Merit Medical Systems (MMSI) 10-Q 30 Oct 24 2024 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2024	Oct. 28, 2024
Cover page.
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2024
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		58,279,409
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 523,128	$ 587,036
Trade receivables - net of allowance for credit losses - 2024 - $9,266 and 2023 - $9,023	189,831	177,885
Other receivables	15,325	10,517
Inventories	310,527	303,871
Prepaid expenses and other current assets	27,105	24,286
Prepaid income taxes	4,216	4,016
Income tax refund receivables	8,185	859
Total current assets	1,078,317	1,108,470
Property and equipment:
Land and land improvements	26,108	26,017
Buildings	192,323	191,491
Manufacturing equipment	334,787	316,930
Furniture and fixtures	66,593	63,044
Leasehold improvements	59,005	53,638
Construction-in-progress	66,699	61,439
Total property and equipment	745,515	712,559
Less accumulated depreciation	(355,862)	(329,036)
Property and equipment - net	389,653	383,523
Other assets:
Goodwill	399,448	382,240
Deferred income tax assets	7,253	7,288
Right-of-use operating lease assets	68,867	63,047
Other assets	62,382	54,793
Total other assets	910,114	833,251
Total assets	2,378,084	2,325,244
Current liabilities:
Trade payables	60,808	65,944
Accrued expenses	127,255	120,447
Short-term operating lease liabilities	11,469	12,087
Income taxes payable	1,547	5,086
Total current liabilities	201,079	203,564
Long-term debt	750,505	823,013
Deferred income tax liabilities	5,571	5,547
Long-term income taxes payable	347	347
Liabilities related to unrecognized tax benefits	1,912	1,912
Deferred compensation payable	19,218	17,167
Deferred credits	1,527	1,605
Long-term operating lease liabilities	57,178	56,259
Other long-term obligations	17,341	13,830
Total liabilities	1,054,678	1,123,244
Commitments and contingencies
Stockholders' equity:
Preferred stock - 5,000 shares authorized; no shares issued as of September 30, 2024 and December 31, 2023
Common stock, no par value - 100,000 shares authorized; issued and outstanding as of September 30, 2024 - 58,274 and December 31, 2023 - 57,858	669,207	638,150
Retained earnings	667,594	575,184
Accumulated other comprehensive loss	(13,395)	(11,334)
Total stockholders' equity	1,323,406	1,202,000
Total liabilities and stockholders' equity	2,378,084	2,325,244
Developed technology
Other assets:
Intangible assets:	322,325	283,999
Other
Other assets:
Intangible assets:	$ 49,839	$ 41,884

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets:
Trade receivables, allowances	$ 9,266	$ 9,023
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)	58,274	57,858
Common stock shares outstanding (in shares)	58,274	57,858
Developed technology
Other assets:
Intangibles, accumulated amortization	$ 361,725	$ 321,488
Other
Other assets:
Intangibles, accumulated amortization	$ 82,979	$ 76,887

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement [Abstract]
Net sales	$ 339,845	$ 315,230	$ 1,001,356	$ 932,851
Cost of sales	182,310	173,031	531,006	499,508
Gross profit	157,535	142,199	470,350	433,343
Operating expenses:
Selling, general and administrative	99,644	86,854	288,657	277,925
Research and development	20,527	19,646	62,272	61,089
Impairment charges				270
Contingent consideration expense	103	562	292	2,177
Acquired in-process research and development				1,550
Total operating expenses	120,274	107,062	351,221	343,011
Income from operations	37,261	35,137	119,129	90,332
Other income (expense):
Interest income	6,652	181	21,489	533
Interest expense	(7,501)	(4,841)	(23,226)	(10,534)
Other income (expense) - net	245	(255)	(544)	291
Total other expense - net	(604)	(4,915)	(2,281)	(9,710)
Income before income taxes	36,657	30,222	116,848	80,622
Income tax expense	8,213	4,388	24,438	13,840
Net income	$ 28,444	$ 25,834	$ 92,410	$ 66,782
Earnings per common share
Basic (in dollars per share)	$ 0.49	$ 0.45	$ 1.59	$ 1.16
Diluted (in dollars per share)	$ 0.48	$ 0.44	$ 1.57	$ 1.14
Weighted average shares outstanding
Basic (in shares)	58,231	57,682	58,110	57,525
Diluted (in shares)	59,537	58,375	58,948	58,345

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
Net income	$ 28,444	$ 25,834	$ 92,410	$ 66,782
Other comprehensive income (loss):
Cash flow hedges	(6,585)	(539)	(5,324)	1,192
Income tax benefit (expense)	1,555	129	1,257	(286)
Foreign currency translation adjustment	7,153	(2,914)	2,061	(2,190)
Income tax benefit (expense)	(89)	17	(55)	(17)
Total other comprehensive income (loss)	2,034	(3,307)	(2,061)	(1,301)
Total comprehensive income	$ 30,478	$ 22,527	$ 90,349	$ 65,481

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, 2022	$ 675,174	$ 480,773	$ (11,550)	$ 1,144,397
Beginning balance (in shares) at Dec. 31, 2022	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
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
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
Beginning balance at Dec. 31, 2023	$ 638,150	575,184	(11,334)	$ 1,202,000
Beginning balance (in shares) at Dec. 31, 2023	57,858			57,858
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		28,240		$ 28,240
Other comprehensive income (loss)			(1,122)	(1,122)
Stock-based compensation expense	$ 4,934			4,934
Options exercised	$ 7,394			7,394
Options exercised (in shares)	213
Issuance of common stock under Employee Stock Purchase Plan	$ 336			336
Issuance of common stock under Employee Stock Purchase Plan (in shares)	5
Shares issued from time-vested restricted stock units (in shares)	47
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)	(21)
Ending balance at Mar. 31, 2024	$ 649,222	603,424	(12,456)	1,240,190
Ending balance (in shares) at Mar. 31, 2024	58,102
Beginning balance at Dec. 31, 2023	$ 638,150	575,184	(11,334)	$ 1,202,000
Beginning balance (in shares) at Dec. 31, 2023	57,858			57,858
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income				$ 92,410
Other comprehensive income (loss)				(2,061)
Ending balance at Sep. 30, 2024	$ 669,207	667,594	(13,395)	$ 1,323,406
Ending balance (in shares) at Sep. 30, 2024	58,274			58,274
Beginning balance at Mar. 31, 2024	$ 649,222	603,424	(12,456)	$ 1,240,190
Beginning balance (in shares) at Mar. 31, 2024	58,102
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		35,726		35,726
Other comprehensive income (loss)			(2,973)	(2,973)
Stock-based compensation expense	$ 6,301			6,301
Options exercised	$ 2,913			2,913
Options exercised (in shares)	66
Issuance of common stock under Employee Stock Purchase Plan	$ 288			288
Issuance of common stock under Employee Stock Purchase Plan (in shares)	4
Shares issued from time-vested restricted stock units (in shares)	20
Ending balance at Jun. 30, 2024	$ 658,724	639,150	(15,429)	1,282,445
Ending balance (in shares) at Jun. 30, 2024	58,192
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		28,444		28,444
Other comprehensive income (loss)			2,034	2,034
Stock-based compensation expense	$ 5,990			5,990
Options exercised	$ 4,247			4,247
Options exercised (in shares)	80
Issuance of common stock under Employee Stock Purchase Plan	$ 246			246
Issuance of common stock under Employee Stock Purchase Plan (in shares)	2
Ending balance at Sep. 30, 2024	$ 669,207	$ 667,594	$ (13,395)	$ 1,323,406
Ending balance (in shares) at Sep. 30, 2024	58,274			58,274

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 92,410	$ 66,782
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	74,093	66,359
Loss on sale or abandonment of property and equipment	215	4,761
Write-off of certain intangible assets and other long-term assets	401	461
Acquired in-process research and development		1,550
Amortization of right-of-use operating lease assets	9,043	8,621
Fair value adjustments related to contingent consideration liabilities	292	2,177
Amortization of deferred credits	(77)	(78)
Amortization of long-term debt issuance costs	4,431	744
Stock-based compensation expense	18,958	15,346
Changes in operating assets and liabilities, net of acquisitions and divestitures:
Trade receivables	(9,540)	(3,852)
Other receivables	(4,670)	(1,040)
Inventories	(2,844)	(34,426)
Prepaid expenses and other current assets	(5,871)	(72)
Prepaid income taxes		(24)
Income tax refund receivables	(7,530)	(8,682)
Other assets	(3,860)	(719)
Trade payables	(6,489)	(20,332)
Accrued expenses	(614)	(599)
Income taxes payable	(2,246)	(3,431)
Deferred compensation payable	2,051	245
Operating lease liabilities	(9,056)	(8,573)
Other long-term obligations	2,958	(2,318)
Total adjustments	59,645	16,118
Net cash, cash equivalents, and restricted cash provided by operating activities	152,055	82,900
Capital expenditures for:
Property and equipment	(31,668)	(27,151)
Intangible assets	(2,138)	(1,756)
Proceeds from the sale of property and equipment	5	181
Issuance of note receivables	(6,662)
Cash paid in acquisitions and investments, net of cash acquired	(113,743)	(138,278)
Net cash, cash equivalents, and restricted cash used in investing activities	(154,206)	(167,004)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of common stock	15,424	11,446
Proceeds from issuance of long-term debt		480,499
Payments on long-term debt	(76,063)	(391,624)
Long-term debt issuance costs		(5,240)
Contingent payments related to acquisitions	(209)	(3,502)
Payment of taxes related to an exchange of common stock	(1,592)	(5,123)
Net cash, cash equivalents, and restricted cash (used in) provided by financing activities	(62,440)	86,456
Effect of exchange rates on cash, cash equivalents, and restricted cash	724	(2,181)
Net increase (decrease) in cash, cash equivalents and restricted cash	(63,867)	171
CASH, CASH EQUIVALENTS AND RESTRICTED CASH:
Beginning of period	589,144	60,558
End of period	525,277	60,729
RECONCILIATION OF CASH, CASH EQUIVALENTS AND RESTRICTED CASH TO THE CONSOLIDATED BALANCE SHEETS:
Cash and cash equivalents	523,128	58,673
Restricted cash reported in prepaid expenses and other current assets	$ 2,149	$ 2,056
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	$ 525,277	$ 60,729
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION
Interest (net of capitalized interest of $712 and $941, respectively)	20,977	9,572
Income taxes	33,054	24,875
SUPPLEMENTAL DISCLOSURES OF NON-CASH INVESTING AND FINANCING ACTIVITIES
Property and equipment purchases in accounts payable	8,907	4,613
Acquisition purchases in accrued expenses and other long-term obligations	4,894	3,674
Merit common stock surrendered (0 and 86 shares, respectively) in exchange for exercise of stock options		5,809
Right-of-use operating lease assets obtained in exchange for operating lease liabilities	$ 9,191	$ 7,560

CONSOLIDATED STATEMENTS OF CA_2

CONSOLIDATED STATEMENTS OF CASH FLOWS (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
CONSOLIDATED STATEMENTS OF CASH FLOWS
Net capitalized interest	$ 941	$ 712
Common stock surrendered in exchange for exercise of stock options (in shares)	0	86

Basis of Presentation and Other

Basis of Presentation and Other Items	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Other Items	1 Basis of Presentation and Other Items.

Recently Issued Accounting Stan

Recently Issued Accounting Standards	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Recently Issued Accounting Standards	2. Recently Issued Accounting Standards. Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures ​ We currently believe there are no other issued and not yet effective accounting standards that are materially relevant to our financial statements. ​

Revenue from Contracts with Cus

Revenue from Contracts with Customers	9 Months Ended
	Sep. 30, 2024
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 2023 Annual Report on Form 10-K. Disaggregation of Revenue Our revenue is disaggregated based on reporting segment, product category and geographic region. We design, develop, manufacture and market medical products for interventional, diagnostic and therapeutic 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. ​ The following tables present revenue from contracts with customers by reporting segment, product category and geographic region for the three and nine-month periods ended September 30, 2024 and 2023 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Three Months Ended ​ ​ September 30, 2024 ​ September 30, 2023 ​ United States International Total United States International Total Cardiovascular ​ ​ ​ ​ ​ ​ ​ Peripheral Intervention ​ $ 84,217 ​ $ 53,715 ​ $ 137,932 ​ $ 78,617 ​ $ 49,768 ​ $ 128,385 Cardiac Intervention ​ 37,248 ​ ​ 53,521 ​ 90,769 ​ 36,593 ​ ​ 52,513 ​ 89,106 Custom Procedural Solutions ​ 30,774 ​ ​ 19,994 ​ 50,768 ​ 29,602 ​ ​ 19,022 ​ 48,624 OEM ​ 38,093 ​ ​ 5,293 ​ 43,386 ​ 34,207 ​ ​ 5,762 ​ 39,969 Total ​ 190,332 ​ ​ 132,523 ​ 322,855 ​ 179,019 ​ 127,065 ​ 306,084 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy Devices ​ 16,160 ​ 830 ​ 16,990 ​ 8,486 ​ 660 ​ 9,146 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ $ 206,492 ​ $ 133,353 ​ $ 339,845 ​ $ 187,505 ​ $ 127,725 ​ $ 315,230 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ Nine Months Ended ​ ​ September 30, 2024 ​ September 30, 2023 ​ United States International Total United States International Total Cardiovascular ​ ​ ​ ​ ​ ​ ​ ​ Peripheral Intervention ​ $ 245,832 ​ $ 165,973 ​ $ 411,805 ​ $ 219,257 ​ $ 148,820 ​ $ 368,077 Cardiac Intervention ​ 109,431 ​ ​ 165,889 ​ 275,320 ​ 106,588 ​ ​ 161,621 ​ 268,209 Custom Procedural Solutions ​ 90,564 ​ ​ 59,414 ​ 149,978 ​ 85,556 ​ ​ 60,153 ​ 145,709 OEM ​ 106,202 ​ ​ 20,739 ​ 126,941 ​ 101,341 ​ ​ 21,999 ​ 123,340 Total ​ 552,029 ​ ​ 412,015 ​ 964,044 ​ 512,742 ​ 392,593 ​ 905,335 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy Devices ​ 35,221 ​ 2,091 ​ 37,312 ​ 25,705 ​ 1,811 ​ 27,516 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ $ 587,250 ​ $ 414,106 ​ $ 1,001,356 ​ $ 538,447 ​ $ 394,404 ​ $ 932,851 ​ ​

Acquisitions and Investments

Acquisitions and Investments	9 Months Ended
	Sep. 30, 2024
Business Combinations [Abstract]
Acquisitions and Investments	​ 4. Acquisitions and Investments. On July 1, 2024, we entered into an Asset Purchase Agreement (the “EGS Purchase Agreement”) with EndoGastric Solutions, Inc., a Delaware corporation (“EGS”), pursuant to which we acquired the EsophyX® Z+ device and various assets related thereto (collectively, the “EGS Acquisition”), which are designed to deliver a durable, minimally invasive non-pharmacological treatment option for patients suffering from gastroesophageal reflux disease. We acquired the purchased assets identified under the EGS Purchase Agreement for a purchase price of $105 million, which amount we financed at closing through current borrowings under our long-term debt obligations, plus the assumption or reimbursement of certain liabilities of EGS. We accounted for the EGS Acquisition under the acquisition method of accounting as a business combination. The sales related to the EGS Acquisition have been included in our endoscopy segment since the acquisition date and were $6.8 million for the three and nine-month periods ended September 30, 2024. It is not practical to separately report earnings related to the EGS Acquisition, as we began to immediately integrate the acquisition into the existing operations, sales distribution networks and management structure of our endoscopy business segment. Acquisition-related costs associated with the EGS Acquisition, which were included in selling, general and administrative expenses in the consolidated statements of income were approximately $1.8 million. The purchase price was preliminarily allocated as follows (in thousands) : ​ ​ ​ ​ ​ Assets Acquired ​ Trade receivables ​ $ 2,568 Inventories ​ ​ 3,553 Prepaid expenses and other current assets ​ ​ 99 Property and equipment ​ ​ 258 Intangible assets ​ ​ Developed technology ​ ​ 72,800 Trademarks ​ ​ 5,400 Customer list ​ ​ 6,600 Goodwill ​ ​ 16,997 Total assets acquired ​ 108,275 ​ ​ ​ ​ Liabilities Assumed ​ Trade payables ​ 494 Accrued expenses ​ 2,752 Total liabilities assumed ​ 3,246 ​ ​ ​ ​ Total net assets acquired ​ $ 105,029 ​ We are amortizing the EGS developed technology intangible assets over ten years, the trademark intangible assets over 11 years, and the customer list intangible asset on an accelerated basis over 11 years. We have estimated the weighted average life of the intangible assets acquired from EGS to be 10.1 years. . On May 17, 2024, Merit Medical Ireland Limited (“MM Ireland”), our indirect wholly-owned subsidiary, entered into a Subscription and Shareholder Agreement (the “CrannMed Agreement”) with CrannMed Limited, a company organized under the laws of Ireland (“CrannMed”). Pursuant to the terms of the CrannMed Agreement, MM Ireland paid €3.0 million to purchase preferred shares of CrannMed. At CrannMed’s election at any time after August 16, 2024, MM Ireland is obligated to pay an additional €3.0 million to acquire additional preferred shares of CrannMed, subject to certain conditions (the “Second Tranche Investment”); no additional amount has been distributed to CrannMed as of September 30, 2024. Additionally, upon the request of CrannMed and subject to the completion of the Second Tranche Investment and other conditions, MM Ireland may pay to CrannMed up to an additional €2.0 million in the form of equity, debt or other investment for the purpose of funding clinical trial activities of CrannMed. MM Ireland’s investment in CrannMed has been recorded as an equity investment accounted for at cost and reflected within other assets in the accompanying consolidated balance sheets because MM Ireland is not able to exercise significant influence over the operations of CrannMed. MM Ireland’s total current investment in CrannMed represented an ownership interest of approximately 10.8% of the outstanding capital stock of CrannMed at the date of the initial purchase. On March 8, 2024, we entered into an asset purchase agreement with Scholten Surgical Instruments, Inc. (“SSI”) to acquire the assets associated with the Bioptome, Novatome, and Sensatome devices. The total purchase price of the SSI assets included an up-front payment of $3 million, and three deferred payments, including (i) $1 million payable upon the earlier of (a) the first anniversary of the closing date or (b) the date on which Merit can independently manufacture the purchased devices (“Deferred Payment Date”), (ii) $1 million payable upon the first anniversary of the Deferred Payment Date, and (iii) $1 million payable upon the second anniversary of the Deferred Payment Date. We have accounted for this transaction as an asset purchase, and recorded the amount paid and deferred payments as a developed technology intangible asset, which we are amortizing over eight years . During March 2024, we paid $0.3 million to acquire additional Series A Preferred Stock of Fluidx Medical Technology, Inc. ("Fluidx"), owner of certain technology proposed to be used in the development of embolic and adhesive agents for use in arterial, venous, vascular graft and cardiovascular applications inside and outside the heart and related appendages. We had previously purchased and continue to hold $4.7 million of participating preferred shares of Fluidx. Our investment has been recorded as an equity investment accounted for at cost and reflected within other assets in the accompanying consolidated balance sheets because we are not able to exercise significant influence over the operations of Fluidx. Our total current investment in Fluidx represented an ownership interest of approximately 19.9% of the outstanding capital stock of Fluidx at the date of this investment. 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 (collectively, the “AngioDynamics Acquisition”) . We accounted for the AngioDynamics Acquisition under the acquisition method of accounting as a business combination. The sales related to the AngioDynamics Acquisition have been included in our cardiovascular segment since the acquisition date and were $21.0 million and $8.3 million for the nine-month periods ended September 30, 2024 and 2023, respectively. It is not practical to separately report earnings related to the AngioDynamics Acquisition, as we began to immediately integrate the acquisition into the existing operations, sales distribution networks and management structure of our cardiovascular business segment. Acquisition-related costs associated with the AngioDynamics Acquisition, which were included in selling, general and administrative expenses in the consolidated statements of income included in the 2023 Annual Report on Form 10-K, were approximately $4.9 million. The purchase price was 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 ten 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 an approximately 19.5% ownership interest 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 transaction under the acquisition method of accounting 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 consolidated statements of income included in the 2023 Annual Report on Form 10-K, were not material. The purchase price was 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.

Inventories

Inventories	9 Months Ended
	Sep. 30, 2024
Inventory Disclosure [Abstract]
Inventories	5. Inventories. Inventories at September 30, 2024 and December 31, 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2024 December 31, 2023 Finished goods ​ $ 159,647 ​ $ 158,893 Work-in-process ​ 37,694 ​ 25,420 Raw materials ​ 113,186 ​ 119,558 Total inventories ​ $ 310,527 ​ $ 303,871 ​

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	6. Goodwill and Intangible Assets. The change in the carrying amount of goodwill by segment for the nine-month period ended September 30, 2024 is detailed as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cardiovascular ​ Endoscopy ​ Total Goodwill balance at January 1 ​ $ 382,240 ​ $ — ​ $ 382,240 Effect of foreign exchange ​ 211 ​ — ​ 211 Additions and adjustments as the result of acquisitions ​ — ​ 16,997 ​ 16,997 Goodwill balance at September 30 ​ $ 382,451 ​ $ 16,997 ​ $ 399,448 ​ Total accumulated goodwill impairment losses aggregated to $8.3 million as of September 30, 2024 and December 31, 2023, respectively. We did not have any goodwill impairments for the nine-month periods ended September 30, 2024 or 2023. ​ Other intangible assets at September 30, 2024 and December 31, 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2024 ​ ​ Gross Carrying ​ Accumulated ​ Net Carrying ​ Amount Amortization Amount Patents ​ $ 30,472 ​ $ (12,315) ​ $ 18,157 Distribution agreements ​ 3,250 ​ (2,975) ​ 275 License agreements ​ 11,599 ​ (8,979) ​ 2,620 Trademarks ​ 40,538 ​ (23,235) ​ 17,303 Customer lists ​ 46,959 ​ (35,475) ​ 11,484 Total ​ $ 132,818 ​ $ (82,979) ​ $ 49,839 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 2023 ​ ​ Gross Carrying ​ Accumulated ​ Net Carrying ​ Amount Amortization Amount Patents ​ $ 28,877 ​ $ (10,916) ​ $ 17,961 Distribution agreements ​ 3,250 ​ (2,919) ​ 331 License agreements ​ 11,142 ​ (8,327) ​ 2,815 Trademarks ​ 35,135 ​ (20,804) ​ 14,331 Customer lists ​ 40,367 ​ (33,921) ​ 6,446 Total ​ $ 118,771 ​ $ (76,887) ​ $ 41,884 ​ Aggregate amortization expense for the three and nine-month periods ended September 30, 2024 was $16.9 million and $46.4 million, respectively. Aggregate amortization expense for the three and nine-month periods ended September 30, 2023 was $15.4 million and $41.1 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. If a triggering event is identified, 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. ​ Estimated amortization expense for developed technology and other intangible assets for the next five years consisted of the following as of September 30, 2024 (in thousands): ​ ​ ​ ​ ​ Estimated Amortization Expense Remaining 2024 ​ $ 17,783 2025 ​ 69,119 2026 ​ 58,484 2027 ​ ​ 54,947 2028 ​ 53,409 ​

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2024
Income Tax Disclosure [Abstract]
Income Taxes	7. Income Taxes. The Organization for Economic Cooperation and Development (“OECD”) Pillar Two 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 Two 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. While we expect our effective income tax rate and cash income tax payments could increase in future years as a result of the global minimum tax, we do not anticipate a material impact to our fiscal 2024 consolidated results of operations. Our assessment could be affected by legislative guidance and future enactment of additional provisions within the Pillar Two framework. 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. ​

Debt

Debt	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Debt	8. Debt. Principal balances outstanding under our long-term debt obligations as of September 30, 2024 and December 31, 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2024 December 31, 2023 Term loans ​ $ 23,000 ​ $ 99,063 Revolving credit loans ​ — ​ — Convertible notes ​ ​ 747,500 ​ ​ 747,500 Less unamortized debt issuance costs ​ (19,995) ​ (23,550) Total long-term debt ​ 750,505 ​ 823,013 Less current portion ​ — ​ — Long-term portion ​ $ 750,505 ​ $ 823,013 ​ Future minimum principal payments on our long-term debt, as of September 30, 2024, were as follows (in thousands): ​ ​ ​ ​ ​ Years Ending ​ Future Minimum December 31, Principal Payments Remaining 2024 $ — 2025 ​ ​ — 2026 ​ ​ — 2027 ​ ​ — 2028 ​ ​ 23,000 Thereafter ​ ​ 747,500 Total future minimum principal payments ​ $ 770,500 ​ Fourth Amended and Restated Credit Agreement ​ On June 6, 2023, we entered into a Fourth Amended and Restated Credit Agreement (the "Fourth A&R Credit Agreement"). The Fourth A&R Credit Agreement is a syndicated loan agreement with Wells Fargo Bank, National Association and other parties. The Fourth A&R Credit Agreement amended and restated in its entirety our previously outstanding Third Amended and Restated Credit Agreement and all amendments thereto. The Fourth A&R 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. ​ On December 5, 2023, we executed an amendment to the Fourth Amended Credit Agreement (as amended, the "Amended Fourth A&R Credit Agreement") to facilitate the issuance of our Convertible Notes described below. Among other things, the amendment also updated the definition of the “Applicable Margin” as used in the Amended Fourth A&R Credit Agreement to determine the interest rates and amended the financial covenants, all as described below. ​ Term loans made under the Amended Fourth A&R Credit Agreement bear interest, at our election, at either (i) the Base Rate plus the Applicable Margin (as defined in the Amended Fourth A&R Credit Agreement) or, (ii) Adjusted Term SOFR plus the Applicable Margin (as defined in the Amended Fourth A&R 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 (as defined in the Amended Fourth A&R Credit Agreement), or (d) Adjusted Daily Simple SONIA plus the Applicable Margin (as defined in the Amended Fourth A&R Credit Agreement). 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 Amended Fourth A&R Credit Agreement is collateralized by substantially all of our assets. The Amended Fourth A&R 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 Amended Fourth A&R Credit Agreement requires that we maintain certain financial covenants, as follows: ​ ​ ​ ​ ​ ​ Covenant Requirement ​ Consolidated Total Net Leverage Ratio (1) ​ 5.0 to 1.0 ​ Consolidated Senior Secured Net Leverage Ratio (2) ​ ​ 3.0 to 1.0 ​ Consolidated Interest Coverage Ratio (3) ​ 3.0 to 1.0 ​ ​ (1) Maximum Consolidated Total Net Leverage Ratio (as defined in the Amended Fourth A&R Credit Agreement) as of any fiscal quarter end. (2) Maximum Consolidated Senior Secured Net Leverage Ratio (as defined in the Amended Fourth A&R Credit Agreement) as of any fiscal quarter end. (3) Minimum ratio of Consolidated EBITDA (as defined in the Amended Fourth A&R Credit Agreement and adjusted for certain expenditures) to Consolidated Interest Expense (as defined in the Amended Fourth A&R Credit Agreement) for any period of four consecutive fiscal quarters. ​ We were in compliance with these financial covenants set forth in the Amended Fourth A&R Credit Agreement as of September 30, 2024. As of September 30, 2024, we had outstanding borrowings of $23.0 million and issued letter of credit guarantees of $2.4 million under the Amended Fourth A&R Credit Agreement, with additional available borrowings of approximately $697 million, based on the maximum net leverage ratio and the aggregate revolving credit commitment pursuant to the Amended Fourth A&R Credit Agreement. Our interest rate as of September 30, 2024 was a variable rate of 6.70% with respect to the outstanding principal amount. Our interest rate as of December 31, 2023 was a fixed rate of 3.39% on $75 million as a result of an interest rate swap and a variable floating rate of 7.21% on $24.1 million. The foregoing interest rates do not reflect potential future changes in the Applicable Margin. Convertible Notes In December 2023, we issued convertible notes which bear interest at 3.00% per year, payable semi-annually in arrears on February 1 and August 1 of each year, beginning on August 1, 2024 (the “Convertible Notes”). The Convertible Notes are senior unsecured obligations (as defined in the indenture governing the Convertible Notes (the “Indenture”)) of Merit and will mature on February 1, 2029, unless repurchased, redeemed or converted in accordance with their terms prior to such date. The net proceeds from the sale of the Convertible Notes were approximately $724.8 million after deducting offering and issuance costs and before the costs of the Capped Call Transactions, as described below. The initial conversion rate of the notes will be 11.5171 shares of our common stock (the “Common Stock”) per $1,000 principal amount of notes, which equates to an initial conversion price of approximately $86.83 per share of Common Stock, subject to adjustments as provided in the Indenture upon the occurrence of certain specified events. In addition, (as defined in the Indenture) ​ Conversion can occur at the option of the Holders at any time on or after October 1, 2028. Prior to October 1, 2028, Holders may only elect to convert the Convertible Notes under the following circumstances: (1) During the five ten 10 20 30 ​ On or after February 7, 2027, we may redeem for cash all or part of the Convertible Notes, at our option, if the last reported sales price of Common Stock has been at least 130% of the conversion price then in effect for at least 20 30 ​ Upon conversion, Merit will (1) pay cash up to the aggregate principal amount of the Convertible Notes to be converted and (2) pay or deliver, as the case may be, cash, shares of Common Stock, or a combination of cash and shares of Common Stock, at Merit’s election, in respect of the remainder, if any, of its conversion obligation in excess of the aggregate principal amount of the Convertible Notes being converted. ​ Capped Call Transactions ​ In December 2023, in connection with the pricing of the Convertible Notes, Merit entered into privately negotiated capped call transactions (“Capped Call Transactions”) with certain of the initial purchasers and/or their respective affiliates and certain other financial institutions. The Capped Call Transactions cover, subject to customary anti-dilution adjustments, the number of shares of Common Stock initially underlying the Convertible Notes and are generally expected to reduce potential dilution to the Common Stock upon any conversion of Convertible Notes and/or offset any cash payments Merit is required to make in excess of the principal amount of converted Convertible Notes, as the case may be, with such reduction and/or offset subject to a cap, based on a cap price initially equal to approximately $114.68 per share of Common Stock, subject to certain adjustments under the terms of the Capped Call Transactions. The cost of the Capped Call Transactions was approximately $66.5 million. The Capped Call Transactions do not meet the criteria for separate accounting as a derivative as they are indexed to the Common Stock. The premiums paid for the Capped Call Transactions have been included as a net reduction to Common Stock within stockholders' equity.

Derivatives

Derivatives	9 Months Ended
	Sep. 30, 2024
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. Derivatives 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 swap 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 As of September 30, 2024, the term of our interest rate swap has expired. On December 31, 2023, our interest rate swap qualified as a cash flow hedge. The fair value of our interest rate swap as of December 31, 2023 was an asset of $1.5 million, partially offset by $0.4 million in deferred taxes. Foreign Currency Risk. Derivatives 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 forward contracts is to reduce the variability of cash flows associated with the forecasted purchase or sale of the foreign currencies. As of September 30, 2024 and December 31, 2023, we had entered into foreign currency forward contracts, which qualified as cash flow hedges, with aggregate notional amounts of $155.4 million and $141.1 million, respectively. Derivatives 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. As of September 30, 2024 and December 31, 2023, we had entered into foreign currency forward contracts related to those balance sheet accounts with aggregate notional amounts of $115.6 million and $108.4 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, 2024 December 31, 2023 Assets ​ ​ Interest rate swap Prepaid expenses and other assets ​ $ — ​ $ 1,503 Foreign currency forward contracts Prepaid expenses and other assets ​ ​ 612 ​ ​ 2,061 Foreign currency forward contracts Other assets (long-term) ​ ​ 137 ​ 216 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (2,968) ​ (1,898) Foreign currency forward contracts Other long-term obligations ​ (1,085) ​ (499) ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value of Derivative Instruments Not Designated as Hedging Instruments Balance Sheet Location September 30, 2024 December 31, 2023 Assets ​ ​ Foreign currency forward contracts Prepaid expenses and other assets ​ $ 685 ​ $ 828 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (1,753) ​ (1,463) ​ 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 2024 2023 Location in statements of income 2024 2023 2024 2023 Interest rate swap ​ $ 1 ​ $ 126 ​ Interest expense ​ $ (7,501) ​ $ (4,841) ​ $ 255 ​ $ 685 Foreign currency forward contracts ​ (5,443) ​ 1,503 ​ Revenue ​ 339,845 ​ 315,230 ​ 709 ​ 866 ​ ​ ​ ​ ​ ​ ​ ​ Cost of sales ​ (182,310) ​ (173,031) ​ 179 ​ 617 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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 2024 2023 Location in statements of income 2024 ​ 2023 2024 2023 Interest rate swap ​ $ 152 ​ $ 726 ​ Interest expense ​ $ (23,226) ​ $ (10,534) ​ $ 1,656 ​ $ 1,850 ​ Foreign currency forward contracts ​ (1,308) ​ 6,067 ​ Revenue ​ 1,001,356 ​ 932,851 ​ 1,549 ​ 2,851 ​ ​ ​ ​ ​ ​ ​ ​ ​ Cost of sales ​ (531,006) ​ (499,508) ​ 963 ​ 900 ​ ​ As of September 30, 2024, $2.0 million, or $1.5 million after taxes, was expected to be reclassified from AOCI to earnings in revenue and cost of sales 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 2024 2023 2024 2023 Foreign currency forward contracts Other income (expense) — net ​ $ (2,124) ​ $ (452) ​ $ (596) ​ $ 2,748 ​ ​

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	10. Commitments and Contingencies. Litigation. hese proceedings, actions and claims may involve product liability, intellectual property, contract disputes, employment, governmental inquiries or other matters, including the matter described below. These matters generally involve inherent uncertainties and often require prolonged periods of time to resolve. In certain proceedings, the claimants may seek damages, as well as other compensatory and equitable relief that could result in the payment of significant claims and settlements and/or the imposition of injunctions or other equitable relief. For legal matters for which our management had sufficient information to reasonably estimate our future obligations, a liability representing management’s best estimate of the probable loss, or the minimum of the range of probable losses when a best estimate within the range is not known, is recorded. The estimates are based on consultation with legal counsel, previous settlement experience and settlement strategies. If actual outcomes are less favorable than those estimated by management, additional expense may be incurred, which could unfavorably affect our financial position, results of operations and cash flows. The ultimate cost to us with respect to 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 (the “SEC Inquiry”). We are cooperating with the requests and investigating the matter. Currently, we are unable to predict the scope, timing, significance or outcome of the SEC Inquiry or estimate a reasonably possible loss or range of loss associated with the matter. It is possible that the ultimate resolution of the SEC Inquiry, if resolved in a manner unfavorable to us, may be materially adverse to our business, financial position, results of operations or liquidity. ​ In management's opinion, based on its examination of these matters, its experience to date and discussions with counsel, other than the SEC Inquiry, we are not currently involved in any legal proceedings which, individually or in the aggregate, could have a material adverse effect on our financial position, results of operations or cash flows. Our management regularly assesses the risks of legal proceedings in which we are involved, and management’s view of these matters may change in the future.

Earnings Per Common Share (EPS)

Earnings Per Common Share (EPS)	9 Months Ended
	Sep. 30, 2024
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, 2024 and 2023 consisted of the following (in thousands, except per share amounts): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ ​ ​ 2024 ​ 2023 ​ 2024 ​ 2023 ​ Net income ​ $ 28,444 ​ $ 25,834 ​ $ 92,410 ​ $ 66,782 ​ Average common shares outstanding ​ 58,231 ​ 57,682 ​ 58,110 ​ 57,525 ​ Basic EPS ​ $ 0.49 ​ $ 0.45 ​ $ 1.59 ​ $ 1.16 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average common shares outstanding ​ ​ 58,231 ​ ​ 57,682 ​ ​ 58,110 ​ ​ 57,525 ​ Effect of dilutive stock awards ​ ​ 866 ​ ​ 693 ​ ​ 691 ​ ​ 820 ​ Effect of dilutive convertible notes ​ ​ 440 ​ ​ — ​ ​ 147 ​ ​ — ​ Total potential shares outstanding ​ ​ 59,537 ​ ​ 58,375 ​ ​ 58,948 ​ ​ 58,345 ​ Diluted EPS ​ $ 0.48 ​ $ 0.44 ​ $ 1.57 ​ $ 1.14 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Equity awards excluded as the impact was anti-dilutive (1) ​ ​ 448 ​ ​ 1,242 ​ ​ 821 ​ ​ 1,091 ​ (1) Does not reflect the impact of incremental repurchases under the treasury stock method. ​ Convertible Notes ​ For our Convertible Notes, the dilutive effect is calculated using the if-converted method. Upon surrender of the Convertible Notes for conversion, Merit will pay cash up to the aggregate principal amount of the Notes to be converted and pay or deliver, as the case may be, cash, shares of Common Stock or a combination of cash and shares of Common Stock, at Merit’s election, in respect of the remainder, if any, of Merit’s conversion obligation in excess of the aggregate principal amount of the Convertible Notes being converted.

Stock-Based Compensation Expens

Stock-Based Compensation Expense	9 Months Ended
	Sep. 30, 2024
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, 2024 and 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ 2024 2023 2024 2023 Cost of sales ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ $ 150 ​ $ 367 ​ $ 875 ​ $ 1,240 Research and development ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 440 ​ 488 ​ ​ 1,221 ​ 1,329 Selling, general and administrative ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 1,442 ​ 2,083 ​ ​ 4,689 ​ 5,304 Performance-based restricted stock units ​ ​ 2,884 ​ ​ 1,838 ​ ​ 7,648 ​ ​ 4,470 Restricted stock units ​ ​ 1,074 ​ ​ 430 ​ ​ 2,792 ​ ​ 1,341 Cash-settled performance-based awards ​ ​ 723 ​ ​ 591 ​ ​ 1,733 ​ ​ 1,662 Total selling, general and administrative ​ ​ 6,123 ​ ​ 4,942 ​ ​ 16,862 ​ ​ 12,777 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Stock-based compensation expense before taxes ​ $ 6,713 ​ $ 5,797 ​ $ 18,958 ​ $ 15,346 ​ 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 period ended September 30, 2023, we granted stock options representing 401,535 shares of our Common Stock. We did not grant any stock options during the nine-month period ended September 30, 2024. 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 Risk-free interest rate 3.6% - 4.6% Expected option term 4.0 years Expected dividend yield — Expected price volatility 44.6% - 47.1% ​ 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, 2024, the total remaining unrecognized compensation cost related to non-vested stock options was $13.2 million, which was expected to be recognized over a weighted average period of 1.9 years. ​ Stock-Settled Performance-Based Restricted Stock Units (“Performance Stock Units”) ​ During the nine-month periods ended September 30, 2024 and 2023, we granted performance stock units which represented up to 364,810 and 286,863 shares of 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, ​ ​ 2024 ​ 2023 Risk-free interest rate 4.4% 3.9% - 4.6% Performance period 2.8 years 2.8 years Expected dividend yield — — Expected price volatility 31.1% 31.4% - 32.6% ​ 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 likely to be 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, 2024, the total remaining unrecognized compensation cost related to stock-settled performance stock units was $17.5 million, which is expected to be recognized over a weighted average period of 1.9 years. Cash-Settled Performance-Based Awards During the nine-month periods ended September 30, 2024 and 2023, we granted performance stock units to our Chief Executive Officer that provide for settlement in cash upon achievement of specific metrics (“Liability Awards”), with total target cash incentives in the amount of $1.6 million and $1.3 million, respectively. The Liability Awards entitle him to a target cash payment based upon our level of rTSR performance and achievement of other performance metrics, as defined in the award agreements. During the nine-month periods ended September 30, 2024 and 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 likely to be awarded based on the performance metrics. The potential maximum payout of these Liability Awards is 250% of the target cash incentive, resulting in a total potential maximum payout of $4.4 million and $4.6 million for Liability Awards granted during the nine-month periods ended September 30, 2024 and 2023, respectively. The settlement generally occurs at the end of three-year performance periods based upon the same performance metrics and vesting period as our performance stock units. The fair value of these Liability Awards is measured at each reporting period until the awards are settled. As of September 30, 2024 and December 31, 2023, the recorded balance associated with these Liability Awards is $4.1 million and $3.4 million, respectively, which are classified as liabilities and reported in accrued expenses and other long-term obligations within our consolidated balance sheets. As of September 30, 2024, the total remaining unrecognized compensation cost related to Liability Awards was $3.8 million, which is expected to be recognized over a weighted average period of 1.8 years. ​ Restricted Stock Units During the nine-month periods ended September 30, 2024 and 2023, we granted restricted stock units to certain employees and non-employee directors representing 158,719 and 20,358 shares of 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 employee are subject to such employee’s continued employment through the vesting date, which is four years from the date of grant. Restricted stock units granted to each non-employee director are subject to such director’s continued service through the vesting date, which is one year from the grant date. As of September 30, 2024, the total remaining unrecognized compensation cost related to restricted stock units was $9.1 million, which will be recognized over a weighted average period of 3.1 years.

Segment Reporting

Segment Reporting	9 Months Ended
	Sep. 30, 2024
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. Our chief operating decision maker is our Chief Executive Officer. 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, 2024 and 2023, were as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended Nine Months Ended ​ September 30, September 30, ​ 2024 2023 2024 2023 Net sales ​ ​ ​ ​ Cardiovascular ​ $ 322,855 ​ $ 306,084 ​ $ 964,044 ​ $ 905,335 Endoscopy ​ 16,990 ​ 9,146 ​ 37,312 ​ 27,516 Total net sales ​ 339,845 ​ 315,230 ​ 1,001,356 ​ 932,851 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Income from operations ​ ​ ​ ​ Cardiovascular ​ 37,555 ​ 32,622 ​ 113,374 ​ 82,966 Endoscopy ​ (294) ​ 2,515 ​ 5,755 ​ 7,366 Total income from operations ​ 37,261 ​ 35,137 ​ 119,129 ​ 90,332 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total other expense — net ​ (604) ​ (4,915) ​ (2,281) ​ (9,710) Income tax expense ​ 8,213 ​ 4,388 ​ 24,438 ​ 13,840 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Net income ​ $ 28,444 ​ $ 25,834 ​ $ 92,410 ​ $ 66,782 ​

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2024
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, 2024 and December 31, 2023 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, 2024 (Level 1) (Level 2) (Level 3) Marketable securities (1) ​ $ 78 ​ $ 78 ​ $ — ​ $ — Foreign currency contract assets, current and long-term (3) ​ $ 1,434 ​ $ — ​ $ 1,434 ​ $ — Foreign currency contract liabilities, current and long-term (4) ​ $ (5,806) ​ $ — ​ $ (5,806) ​ $ — Contingent consideration liabilities ​ $ (3,419) ​ $ — ​ $ — ​ $ (3,419) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value Measurements Using ​ ​ Total Fair ​ Quoted prices in ​ Significant other ​ Significant ​ ​ Value at ​ active markets ​ observable inputs ​ unobservable inputs ​ December 31, 2023 (Level 1) (Level 2) (Level 3) Marketable securities (1) ​ $ 78 ​ $ 78 ​ $ — ​ ​ — Interest rate contract asset, current (2) ​ $ 1,503 ​ $ — ​ $ 1,503 ​ $ — Foreign currency contract assets, current and long-term (3) ​ $ 3,105 ​ $ — ​ $ 3,105 ​ $ — Foreign currency contract liabilities, current and long-term (4) ​ $ (3,860) ​ $ — ​ $ (3,860) ​ $ — Contingent consideration liabilities ​ $ (3,447) ​ $ — ​ $ — ​ $ (3,447) ​ (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 recorded as prepaid and other current assets 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 a prepaid expense and other current asset or other long-term asset 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 expense or other long-term obligation 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, 2024 and 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended Nine Months Ended ​ September 30, September 30, ​ 2024 2023 2024 2023 Beginning balance ​ $ 3,435 ​ $ 3,581 ​ $ 3,447 ​ $ 18,073 Contingent consideration expense ​ 103 ​ 563 ​ 292 ​ 2,177 Contingent payments made ​ (119) ​ (122) ​ (320) ​ (16,228) Ending balance ​ $ 3,419 ​ $ 4,022 ​ $ 3,419 ​ $ 4,022 ​ As of September 30, 2024, $3.0 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, 2023, $3.0 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. Payments related to the settlement of the contingent consideration liability recognized at fair value as of the applicable acquisition date of $0.2 million and $3.5 million for the nine-month periods ended September 30, 2024 and 2023, 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 $0.1 million and $12.7 million for the nine-month periods ended September 30, 2024 and 2023, 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, 2024 and December 31, 2023 (amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ Valuation ​ ​ ​ ​ ​ Weighted Contingent consideration liability 2024 technique Unobservable inputs Range ​ Average (1) Revenue-based royalty payments contingent liability ​ $ 2,897 Discounted cash flow Discount rate ​ 11% - 15% ​ 14.4% ​ ​ ​ Projected year of payments ​ 2024-2034 ​ 2028 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue milestones contingent liability ​ $ 98 Monte Carlo simulation Discount rate ​ 12.0% ​ ​ ​ ​ ​ Projected year of payments ​ 2024-2040 ​ 2040 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Regulatory approval contingent liability ​ $ 424 ​ Scenario-based method ​ Discount rate ​ 5.4% ​ ​ ​ ​ ​ ​ ​ ​ ​ Probability of milestone payment ​ 50.0% ​ ​ ​ ​ ​ ​ ​ ​ ​ Projected year of payment ​ 2024-2030 ​ 2030 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ Valuation ​ ​ ​ ​ ​ Weighted Contingent consideration liability 2023 technique Unobservable inputs Range ​ Average (1) Revenue-based royalty payments contingent liability ​ $ 2,945 Discounted cash flow Discount rate ​ 12.0% - 16.0% ​ 14.6% ​ ​ ​ Projected year of payments ​ 2024-2034 ​ 2028 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue milestones contingent liability ​ $ 93 Monte Carlo simulation Discount rate ​ 13.0% ​ ​ ​ ​ ​ Projected year of payments ​ 2024-2039 ​ 2039 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Regulatory approval contingent liability ​ $ 409 ​ Scenario-based method ​ Discount rate ​ 5.5% ​ ​ ​ ​ ​ ​ ​ ​ ​ Probability of milestone payment ​ 50.0% ​ ​ ​ ​ ​ ​ ​ ​ ​ Projected year of payment ​ 2024-2030 ​ 2030 (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. 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 under our Amended Fourth A&R Credit Agreement 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. We believe the fair value our long-term debt under our Convertible Notes approximates carrying value as the notes were issued in December 2023. ​ 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. ​ Our equity investments in privately-held companies were $22.6 million and $19.1 million at September 30, 2024 and December 31, 2023, respectively, which are included within other long-term assets in our consolidated balance sheets. 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 investment. 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 ​ Current Expected Credit Losses ​ Our outstanding long-term notes receivable, including accrued interest and an allowance for current expected credit losses, were $9.3 million and $3.2 million as of September 30, 2024 and December 31, 2023, respectively. Long-term notes receivable issued were $6.7 million for the nine-month period ended September 30, 2024 and were related to loans issued to Selio Medical Limited (“Selio”) of $1.7 million, Solo Pace Inc. (“Solo Pace”) of $2.0 million and Fluidx of $3.0 million. As of September 30, 2024 and December 31, 2023, we had an allowance for current expected credit losses of $1.6 million and $0.6 million, 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 roll-forward of the allowance for current expected credit losses on our notes receivable for the three and nine-month periods ended September 30, 2024 and 2023 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ ​ 2024 2023 ​ 2024 2023 Beginning balance ​ $ 1,406 ​ $ 296 ​ $ 568 ​ $ 281 Provision for credit loss expense ​ ​ 189 ​ ​ 32 ​ ​ 1,027 ​ ​ 47 Ending balance ​ $ 1,595 ​ $ 328 ​ $ 1,595 ​ $ 328 ​

Accumulated Other Comprehensive

Accumulated Other Comprehensive Income (Loss)	9 Months Ended
	Sep. 30, 2024
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, 2024 $ 2,625 ​ $ (18,054) ​ $ (15,429) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) (5,442) ​ ​ 7,153 ​ ​ 1,711 Income taxes 1,555 ​ ​ (89) ​ ​ 1,466 Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (709) ​ ​ ​ ​ ​ (709) Cost of sales ​ (179) ​ ​ ​ ​ ​ (179) Interest expense ​ (255) ​ ​ ​ ​ ​ (255) Net other comprehensive income (loss) ​ (5,030) ​ ​ 7,064 ​ ​ 2,034 ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2024 $ (2,405) ​ $ (10,990) ​ $ (13,395) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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 January 1, 2024 $ 1,662 ​ $ (12,996) ​ $ (11,334) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) (1,156) ​ ​ 2,061 ​ ​ 905 Income taxes 1,257 ​ ​ (55) ​ ​ 1,202 Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (1,549) ​ ​ ​ ​ ​ (1,549) Cost of sales ​ (963) ​ ​ ​ ​ ​ (963) Interest expense ​ (1,656) ​ ​ ​ ​ ​ (1,656) Net other comprehensive income (loss) ​ (4,067) ​ ​ 2,006 ​ ​ (2,061) ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2024 $ (2,405) ​ $ (10,990) ​ $ (13,395) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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) ​

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2024
Subsequent Events [Abstract]
Subsequent Events	​ 16. Subsequent Events. We are currently evaluating the accounting treatment of the Cook Acquisition, as well as performing the valuation of the assets acquired and the related purchase price allocation. ​ ​

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 28,444	$ 35,726	$ 28,240	$ 25,834	$ 20,245	$ 20,703	$ 92,410	$ 66,782

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Basis of Presentation and Oth_2

Basis of Presentation and Other Items (Policies)	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Other Items	1 Basis of Presentation and Other Items.
Recently Issued Accounting Standards	2. Recently Issued Accounting Standards. Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures ​ We currently believe there are no other issued and not yet effective accounting standards that are materially relevant to our financial statements.
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 2023 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. Derivatives 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 swap 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 As of September 30, 2024, the term of our interest rate swap has expired. On December 31, 2023, our interest rate swap qualified as a cash flow hedge. The fair value of our interest rate swap as of December 31, 2023 was an asset of $1.5 million, partially offset by $0.4 million in deferred taxes. Foreign Currency Risk. Derivatives Designated as Cash Flow Hedges Derivatives 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, 2024
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 geographic region for the three and nine-month periods ended September 30, 2024 and 2023 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Three Months Ended ​ ​ September 30, 2024 ​ September 30, 2023 ​ United States International Total United States International Total Cardiovascular ​ ​ ​ ​ ​ ​ ​ Peripheral Intervention ​ $ 84,217 ​ $ 53,715 ​ $ 137,932 ​ $ 78,617 ​ $ 49,768 ​ $ 128,385 Cardiac Intervention ​ 37,248 ​ ​ 53,521 ​ 90,769 ​ 36,593 ​ ​ 52,513 ​ 89,106 Custom Procedural Solutions ​ 30,774 ​ ​ 19,994 ​ 50,768 ​ 29,602 ​ ​ 19,022 ​ 48,624 OEM ​ 38,093 ​ ​ 5,293 ​ 43,386 ​ 34,207 ​ ​ 5,762 ​ 39,969 Total ​ 190,332 ​ ​ 132,523 ​ 322,855 ​ 179,019 ​ 127,065 ​ 306,084 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy Devices ​ 16,160 ​ 830 ​ 16,990 ​ 8,486 ​ 660 ​ 9,146 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ $ 206,492 ​ $ 133,353 ​ $ 339,845 ​ $ 187,505 ​ $ 127,725 ​ $ 315,230 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ Nine Months Ended ​ ​ September 30, 2024 ​ September 30, 2023 ​ United States International Total United States International Total Cardiovascular ​ ​ ​ ​ ​ ​ ​ ​ Peripheral Intervention ​ $ 245,832 ​ $ 165,973 ​ $ 411,805 ​ $ 219,257 ​ $ 148,820 ​ $ 368,077 Cardiac Intervention ​ 109,431 ​ ​ 165,889 ​ 275,320 ​ 106,588 ​ ​ 161,621 ​ 268,209 Custom Procedural Solutions ​ 90,564 ​ ​ 59,414 ​ 149,978 ​ 85,556 ​ ​ 60,153 ​ 145,709 OEM ​ 106,202 ​ ​ 20,739 ​ 126,941 ​ 101,341 ​ ​ 21,999 ​ 123,340 Total ​ 552,029 ​ ​ 412,015 ​ 964,044 ​ 512,742 ​ 392,593 ​ 905,335 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy Devices ​ 35,221 ​ 2,091 ​ 37,312 ​ 25,705 ​ 1,811 ​ 27,516 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ $ 587,250 ​ $ 414,106 ​ $ 1,001,356 ​ $ 538,447 ​ $ 394,404 ​ $ 932,851

Acquisitions and Investments (T

Acquisitions and Investments (Tables)	9 Months Ended
	Sep. 30, 2024
Angio Dynamics Inc
Business Acquisition [Line Items]
Schedule of Purchase price allocation	The purchase price was 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 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, 2024
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventories at September 30, 2024 and December 31, 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2024 December 31, 2023 Finished goods ​ $ 159,647 ​ $ 158,893 Work-in-process ​ 37,694 ​ 25,420 Raw materials ​ 113,186 ​ 119,558 Total inventories ​ $ 310,527 ​ $ 303,871 ​

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Changes in carrying amount of goodwill	The change in the carrying amount of goodwill by segment for the nine-month period ended September 30, 2024 is detailed as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cardiovascular ​ Endoscopy ​ Total Goodwill balance at January 1 ​ $ 382,240 ​ $ — ​ $ 382,240 Effect of foreign exchange ​ 211 ​ — ​ 211 Additions and adjustments as the result of acquisitions ​ — ​ 16,997 ​ 16,997 Goodwill balance at September 30 ​ $ 382,451 ​ $ 16,997 ​ $ 399,448
Other intangible assets	Other intangible assets at September 30, 2024 and December 31, 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2024 ​ ​ Gross Carrying ​ Accumulated ​ Net Carrying ​ Amount Amortization Amount Patents ​ $ 30,472 ​ $ (12,315) ​ $ 18,157 Distribution agreements ​ 3,250 ​ (2,975) ​ 275 License agreements ​ 11,599 ​ (8,979) ​ 2,620 Trademarks ​ 40,538 ​ (23,235) ​ 17,303 Customer lists ​ 46,959 ​ (35,475) ​ 11,484 Total ​ $ 132,818 ​ $ (82,979) ​ $ 49,839 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 2023 ​ ​ Gross Carrying ​ Accumulated ​ Net Carrying ​ Amount Amortization Amount Patents ​ $ 28,877 ​ $ (10,916) ​ $ 17,961 Distribution agreements ​ 3,250 ​ (2,919) ​ 331 License agreements ​ 11,142 ​ (8,327) ​ 2,815 Trademarks ​ 35,135 ​ (20,804) ​ 14,331 Customer lists ​ 40,367 ​ (33,921) ​ 6,446 Total ​ $ 118,771 ​ $ (76,887) ​ $ 41,884
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, 2024 (in thousands): ​ ​ ​ ​ ​ Estimated Amortization Expense Remaining 2024 ​ $ 17,783 2025 ​ 69,119 2026 ​ 58,484 2027 ​ ​ 54,947 2028 ​ 53,409 ​

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Schedule of Long-term Debt Instruments	Principal balances outstanding under our long-term debt obligations as of September 30, 2024 and December 31, 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2024 December 31, 2023 Term loans ​ $ 23,000 ​ $ 99,063 Revolving credit loans ​ — ​ — Convertible notes ​ ​ 747,500 ​ ​ 747,500 Less unamortized debt issuance costs ​ (19,995) ​ (23,550) Total long-term debt ​ 750,505 ​ 823,013 Less current portion ​ — ​ — Long-term portion ​ $ 750,505 ​ $ 823,013
Schedule of Maturities of Long-term Debt	Future minimum principal payments on our long-term debt, as of September 30, 2024, were as follows (in thousands): ​ ​ ​ ​ ​ Years Ending ​ Future Minimum December 31, Principal Payments Remaining 2024 $ — 2025 ​ ​ — 2026 ​ ​ — 2027 ​ ​ — 2028 ​ ​ 23,000 Thereafter ​ ​ 747,500 Total future minimum principal payments ​ $ 770,500
Schedule of Long-term Debt Covenants	The Amended Fourth A&R Credit Agreement is collateralized by substantially all of our assets. The Amended Fourth A&R 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 Amended Fourth A&R Credit Agreement requires that we maintain certain financial covenants, as follows: ​ ​ ​ ​ ​ ​ Covenant Requirement ​ Consolidated Total Net Leverage Ratio (1) ​ 5.0 to 1.0 ​ Consolidated Senior Secured Net Leverage Ratio (2) ​ ​ 3.0 to 1.0 ​ Consolidated Interest Coverage Ratio (3) ​ 3.0 to 1.0 ​ ​ (1) Maximum Consolidated Total Net Leverage Ratio (as defined in the Amended Fourth A&R Credit Agreement) as of any fiscal quarter end. (2) Maximum Consolidated Senior Secured Net Leverage Ratio (as defined in the Amended Fourth A&R Credit Agreement) as of any fiscal quarter end. (3) Minimum ratio of Consolidated EBITDA (as defined in the Amended Fourth A&R Credit Agreement and adjusted for certain expenditures) to Consolidated Interest Expense (as defined in the Amended Fourth A&R Credit Agreement) for any period of four consecutive fiscal quarters.

Derivatives (Tables)

Derivatives (Tables)	9 Months Ended
	Sep. 30, 2024
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, 2024 December 31, 2023 Assets ​ ​ Interest rate swap Prepaid expenses and other assets ​ $ — ​ $ 1,503 Foreign currency forward contracts Prepaid expenses and other assets ​ ​ 612 ​ ​ 2,061 Foreign currency forward contracts Other assets (long-term) ​ ​ 137 ​ 216 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (2,968) ​ (1,898) Foreign currency forward contracts Other long-term obligations ​ (1,085) ​ (499) ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value of Derivative Instruments Not Designated as Hedging Instruments Balance Sheet Location September 30, 2024 December 31, 2023 Assets ​ ​ Foreign currency forward contracts Prepaid expenses and other assets ​ $ 685 ​ $ 828 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (1,753) ​ (1,463)
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 2024 2023 Location in statements of income 2024 2023 2024 2023 Interest rate swap ​ $ 1 ​ $ 126 ​ Interest expense ​ $ (7,501) ​ $ (4,841) ​ $ 255 ​ $ 685 Foreign currency forward contracts ​ (5,443) ​ 1,503 ​ Revenue ​ 339,845 ​ 315,230 ​ 709 ​ 866 ​ ​ ​ ​ ​ ​ ​ ​ Cost of sales ​ (182,310) ​ (173,031) ​ 179 ​ 617 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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 2024 2023 Location in statements of income 2024 ​ 2023 2024 2023 Interest rate swap ​ $ 152 ​ $ 726 ​ Interest expense ​ $ (23,226) ​ $ (10,534) ​ $ 1,656 ​ $ 1,850 ​ Foreign currency forward contracts ​ (1,308) ​ 6,067 ​ Revenue ​ 1,001,356 ​ 932,851 ​ 1,549 ​ 2,851 ​ ​ ​ ​ ​ ​ ​ ​ ​ Cost of sales ​ (531,006) ​ (499,508) ​ 963 ​ 900 ​
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 2024 2023 2024 2023 Foreign currency forward contracts Other income (expense) — net ​ $ (2,124) ​ $ (452) ​ $ (596) ​ $ 2,748 ​ ​

Earnings Per Common Share (EP_2

Earnings Per Common Share (EPS) (Tables)	9 Months Ended
	Sep. 30, 2024
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, 2024 and 2023 consisted of the following (in thousands, except per share amounts): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ ​ ​ 2024 ​ 2023 ​ 2024 ​ 2023 ​ Net income ​ $ 28,444 ​ $ 25,834 ​ $ 92,410 ​ $ 66,782 ​ Average common shares outstanding ​ 58,231 ​ 57,682 ​ 58,110 ​ 57,525 ​ Basic EPS ​ $ 0.49 ​ $ 0.45 ​ $ 1.59 ​ $ 1.16 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average common shares outstanding ​ ​ 58,231 ​ ​ 57,682 ​ ​ 58,110 ​ ​ 57,525 ​ Effect of dilutive stock awards ​ ​ 866 ​ ​ 693 ​ ​ 691 ​ ​ 820 ​ Effect of dilutive convertible notes ​ ​ 440 ​ ​ — ​ ​ 147 ​ ​ — ​ Total potential shares outstanding ​ ​ 59,537 ​ ​ 58,375 ​ ​ 58,948 ​ ​ 58,345 ​ Diluted EPS ​ $ 0.48 ​ $ 0.44 ​ $ 1.57 ​ $ 1.14 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Equity awards excluded as the impact was anti-dilutive (1) ​ ​ 448 ​ ​ 1,242 ​ ​ 821 ​ ​ 1,091 ​ (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, 2024
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, 2024 and 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ 2024 2023 2024 2023 Cost of sales ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ $ 150 ​ $ 367 ​ $ 875 ​ $ 1,240 Research and development ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 440 ​ 488 ​ ​ 1,221 ​ 1,329 Selling, general and administrative ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 1,442 ​ 2,083 ​ ​ 4,689 ​ 5,304 Performance-based restricted stock units ​ ​ 2,884 ​ ​ 1,838 ​ ​ 7,648 ​ ​ 4,470 Restricted stock units ​ ​ 1,074 ​ ​ 430 ​ ​ 2,792 ​ ​ 1,341 Cash-settled performance-based awards ​ ​ 723 ​ ​ 591 ​ ​ 1,733 ​ ​ 1,662 Total selling, general and administrative ​ ​ 6,123 ​ ​ 4,942 ​ ​ 16,862 ​ ​ 12,777 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Stock-based compensation expense before taxes ​ $ 6,713 ​ $ 5,797 ​ $ 18,958 ​ $ 15,346
Employee Stock Option
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 Risk-free interest rate 3.6% - 4.6% Expected option term 4.0 years Expected dividend yield — Expected price volatility 44.6% - 47.1%
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, ​ ​ 2024 ​ 2023 Risk-free interest rate 4.4% 3.9% - 4.6% Performance period 2.8 years 2.8 years Expected dividend yield — — Expected price volatility 31.1% 31.4% - 32.6%

Segment Reporting (Tables)

Segment Reporting (Tables)	9 Months Ended
	Sep. 30, 2024
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, 2024 and 2023, were as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended Nine Months Ended ​ September 30, September 30, ​ 2024 2023 2024 2023 Net sales ​ ​ ​ ​ Cardiovascular ​ $ 322,855 ​ $ 306,084 ​ $ 964,044 ​ $ 905,335 Endoscopy ​ 16,990 ​ 9,146 ​ 37,312 ​ 27,516 Total net sales ​ 339,845 ​ 315,230 ​ 1,001,356 ​ 932,851 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Income from operations ​ ​ ​ ​ Cardiovascular ​ 37,555 ​ 32,622 ​ 113,374 ​ 82,966 Endoscopy ​ (294) ​ 2,515 ​ 5,755 ​ 7,366 Total income from operations ​ 37,261 ​ 35,137 ​ 119,129 ​ 90,332 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total other expense — net ​ (604) ​ (4,915) ​ (2,281) ​ (9,710) Income tax expense ​ 8,213 ​ 4,388 ​ 24,438 ​ 13,840 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Net income ​ $ 28,444 ​ $ 25,834 ​ $ 92,410 ​ $ 66,782 ​

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2024
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, 2024 and December 31, 2023 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, 2024 (Level 1) (Level 2) (Level 3) Marketable securities (1) ​ $ 78 ​ $ 78 ​ $ — ​ $ — Foreign currency contract assets, current and long-term (3) ​ $ 1,434 ​ $ — ​ $ 1,434 ​ $ — Foreign currency contract liabilities, current and long-term (4) ​ $ (5,806) ​ $ — ​ $ (5,806) ​ $ — Contingent consideration liabilities ​ $ (3,419) ​ $ — ​ $ — ​ $ (3,419) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value Measurements Using ​ ​ Total Fair ​ Quoted prices in ​ Significant other ​ Significant ​ ​ Value at ​ active markets ​ observable inputs ​ unobservable inputs ​ December 31, 2023 (Level 1) (Level 2) (Level 3) Marketable securities (1) ​ $ 78 ​ $ 78 ​ $ — ​ ​ — Interest rate contract asset, current (2) ​ $ 1,503 ​ $ — ​ $ 1,503 ​ $ — Foreign currency contract assets, current and long-term (3) ​ $ 3,105 ​ $ — ​ $ 3,105 ​ $ — Foreign currency contract liabilities, current and long-term (4) ​ $ (3,860) ​ $ — ​ $ (3,860) ​ $ — Contingent consideration liabilities ​ $ (3,447) ​ $ — ​ $ — ​ $ (3,447) ​ (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 recorded as prepaid and other current assets 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 a prepaid expense and other current asset or other long-term asset 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 expense or other long-term obligation 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, 2024 and 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended Nine Months Ended ​ September 30, September 30, ​ 2024 2023 2024 2023 Beginning balance ​ $ 3,435 ​ $ 3,581 ​ $ 3,447 ​ $ 18,073 Contingent consideration expense ​ 103 ​ 563 ​ 292 ​ 2,177 Contingent payments made ​ (119) ​ (122) ​ (320) ​ (16,228) Ending balance ​ $ 3,419 ​ $ 4,022 ​ $ 3,419 ​ $ 4,022
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, 2024 and December 31, 2023 (amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ Valuation ​ ​ ​ ​ ​ Weighted Contingent consideration liability 2024 technique Unobservable inputs Range ​ Average (1) Revenue-based royalty payments contingent liability ​ $ 2,897 Discounted cash flow Discount rate ​ 11% - 15% ​ 14.4% ​ ​ ​ Projected year of payments ​ 2024-2034 ​ 2028 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue milestones contingent liability ​ $ 98 Monte Carlo simulation Discount rate ​ 12.0% ​ ​ ​ ​ ​ Projected year of payments ​ 2024-2040 ​ 2040 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Regulatory approval contingent liability ​ $ 424 ​ Scenario-based method ​ Discount rate ​ 5.4% ​ ​ ​ ​ ​ ​ ​ ​ ​ Probability of milestone payment ​ 50.0% ​ ​ ​ ​ ​ ​ ​ ​ ​ Projected year of payment ​ 2024-2030 ​ 2030 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ Valuation ​ ​ ​ ​ ​ Weighted Contingent consideration liability 2023 technique Unobservable inputs Range ​ Average (1) Revenue-based royalty payments contingent liability ​ $ 2,945 Discounted cash flow Discount rate ​ 12.0% - 16.0% ​ 14.6% ​ ​ ​ Projected year of payments ​ 2024-2034 ​ 2028 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue milestones contingent liability ​ $ 93 Monte Carlo simulation Discount rate ​ 13.0% ​ ​ ​ ​ ​ Projected year of payments ​ 2024-2039 ​ 2039 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Regulatory approval contingent liability ​ $ 409 ​ Scenario-based method ​ Discount rate ​ 5.5% ​ ​ ​ ​ ​ ​ ​ ​ ​ Probability of milestone payment ​ 50.0% ​ ​ ​ ​ ​ ​ ​ ​ ​ Projected year of payment ​ 2024-2030 ​ 2030 (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 roll-forward of the allowance for current expected credit losses on our notes receivable for the three and nine-month periods ended September 30, 2024 and 2023 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ ​ 2024 2023 ​ 2024 2023 Beginning balance ​ $ 1,406 ​ $ 296 ​ $ 568 ​ $ 281 Provision for credit loss expense ​ ​ 189 ​ ​ 32 ​ ​ 1,027 ​ ​ 47 Ending balance ​ $ 1,595 ​ $ 328 ​ $ 1,595 ​ $ 328 ​

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Income (Loss) (Tables)	9 Months Ended
	Sep. 30, 2024
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, 2024 and 2023 were as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash Flow Hedges Foreign Currency Translation Total Balance as of July 1, 2024 $ 2,625 ​ $ (18,054) ​ $ (15,429) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) (5,442) ​ ​ 7,153 ​ ​ 1,711 Income taxes 1,555 ​ ​ (89) ​ ​ 1,466 Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (709) ​ ​ ​ ​ ​ (709) Cost of sales ​ (179) ​ ​ ​ ​ ​ (179) Interest expense ​ (255) ​ ​ ​ ​ ​ (255) Net other comprehensive income (loss) ​ (5,030) ​ ​ 7,064 ​ ​ 2,034 ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2024 $ (2,405) ​ $ (10,990) ​ $ (13,395) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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 January 1, 2024 $ 1,662 ​ $ (12,996) ​ $ (11,334) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) (1,156) ​ ​ 2,061 ​ ​ 905 Income taxes 1,257 ​ ​ (55) ​ ​ 1,202 Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (1,549) ​ ​ ​ ​ ​ (1,549) Cost of sales ​ (963) ​ ​ ​ ​ ​ (963) Interest expense ​ (1,656) ​ ​ ​ ​ ​ (1,656) Net other comprehensive income (loss) ​ (4,067) ​ ​ 2,006 ​ ​ (2,061) ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of September 30, 2024 $ (2,405) ​ $ (10,990) ​ $ (13,395) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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) ​

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, 2024 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2024 USD ($) item segment	Sep. 30, 2023 USD ($)
Disaggregation of Revenue [Line Items]
Number of operating segments | segment			2
Net sales	$ 339,845	$ 315,230	$ 1,001,356	$ 932,851
United States
Disaggregation of Revenue [Line Items]
Net sales	206,492	187,505	587,250	538,447
International
Disaggregation of Revenue [Line Items]
Net sales	133,353	127,725	$ 414,106	394,404
Cardiovascular
Disaggregation of Revenue [Line Items]
Number of product categories | item			4
Net sales	322,855	306,084	$ 964,044	905,335
Cardiovascular | Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	137,932	128,385	411,805	368,077
Cardiovascular | Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	90,769	89,106	275,320	268,209
Cardiovascular | Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	50,768	48,624	149,978	145,709
Cardiovascular | OEM
Disaggregation of Revenue [Line Items]
Net sales	43,386	39,969	126,941	123,340
Cardiovascular | United States
Disaggregation of Revenue [Line Items]
Net sales	190,332	179,019	552,029	512,742
Cardiovascular | United States | Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	84,217	78,617	245,832	219,257
Cardiovascular | United States | Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	37,248	36,593	109,431	106,588
Cardiovascular | United States | Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	30,774	29,602	90,564	85,556
Cardiovascular | United States | OEM
Disaggregation of Revenue [Line Items]
Net sales	38,093	34,207	106,202	101,341
Cardiovascular | International
Disaggregation of Revenue [Line Items]
Net sales	132,523	127,065	412,015	392,593
Cardiovascular | International | Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	53,715	49,768	165,973	148,820
Cardiovascular | International | Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	53,521	52,513	165,889	161,621
Cardiovascular | International | Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	19,994	19,022	59,414	60,153
Cardiovascular | International | OEM
Disaggregation of Revenue [Line Items]
Net sales	5,293	5,762	20,739	21,999
Endoscopy
Disaggregation of Revenue [Line Items]
Net sales	16,990	9,146	37,312	27,516
Endoscopy | Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	16,990	9,146	37,312	27,516
Endoscopy | United States | Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	16,160	8,486	35,221	25,705
Endoscopy | International | Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	$ 830	$ 660	$ 2,091	$ 1,811

Acquisitions and Investments -

Acquisitions and Investments - EGS Purchase Agreement (Details) - EGS - USD ($) $ in Millions		3 Months Ended	9 Months Ended
	Jul. 01, 2024	Sep. 30, 2024	Sep. 30, 2024
Asset Acquisition [Line Items]
Purchase price	$ 105
Net sales related to acquisition		$ 6.8	$ 6.8
Acquisition-related costs			$ 1.8
Weighted Average
Asset Acquisition [Line Items]
Amortization period	10 years 1 month 6 days
Developed technology
Asset Acquisition [Line Items]
Amortization period	10 years
Trademarks
Asset Acquisition [Line Items]
Amortization period	11 years
Customer Lists
Asset Acquisition [Line Items]
Amortization period	11 years

Acquisitions and Investments _2

Acquisitions and Investments - CrannMed Limited (Details) - MM Ireland - CrannMed € in Millions	May 17, 2024 EUR (€)
Business Acquisition [Line Items]
Payments to acquire shares	€ 3
Ownership percentage	10.80%
Commitment to Invest in Preference Shares
Business Acquisition [Line Items]
Additional funding commitment	€ 3
Additional Funding
Business Acquisition [Line Items]
Additional funding commitment	€ 2

Acquisitions and Investments _3

Acquisitions and Investments - SSI (Details) - SSI $ in Millions	Mar. 08, 2024 USD ($) item
Asset Acquisition [Line Items]
Purchase price	$ 3
Number of annual payments | item	3
Amortization period	8 years
First Payment
Asset Acquisition [Line Items]
Additional payments upon the achievement of specified milestones	$ 1
Second Payment
Asset Acquisition [Line Items]
Additional payments upon the achievement of specified milestones	1
Third Payment
Asset Acquisition [Line Items]
Additional payments upon the achievement of specified milestones	$ 1

Acquisitions and Investments _4

Acquisitions and Investments - Fluidx Medical Technology, Inc (Details) - Fluidx - USD ($) $ in Millions	1 Months Ended	36 Months Ended
	Mar. 31, 2024	Dec. 31, 2021
Business Acquisition [Line Items]
Payments to acquire shares	$ 0.3	$ 4.7
Ownership percentage	19.90%

Acquisitions and Investments _5

Acquisitions and Investments - Angio Dynamics, Inc (Details) - Angio Dynamics Inc - USD ($) $ in Millions		9 Months Ended		12 Months Ended
	Jun. 08, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Asset Acquisition [Line Items]
Total purchase price	$ 100
Net sales related to acquisition		$ 21	$ 8.3
Acquisition-related costs				$ 4.9
Weighted Average
Asset Acquisition [Line Items]
Amortization period	10 years 6 months
Developed technology
Asset Acquisition [Line Items]
Amortization period	10 years
Trademarks
Asset Acquisition [Line Items]
Amortization period	11 years
Customer Lists
Asset Acquisition [Line Items]
Amortization period	10 years

Acquisitions and Investments _6

Acquisitions and Investments - Bluegrass Vascular Technologies (Details) - USD ($)	May 04, 2023	May 03, 2023
Bluegrass Vascular Technologies, Inc
Business Acquisition [Line Items]
Total purchase price	$ 32,700,000
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		$ 245,000

Acquisitions and Investments _7

Acquisitions and Investments - Purchase Price Allocation (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Jul. 01, 2024	Dec. 31, 2023	Jun. 08, 2023	May 04, 2023
Assets Acquired
Goodwill	$ 399,448		$ 382,240
EGS
Assets Acquired
Trade receivables		$ 2,568
Prepaid expenses		99
Inventories		3,553
Property and equipment		258
Goodwill		16,997
Total assets acquired		108,275
Liabilities Assumed
Trade payables		494
Accrued expenses		2,752
Total liabilities assumed		3,246
Total net assets acquired		105,029
EGS | Developed technology
Assets Acquired
Intangible assets		72,800
EGS | Trademarks
Assets Acquired
Intangible assets		5,400
EGS | Customer Lists
Assets Acquired
Intangible assets		$ 6,600
Angio Dynamics Inc
Assets Acquired
Prepaid expenses				$ 2,000
Inventories				5,254
Property and equipment				108
Goodwill				17,638
Liabilities Assumed
Total net assets acquired				100,000
Angio Dynamics Inc | Developed technology
Assets Acquired
Intangible assets				65,200
Angio Dynamics Inc | Trademarks
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
Liabilities Assumed
Total net assets acquired					32,973
Bluegrass Vascular Technologies, Inc | Developed technology
Assets Acquired
Intangible assets					28,000
Bluegrass Vascular Technologies, Inc | Trademarks
Assets Acquired
Intangible assets					$ 900

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Finished goods	$ 159,647	$ 158,893
Work-in-process	37,694	25,420
Raw materials	113,186	119,558
Total Inventories	$ 310,527	$ 303,871

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Goodwill (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($)
Goodwill [Roll Forward]
Goodwill balance at beginning of period	$ 382,240
Effect of foreign exchange	(211)
Additions and adjustments as the result of acquisitions	16,997
Goodwill balance at end of period	399,448
Cardiovascular
Goodwill [Roll Forward]
Goodwill balance at beginning of period	382,240
Effect of foreign exchange	(211)
Goodwill balance at end of period	382,451
Endoscopy
Goodwill [Roll Forward]
Additions and adjustments as the result of acquisitions	16,997
Goodwill balance at end of period	$ 16,997

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Other Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Other
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 132,818	$ 118,771
Accumulated Amortization	(82,979)	(76,887)
Net Carrying Amount	49,839	41,884
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	30,472	28,877
Accumulated Amortization	(12,315)	(10,916)
Net Carrying Amount	18,157	17,961
Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	3,250	3,250
Accumulated Amortization	(2,975)	(2,919)
Net Carrying Amount	275	331
License agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	11,599	11,142
Accumulated Amortization	(8,979)	(8,327)
Net Carrying Amount	2,620	2,815
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	40,538	35,135
Accumulated Amortization	(23,235)	(20,804)
Net Carrying Amount	17,303	14,331
Customer Lists
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	46,959	40,367
Accumulated Amortization	(35,475)	(33,921)
Net Carrying Amount	$ 11,484	$ 6,446

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Accumulated goodwill impairment losses	$ 8.3		$ 8.3		$ 8.3
Goodwill impairment loss			0	$ 0
Aggregate amortization expense	$ 16.9	$ 15.4	46.4	41.1
Impairment of intangible assets			$ 0	$ 0

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Future Amortization Expense (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Remaining 2024	$ 17,783
2025	69,119
2026	58,484
2027	54,947
2028	$ 53,409

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Income tax expense	$ 8,213	$ 4,388	$ 24,438	$ 13,840
Effective tax rate	22.40%	14.50%	20.90%	17.20%

Debt - Principal Balances under

Debt - Principal Balances under Long-term Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Long-term debt	$ 770,500
Less unamortized debt issuance costs	(19,995)	$ (23,550)
Total long-term debt	750,505	823,013
Long-term portion	750,505	823,013
Term Loan
Debt Instrument [Line Items]
Long-term debt	23,000	99,063
Convertible Notes
Debt Instrument [Line Items]
Long-term debt	$ 747,500	$ 747,500

Debt - Future Minimum Payments

Debt - Future Minimum Payments on Long-term Debt (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Debt Disclosure [Abstract]
2028	$ 23,000
Thereafter	747,500
Total future minimum principal payments	$ 770,500

Debt - Narrative (Details)

Debt - Narrative (Details)	1 Months Ended
	Dec. 31, 2023 USD ($) $ / shares $ / derivative shares	Sep. 30, 2024 USD ($) $ / shares	Jun. 06, 2023 USD ($)
Debt Instrument [Line Items]
Outstanding borrowings		$ 770,500,000
Credit Agreement
Debt Instrument [Line Items]
Outstanding borrowings		23,000,000
Letter of credit guarantees		2,400,000
Available borrowing capacity		$ 697,000,000
Fixed interest rate percent	3.39%
Debt subject to fixed interest rate	$ 75,000,000
Variable interest rate percent	7.21%	6.70%
Debt subject to variable interest rate	$ 24,100,000
Term Loan
Debt Instrument [Line Items]
Outstanding borrowings	$ 99,063,000	$ 23,000,000
Term Loan | Credit Agreement
Debt Instrument [Line Items]
Debt instrument, face amount			$ 150,000,000
Revolving Credit Facility | Credit Agreement
Debt Instrument [Line Items]
Maximum borrowing capacity			$ 700,000,000
Senior unsecured convertible notes | Convertible debt
Debt Instrument [Line Items]
Interest rate	3%
Net proceeds from convertible notes	$ 724,800,000
Shares issued upon conversion | shares	11.5171
Debt instrument conversion ratio multiple of principal	$ 1,000
Repurchase percentage on principal, accrued and unpaid interest	100%
Number of business days period after consecutive trading days	5 days
Consecutive trading days, trading price per share after which to be observed for conversion	10 days
Percentage of sale price	98%
Common stock at a price per share less than the average closing sale price	60 days
Purchase shares of common stock at a price per share less than the average closing sale price of consecutive trading days	10 days
Percentage of distribution to common stockholders	10%
Percentage of applicable conversion price	130%
Percentage of applicable conversion price on each applicable trading day	20 days
Consecutive trading day period ending	30 days
Senior unsecured convertible notes | Convertible debt | Call option
Debt Instrument [Line Items]
Cap price | $ / derivative	114.68
Capped call transaction cost	$ 66,500,000
Senior unsecured convertible notes | Convertible debt | Common Stock
Debt Instrument [Line Items]
Conversion price | $ / shares	$ 86.83	$ 86.83
Senior unsecured convertible notes | Convertible debt | Minimum
Debt Instrument [Line Items]
Reported sales price of common stock	130%
Conversion price then in effect for at least number of trading days	20 days

Debt - Financial Covenants (Det

Debt - Financial Covenants (Details) - Credit Agreement	9 Months Ended
	Sep. 30, 2024
Debt Instrument [Line Items]
Consolidated Total Leverage Ratio	5
Consolidated Senior Secured Net Leverage Ratio	3
Consolidated Interest Coverage Ratio	3

Derivatives - Narrative (Detail

Derivatives - Narrative (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Dec. 31, 2023	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	$ 2
Amount expected to be reclassified from accumulated other comprehensive income to earnings (loss) in next twelve months, net of tax	$ 1.5
Interest rate swap | Designated as hedging instrument
Derivative [Line Items]
Fair value of derivative asset		$ 1.5
Deferred tax liability used to offset fair value of interest rate swap		$ (0.4)
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:SecuredOvernightFinancingRateSofrMember
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 - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Designated as hedging instrument | Derivatives designated as cash flow hedges
Derivative [Line Items]
Aggregate notional amount of derivative	$ 155.4	$ 141.1
Not designated as hedging instrument | Fair Value Hedging
Derivative [Line Items]
Aggregate notional amount of derivative	$ 115.6	$ 108.4

Derivatives - Fair Value of Der

Derivatives - Fair Value of Derivative Instruments (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Designated as hedging instrument | Interest rate swap
Derivatives, Fair Value [Line Items]
Fair value of derivative asset		$ 1,500
Designated as hedging instrument | Interest rate swap | Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Fair value of derivative asset		1,503
Designated as hedging instrument | Foreign currency forward contracts | Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	$ 612	2,061
Designated as hedging instrument | Foreign currency forward contracts | Other assets (long-term)
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	137	216
Designated as hedging instrument | Foreign currency forward contracts | Accrued expenses
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(2,968)	(1,898)
Designated as hedging instrument | Foreign currency forward contracts | Other long-term obligations
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(1,085)	(499)
Not designated as hedging instrument | Foreign currency forward contracts | Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	685	828
Not designated as hedging instrument | Foreign currency forward contracts | Accrued expenses
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	$ (1,753)	$ (1,463)

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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	$ (6,585)	$ (539)	$ (5,324)	$ 1,192
Interest expense	(7,501)	(4,841)	(23,226)	(10,534)
Net sales	339,845	315,230	1,001,356	932,851
Cost of sales	(182,310)	(173,031)	(531,006)	(499,508)
Derivatives designated as cash flow hedges | Interest rate swap
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	1	126	152	726
Derivatives designated as cash flow hedges | Interest rate swap | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	255	685	1,656	1,850
Derivatives designated as cash flow hedges | Foreign currency forward contracts
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	(5,443)	1,503	(1,308)	6,067
Derivatives designated as cash flow hedges | Foreign currency forward contracts | Revenue
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	709	866	1,549	2,851
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	$ 179	$ 617	$ 963	$ 900

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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Derivative [Line Items]
Gain (loss) on derivative	$ (2,124)	$ (452)	$ (596)	$ 2,748
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, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023
Earnings Per Share [Abstract]
Net income	$ 28,444	$ 35,726	$ 28,240	$ 25,834	$ 20,245	$ 20,703	$ 92,410	$ 66,782
Average common shares outstanding (in shares)	58,231			57,682			58,110	57,525
Basic EPS (in dollars per share)	$ 0.49			$ 0.45			$ 1.59	$ 1.16

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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Earnings Per Share [Abstract]
Average common shares outstanding (in shares)	58,231	57,682	58,110	57,525
Effect of dilutive stock awards (in shares)	866	693	691	820
Effect of dilutive convertible notes (in Shares)	440		147
Total potential shares outstanding (in shares)	59,537	58,375	58,948	58,345
Diluted EPS (in dollars per share)	$ 0.48	$ 0.44	$ 1.57	$ 1.14
Equity awards excluded as the impact was anti-dilutive (in shares)	448	1,242	821	1,091

Earnings Per Common Share (EP_5

Earnings Per Common Share (EPS) - Convertible Noes (Details) - $ / shares	Sep. 30, 2024	Dec. 31, 2023
Convertible Notes | Senior unsecured convertible notes | Common Stock
Debt Instrument [Line Items]
Conversion price	$ 86.83	$ 86.83

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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 6,713	$ 5,797	$ 18,958	$ 15,346
Cost of sales | Employee Stock Option
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	150	367	875	1,240
Research and development | Employee Stock Option
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	440	488	1,221	1,329
Selling, general and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	6,123	4,942	16,862	12,777
Selling, general and administrative | Employee Stock Option
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	1,442	2,083	4,689	5,304
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	2,884	1,838	7,648	4,470
Selling, general and administrative | Restricted Stock Units
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	1,074	430	2,792	1,341
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	$ 723	$ 591	$ 1,733	$ 1,662

Stock-Based Compensation Expe_4

Stock-Based Compensation Expense - Narrative (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Restricted stock units granted (in shares)		20,358
Employee Stock Option
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Options granted in period (in shares)	0	401,535
Compensation cost not yet recognized	$ 13.2
Compensation cost not yet recognized, period of recognition	1 year 10 months 24 days
Stock-Settled Performance-Based Restricted Stock Units
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Stock units granted in period (in shares)		286,863
Compensation cost not yet recognized	$ 17.5
Compensation cost not yet recognized, period of recognition	1 year 10 months 24 days
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)	364,810
Cash-Settled Performance-Based Share-Based Awards (Liability Awards)
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Target cash incentive	$ 1.6	$ 1.3
Compensation cost not yet recognized	$ 3.8
Compensation cost not yet recognized, period of recognition	1 year 9 months 18 days
Fair value of awards	$ 4.1		$ 3.4
Cash-Settled Performance-Based Share-Based Awards (Liability Awards) | Maximum
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Target cash incentive	$ 4.4	$ 4.6
Multiplying factor	250%	250%
Restricted Stock Units
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Restricted stock units granted (in shares)	158,719
Compensation cost not yet recognized	$ 9.1
Compensation cost not yet recognized, period of recognition	3 years 1 month 6 days
Restricted Stock Units | Employee
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Award vesting period	4 years
Restricted Stock Units | Non-employee members
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Award vesting period	1 year

Stock-Based Compensation Expe_5

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

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, 2024	Sep. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum		3.90%
Risk-free interest rate, maximum		4.60%
Risk-free interest rate	4.40%
Expected option term / Performance Period	2 years 9 months 18 days	2 years 9 months 18 days
Expected dividend yield	0%	0%
Expected price volatility, minimum		31.40%
Expected price volatility, maximum		32.60%
Expected price volatility	31.10%

Segment Reporting - Narrative (

Segment Reporting - Narrative (Details)	9 Months Ended
	Sep. 30, 2024 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, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023
Segment Reporting Information [Line Items]
Net sales	$ 339,845			$ 315,230			$ 1,001,356	$ 932,851
Income from operations	37,261			35,137			119,129	90,332
Total other expense - net	(604)			(4,915)			(2,281)	(9,710)
Income tax expense	8,213			4,388			24,438	13,840
Net income	28,444	$ 35,726	$ 28,240	25,834	$ 20,245	$ 20,703	92,410	66,782
Cardiovascular
Segment Reporting Information [Line Items]
Net sales	322,855			306,084			964,044	905,335
Income from operations	37,555			32,622			113,374	82,966
Endoscopy
Segment Reporting Information [Line Items]
Net sales	16,990			9,146			37,312	27,516
Income from operations	$ (294)			$ 2,515			$ 5,755	$ 7,366

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, 2024	Dec. 31, 2023
Fair Value, Inputs, Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	$ 78	$ 78
Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate contract asset, current		1,503
Foreign currency contract assets, current and long-term	1,434	3,105
Foreign currency contract liabilities, current and long-term	(5,806)	(3,860)
Fair Value, Inputs, Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liabilities	(3,419)	(3,447)
Estimate of Fair Value, Fair Value Disclosure
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	78	78
Interest rate contract asset, current		1,503
Foreign currency contract assets, current and long-term	1,434	3,105
Foreign currency contract liabilities, current and long-term	(5,806)	(3,860)
Contingent consideration liabilities	$ (3,419)	$ (3,447)

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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 3,435	$ 3,581	$ 3,447	$ 18,073
Contingent consideration expense	$ 103	$ 563	$ 292	$ 2,177
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	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	$ (119)	$ (122)	$ (320)	$ (16,228)
Ending balance	$ 3,419	$ 4,022	$ 3,419	$ 4,022

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Jun. 30, 2024	Mar. 31, 2024	Dec. 31, 2023	Jun. 30, 2023	May 03, 2023	Dec. 31, 2022
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			$ 209,000	$ 3,502,000
Payments related to the settlement of the contingent consideration liability, Operating activities			100,000	12,700,000
Impairment of equity method investment			0
Impairment of intangible assets			0	0
Interest income	$ 6,652,000	$ 181,000	21,489,000	533,000
Investments in privately held companies	22,600,000		22,600,000				$ 19,100,000
Long-term notes receivable, net	9,300,000		9,300,000				3,200,000
Long-term notes receivable issued			6,700,000
Allowance for expected credit losses	1,595,000	$ 328,000	1,595,000	328,000	$ 1,406,000		568,000	$ 296,000		$ 281,000
Solo Pace
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Long-term notes receivable issued			2,000,000
Fluidx
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Ownership percentage						19.90%
Long-term notes receivable issued			3,000,000
Bluegrass Vascular Technologies, Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of equity method investment				$ 300,000
Ownership percentage									19.50%
Equity method investment									$ 245,000
Selio
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Long-term notes receivable issued			1,700,000
Allowance for expected credit losses	1,600,000		1,600,000				600,000
Other long-term obligations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability, noncurrent	3,000,000		3,000,000				3,000,000
Accrued expenses
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability, current	$ 400,000		$ 400,000				$ 400,000

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value Inputs, Liabilities, Quantitative Information (Details) - Fair Value, Inputs, Level 3 $ in Thousands	Sep. 30, 2024 USD ($)	Dec. 31, 2023 USD ($)
Revenue-based royalty
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	$ 2,897	$ 2,945
Revenue milestones
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	98	93
Regulatory approval
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	$ 424	$ 409
Discount rate | Revenue-based royalty | Minimum | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.11	0.120
Discount rate | Revenue-based royalty | Maximum | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.15	0.160
Discount rate | Revenue-based royalty | Weighted Average | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.144	0.146
Discount rate | Revenue milestones | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.120
Discount rate | Revenue milestones | Minimum | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability		0.130
Discount rate | Regulatory approval | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.054	0.055
Probability of milestone payment | Regulatory approval | Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.500	0.500

Fair Value Measurements - Allow

Fair Value Measurements - Allowance for Credit Losses (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 1,406	$ 296	$ 568	$ 281
Provision for credit loss expense	189	32	1,027	47
Ending balance	$ 1,595	$ 328	$ 1,595	$ 328

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive Income (Loss) - Changes in AOCI (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Accumulated other comprehensive income (loss)
Beginning balance	$ 1,282,445	$ 1,203,700	$ 1,202,000	$ 1,144,397
Reclassifications to:
Cost of sales	(182,310)	(173,031)	(531,006)	(499,508)
Interest expense	(7,501)	(4,841)	(23,226)	(10,534)
Ending balance	1,323,406	1,229,885	1,323,406	1,229,885
Accumulated Other Comprehensive Loss
Accumulated other comprehensive income (loss)
Beginning balance	(15,429)	(9,544)	(11,334)	(11,550)
Other comprehensive income (loss)	1,711	(1,285)	905	4,603
Income taxes	1,466	146	1,202	(303)
Reclassifications to:
Net other comprehensive income (loss)	2,034	(3,307)	(2,061)	(1,301)
Ending balance	(13,395)	(12,851)	(13,395)	(12,851)
Accumulated Other Comprehensive Loss | Reclassification out of Accumulated Other Comprehensive Income
Reclassifications to:
Revenue	(709)	(866)	(1,549)	(2,851)
Cost of sales	(179)	(617)	(963)	(900)
Interest expense	(255)	(685)	(1,656)	(1,850)
Cash Flow Hedges
Accumulated other comprehensive income (loss)
Beginning balance	2,625	5,682	1,662	4,366
Other comprehensive income (loss)	(5,442)	1,629	(1,156)	6,793
Income taxes	1,555	129	1,257	(286)
Reclassifications to:
Net other comprehensive income (loss)	(5,030)	(410)	(4,067)	906
Ending balance	(2,405)	5,272	(2,405)	5,272
Cash Flow Hedges | Reclassification out of Accumulated Other Comprehensive Income
Reclassifications to:
Revenue	(709)	(866)	(1,549)	(2,851)
Cost of sales	(179)	(617)	(963)	(900)
Interest expense	(255)	(685)	(1,656)	(1,850)
Foreign Currency Translation
Accumulated other comprehensive income (loss)
Beginning balance	(18,054)	(15,226)	(12,996)	(15,916)
Other comprehensive income (loss)	7,153	(2,914)	2,061	(2,190)
Income taxes	(89)	17	(55)	(17)
Reclassifications to:
Net other comprehensive income (loss)	7,064	(2,897)	2,006	(2,207)
Ending balance	$ (10,990)	$ (18,123)	$ (10,990)	$ (18,123)

Subsequent Events (Details)

Subsequent Events (Details) - Subsequent Event - Cook Medical $ in Millions	3 Months Ended
	Dec. 31, 2024 USD ($)
Subsequent Events
Purchase price	$ 210
Period of transition	2 years

Uncategorized Items - mmsi-2024

Label	Element	Value
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents	$ 589,144,000