 108 Intangible assets ​ ​ Developed technology ​ ​ 65,200 Trademarks ​ ​ 4,000 Customer list ​ ​ 5,800 Goodwill ​ ​ 17,638 Total net assets acquired ​ $ 100,000 ​ We are amortizing the AngioDynamics developed technology intangible assets over nine years, the trademark intangible assets over 11 years, and the customer list intangible asset on an accelerated basis over ten years. We have estimated the weighted average life of the intangible assets acquired from AngioDynamics to be 10.5 years. impracticable to obtain information to determine earnings associated with the acquired product lines which represent only a small portion of the product lines of a large, consolidated company without standalone financial information. On May 4, 2023, we entered into an asset purchase agreement to acquire the assets associated with the Surfacer® Inside-Out® Access Catheter System from Bluegrass Vascular Technologies, Inc. (“Bluegrass”), for a purchase price of $32.7 million. Prior to the acquisition, we held an equity investment of 1,251,878 Bluegrass common shares representing approximately 19.5% ownership in Bluegrass. The fair value of this previously-held equity investment of approximately $245,000 is included in the purchase price allocation. We accounted for this acquisition as a business combination. The sales and results of operations related to the acquisition have been included in our cardiovascular segment since the acquisition date and were not material. Acquisition-related costs associated with the Bluegrass acquisition, which were included in selling, general and administrative expenses in the accompanying consolidated statements of income, were not material. The purchase price was preliminarily allocated as follows (in thousands): ​ ​ ​ ​ ​ Assets Acquired ​ Inventories ​ $ 175 Intangible assets ​ ​ Developed technology ​ ​ 28,000 Trademarks ​ ​ 900 Goodwill ​ ​ 3,898 Total net assets acquired ​ $ 32,973 ​ We are amortizing the Bluegrass developed technology intangible asset over 15 years and the related trademarks over 13 years. We have estimated the weighted average life of the intangible assets acquired from Bluegrass to be 14.9 years. ​ On May 1, 2023, we entered into an asset purchase agreement to acquire certain assets from Advanced Radiation Therapy, LLC (“ART”), related to intellectual property rights for soft tissue markers. The total purchase price of the ART assets included an up-front payment of $750,000, a deferred payment of $750,000 payable upon the first to occur of (1) shipment and installation of two commercial production winders used to manufacture the product or (2) 30 days after delivery of the winders to Merit, and, a deferred payment of $500,000 payable upon regulatory approval from the U.S. Food and Drug Administration for Merit to commence commercialization, marketing and sale of the product in the United States. We have accounted for this transaction as an asset purchase and recorded $1.5 million of acquired in-process research and development expense associated with the upfront payment and completion of the milestone related to the installation of the commercial production winders. The payments are reported within operating expenses because the technological feasibility of the underlying research and development project has not yet been reached and such technology has no identified future alternative use as of the date of acquisition. ​ We entered into a stock purchase agreement on January 11, 2023, and an exclusive distribution agreement on April 5, 2023, with Solo Pace Inc. ("Solo Pace”), owner and developer of a temporary external pulse generator and grounding pad with associated remote control module. Pursuant to these agreements, we paid $4.0 million to acquire (a) shares of Series Seed-1 Preferred Stock of Solo Pace, (b) an option to purchase the outstanding equity of Solo Pace within the earlier of five years after product commercialization or within 120 days after the twelve-month period wherein sales of the Solo Pace product exceed $6.0 million, and (c) exclusive rights to distribute the Solo Pace product upon commercialization. The shares of Solo Pace stock have been reflected within other assets in the accompanying consolidated balance sheets. Our investment in Solo Pace represents an ownership of approximately 19% of its outstanding capital stock and has been recorded as an equity investment accounted for at cost because the equity interest does not have a readily determinable fair value and because we are not able to exercise significant influence over the operations of Solo Pace.

Inventories

Inventories	9 Months Ended
	Sep. 30, 2023
Inventory Disclosure [Abstract]
Inventories	5. Inventories. Inventories at September 30, 2023 and December 31, 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2023 December 31, 2022 Finished goods ​ $ 156,074 ​ $ 147,051 Work-in-process ​ 34,092 ​ 29,534 Raw materials ​ 113,757 ​ 89,406 Total inventories ​ $ 303,923 ​ $ 265,991 ​

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	6. Goodwill and Intangible Assets. The change in the carrying amount of goodwill for the nine-month period ended September 30, 2023 is detailed as follows (in thousands): ​ ​ ​ ​ ​ ​ 2023 Goodwill balance at January 1 ​ $ 359,821 Effect of foreign exchange ​ (305) Additions and adjustments as the result of acquisitions ​ 21,536 Goodwill balance at September 30 ​ $ 381,052 ​ Total accumulated goodwill impairment losses aggregated $8.3 million as of September 30, 2023 and December 31, 2022, respectively. We did not have any goodwill impairments for the nine-month periods ended September 30, 2023 or 2022. The total goodwill balances as of September 30, 2023 and December 31, 2022 were related to our cardiovascular segment. ​ Other intangible assets at September 30, 2023 and December 31, 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2023 ​ ​ Gross Carrying ​ Accumulated ​ Net Carrying ​ Amount Amortization Amount Patents ​ $ 30,969 ​ $ (12,657) ​ $ 18,312 Distribution agreements ​ 3,250 ​ (2,868) ​ 382 License agreements ​ 11,128 ​ (8,076) ​ 3,052 Trademarks ​ 35,119 ​ (19,998) ​ 15,121 Customer lists ​ 40,287 ​ (33,310) ​ 6,977 Total ​ $ 120,753 ​ $ (76,909) ​ $ 43,844 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 2022 ​ ​ Gross Carrying ​ Accumulated ​ Net Carrying ​ Amount Amortization Amount Patents ​ $ 29,445 ​ $ (10,203) ​ $ 19,242 Distribution agreements ​ 3,250 ​ (2,715) ​ 535 License agreements ​ 11,109 ​ (7,250) ​ 3,859 Trademarks ​ 30,221 ​ (17,863) ​ 12,358 Customer lists ​ 34,105 ​ (31,749) ​ 2,356 Total ​ $ 108,130 ​ $ (69,780) ​ $ 38,350 ​ Aggregate amortization expense for the three and nine-month periods ended September 30, 2023 was $15.4 million and $41.1 million, respectively. Aggregate amortization expense for the three and nine-month periods ended September 30, 2022 was $12.1 million and $36.3 million, respectively. ​ We evaluate long-lived assets, including amortizing intangible assets, for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We perform the impairment analysis at the asset group for which the lowest level of identifiable cash flows is largely independent of the cash flows of other assets and liabilities. We determine the fair value of our amortizing assets based on estimated future cash flows discounted back to their present value using a discount rate that reflects the risk profiles of the underlying activities. ​ For the nine-month period ended September 30, 2022, we identified indicators of impairment associated with certain acquired intangible assets based on our qualitative assessment, which led us to complete an interim quantitative impairment assessment. The primary indicator of impairment was our divestiture of the STD Pharmaceutical Products Limited (“STD Pharmaceutical”) business acquired in our August 2019 acquisition of Fibrovein Holdings Limited. On April 30, 2022, we completed the divestiture of Fibrovein Holdings Limited, in exchange for the termination of our obligations arising from the acquisition and the purchaser’s agreement to make potential future payments upon a qualifying disposition of the STD Pharmaceutical business. We recorded an impairment charge for the carrying value of $1.7 million of intangible assets during the nine months ended September 30, 2022 , all of which pertained to our cardiovascular segment. ​ Estimated amortization expense for developed technology and other intangible assets for the next five years consisted of the following as of September 30, 2023 (in thousands): ​ ​ ​ ​ ​ Estimated Amortization Expense Remaining 2023 ​ $ 15,764 2024 ​ 59,656 2025 ​ 57,661 2026 ​ ​ 46,955 2027 ​ 43,774 ​

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Income Taxes	​ 7. Income Taxes. The Organization for Economic Cooperation and Development (“OECD”) Pillar 2 global minimum tax rules, which generally provide for a minimum effective tax rate of 15%, are intended to apply for tax years beginning in 2024. On February 2, 2023, the OECD issued administrative guidance providing transition and safe harbor rules around the implementation of the Pillar 2 global minimum tax. Under a transitional safe harbor released July 17, 2023, the undertaxed profits rule top-up tax in the jurisdiction of a company's ultimate parent entity will be zero for each fiscal year of the transition period, if that jurisdiction has a corporate tax rate of at least 20%. The safe harbor transition period will apply to fiscal years beginning on or before December 31, 2025 and ending before December 31, 2026. We are closely monitoring developments and evaluating the impact these new rules are anticipated to have on our tax rate, including eligibility to qualify for these safe harbor rules. ​

Revolving Credit Facility and L

Revolving Credit Facility and Long-Term Debt	9 Months Ended
	Sep. 30, 2023
Debt Disclosure [Abstract]
Revolving Credit Facility and Long-Term Debt	8. Revolving Credit Facility and Long-Term Debt. Principal balances outstanding under our long-term debt obligations as of September 30, 2023 and December 31, 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2023 December 31, 2022 Term loans ​ $ 149,063 ​ $ 124,688 Revolving credit loans ​ 138,000 ​ 73,500 Less unamortized debt issuance costs ​ (943) ​ (179) Total long-term debt ​ 286,120 ​ 198,009 Less current portion ​ 3,750 ​ 11,250 Long-term portion ​ $ 282,370 ​ $ 186,759 ​ On June 6, 2023, we entered into a Fourth Amended and Restated Credit Agreement (the "Fourth Amended Credit Agreement"). The Fourth Amended Credit Agreement is a syndicated loan agreement with Wells Fargo Bank, National Association and other parties. The Fourth Amended Credit Agreement amended and restated in its entirety our previously outstanding Third Amended and Restated Credit Agreement and all amendments thereto. The Fourth Amended Credit Agreement provides for a term loan of $150 million and a revolving credit commitment of up to an aggregate amount of $700 million, inclusive of sub-facilities for multicurrency borrowings, standby letters of credit and swingline loans. On June 6, 2028, all principal, interest and other amounts outstanding under the Fourth Amended Credit Agreement are payable in full. At any time prior to the maturity date, we may repay any amounts owing under all term loans and revolving credit loans in whole or in part, without premium or penalty. ​ Term loans made under the Fourth Amended Credit Agreement bear interest, at our election, at either (i) the Base Rate (as defined in the Fourth Amended Credit Agreement) plus the Applicable Margin (as defined in the Fourth Amended Credit Agreement) or, (ii) Adjusted Term SOFR (as defined in the Fourth Amended Credit Agreement) plus the Applicable Margin (as defined in the Fourth Amended Credit Agreement). Revolving credit loans bear interest, at our election, at either (a) the Base Rate plus the Applicable Margin, (b) Adjusted Term SOFR plus the Applicable Margin, (c) Adjusted Eurocurrency Rate plus the Applicable Margin or (d) Adjusted Daily Simple SONIA (as defined in the Fourth Amended Credit Agreement) plus the Applicable Margin. Swingline loans bear interest at the Base Rate plus the Applicable Margin. Interest on each loan featuring the Base Rate and each Daily Simple SONIA Loan is due and payable on the last business day of each calendar month; interest on each loan featuring the Eurocurrency Rate and each Term SOFR Loan is due and payable on the last day of each interest period applicable thereto, and if such interest period extends over three months, at the end of each three-month interval during such interest period. ​ The Fourth Amended Credit Agreement is collateralized by substantially all our assets. The Fourth Amended Credit Agreement contains affirmative and negative covenants, representations and warranties, events of default and other terms customary for loans of this nature. In particular, the Fourth Amended Credit Agreement requires that we maintain certain financial covenants, as follows: ​ ​ ​ ​ ​ ​ Covenant Requirement ​ Consolidated Total Leverage Ratio (1) ​ 4.0 to 1.0 ​ Consolidated Interest Coverage Ratio (2) ​ 3.0 to 1.0 ​ (1) Maximum Consolidated Total Net Leverage Ratio (as defined in the Fourth Amended Credit Agreement) as of any fiscal quarter end. (2) Minimum ratio of Consolidated EBITDA (as defined in the Fourth Amended Credit Agreement and adjusted for certain expenditures) to Consolidated Interest Expense (as defined in the Fourth Amended Credit Agreement) for any period of four consecutive fiscal quarters. ​ We believe we were in compliance with all covenants set forth in the Fourth Amended Credit Agreement as of September 30, 2023. As of September 30, 2023, we had outstanding borrowings of $287.1 million and issued letter of credit guarantees of $3.8 million under the Fourth Amended Credit Agreement, with additional available borrowings of approximately $558 million, based on the maximum net leverage ratio and the aggregate revolving credit commitment pursuant to the Fourth Amended Credit Agreement. Our interest rate as of September 30, 2023 was a fixed rate of 2.89% with respect to $75 million of the principal amount, as a result of an interest rate swap (see Note 9), and a variable floating rate of 6.67% with respect to $212.1 million of the principal amount. Our interest rate as of December 31, 2022 was a fixed rate of 2.71% on $75 million as a result of an interest rate swap and a variable floating rate of 5.38% on $123.2 million. The foregoing fixed rates do not reflect potential future changes in the applicable margin. Future minimum principal payments on our long-term debt, as of September 30, 2023, were as follows (in thousands): ​ ​ ​ ​ ​ Years Ending ​ Future Minimum December 31, Principal Payments Remaining 2023 $ 938 2024 ​ ​ 3,750 2025 ​ ​ 5,625 2026 ​ ​ 7,500 2027 ​ ​ 9,375 2028 ​ ​ 259,875 Total future minimum principal payments ​ $ 287,063 ​

Derivatives

Derivatives	9 Months Ended
	Sep. 30, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives	9. Derivatives. General. ​ We formally document, designate and assess the effectiveness of transactions that receive hedge accounting treatment initially and on an ongoing basis. For qualifying hedges, the change in fair value is deferred in accumulated other comprehensive income, a component of stockholders’ equity in the accompanying consolidated balance sheets, and recognized in earnings at the same time the hedged item affects earnings. Changes in the fair value of derivative instruments not designated as hedging instruments are recorded in earnings throughout the term of the derivative. ​ Interest Rate Risk. Derivative Instruments Designated as Cash Flow Hedges On December 23, 2019, we entered into a pay-fixed, receive-variable interest rate swap with a notional amount of $75 million with Wells Fargo. In June 2023, certain terms under the agreement were amended to reflect the transition from LIBOR to SOFR, an alternative reference rate. Under the interest rate swap agreement we fixed the one-month On September 30, 2023 and December 31, 2022, our interest rate swap qualified as a cash flow hedge. The fair value of our interest rate swap as of September 30, 2023 was an asset of $2.3 million, which was partially offset by $0.6 million in deferred taxes. The fair value of our interest rate swap as of December 31, 2022 was an asset of $3.4 million, partially offset by $0.8 million in deferred taxes. Foreign Currency Risk. Derivative Instruments Designated as Cash Flow Hedges ​ For derivative instruments that are designated and qualify as cash flow hedges, the gain or loss on the derivative instrument is temporarily reported as a component of other comprehensive income and then reclassified into earnings in the same line item associated with the forecasted transaction and in the same period or periods during which the hedged transaction affects earnings. We entered into forward contracts on various foreign currencies to manage the risk associated with forecasted exchange rates which impact revenues, cost of sales, and operating expenses in various international markets. The objective of the hedges is to reduce the variability of cash flows associated with the forecasted purchase or sale of the foreign currencies. We enter into approximately 100 cash flow foreign currency hedges every month. As of September 30, 2023 and December 31, 2022, we had entered into foreign currency forward contracts, which qualified as cash flow hedges, with aggregate notional amounts of $155.7 million and $87.8 million, respectively. Derivative Instruments Not Designated as Cash Flow Hedges ​ We forecast our net exposure in various receivables and payables to fluctuations in the value of various currencies, and we enter into foreign currency forward contracts to mitigate that exposure. We enter into approximately 50 foreign currency fair value hedges every month. As of September 30, 2023 and December 31, 2022, we had entered into foreign currency forward contracts related to those balance sheet accounts with aggregate notional amounts of $96.0 million and $92.4 million, respectively. Balance Sheet Presentation of Derivative Instruments. The fair value of derivative instruments on a gross basis was as follows on the dates indicated (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value of Derivative Instruments Designated as Hedging Instruments Balance Sheet Location September 30, 2023 December 31, 2022 Assets ​ ​ Interest rate swaps Prepaid expenses and other assets ​ $ 2,320 ​ $ — Interest rate swaps Other assets (long-term) ​ ​ — ​ ​ 3,444 Foreign currency forward contracts Prepaid expenses and other assets ​ ​ 3,463 ​ ​ 3,215 Foreign currency forward contracts Other assets (long-term) ​ ​ 698 ​ 56 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (845) ​ (1,509) Foreign currency forward contracts Other long-term obligations ​ (238) ​ (531) ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value of Derivative Instruments Not Designated as Hedging Instruments Balance Sheet Location September 30, 2023 December 31, 2022 Assets ​ ​ Foreign currency forward contracts Prepaid expenses and other assets ​ $ 1,874 ​ $ 1,512 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (1,897) ​ (1,946) ​ Income Statement Presentation of Derivative Instruments. ​ Derivative Instruments Designated as Cash Flow Hedges ​ Derivative instruments designated as cash flow hedges had the following effects, before income taxes, on other comprehensive income (“OCI”), accumulated other comprehensive income (“AOCI”), and net earnings in our consolidated statements of income, consolidated statements of comprehensive income and consolidated balance sheets (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amount of Gain/(Loss) ​ ​ ​ Consolidated Statements ​ Amount of Gain/(Loss) ​ ​ Recognized in OCI ​ ​ ​ of Income ​ Reclassified from AOCI ​ ​ Three Months Ended September 30, ​ Three Months Ended September 30, ​ Three Months Ended September 30, Derivative instrument 2023 2022 Location in statements of income 2023 2022 2023 2022 Interest rate swaps ​ $ 126 ​ $ 1,504 ​ Interest expense ​ $ (4,841) ​ $ (1,831) ​ $ 685 ​ $ 94 Foreign currency forward contracts ​ 1,503 ​ 3,491 ​ Revenue ​ 315,230 ​ 287,175 ​ 866 ​ 1,491 ​ ​ ​ ​ ​ ​ ​ ​ Cost of sales ​ (173,031) ​ (158,602) ​ 617 ​ (440) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amount of Gain/(Loss) ​ ​ Consolidated Statements ​ Amount of Gain/(Loss) ​ ​ ​ Recognized in OCI ​ ​ of Income ​ Reclassified from AOCI ​ ​ ​ Nine Months Ended September 30, ​ ​ Nine Months Ended September 30, ​ Nine Months Ended September 30, Derivative instrument 2023 2022 Location in statements of income 2023 ​ 2022 2023 2022 Interest rate swaps ​ $ 726 ​ $ 4,507 ​ Interest expense ​ $ (10,534) ​ $ (4,180) ​ $ 1,850 ​ $ (379) ​ Foreign currency forward contracts ​ 6,067 ​ 8,713 ​ Revenue ​ 932,851 ​ 857,566 ​ 2,851 ​ 1,303 ​ ​ ​ ​ ​ Cost of sales ​ (499,508) ​ (473,019) ​ 900 ​ (886) ​ ​ As of September 30, 2023, $4.0 million, or $3.0 million after taxes, was expected to be reclassified from AOCI to earnings in revenue and cost of sales over the succeeding twelve months. As of September 30, 2023, $2.3 million, or $1.8 million after taxes, was expected to be reclassified from AOCI to earnings in interest expense over the succeeding twelve months. Derivative Instruments Not Designated as Hedging Instruments ​ The following gains/(losses) from these derivative instruments were recognized in our consolidated statements of income for the periods presented (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended September 30, Nine Months Ended September 30, Derivative Instrument Location in statements of income 2023 2022 2023 2022 Foreign currency forward contracts Other income (expense) — net ​ $ (452) ​ $ 1,034 ​ $ 2,748 ​ $ 1,212 ​ ​

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	10. Commitments and Contingencies. Litigation. ​ SEC Inquiry ​ We have received requests from the Division of Enforcement of the U.S. Securities and Exchange Commission (“SEC”) seeking the voluntary production of information relating to the business activities of Merit’s subsidiary in China, including interactions with hospitals and health care officials in China. We are cooperating with the requests and investigating the matter and, at this time, are unable to predict the scope, timing, significance or outcome of this matter. ​ It is possible that the ultimate resolution of the foregoing matter, or similar matters, if resolved in a manner unfavorable to us, may be materially adverse to our business, financial condition, results of operations or liquidity. Legal costs for these matters, such as outside counsel fees and expenses, are charged to expense in the period incurred.

Earnings Per Common Share (EPS)

Earnings Per Common Share (EPS)	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Earnings Per Common Share (EPS)	11. Earnings Per Common Share (EPS). The computation of weighted average shares outstanding and the basic and diluted earnings per common share for the three and nine-month periods ended September 30, 2023 and 2022 consisted of the following (in thousands, except per share amounts): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ ​ ​ 2023 ​ 2022 ​ 2023 ​ 2022 ​ Net income ​ $ 25,834 ​ $ 15,272 ​ $ 66,782 ​ $ 41,115 ​ Average common shares outstanding ​ 57,682 ​ 56,835 ​ 57,525 ​ 56,707 ​ Basic EPS ​ $ 0.45 ​ $ 0.27 ​ $ 1.16 ​ $ 0.73 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average common shares outstanding ​ ​ 57,682 ​ ​ 56,835 ​ ​ 57,525 ​ ​ 56,707 ​ Effect of dilutive stock awards ​ ​ 693 ​ ​ 751 ​ ​ 820 ​ ​ 866 ​ Total potential shares outstanding ​ ​ 58,375 ​ ​ 57,586 ​ ​ 58,345 ​ ​ 57,573 ​ Diluted EPS ​ $ 0.44 ​ $ 0.27 ​ $ 1.14 ​ $ 0.71 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Equity awards excluded as the impact was anti-dilutive (1) ​ ​ 1,242 ​ ​ 1,641 ​ ​ 1,091 ​ ​ 1,612 ​ (1) Does not reflect the impact of incremental repurchases under the treasury stock method.

Stock-Based Compensation Expens

Stock-Based Compensation Expense	9 Months Ended
	Sep. 30, 2023
Share-based Payment Arrangement [Abstract]
Stock-Based Compensation Expense	12. Stock-Based Compensation Expense. Stock-based compensation expense before income tax expense for the three and nine-month periods ended September 30, 2023 and 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ 2023 2022 2023 2022 Cost of sales ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ $ 367 ​ $ 150 ​ $ 1,240 ​ $ 1,247 Research and development ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 488 ​ 476 ​ ​ 1,329 ​ 1,412 Selling, general and administrative ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 2,083 ​ 2,166 ​ ​ 5,304 ​ 5,297 Performance-based restricted stock units ​ ​ 1,838 ​ ​ 647 ​ ​ 4,470 ​ ​ 2,719 Restricted stock units ​ ​ 430 ​ ​ 454 ​ ​ 1,341 ​ ​ 1,382 Cash-settled performance-based share-based awards ("Liability Awards") ​ ​ 591 ​ ​ 705 ​ ​ 1,662 ​ ​ 1,634 Total selling, general and administrative ​ ​ 4,942 ​ ​ 3,972 ​ ​ 12,777 ​ ​ 11,032 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Stock-based compensation expense before taxes ​ $ 5,797 ​ $ 4,598 ​ $ 15,346 ​ $ 13,691 ​ We recognize stock-based compensation expense (net of a forfeiture rate), for those awards which are expected to vest, on a straight-line basis over the requisite service period. We estimate the forfeiture rate based on our historical experience and expectations about future forfeitures. ​ Nonqualified Stock Options During the nine-month periods ended September 30, 2023 and 2022, we granted stock options representing 401,535 and 203,606 shares of our common stock, respectively. We use the Black-Scholes methodology to value the stock-based compensation expense for options. In applying the Black-Scholes methodology to the option grants, the fair value of our stock-based awards granted was estimated using the following assumptions for the periods indicated below: ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ ​ September 30, ​ ​ 2023 ​ 2022 Risk-free interest rate 3.6% - 4.6% 1.4% - 3.4% Expected option term 4.0 years 4.0 years Expected dividend yield — — Expected price volatility 44.6% - 47.1% 46.2% - 47.4% ​ The average risk-free interest rate is determined using the U.S. Treasury rate in effect as of the date of grant, based on the expected term of the stock award. We determine the expected term of stock options using the historical exercise behavior of employees. The expected price volatility was determined using a weighted average of daily historical volatility of our stock price over the corresponding expected option term and implied volatility based on recent trends of the daily historical volatility. For awards with a vesting period, compensation expense is recognized on a straight-line basis over the service period, which corresponds to the vesting period. ​ As of September 30, 2023, the total remaining unrecognized compensation cost related to non-vested stock options was $22.5 million, which was expected to be recognized over a weighted average period of 2.3 years. ​ Stock-Settled Performance-Based Restricted Stock Units (“Performance Stock Units”) ​ During the nine-month periods ended September 30, 2023 and 2022, we granted performance stock units which represent up to 286,863 and 120,710 shares of our common stock, respectively. Conversion of the performance stock units occurs at the end of the relevant performance periods, or one year after the agreement date, whichever is later. The number of shares delivered upon vesting at the end of the performance periods are based upon performance against specified financial performance metrics and relative total shareholder return as compared to the Russell 2000 Index (“rTSR”), as defined in the award agreements. ​ We use Monte-Carlo simulations to estimate the grant-date fair value of the performance stock units linked to total shareholder return. The fair value of each performance stock unit was estimated as of the grant date using the following assumptions for awards granted in the periods indicated below: ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ ​ September 30, ​ ​ 2023 ​ 2022 Risk-free interest rate 3.9% - 4.6% 1.6% - 2.7% Performance period 2.8 years 2.6 - 2.8 years Expected dividend yield — — Expected price volatility 31.4% - 32.6% 38.5% - 46.2% ​ The risk-free interest rate of return was determined using the U.S. Treasury rate at the time of grant with a term equal to the expected term of the award. The expected volatility was based on the weighted average volatility of our stock price and the average volatility of our compensation peer group's stock price. The expected dividend yield was assumed to be zero because, at the time of the grant, we had no plans to declare a dividend. Compensation expense is recognized using the grant-date fair value for the number of shares that are probable of being awarded based on the performance metrics. Each reporting period, this probability assessment is updated, and cumulative adjustments are recorded based on the financial performance metrics expected to be achieved. At the end of the performance period, cumulative expense is calculated based on the actual performance metrics achieved. As of September 30, 2023, the total remaining unrecognized compensation cost related to stock-settled performance stock units was $12.3 million, which is expected to be recognized over a weighted average period of 2.0 years. Liability Awards During the nine-month periods ended September 30, 2023 and 2022, we granted liability awards to our Chief Executive Officer with total target cash incentives in the amount of $1.3 million and $1.0 million, respectively. These awards entitle him to a target cash payment based upon our relative shareholder return as compared to the rTSR and achievement of specified performance metrics, as defined in the award agreements. During the nine-month period ended September 30, 2023, we granted additional performance stock units to certain employees that provide for settlement in cash upon our achievement of specified financial metrics. The cash payable upon vesting at the end of the service period is based upon performance against specified financial performance metrics and relative total shareholder return as compared to the rTSR, as defined in the award agreements. Compensation expense is recognized for the cash payment probable of being awarded based on the performance metrics. The fair value of these liability awards is measured at each reporting period until the awards are settled. These awards are classified as liabilities and reported in accrued expenses and other long-term obligations within our consolidated balance sheet. As of September 30, 2023, the total remaining unrecognized compensation cost related to cash-settled performance-based share-based awards was $3.6 million, which is expected to be recognized over a weighted average period of 2.0 years. ​ Restricted Stock Units During the nine-month periods ended September 30, 2023 and 2022, we granted restricted stock units to our non-employee directors representing 20,358 and 30,500 shares of our common stock, respectively. The expense recognized for restricted stock units is equal to the closing stock price on the date of grant, which is recognized over the vesting period. Restricted stock units granted to each director are subject to such director’s continued service through the vesting date, which is one year from the date of grant. As of September 30, 2023, the total remaining unrecognized compensation cost related to restricted stock units was $1.1 million, which will be recognized over the remaining vesting period.

Segment Reporting

Segment Reporting	9 Months Ended
	Sep. 30, 2023
Segment Reporting [Abstract]
Segment Reporting	13. Segment Reporting. We report our operations in two operating segments: cardiovascular and endoscopy. Our cardiovascular segment consists of four product categories: peripheral intervention, cardiac intervention, custom procedural solutions, and OEM. Within these product categories, we sell a variety of products, including cardiology and radiology devices (which assist in diagnosing and treating coronary arterial disease, peripheral vascular disease and other non-vascular diseases), as well as embolotherapeutic, cardiac rhythm management, electrophysiology, critical care, breast cancer localization and guidance, biopsy, and interventional oncology and spine devices. Our endoscopy segment consists of gastroenterology and pulmonology devices which assist in the palliative treatment of expanding esophageal, tracheobronchial and biliary strictures caused by malignant tumors. We evaluate the performance of our operating segments based on net sales and income from operations. Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the three and nine-month periods ended September 30, 2023 and 2022, were as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended Nine Months Ended ​ September 30, September 30, ​ 2023 2022 2023 2022 Net sales ​ ​ ​ ​ Cardiovascular ​ $ 306,084 ​ $ 278,949 ​ $ 905,335 ​ $ 832,555 Endoscopy ​ 9,146 ​ 8,226 ​ 27,516 ​ 25,011 Total net sales ​ 315,230 ​ 287,175 ​ 932,851 ​ 857,566 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Income from operations ​ ​ ​ ​ Cardiovascular ​ 32,622 ​ 17,435 ​ 82,966 ​ 51,836 Endoscopy ​ 2,515 ​ 1,222 ​ 7,366 ​ 5,310 Total income from operations ​ 35,137 ​ 18,657 ​ 90,332 ​ 57,146 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total other expense — net ​ (4,915) ​ (1,055) ​ (9,710) ​ (4,672) Income tax expense ​ 4,388 ​ 2,330 ​ 13,840 ​ 11,359 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Net income ​ $ 25,834 ​ $ 15,272 ​ $ 66,782 ​ $ 41,115 ​

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Fair Value Measurements	14. Fair Value Measurements. Assets (Liabilities) Measured at Fair Value on a Recurring Basis Our financial assets and (liabilities) carried at fair value and measured on a recurring basis as of September 30, 2023 and December 31, 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value Measurements Using ​ ​ Total Fair ​ Quoted prices in ​ Significant other ​ Significant ​ ​ Value at ​ active markets ​ observable inputs ​ unobservable inputs ​ September 30, 2023 (Level 1) (Level 2) (Level 3) Marketable securities (1) ​ $ 73 ​ $ 73 ​ $ — ​ $ — Interest rate contract asset, current (2) ​ $ 2,320 ​ $ — ​ $ 2,320 ​ $ — Foreign currency contract assets, current and long-term (3) ​ $ 6,035 ​ $ — ​ $ 6,035 ​ $ — Foreign currency contract liabilities, current and long-term (4) ​ $ (2,980) ​ $ — ​ $ (2,980) ​ $ — Contingent consideration liabilities ​ $ (4,022) ​ $ — ​ $ — ​ $ (4,022) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value Measurements Using ​ ​ Total Fair ​ Quoted prices in ​ Significant other ​ Significant ​ ​ Value at ​ active markets ​ observable inputs ​ unobservable inputs ​ December 31, 2022 (Level 1) (Level 2) (Level 3) Marketable securities (1) ​ $ 138 ​ $ 138 ​ $ — ​ ​ — Interest rate contract asset, long-term (2) ​ $ 3,444 ​ $ — ​ $ 3,444 ​ $ — Foreign currency contract assets, current and long-term (3) ​ $ 4,783 ​ $ — ​ $ 4,783 ​ $ — Foreign currency contract liabilities, current and long-term (4) ​ $ (3,986) ​ $ — ​ $ (3,986) ​ $ — Contingent consideration liabilities ​ $ (18,073) ​ $ — ​ $ — ​ $ (18,073) (1) Our marketable securities, which consist entirely of available-for-sale equity securities, are valued using market prices in active markets. Level 1 instrument valuations are obtained from real-time quotes for transactions in active exchange markets involving identical assets. (2) The fair value of the interest rate contract is determined using Level 2 fair value inputs and is reported within prepaid expenses and other current assets as of September 30, 2023 and other long-term assets as of December 31, 2022 in the consolidated balance sheets. (3) The fair value of the foreign currency contract assets (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as prepaid expenses and other current assets or other long-term assets in the consolidated balance sheets. (4) The fair value of the foreign currency contract liabilities (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as accrued expenses or other long-term obligations in the consolidated balance sheets. ​ Certain of our past business combinations involve the potential for the payment of future contingent consideration, generally based on a percentage of future product sales or upon attaining specified future revenue or other milestones. The contingent consideration liability is re-measured at the estimated fair value at the end of each reporting period with the change in fair value recognized within operating expenses in the accompanying consolidated statements of income for such period. We measure the initial liability and re-measure the liability on a recurring basis using Level 3 inputs as defined under authoritative guidance for fair value measurements. Changes in the fair value of our contingent consideration liabilities during the three and nine-month periods ended September 30, 2023 and 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended Nine Months Ended ​ September 30, September 30, ​ 2023 2022 2023 2022 Beginning balance ​ $ 3,581 ​ $ 17,426 ​ $ 18,073 ​ $ 48,234 ​ Contingent consideration expense ​ 563 ​ 915 ​ 2,177 ​ 4,702 ​ Contingent payments made ​ (122) ​ (91) ​ (16,228) ​ (34,676) ​ Effect of foreign exchange ​ ​ — ​ ​ — ​ ​ — ​ ​ (10) ​ Ending balance ​ $ 4,022 ​ $ 18,250 ​ $ 4,022 ​ $ 18,250 ​ ​ As of September 30, 2023, $3.6 million in contingent consideration liability was included in other long-term obligations and $0.4 million in contingent consideration liability was included in accrued expenses in our consolidated balance sheet. As of December 31, 2022, $2.3 million in contingent consideration liability was included in other long-term obligations and $15.8 million in contingent consideration liability was included in accrued expenses in our consolidated balance sheet. Payments related to the settlement of the contingent consideration liability recognized at fair value as of the applicable acquisition date of $3.5 million and $32.9 million for the nine-month periods ended September 30, 2023 and 2022, respectively, have been reflected as a cash outflow from financing activities in the accompanying consolidated statements of cash flows. Payments related to increases in the contingent consideration liability subsequent to the date of acquisition of $12.7 million and $1.8 million for the nine-month period ended September 30, 2023 and 2022, respectively, are reflected as operating cash flows. The recurring Level 3 measurement of our contingent consideration liabilities included the following significant unobservable inputs at September 30, 2023 and December 31, 2022 (amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ Valuation ​ ​ ​ ​ ​ Weighted Contingent consideration liability 2023 technique Unobservable inputs Range ​ Average (1) Revenue-based royalty payments contingent liability ​ $ 3,534 Discounted cash flow Discount rate ​ 12% - 16% ​ 14.9% ​ ​ ​ Projected year of payments ​ 2023-2034 ​ 2028 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue milestones contingent liability ​ $ 88 Monte Carlo simulation Discount rate ​ 13.0% ​ ​ ​ ​ ​ Projected year of payments ​ 2023-2039 ​ 2039 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Regulatory approval contingent liability ​ $ 400 ​ Scenario-based method ​ Discount rate ​ 5.7% ​ ​ ​ ​ ​ ​ ​ ​ ​ Probability of milestone payment ​ 50.0% ​ ​ ​ ​ ​ ​ ​ ​ ​ Projected year of payment ​ 2023-2030 ​ 2030 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ Valuation ​ ​ ​ ​ ​ Weighted Contingent consideration liability 2022 technique Unobservable inputs Range ​ Average (1) Revenue-based royalty payments contingent liability ​ $ 2,097 Discounted cash flow Discount rate ​ 14% - 17% ​ 15.7% ​ ​ ​ Projected year of payments ​ 2023-2034 ​ 2026 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue milestones contingent liability ​ $ 13,064 Monte Carlo simulation Discount rate ​ 5.1% - 14.0% ​ 5.2% ​ ​ ​ Projected year of payments ​ 2023-2033 ​ 2023 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Regulatory approval contingent liability ​ $ 2,912 ​ Scenario-based method ​ Discount rate ​ 5.7% ​ ​ ​ ​ ​ ​ ​ ​ ​ Probability of milestone payment ​ 90% ​ ​ ​ ​ ​ ​ ​ ​ ​ Projected year of payment ​ 2023-2030 ​ 2024 (1) Unobservable inputs were weighted by the relative fair value of the instruments. No weighted average is reported for contingent consideration liabilities without a range of unobservable inputs. ​ The contingent consideration liability is re-measured to fair value each reporting period. Significant increases or decreases in projected revenues, based on our most recent internal operational budgets and long-range strategic plans, discount rates or the time until payment is made would have resulted in a significantly lower or higher fair value measurement. Contingent Payments to Related Parties As a former shareholder of Cianna Medical Inc. (“Cianna Medical”), a former Merit director was eligible for payments for the achievement of sales milestones specified in our merger agreement with Cianna Medical completed in 2018. The terms of the acquisition, including contingent consideration payments, were determined prior to the appointment of the former Cianna Medical shareholder as a Merit director. During the nine-month period ended September 30, 2023, we made the final contingent payment to Cianna Medical shareholders, including $0.9 million paid to the former Merit director who is a former Cianna Medical shareholder. During the nine-month period ended September 30, 2022, we made aggregate contingent payments of $1.6 million to the former Merit director as a former shareholder of Cianna Medical. ​ Fair Value of Other Assets (Liabilities) ​ The carrying amount of cash and cash equivalents, receivables, and trade payables approximate fair value because of the immediate, short-term maturity of these financial instruments. Our long-term debt re-prices frequently due to variable rates and entails no significant changes in credit risk and, as a result, we believe the fair value of long-term debt approximates carrying value. The fair value of assets and liabilities whose carrying value approximates fair value is determined using Level 2 inputs, with the exception of cash and cash equivalents, which use Level 1 inputs. ​ We analyze our investments in privately-held companies to determine if they should be accounted for using the equity method based on our ability to exercise significant influence over operating and financial policies of the company in which we have invested. Investments not accounted for under the equity method of accounting are accounted for at cost minus impairment, if applicable, plus or minus changes in valuation resulting from observable transactions for identical or similar investments. ​ Impairment Charges ​ We recognize or disclose the fair value of certain assets, such as non-financial assets, primarily property and equipment, right-of-use operating lease assets, equity investments, intangible assets and goodwill in connection with impairment evaluations. Such assets are reported at carrying value and are not subject to recurring fair value measurements. We review our long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Fair value is generally determined based on discounted future cash flow. All our nonrecurring valuations use significant unobservable inputs and therefore fall under Level 3 of the fair value hierarchy. ​ Equity Investments. Intangible Assets. September 30, 2022 Current Expected Credit Losses ​ Our outstanding long-term notes receivable, including accrued interest and an allowance for current expected credit losses, were $2.4 million and $2.4 million as of September 30, 2023 and December 31, 2022, respectively. As of September 30, 2023 and December 31, 2022, we had an allowance for current expected credit losses of $328,000 and $281,000, respectively, associated with these notes receivable. We assess the allowance for current expected credit losses on an individual security basis, due to the limited number of securities, using a probability of default model, which is based on relevant information about past events, including historical experience, current conditions and reasonable and supportable forecasts that affect the expected collectability of securities, and other security specific factors. ​ The table below presents a rollforward of the allowance for current expected credit losses on our notes receivable for the three and nine-month periods ended September 30, 2023 and 2022 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ ​ 2023 2022 ​ 2023 2022 Beginning balance ​ $ 296 ​ $ 192 ​ $ 281 ​ $ 199 Provision for credit loss expense ​ ​ 32 ​ ​ (6) ​ ​ 47 ​ ​ (13) Ending balance ​ $ 328 ​ $ 186 ​ $ 328 ​ $ 186 ​

Accumulated Other Comprehensive

Accumulated Other Comprehensive Income (Loss)	9 Months Ended
	Sep. 30, 2023
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest [Abstract]
Accumulated Other Comprehensive Income (Loss)	15. Accumulated Other Comprehensive Income (Loss). ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash Flow Hedges Foreign Currency Translation Total Balance as of July 1, 2023 $ 5,682 ​ $ (15,226) ​ $ (9,544) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 1,629 ​ ​ (2,914) ​ ​ (1,285) Income taxes 129 ​ ​ 17 ​ ​ 146 Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (866) ​ ​ ​ ​ ​ (866) Cost of sales ​ (617) ​ ​ ​ ​ ​ (617) Interest expense ​ (685) ​ ​ ​ ​ ​ (685) Net other comprehensive loss ​ (410) ​ ​ (2,897) ​ ​ (3,307) ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2023 $ 5,272 ​ $ (18,123) ​ $ (12,851) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash Flow Hedges Foreign Currency Translation Total Balance as of July 1, 2022 $ 4,584 ​ $ (15,303) ​ $ (10,719) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 4,995 ​ ​ (9,003) ​ ​ (4,008) Income taxes (942) ​ ​ 85 ​ ​ (857) Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (1,491) ​ ​ ​ ​ ​ (1,491) Cost of sales ​ 440 ​ ​ ​ ​ ​ 440 Interest expense ​ (94) ​ ​ ​ ​ ​ (94) Net other comprehensive income (loss) ​ 2,908 ​ ​ (8,918) ​ ​ (6,010) ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2022 $ 7,492 ​ $ (24,221) ​ $ (16,729) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash Flow Hedges Foreign Currency Translation Total Balance as of January 1, 2023 $ 4,366 ​ $ (15,916) ​ $ (11,550) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 6,793 ​ ​ (2,190) ​ ​ 4,603 Income taxes (286) ​ ​ (17) ​ ​ (303) Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (2,851) ​ ​ ​ ​ ​ (2,851) Cost of sales ​ (900) ​ ​ ​ ​ ​ (900) Interest expense ​ (1,850) ​ ​ ​ ​ ​ (1,850) Net other comprehensive income (loss) ​ 906 ​ ​ (2,207) ​ ​ (1,301) ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2023 $ 5,272 ​ $ (18,123) ​ $ (12,851) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash Flow Hedges Foreign Currency Translation Total Balance as of January 1, 2022 $ (2,464) ​ $ (5,527) ​ $ (7,991) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 13,220 ​ ​ (17,739) ​ ​ (4,519) Income taxes (3,226) ​ ​ 81 ​ ​ (3,145) Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (1,303) ​ ​ ​ ​ ​ (1,303) Cost of sales ​ 886 ​ ​ ​ ​ ​ 886 Interest expense ​ 379 ​ ​ ​ ​ ​ 379 Other expense - net ​ ​ ​ ​ (1,036) ​ ​ (1,036) Net other comprehensive income (loss) ​ 9,956 ​ ​ (18,694) ​ ​ (8,738) ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2022 $ 7,492 ​ $ (24,221) ​ $ (16,729) ​

Basis of Presentation (Policies

Basis of Presentation (Policies)	9 Months Ended
	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Other Items	1. Basis of Presentation and Other Items. ​
Recently Adopted Financial Accounting Standards	Recently Issued Accounting Standards.
Revenue from Contracts with Customers	Revenue from Contracts with Customers. We recognize revenue when a customer obtains control of promised goods. The amount of revenue recognized reflects the consideration we expect to receive in exchange for these goods. Our revenue recognition policies have not changed from those disclosed in Note 1 to our consolidated financial statements in Item 8 of the 2022 Annual Report on Form 10-K.
Derivatives	Derivatives. General. ​ We formally document, designate and assess the effectiveness of transactions that receive hedge accounting treatment initially and on an ongoing basis. For qualifying hedges, the change in fair value is deferred in accumulated other comprehensive income, a component of stockholders’ equity in the accompanying consolidated balance sheets, and recognized in earnings at the same time the hedged item affects earnings. Changes in the fair value of derivative instruments not designated as hedging instruments are recorded in earnings throughout the term of the derivative. ​ Interest Rate Risk. Derivative Instruments Designated as Cash Flow Hedges On December 23, 2019, we entered into a pay-fixed, receive-variable interest rate swap with a notional amount of $75 million with Wells Fargo. In June 2023, certain terms under the agreement were amended to reflect the transition from LIBOR to SOFR, an alternative reference rate. Under the interest rate swap agreement we fixed the one-month On September 30, 2023 and December 31, 2022, our interest rate swap qualified as a cash flow hedge. The fair value of our interest rate swap as of September 30, 2023 was an asset of $2.3 million, which was partially offset by $0.6 million in deferred taxes. The fair value of our interest rate swap as of December 31, 2022 was an asset of $3.4 million, partially offset by $0.8 million in deferred taxes. Foreign Currency Risk. Derivative Instruments Designated as Cash Flow Hedges ​ For derivative instruments that are designated and qualify as cash flow hedges, the gain or loss on the derivative instrument is temporarily reported as a component of other comprehensive income and then reclassified into earnings in the same line item associated with the forecasted transaction and in the same period or periods during which the hedged transaction affects earnings. We entered into forward contracts on various foreign currencies to manage the risk associated with forecasted exchange rates which impact revenues, cost of sales, and operating expenses in various international markets. The objective of the hedges is to reduce the variability of cash flows associated with the forecasted purchase or sale of the foreign currencies. Derivative Instruments Not Designated as Cash Flow Hedges Balance Sheet Presentation of Derivative Instruments.

Revenue from Contracts with C_2

Revenue from Contracts with Customers (Tables)	9 Months Ended
	Sep. 30, 2023
Revenue from Contract with Customer [Abstract]
Schedule of Disaggregation of Revenue	The following tables present revenue from contracts with customers by reporting segment, product category and geographical region for the three and nine-month periods ended September 30, 2023 and 2022 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Three Months Ended ​ ​ September 30, 2023 ​ September 30, 2022 ​ United States International Total United States International Total Cardiovascular ​ ​ ​ ​ ​ ​ ​ Peripheral Intervention ​ $ 78,617 ​ $ 49,768 ​ $ 128,385 ​ $ 67,200 ​ $ 43,498 ​ $ 110,698 Cardiac Intervention ​ 36,593 ​ ​ 52,513 ​ 89,106 ​ 33,194 ​ ​ 53,654 ​ 86,848 Custom Procedural Solutions ​ 29,602 ​ ​ 19,022 ​ 48,624 ​ 27,078 ​ ​ 18,614 ​ 45,692 OEM ​ 34,207 ​ ​ 5,762 ​ 39,969 ​ 29,425 ​ ​ 6,286 ​ 35,711 Total ​ 179,019 ​ ​ 127,065 ​ 306,084 ​ 156,897 ​ 122,052 ​ 278,949 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy Devices ​ 8,486 ​ 660 ​ 9,146 ​ 7,674 ​ ​ 552 ​ 8,226 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ $ 187,505 ​ $ 127,725 ​ $ 315,230 ​ $ 164,571 ​ $ 122,604 ​ $ 287,175 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ Nine Months Ended ​ ​ September 30, 2023 ​ September 30, 2022 ​ United States International Total United States International Total Cardiovascular ​ ​ ​ ​ ​ ​ ​ ​ Peripheral Intervention ​ $ 219,257 ​ $ 148,820 ​ $ 368,077 ​ $ 195,095 ​ $ 132,331 ​ $ 327,426 Cardiac Intervention ​ 106,588 ​ ​ 161,621 ​ 268,209 ​ 95,652 ​ 162,257 ​ 257,909 Custom Procedural Solutions ​ 85,556 ​ ​ 60,153 ​ 145,709 ​ 80,951 ​ 60,096 ​ 141,047 OEM ​ 101,341 ​ ​ 21,999 ​ 123,340 ​ 87,269 ​ 18,904 ​ 106,173 Total ​ 512,742 ​ ​ 392,593 ​ 905,335 ​ 458,967 ​ 373,588 ​ 832,555 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy Devices ​ 25,705 ​ 1,811 ​ 27,516 ​ 23,270 ​ 1,741 ​ 25,011 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ $ 538,447 ​ $ 394,404 ​ $ 932,851 ​ $ 482,237 ​ $ 375,329 ​ $ 857,566 ​

Acquisitions (Tables)

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2023
Angio Dynamics, Inc
Business Acquisition [Line Items]
Schedule of Purchase price allocation	The purchase price was preliminarily allocated as follows (in thousands): ​ ​ ​ ​ ​ Assets Acquired ​ Prepaid expenses ​ $ 2,000 Inventories ​ 5,254 Property and equipment ​ ​ 108 Intangible assets ​ ​ Developed technology ​ ​ 65,200 Trademarks ​ ​ 4,000 Customer list ​ ​ 5,800 Goodwill ​ ​ 17,638 Total net assets acquired ​ $ 100,000
Bluegrass Vascular Technologies, Inc
Business Acquisition [Line Items]
Schedule of Purchase price allocation	The purchase price was preliminarily allocated as follows (in thousands): ​ ​ ​ ​ ​ Assets Acquired ​ Inventories ​ $ 175 Intangible assets ​ ​ Developed technology ​ ​ 28,000 Trademarks ​ ​ 900 Goodwill ​ ​ 3,898 Total net assets acquired ​ $ 32,973

Inventories (Tables)

Inventories (Tables)	9 Months Ended
	Sep. 30, 2023
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventories at September 30, 2023 and December 31, 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2023 December 31, 2022 Finished goods ​ $ 156,074 ​ $ 147,051 Work-in-process ​ 34,092 ​ 29,534 Raw materials ​ 113,757 ​ 89,406 Total inventories ​ $ 303,923 ​ $ 265,991 ​

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Changes in carrying amount of goodwill	The change in the carrying amount of goodwill for the nine-month period ended September 30, 2023 is detailed as follows (in thousands): ​ ​ ​ ​ ​ ​ 2023 Goodwill balance at January 1 ​ $ 359,821 Effect of foreign exchange ​ (305) Additions and adjustments as the result of acquisitions ​ 21,536 Goodwill balance at September 30 ​ $ 381,052
Other intangible assets	Other intangible assets at September 30, 2023 and December 31, 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2023 ​ ​ Gross Carrying ​ Accumulated ​ Net Carrying ​ Amount Amortization Amount Patents ​ $ 30,969 ​ $ (12,657) ​ $ 18,312 Distribution agreements ​ 3,250 ​ (2,868) ​ 382 License agreements ​ 11,128 ​ (8,076) ​ 3,052 Trademarks ​ 35,119 ​ (19,998) ​ 15,121 Customer lists ​ 40,287 ​ (33,310) ​ 6,977 Total ​ $ 120,753 ​ $ (76,909) ​ $ 43,844 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 2022 ​ ​ Gross Carrying ​ Accumulated ​ Net Carrying ​ Amount Amortization Amount Patents ​ $ 29,445 ​ $ (10,203) ​ $ 19,242 Distribution agreements ​ 3,250 ​ (2,715) ​ 535 License agreements ​ 11,109 ​ (7,250) ​ 3,859 Trademarks ​ 30,221 ​ (17,863) ​ 12,358 Customer lists ​ 34,105 ​ (31,749) ​ 2,356 Total ​ $ 108,130 ​ $ (69,780) ​ $ 38,350
Estimated amortization expense	Estimated amortization expense for developed technology and other intangible assets for the next five years consisted of the following as of September 30, 2023 (in thousands): ​ ​ ​ ​ ​ Estimated Amortization Expense Remaining 2023 ​ $ 15,764 2024 ​ 59,656 2025 ​ 57,661 2026 ​ ​ 46,955 2027 ​ 43,774 ​

Revolving Credit Facility and_2

Revolving Credit Facility and Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2023
Debt Disclosure [Abstract]
Schedule of Long-term Debt Instruments	Principal balances outstanding under our long-term debt obligations as of September 30, 2023 and December 31, 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2023 December 31, 2022 Term loans ​ $ 149,063 ​ $ 124,688 Revolving credit loans ​ 138,000 ​ 73,500 Less unamortized debt issuance costs ​ (943) ​ (179) Total long-term debt ​ 286,120 ​ 198,009 Less current portion ​ 3,750 ​ 11,250 Long-term portion ​ $ 282,370 ​ $ 186,759
Schedule of Long-term Debt Covenants	The Fourth Amended Credit Agreement is collateralized by substantially all our assets. The Fourth Amended Credit Agreement contains affirmative and negative covenants, representations and warranties, events of default and other terms customary for loans of this nature. In particular, the Fourth Amended Credit Agreement requires that we maintain certain financial covenants, as follows: ​ ​ ​ ​ ​ ​ Covenant Requirement ​ Consolidated Total Leverage Ratio (1) ​ 4.0 to 1.0 ​ Consolidated Interest Coverage Ratio (2) ​ 3.0 to 1.0 ​ (1) Maximum Consolidated Total Net Leverage Ratio (as defined in the Fourth Amended Credit Agreement) as of any fiscal quarter end. (2) Minimum ratio of Consolidated EBITDA (as defined in the Fourth Amended Credit Agreement and adjusted for certain expenditures) to Consolidated Interest Expense (as defined in the Fourth Amended Credit Agreement) for any period of four consecutive fiscal quarters.
Schedule of Maturities of Long-term Debt	Future minimum principal payments on our long-term debt, as of September 30, 2023, were as follows (in thousands): ​ ​ ​ ​ ​ Years Ending ​ Future Minimum December 31, Principal Payments Remaining 2023 $ 938 2024 ​ ​ 3,750 2025 ​ ​ 5,625 2026 ​ ​ 7,500 2027 ​ ​ 9,375 2028 ​ ​ 259,875 Total future minimum principal payments ​ $ 287,063 ​

Derivatives (Tables)

Derivatives (Tables)	9 Months Ended
	Sep. 30, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Derivative Instruments in Statement of Financial Position, Fair Value	The fair value of derivative instruments on a gross basis was as follows on the dates indicated (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value of Derivative Instruments Designated as Hedging Instruments Balance Sheet Location September 30, 2023 December 31, 2022 Assets ​ ​ Interest rate swaps Prepaid expenses and other assets ​ $ 2,320 ​ $ — Interest rate swaps Other assets (long-term) ​ ​ — ​ ​ 3,444 Foreign currency forward contracts Prepaid expenses and other assets ​ ​ 3,463 ​ ​ 3,215 Foreign currency forward contracts Other assets (long-term) ​ ​ 698 ​ 56 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (845) ​ (1,509) Foreign currency forward contracts Other long-term obligations ​ (238) ​ (531) ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value of Derivative Instruments Not Designated as Hedging Instruments Balance Sheet Location September 30, 2023 December 31, 2022 Assets ​ ​ Foreign currency forward contracts Prepaid expenses and other assets ​ $ 1,874 ​ $ 1,512 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (1,897) ​ (1,946)
Schedule of Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss)	Derivative instruments designated as cash flow hedges had the following effects, before income taxes, on other comprehensive income (“OCI”), accumulated other comprehensive income (“AOCI”), and net earnings in our consolidated statements of income, consolidated statements of comprehensive income and consolidated balance sheets (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amount of Gain/(Loss) ​ ​ ​ Consolidated Statements ​ Amount of Gain/(Loss) ​ ​ Recognized in OCI ​ ​ ​ of Income ​ Reclassified from AOCI ​ ​ Three Months Ended September 30, ​ Three Months Ended September 30, ​ Three Months Ended September 30, Derivative instrument 2023 2022 Location in statements of income 2023 2022 2023 2022 Interest rate swaps ​ $ 126 ​ $ 1,504 ​ Interest expense ​ $ (4,841) ​ $ (1,831) ​ $ 685 ​ $ 94 Foreign currency forward contracts ​ 1,503 ​ 3,491 ​ Revenue ​ 315,230 ​ 287,175 ​ 866 ​ 1,491 ​ ​ ​ ​ ​ ​ ​ ​ Cost of sales ​ (173,031) ​ (158,602) ​ 617 ​ (440) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amount of Gain/(Loss) ​ ​ Consolidated Statements ​ Amount of Gain/(Loss) ​ ​ ​ Recognized in OCI ​ ​ of Income ​ Reclassified from AOCI ​ ​ ​ Nine Months Ended September 30, ​ ​ Nine Months Ended September 30, ​ Nine Months Ended September 30, Derivative instrument 2023 2022 Location in statements of income 2023 ​ 2022 2023 2022 Interest rate swaps ​ $ 726 ​ $ 4,507 ​ Interest expense ​ $ (10,534) ​ $ (4,180) ​ $ 1,850 ​ $ (379) ​ Foreign currency forward contracts ​ 6,067 ​ 8,713 ​ Revenue ​ 932,851 ​ 857,566 ​ 2,851 ​ 1,303 ​ ​ ​ ​ ​ Cost of sales ​ (499,508) ​ (473,019) ​ 900 ​ (886) ​
Derivative Instruments, Gain (Loss)	The following gains/(losses) from these derivative instruments were recognized in our consolidated statements of income for the periods presented (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended September 30, Nine Months Ended September 30, Derivative Instrument Location in statements of income 2023 2022 2023 2022 Foreign currency forward contracts Other income (expense) — net ​ $ (452) ​ $ 1,034 ​ $ 2,748 ​ $ 1,212 ​ ​

Earnings Per Common Share (EP_2

Earnings Per Common Share (EPS) (Tables)	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Schedule of Earnings (Loss) Per Share, Basic and Diluted	The computation of weighted average shares outstanding and the basic and diluted earnings per common share for the three and nine-month periods ended September 30, 2023 and 2022 consisted of the following (in thousands, except per share amounts): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ ​ ​ 2023 ​ 2022 ​ 2023 ​ 2022 ​ Net income ​ $ 25,834 ​ $ 15,272 ​ $ 66,782 ​ $ 41,115 ​ Average common shares outstanding ​ 57,682 ​ 56,835 ​ 57,525 ​ 56,707 ​ Basic EPS ​ $ 0.45 ​ $ 0.27 ​ $ 1.16 ​ $ 0.73 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average common shares outstanding ​ ​ 57,682 ​ ​ 56,835 ​ ​ 57,525 ​ ​ 56,707 ​ Effect of dilutive stock awards ​ ​ 693 ​ ​ 751 ​ ​ 820 ​ ​ 866 ​ Total potential shares outstanding ​ ​ 58,375 ​ ​ 57,586 ​ ​ 58,345 ​ ​ 57,573 ​ Diluted EPS ​ $ 0.44 ​ $ 0.27 ​ $ 1.14 ​ $ 0.71 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Equity awards excluded as the impact was anti-dilutive (1) ​ ​ 1,242 ​ ​ 1,641 ​ ​ 1,091 ​ ​ 1,612 ​ (1) Does not reflect the impact of incremental repurchases under the treasury stock method.

Stock-Based Compensation Expe_2

Stock-Based Compensation Expense (Tables)	9 Months Ended
	Sep. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of Employee Service Share-based Compensation, Allocation of Recognized Period Costs	Stock-based compensation expense before income tax expense for the three and nine-month periods ended September 30, 2023 and 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ 2023 2022 2023 2022 Cost of sales ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ $ 367 ​ $ 150 ​ $ 1,240 ​ $ 1,247 Research and development ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 488 ​ 476 ​ ​ 1,329 ​ 1,412 Selling, general and administrative ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 2,083 ​ 2,166 ​ ​ 5,304 ​ 5,297 Performance-based restricted stock units ​ ​ 1,838 ​ ​ 647 ​ ​ 4,470 ​ ​ 2,719 Restricted stock units ​ ​ 430 ​ ​ 454 ​ ​ 1,341 ​ ​ 1,382 Cash-settled performance-based share-based awards ("Liability Awards") ​ ​ 591 ​ ​ 705 ​ ​ 1,662 ​ ​ 1,634 Total selling, general and administrative ​ ​ 4,942 ​ ​ 3,972 ​ ​ 12,777 ​ ​ 11,032 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Stock-based compensation expense before taxes ​ $ 5,797 ​ $ 4,598 ​ $ 15,346 ​ $ 13,691
Employee Stock Option [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions	​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ ​ September 30, ​ ​ 2023 ​ 2022 Risk-free interest rate 3.6% - 4.6% 1.4% - 3.4% Expected option term 4.0 years 4.0 years Expected dividend yield — — Expected price volatility 44.6% - 47.1% 46.2% - 47.4%
Stock-Settled Performance-Based Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions	​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ ​ September 30, ​ ​ 2023 ​ 2022 Risk-free interest rate 3.9% - 4.6% 1.6% - 2.7% Performance period 2.8 years 2.6 - 2.8 years Expected dividend yield — — Expected price volatility 31.4% - 32.6% 38.5% - 46.2%

Segment Reporting (Tables)

Segment Reporting (Tables)	9 Months Ended
	Sep. 30, 2023
Segment Reporting [Abstract]
Schedule of Segment Reporting Information, by Segment	Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the three and nine-month periods ended September 30, 2023 and 2022, were as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended Nine Months Ended ​ September 30, September 30, ​ 2023 2022 2023 2022 Net sales ​ ​ ​ ​ Cardiovascular ​ $ 306,084 ​ $ 278,949 ​ $ 905,335 ​ $ 832,555 Endoscopy ​ 9,146 ​ 8,226 ​ 27,516 ​ 25,011 Total net sales ​ 315,230 ​ 287,175 ​ 932,851 ​ 857,566 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Income from operations ​ ​ ​ ​ Cardiovascular ​ 32,622 ​ 17,435 ​ 82,966 ​ 51,836 Endoscopy ​ 2,515 ​ 1,222 ​ 7,366 ​ 5,310 Total income from operations ​ 35,137 ​ 18,657 ​ 90,332 ​ 57,146 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total other expense — net ​ (4,915) ​ (1,055) ​ (9,710) ​ (4,672) Income tax expense ​ 4,388 ​ 2,330 ​ 13,840 ​ 11,359 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Net income ​ $ 25,834 ​ $ 15,272 ​ $ 66,782 ​ $ 41,115 ​

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis	Our financial assets and (liabilities) carried at fair value and measured on a recurring basis as of September 30, 2023 and December 31, 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value Measurements Using ​ ​ Total Fair ​ Quoted prices in ​ Significant other ​ Significant ​ ​ Value at ​ active markets ​ observable inputs ​ unobservable inputs ​ September 30, 2023 (Level 1) (Level 2) (Level 3) Marketable securities (1) ​ $ 73 ​ $ 73 ​ $ — ​ $ — Interest rate contract asset, current (2) ​ $ 2,320 ​ $ — ​ $ 2,320 ​ $ — Foreign currency contract assets, current and long-term (3) ​ $ 6,035 ​ $ — ​ $ 6,035 ​ $ — Foreign currency contract liabilities, current and long-term (4) ​ $ (2,980) ​ $ — ​ $ (2,980) ​ $ — Contingent consideration liabilities ​ $ (4,022) ​ $ — ​ $ — ​ $ (4,022) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value Measurements Using ​ ​ Total Fair ​ Quoted prices in ​ Significant other ​ Significant ​ ​ Value at ​ active markets ​ observable inputs ​ unobservable inputs ​ December 31, 2022 (Level 1) (Level 2) (Level 3) Marketable securities (1) ​ $ 138 ​ $ 138 ​ $ — ​ ​ — Interest rate contract asset, long-term (2) ​ $ 3,444 ​ $ — ​ $ 3,444 ​ $ — Foreign currency contract assets, current and long-term (3) ​ $ 4,783 ​ $ — ​ $ 4,783 ​ $ — Foreign currency contract liabilities, current and long-term (4) ​ $ (3,986) ​ $ — ​ $ (3,986) ​ $ — Contingent consideration liabilities ​ $ (18,073) ​ $ — ​ $ — ​ $ (18,073) (1) Our marketable securities, which consist entirely of available-for-sale equity securities, are valued using market prices in active markets. Level 1 instrument valuations are obtained from real-time quotes for transactions in active exchange markets involving identical assets. (2) The fair value of the interest rate contract is determined using Level 2 fair value inputs and is reported within prepaid expenses and other current assets as of September 30, 2023 and other long-term assets as of December 31, 2022 in the consolidated balance sheets. (3) The fair value of the foreign currency contract assets (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as prepaid expenses and other current assets or other long-term assets in the consolidated balance sheets. (4) The fair value of the foreign currency contract liabilities (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as accrued expenses or other long-term obligations in the consolidated balance sheets. ​
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	Changes in the fair value of our contingent consideration liabilities during the three and nine-month periods ended September 30, 2023 and 2022 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended Nine Months Ended ​ September 30, September 30, ​ 2023 2022 2023 2022 Beginning balance ​ $ 3,581 ​ $ 17,426 ​ $ 18,073 ​ $ 48,234 ​ Contingent consideration expense ​ 563 ​ 915 ​ 2,177 ​ 4,702 ​ Contingent payments made ​ (122) ​ (91) ​ (16,228) ​ (34,676) ​ Effect of foreign exchange ​ ​ — ​ ​ — ​ ​ — ​ ​ (10) ​ Ending balance ​ $ 4,022 ​ $ 18,250 ​ $ 4,022 ​ $ 18,250 ​
Fair Value Inputs, Liabilities, Quantitative Information	The recurring Level 3 measurement of our contingent consideration liabilities included the following significant unobservable inputs at September 30, 2023 and December 31, 2022 (amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ Valuation ​ ​ ​ ​ ​ Weighted Contingent consideration liability 2023 technique Unobservable inputs Range ​ Average (1) Revenue-based royalty payments contingent liability ​ $ 3,534 Discounted cash flow Discount rate ​ 12% - 16% ​ 14.9% ​ ​ ​ Projected year of payments ​ 2023-2034 ​ 2028 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue milestones contingent liability ​ $ 88 Monte Carlo simulation Discount rate ​ 13.0% ​ ​ ​ ​ ​ Projected year of payments ​ 2023-2039 ​ 2039 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Regulatory approval contingent liability ​ $ 400 ​ Scenario-based method ​ Discount rate ​ 5.7% ​ ​ ​ ​ ​ ​ ​ ​ ​ Probability of milestone payment ​ 50.0% ​ ​ ​ ​ ​ ​ ​ ​ ​ Projected year of payment ​ 2023-2030 ​ 2030 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ Valuation ​ ​ ​ ​ ​ Weighted Contingent consideration liability 2022 technique Unobservable inputs Range ​ Average (1) Revenue-based royalty payments contingent liability ​ $ 2,097 Discounted cash flow Discount rate ​ 14% - 17% ​ 15.7% ​ ​ ​ Projected year of payments ​ 2023-2034 ​ 2026 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue milestones contingent liability ​ $ 13,064 Monte Carlo simulation Discount rate ​ 5.1% - 14.0% ​ 5.2% ​ ​ ​ Projected year of payments ​ 2023-2033 ​ 2023 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Regulatory approval contingent liability ​ $ 2,912 ​ Scenario-based method ​ Discount rate ​ 5.7% ​ ​ ​ ​ ​ ​ ​ ​ ​ Probability of milestone payment ​ 90% ​ ​ ​ ​ ​ ​ ​ ​ ​ Projected year of payment ​ 2023-2030 ​ 2024 (1) Unobservable inputs were weighted by the relative fair value of the instruments. No weighted average is reported for contingent consideration liabilities without a range of unobservable inputs.
Schedule of Rollforward of Allowance for Credit Losses	​ The table below presents a rollforward of the allowance for current expected credit losses on our notes receivable for the three and nine-month periods ended September 30, 2023 and 2022 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ ​ 2023 2022 ​ 2023 2022 Beginning balance ​ $ 296 ​ $ 192 ​ $ 281 ​ $ 199 Provision for credit loss expense ​ ​ 32 ​ ​ (6) ​ ​ 47 ​ ​ (13) Ending balance ​ $ 328 ​ $ 186 ​ $ 328 ​ $ 186 ​

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Income (Loss) (Tables)	9 Months Ended
	Sep. 30, 2023
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest [Abstract]
Schedule of Components of Accumulated Other Comprehensive Income (Loss)	The changes in each component of accumulated other comprehensive income (loss) for the three and nine-month periods ended September 30, 2023 and 2022 were as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash Flow Hedges Foreign Currency Translation Total Balance as of July 1, 2023 $ 5,682 ​ $ (15,226) ​ $ (9,544) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 1,629 ​ ​ (2,914) ​ ​ (1,285) Income taxes 129 ​ ​ 17 ​ ​ 146 Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (866) ​ ​ ​ ​ ​ (866) Cost of sales ​ (617) ​ ​ ​ ​ ​ (617) Interest expense ​ (685) ​ ​ ​ ​ ​ (685) Net other comprehensive loss ​ (410) ​ ​ (2,897) ​ ​ (3,307) ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2023 $ 5,272 ​ $ (18,123) ​ $ (12,851) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash Flow Hedges Foreign Currency Translation Total Balance as of July 1, 2022 $ 4,584 ​ $ (15,303) ​ $ (10,719) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 4,995 ​ ​ (9,003) ​ ​ (4,008) Income taxes (942) ​ ​ 85 ​ ​ (857) Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (1,491) ​ ​ ​ ​ ​ (1,491) Cost of sales ​ 440 ​ ​ ​ ​ ​ 440 Interest expense ​ (94) ​ ​ ​ ​ ​ (94) Net other comprehensive income (loss) ​ 2,908 ​ ​ (8,918) ​ ​ (6,010) ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2022 $ 7,492 ​ $ (24,221) ​ $ (16,729) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash Flow Hedges Foreign Currency Translation Total Balance as of January 1, 2023 $ 4,366 ​ $ (15,916) ​ $ (11,550) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 6,793 ​ ​ (2,190) ​ ​ 4,603 Income taxes (286) ​ ​ (17) ​ ​ (303) Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (2,851) ​ ​ ​ ​ ​ (2,851) Cost of sales ​ (900) ​ ​ ​ ​ ​ (900) Interest expense ​ (1,850) ​ ​ ​ ​ ​ (1,850) Net other comprehensive income (loss) ​ 906 ​ ​ (2,207) ​ ​ (1,301) ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2023 $ 5,272 ​ $ (18,123) ​ $ (12,851) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash Flow Hedges Foreign Currency Translation Total Balance as of January 1, 2022 $ (2,464) ​ $ (5,527) ​ $ (7,991) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 13,220 ​ ​ (17,739) ​ ​ (4,519) Income taxes (3,226) ​ ​ 81 ​ ​ (3,145) Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (1,303) ​ ​ ​ ​ ​ (1,303) Cost of sales ​ 886 ​ ​ ​ ​ ​ 886 Interest expense ​ 379 ​ ​ ​ ​ ​ 379 Other expense - net ​ ​ ​ ​ (1,036) ​ ​ (1,036) Net other comprehensive income (loss) ​ 9,956 ​ ​ (18,694) ​ ​ (8,738) ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2022 $ 7,492 ​ $ (24,221) ​ $ (16,729) ​

Revenue from Contracts with C_3

Revenue from Contracts with Customers - Disaggregation of Revenue (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2023 USD ($) item segment	Sep. 30, 2022 USD ($)
Disaggregation of Revenue [Line Items]
Number of operating segments | segment			2
Net sales	$ 315,230	$ 287,175	$ 932,851	$ 857,566
United States
Disaggregation of Revenue [Line Items]
Net sales	187,505	164,571	538,447	482,237
International
Disaggregation of Revenue [Line Items]
Net sales	127,725	122,604	$ 394,404	375,329
Cardiovascular
Disaggregation of Revenue [Line Items]
Number of product categories | item			4
Net sales	306,084	278,949	$ 905,335	832,555
Cardiovascular | Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	128,385	110,698	368,077	327,426
Cardiovascular | Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	89,106	86,848	268,209	257,909
Cardiovascular | Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	48,624	45,692	145,709	141,047
Cardiovascular | OEM
Disaggregation of Revenue [Line Items]
Net sales	39,969	35,711	123,340	106,173
Cardiovascular | United States
Disaggregation of Revenue [Line Items]
Net sales	179,019	156,897	512,742	458,967
Cardiovascular | United States | Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	78,617	67,200	219,257	195,095
Cardiovascular | United States | Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	36,593	33,194	106,588	95,652
Cardiovascular | United States | Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	29,602	27,078	85,556	80,951
Cardiovascular | United States | OEM
Disaggregation of Revenue [Line Items]
Net sales	34,207	29,425	101,341	87,269
Cardiovascular | International
Disaggregation of Revenue [Line Items]
Net sales	127,065	122,052	392,593	373,588
Cardiovascular | International | Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	49,768	43,498	148,820	132,331
Cardiovascular | International | Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	52,513	53,654	161,621	162,257
Cardiovascular | International | Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	19,022	18,614	60,153	60,096
Cardiovascular | International | OEM
Disaggregation of Revenue [Line Items]
Net sales	5,762	6,286	21,999	18,904
Endoscopy
Disaggregation of Revenue [Line Items]
Net sales	9,146	8,226	27,516	25,011
Endoscopy | Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	9,146	8,226	27,516	25,011
Endoscopy | United States | Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	8,486	7,674	25,705	23,270
Endoscopy | International | Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	$ 660	$ 552	$ 1,811	$ 1,741

Acquisitions - Angio Dynamics,

Acquisitions - Angio Dynamics, Inc (Details) - Angio Dynamics Inc - USD ($) $ in Millions		3 Months Ended	9 Months Ended
	Jun. 08, 2023	Sep. 30, 2023	Sep. 30, 2023
Asset Acquisition [Line Items]
Total purchase price	$ 100
Net sales related to acquisition		$ 7.3	$ 8.3
Acquisition-related costs		$ 0.1	$ 4.9
Weighted Average
Asset Acquisition [Line Items]
Amortization period	10 years 6 months
Developed technology
Asset Acquisition [Line Items]
Amortization period	9 years
Trade Names
Asset Acquisition [Line Items]
Amortization period	11 years
Customer Lists
Asset Acquisition [Line Items]
Amortization period	10 years

Acquisitions - Bluegrass Vascul

Acquisitions - Bluegrass Vascular Technologies (Details) - USD ($) $ in Thousands	May 04, 2023	May 03, 2023
Bluegrass Vascular Technologies, Inc
Business Acquisition [Line Items]
Total purchase price	$ 32,700
Bluegrass Vascular Technologies, Inc | Weighted Average
Business Acquisition [Line Items]
Amortization period	14 years 10 months 24 days
Bluegrass Vascular Technologies, Inc | Developed technology
Business Acquisition [Line Items]
Amortization period	15 years
Bluegrass Vascular Technologies, Inc | Trademarks
Business Acquisition [Line Items]
Amortization period	13 years
Bluegrass Vascular Technologies, Inc
Business Acquisition [Line Items]
Ownership percentage		19.50%
Investment of common shares		1,251,878
Equity method investment		$ 245

Acquisitions - Advanced Radiati

Acquisitions - Advanced Radiation Therapy (Details) - Advanced Radiation Therapy, LLC	May 01, 2023 USD ($)
Asset Acquisition [Line Items]
Purchase price	$ 750,000
Payment period	30 days
Acquired in-process research and development expense	$ 1,500,000
First Payment
Asset Acquisition [Line Items]
Deferred payment	500,000
Second Payment
Asset Acquisition [Line Items]
Deferred payment	$ 750,000

Acquisitions - Solo Pace, Inc (

Acquisitions - Solo Pace, Inc (Details) - Solo Pace $ in Millions	Jan. 11, 2023 USD ($)
Business Acquisition [Line Items]
Payments to acquire shares	$ 4
Option to purchase business	5 years
Sales threshold	$ 6
Ownership percentage	19%

Acquisitions - Purchase Price A

Acquisitions - Purchase Price Allocation (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Jun. 08, 2023	May 04, 2023	Dec. 31, 2022
Assets Acquired
Goodwill	$ 381,052			$ 359,821
Angio Dynamics Inc
Assets Acquired
Prepaid expenses		$ 2,000
Inventories		5,254
Property and equipment		108
Goodwill		17,638
Total net assets acquired		100,000
Angio Dynamics Inc | Developed technology
Assets Acquired
Intangible assets		65,200
Angio Dynamics Inc | Trade Names
Assets Acquired
Intangible assets		4,000
Angio Dynamics Inc | Customer Lists
Assets Acquired
Intangible assets		$ 5,800
Bluegrass Vascular Technologies, Inc
Assets Acquired
Inventories			$ 175
Goodwill			3,898
Total net assets acquired			32,973
Bluegrass Vascular Technologies, Inc | Developed technology
Assets Acquired
Intangible assets			28,000
Bluegrass Vascular Technologies, Inc | Trade Names
Assets Acquired
Intangible assets			$ 900

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Finished goods	$ 156,074	$ 147,051
Work-in-process	34,092	29,534
Raw materials	113,757	89,406
Total Inventories	$ 303,923	$ 265,991

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Goodwill (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2023 USD ($)
Goodwill [Roll Forward]
Goodwill balance at beginning of period	$ 359,821
Effect of foreign exchange	305
Additions and adjustments as the result of acquisitions	21,536
Goodwill balance at end of period	$ 381,052

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Other Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Other
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 120,753	$ 108,130
Accumulated Amortization	(76,909)	(69,780)
Net Carrying Amount	43,844	38,350
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	30,969	29,445
Accumulated Amortization	(12,657)	(10,203)
Net Carrying Amount	18,312	19,242
Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	3,250	3,250
Accumulated Amortization	(2,868)	(2,715)
Net Carrying Amount	382	535
License agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	11,128	11,109
Accumulated Amortization	(8,076)	(7,250)
Net Carrying Amount	3,052	3,859
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	35,119	30,221
Accumulated Amortization	(19,998)	(17,863)
Net Carrying Amount	15,121	12,358
Customer Lists
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	40,287	34,105
Accumulated Amortization	(33,310)	(31,749)
Net Carrying Amount	$ 6,977	$ 2,356

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Accumulated goodwill impairment losses	$ 8.3		$ 8.3		$ 8.3
Goodwill impairment loss			0	$ 0
Aggregate amortization expense	$ 15.4	$ 12.1	41.1	36.3
Impairment of intangible assets			$ 0
STD Pharmaceutical Products Limited
Finite-Lived Intangible Assets [Line Items]
Impairment of intangible assets				$ 1.7
Impairment, Intangible Asset, Finite-Lived, Statement of Income or Comprehensive Income [Extensible Enumeration]				Asset Impairment Charges

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Future Amortization Expense (Details) $ in Thousands	Sep. 30, 2023 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Remaining 2023	$ 15,764
2024	59,656
2025	57,661
2026	46,955
2027	$ 43,774

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Income tax expense	$ 4,388	$ 2,330	$ 13,840	$ 11,359
Effective tax rate	14.50%	13.20%	17.20%	21.60%

Revolving Credit Facility and_3

Revolving Credit Facility and Long-Term Debt - Principal Balances under Long-term Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Long-term debt	$ 287,063
Less unamortized debt issuance costs	(943)	$ (179)
Total long-term debt	286,120	198,009
Less current portion	3,750	11,250
Long-term portion	282,370	186,759
Term Loan
Debt Instrument [Line Items]
Long-term debt	149,063	124,688
Revolving Credit Facility
Debt Instrument [Line Items]
Long-term debt	$ 138,000	$ 73,500

Revolving Credit Facility and_4

Revolving Credit Facility and Long-Term Debt - Narrative (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Jun. 06, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Outstanding borrowings	$ 287,063
Credit Agreement
Debt Instrument [Line Items]
Outstanding borrowings	287,100
Letter of credit guarantees	3,800
Available borrowing capacity	$ 558,000
Fixed interest rate percent	2.89%		2.71%
Debt subject to fixed interest rate	$ 75,000		$ 75,000
Variable interest rate percent	6.67%		5.38%
Debt subject to variable interest rate	$ 212,100		$ 123,200
Term Loan
Debt Instrument [Line Items]
Outstanding borrowings	149,063		124,688
Term Loan | Credit Agreement
Debt Instrument [Line Items]
Debt instrument, face amount		$ 150,000
Revolving Credit Facility
Debt Instrument [Line Items]
Outstanding borrowings	$ 138,000		$ 73,500
Revolving Credit Facility | Credit Agreement
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 700,000

Revolving Credit Facility and_5

Revolving Credit Facility and Long-Term Debt - Financial Covenants (Details) - Credit Agreement	9 Months Ended
	Sep. 30, 2023
Debt Instrument [Line Items]
Consolidated Total Leverage Ratio	4
Consolidated Interest Coverage Ratio	3

Revolving Credit Facility and_6

Revolving Credit Facility and Long-Term Debt - Future Minimum Payments on Long-term Debt (Details) $ in Thousands	Sep. 30, 2023 USD ($)
Debt Disclosure [Abstract]
Remaining 2023	$ 938
2024	3,750
2025	5,625
2026	7,500
2027	9,375
2028	259,875
Total future minimum principal payments	$ 287,063

Derivatives - Narrative (Detail

Derivatives - Narrative (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Dec. 31, 2022	Dec. 23, 2019
Revenue and cost of sales
Derivative [Line Items]
Amount expected to be reclassified from accumulated other comprehensive income (loss) to earnings in next twelve months, gross	$ 4
Amount expected to be reclassified from accumulated other comprehensive income to earnings (loss) in next twelve months, net of tax	3
Interest expense
Derivative [Line Items]
Amount expected to be reclassified from accumulated other comprehensive income (loss) to earnings in next twelve months, gross	2.3
Amount expected to be reclassified from accumulated other comprehensive income to earnings (loss) in next twelve months, net of tax	1.8
Interest rate swap | Designated as hedging instrument
Derivative [Line Items]
Fair value of derivative asset	2.3	$ 3.4
Deferred tax liability used to offset fair value of interest rate swap	$ (0.6)	$ (0.8)
Interest rate swap | Wells Fargo 1.71% one-month LIBOR | Designated as hedging instrument
Derivative [Line Items]
Notional amount of derivative			$ 75
Fixed rate			1.64%
Investment, Variable Interest Rate, Type [Extensible Enumeration]			us-gaap:SecuredOvernightFinancingRateSofrOvernightIndexSwapRateMember
Foreign currency forward contracts
Derivative [Line Items]
Maturity of derivative contract (up to)	2 years

Derivatives - Forward Notional

Derivatives - Forward Notional Contracts (Details) - Foreign currency forward contracts $ in Millions	Sep. 30, 2023 USD ($) DerivativeInstrument	Dec. 31, 2022 USD ($)
Designated as hedging instrument | Derivatives designated as cash flow hedges
Derivative [Line Items]
Average number of contracts entered into per month | DerivativeInstrument	100
Aggregate notional amount of derivative | $	$ 155.7	$ 87.8
Not designated as hedging instrument | Fair Value Hedging
Derivative [Line Items]
Average number of contracts entered into per month | DerivativeInstrument	50
Aggregate notional amount of derivative | $	$ 96	$ 92.4

Derivatives - Fair Value of Der

Derivatives - Fair Value of Derivative Instruments (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Designated as hedging instrument | Interest rate swap
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	$ 2,300	$ 3,400
Designated as hedging instrument | Interest rate swap | Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	2,320
Designated as hedging instrument | Interest rate swap | Other assets (long-term)
Derivatives, Fair Value [Line Items]
Fair value of derivative asset		3,444
Designated as hedging instrument | Foreign currency forward contracts | Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	3,463	3,215
Designated as hedging instrument | Foreign currency forward contracts | Other assets (long-term)
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	698	56
Designated as hedging instrument | Foreign currency forward contracts | Accrued expenses
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(845)	(1,509)
Designated as hedging instrument | Foreign currency forward contracts | Other long-term obligations
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(238)	(531)
Not designated as hedging instrument | Foreign currency forward contracts | Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	1,874	1,512
Not designated as hedging instrument | Foreign currency forward contracts | Accrued expenses
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	$ (1,897)	$ (1,946)

Derivatives - Amount of Gain (L

Derivatives - Amount of Gain (Loss) Recognized in OCI and Income Statement (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	$ (539)	$ 3,850	$ 1,192	$ 13,182
Interest expense	(4,841)	(1,831)	(10,534)	(4,180)
Net sales	315,230	287,175	932,851	857,566
Cost of sales	(173,031)	(158,602)	(499,508)	(473,019)
Derivatives designated as cash flow hedges | Interest rate swap
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	126	1,504	726	4,507
Derivatives designated as cash flow hedges | Interest rate swap | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	685	94	1,850	(379)
Derivatives designated as cash flow hedges | Foreign currency forward contracts
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	1,503	3,491	6,067	8,713
Derivatives designated as cash flow hedges | Foreign currency forward contracts | Revenue
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	866	1,491	2,851	1,303
Derivatives designated as cash flow hedges | Foreign currency forward contracts | Cost of sales
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	$ 617	$ (440)	$ 900	$ (886)

Derivatives - Gain (Loss) in th

Derivatives - Gain (Loss) in the Consolidated Statements of Income (Details) - Not designated as hedging instrument - Foreign currency forward contracts - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Derivative [Line Items]
Gain (loss) on derivative	$ (452)	$ 1,034	$ 2,748	$ 1,212
Derivative, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Other Nonoperating Income (Expense)	Other Nonoperating Income (Expense)	Other Nonoperating Income (Expense)	Other Nonoperating Income (Expense)

Earnings Per Common Share (EP_3

Earnings Per Common Share (EPS) - Basic EPS (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Net income	$ 25,834	$ 20,245	$ 20,703	$ 15,272	$ 15,298	$ 10,545	$ 66,782	$ 41,115
Average common shares outstanding (in shares)	57,682			56,835			57,525	56,707
Basic EPS (in dollars per share)	$ 0.45			$ 0.27			$ 1.16	$ 0.73

Earnings Per Common Share (EP_4

Earnings Per Common Share (EPS) - Diluted EPS (Details) - $ / shares shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Average common shares outstanding (in shares)	57,682	56,835	57,525	56,707
Effect of dilutive stock awards (in shares)	693	751	820	866
Total potential shares outstanding (in shares)	58,375	57,586	58,345	57,573
Diluted EPS (in dollars per share)	$ 0.44	$ 0.27	$ 1.14	$ 0.71
Equity awards excluded as the impact was anti-dilutive (in shares)	1,242	1,641	1,091	1,612

Stock-Based Compensation Expe_3

Stock-Based Compensation Expense - Allocation of Recognized Period Costs (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 5,797	$ 4,598	$ 15,346	$ 13,691
Cost of sales | Employee Stock Option [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	367	150	1,240	1,247
Research and development | Employee Stock Option [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	488	476	1,329	1,412
Selling, general and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	4,942	3,972	12,777	11,032
Selling, general and administrative | Employee Stock Option [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	2,083	2,166	5,304	5,297
Selling, general and administrative | Stock-Settled Performance-Based Restricted Stock Units
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	1,838	647	4,470	2,719
Selling, general and administrative | Restricted Stock Units
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	430	454	1,341	1,382
Selling, general and administrative | Cash-Settled Performance-Based Share-Based Awards (Liability Awards)
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 591	$ 705	$ 1,662	$ 1,634

Stock-Based Compensation Expe_4

Stock-Based Compensation Expense - Narrative (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Employee Stock Option [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted in period (in shares)	401,535	203,606
Compensation cost not yet recognized	$ 22.5
Compensation cost not yet recognized, period of recognition	2 years 3 months 18 days
Stock-Settled Performance-Based Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Compensation cost not yet recognized	$ 12.3
Compensation cost not yet recognized, period of recognition	2 years
Award vesting period	1 year
Stock-Settled Performance-Based Restricted Stock Units | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock units granted in period (in shares)	286,863	120,710
Cash-Settled Performance-Based Share-Based Awards (Liability Awards)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Target cash incentive	$ 1.3	$ 1
Compensation cost not yet recognized	$ 3.6
Compensation cost not yet recognized, period of recognition	2 years
Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted stock units granted (in shares)	20,358	30,500
Compensation cost not yet recognized	$ 1.1
Award vesting period	1 year

Stock-Based Compensation Expe_5

Stock-Based Compensation Expense - Option Granted Fair Value Calculation Assumptions (Details) - Employee Stock Option [Member]	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum	3.60%	1.40%
Risk-free interest rate, maximum	4.60%	3.40%
Expected option term / Performance Period	4 years	4 years
Expected price volatility, minimum	44.60%	46.20%
Expected price volatility, maximum	47.10%	47.40%

Stock-Based Compensation Expe_6

Stock-Based Compensation Expense - PSUs Fair Value Calculation Assumptions (Details) - Stock-Settled Performance-Based Restricted Stock Units	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum	3.90%	1.60%
Risk-free interest rate, maximum	4.60%	2.70%
Expected option term / Performance Period	2 years 9 months 18 days
Expected price volatility, minimum	31.40%	38.50%
Expected price volatility, maximum	32.60%	46.20%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected option term / Performance Period		2 years 7 months 6 days
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected option term / Performance Period		2 years 9 months 18 days

Segment Reporting - Narrative (

Segment Reporting - Narrative (Details)	9 Months Ended
	Sep. 30, 2023 item segment
Segment Reporting Information [Line Items]
Number of operating segments | segment	2
Cardiovascular
Segment Reporting Information [Line Items]
Number of Product Categories | item	4

Segment Reporting - Operating I

Segment Reporting - Operating Income (Details) - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Segment Reporting Information [Line Items]
Net sales	$ 315,230			$ 287,175			$ 932,851	$ 857,566
Income from operations	35,137			18,657			90,332	57,146
Total other expense - net	(4,915)			(1,055)			(9,710)	(4,672)
Income tax expense	4,388			2,330			13,840	11,359
Net income	25,834	$ 20,245	$ 20,703	15,272	$ 15,298	$ 10,545	66,782	41,115
Cardiovascular
Segment Reporting Information [Line Items]
Net sales	306,084			278,949			905,335	832,555
Income from operations	32,622			17,435			82,966	51,836
Endoscopy
Segment Reporting Information [Line Items]
Net sales	9,146			8,226			27,516	25,011
Income from operations	$ 2,515			$ 1,222			$ 7,366	$ 5,310

Fair Value Measurements - Finan

Fair Value Measurements - Financial Assets and (Liabilities) Carried at Fair Value (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Fair Value, Inputs, Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	$ 73	$ 138
Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate contract asset, current and long-term	2,320	3,444
Foreign currency contract assets, current and long-term	6,035	4,783
Foreign currency contract liabilities, current and long-term	(2,980)	(3,986)
Fair Value, Inputs, Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liabilities	(4,022)	(18,073)
Estimate of Fair Value, Fair Value Disclosure
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	73	138
Interest rate contract asset, current and long-term	2,320	3,444
Foreign currency contract assets, current and long-term	6,035	4,783
Foreign currency contract liabilities, current and long-term	(2,980)	(3,986)
Contingent consideration liabilities	$ (4,022)	$ (18,073)

Fair Value Measurements - Liabi

Fair Value Measurements - Liability Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - Contingent Consideration - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 3,581	$ 17,426	$ 18,073	$ 48,234
Contingent consideration expense	$ 563	$ 915	$ 2,177	$ 4,702
Fair Value, Recurring Basis, Unobservable Input Reconciliation, Liability, Gain (Loss), Statement of Income [Extensible List]	Business Combination, Contingent Consideration Arrangements, Contingent Consideration Benefit	Business Combination, Contingent Consideration Arrangements, Contingent Consideration Benefit	Business Combination, Contingent Consideration Arrangements, Contingent Consideration Benefit	Business Combination, Contingent Consideration Arrangements, Contingent Consideration Benefit
Contingent payments made	$ (122)	$ (91)	$ (16,228)	$ (34,676)
Effect of foreign exchange				(10)
Ending balance	$ 4,022	$ 18,250	$ 4,022	$ 18,250

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended			9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Jun. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Jun. 30, 2023	May 03, 2023	Dec. 31, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Payments related to the settlement of the contingent consideration liability, Financing activities				$ 3,502	$ 32,862
Payments related to the settlement of the contingent consideration liability, Operating activities				12,700	1,800
Impairment of intangible assets				0
Loss on disposition of business					1,389
Interest income	$ 181	$ 116		533	316
Allowance for expected credit losses	328	$ 186	$ 192	328	186	$ 296		$ 281	$ 199
Fibrovein Holdings Limited | Disposal Group, Not Discontinued Operations [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Loss on disposition of business			1,300
Cash			1,000
Inventory			1,200
Reclassification of foreign currency translation gains			$ 1,000
Bluegrass Vascular Technologies, Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of equity method investment				270
Ownership percentage							19.50%
Equity method investment							$ 245
STD Pharmaceutical Products Limited
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of intangible assets					$ 1,700
Impairment, Intangible Asset, Finite-Lived, Statement of Income or Comprehensive Income [Extensible Enumeration]					Asset Impairment Charges
Selio
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Long-term notes receivable, net	2,400			2,400				2,400
Allowance for expected credit losses	328			328				281
Director | Cianna Medical
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent payments related to acquisition				900	$ 1,600
Other long-term obligations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability, noncurrent	3,600			3,600				2,300
Accrued expenses
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability, current	$ 400			$ 400				$ 15,800

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value Inputs, Liabilities, Quantitative Information (Details) - Fair Value, Inputs, Level 3 $ in Thousands	Sep. 30, 2023 USD ($)	Dec. 31, 2022 USD ($)
Revenue-based royalty
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	$ 3,534	$ 2,097
Revenue milestones
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	88	13,064
Regulatory approval
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	$ 400	$ 2,912
Discount rate | Revenue-based royalty | Minimum | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.12	0.14
Discount rate | Revenue-based royalty | Maximum | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.16	0.17
Discount rate | Revenue-based royalty | Weighted Average | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.149	0.157
Discount rate | Revenue milestones | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.130
Discount rate | Revenue milestones | Minimum | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability		0.051
Discount rate | Revenue milestones | Maximum | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability		0.140
Discount rate | Revenue milestones | Weighted Average | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability		0.052
Discount rate | Regulatory approval | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.057	0.057
Probability of milestone payment | Regulatory approval | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.500	0.90

Fair Value Measurements - Allow

Fair Value Measurements - Allowance for Credit Losses (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 296	$ 192	$ 281	$ 199
Provision for credit loss expense	32	(6)	47	(13)
Ending balance	$ 328	$ 186	$ 328	$ 186

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive Income (Loss) - Changes in AOCI (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Accumulated other comprehensive income (loss)
Beginning balance	$ 1,203,700	$ 1,073,307	$ 1,144,397	$ 1,039,799
Reclassifications to:
Cost of sales	(173,031)	(158,602)	(499,508)	(473,019)
Interest expense	(4,841)	(1,831)	(10,534)	(4,180)
Other expense - net	(255)	660	291	(808)
Ending balance	1,229,885	1,088,841	1,229,885	1,088,841
Accumulated Other Comprehensive Loss
Accumulated other comprehensive income (loss)
Beginning balance	(9,544)	(10,719)	(11,550)	(7,991)
Other comprehensive income (loss)	(1,285)	(4,008)	4,603	(4,519)
Income taxes	146	(857)	(303)	(3,145)
Reclassifications to:
Net other comprehensive income (loss)	(3,307)	(6,010)	(1,301)	(8,738)
Ending balance	(12,851)	(16,729)	(12,851)	(16,729)
Accumulated Other Comprehensive Loss | Reclassification out of Accumulated Other Comprehensive Income [Member]
Reclassifications to:
Revenue	(866)	(1,491)	(2,851)	(1,303)
Cost of sales	(617)	440	(900)	886
Interest expense	(685)	(94)	(1,850)	379
Other expense - net				(1,036)
Cash Flow Hedges
Accumulated other comprehensive income (loss)
Beginning balance	5,682	4,584	4,366	(2,464)
Other comprehensive income (loss)	1,629	4,995	6,793	13,220
Income taxes	129	(942)	(286)	(3,226)
Reclassifications to:
Net other comprehensive income (loss)	(410)	2,908	906	9,956
Ending balance	5,272	7,492	5,272	7,492
Cash Flow Hedges | Reclassification out of Accumulated Other Comprehensive Income [Member]
Reclassifications to:
Revenue	(866)	(1,491)	(2,851)	(1,303)
Cost of sales	(617)	440	(900)	886
Interest expense	(685)	(94)	(1,850)	379
Foreign Currency Translation
Accumulated other comprehensive income (loss)
Beginning balance	(15,226)	(15,303)	(15,916)	(5,527)
Other comprehensive income (loss)	(2,914)	(9,003)	(2,190)	(17,739)
Income taxes	17	85	(17)	81
Reclassifications to:
Net other comprehensive income (loss)	(2,897)	(8,918)	(2,207)	(18,694)
Ending balance	$ (18,123)	$ (24,221)	$ (18,123)	(24,221)
Foreign Currency Translation | Reclassification out of Accumulated Other Comprehensive Income [Member]
Reclassifications to:
Other expense - net				$ (1,036)

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net Income (Loss)	$ 25,834	$ 20,245	$ 20,703	$ 15,272	$ 15,298	$ 10,545	$ 66,782	$ 41,115

Insider Trading Arrangements

Insider Trading Arrangements - F. Ann Millner, Ed.D.	3 Months Ended
	Sep. 30, 2023 shares
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On August 7, 2023, F. Ann Millner, Ed.D., one of our directors, adopted a trading arrangement for the sale of shares of our common stock (a “Rule 10b5-1 Trading Plan”) that is intended to satisfy the affirmative defense conditions of Exchange Act Rule 10b5-1(c). Dr. Millner’s Rule 10b5-1 Trading Plan, which has a term of two years, provides for sales of up to 66,250 shares of common stock pursuant to the terms of the plan.
Name	F. Ann Millner, Ed.D
Title	directors
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	August 7, 2023
Arrangement Duration	2 years
Aggregate Available	66,250