Merit Medical Systems (MMSI) 10-K 25 Feb 25 2024 FY Annual report Financial data

Cover Page

Cover Page - USD ($) $ in Billions	12 Months Ended
	Dec. 31, 2024	Feb. 21, 2025	Jun. 30, 2024
Cover page.
Document Type	10-K
Document Annual Report	true
Document Transition Report	false
Document Period End Date	Dec. 31, 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 Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
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
ICFR Auditor Attestation Flag	true
Entity Shell Company	false
Document Financial Statement Error Correction [Flag]	false
Entity Common Stock, Shares Outstanding		58,834,568
Entity Public Float			$ 4.9
Auditor Name	DELOITTE & TOUCHE LLP
Auditor Firm ID	34
Auditor Location	Salt Lake City, Utah
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	FY
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 376,715	$ 587,036
Trade receivables - net of allowance for credit losses - 2024 - $9,729 and 2023 - $9,023	190,243	177,885
Other receivables	16,588	10,517
Inventories	306,063	303,871
Prepaid expenses and other current assets	28,544	24,286
Prepaid income taxes	3,286	4,016
Income tax refund receivables	2,335	859
Total current assets	923,774	1,108,470
Property and equipment:
Land and land improvements	25,846	26,017
Buildings	192,296	191,491
Manufacturing equipment	340,864	316,930
Furniture and fixtures	61,321	63,044
Leasehold improvements	58,770	53,638
Construction-in-progress	58,673	61,439
Total property and equipment	737,770	712,559
Less accumulated depreciation	(351,605)	(329,036)
Property and equipment - net	386,165	383,523
Other assets:
Goodwill	463,511	382,240
Deferred income tax assets	16,044	7,288
Right-of-use operating lease assets	65,508	63,047
Other assets	65,336	54,793
Total other assets	1,108,664	833,251
Total assets	2,418,603	2,325,244
Current liabilities:
Trade payables	68,502	65,944
Accrued expenses	134,077	120,447
Short-term operating lease liabilities	10,331	12,087
Income taxes payable	3,492	5,086
Total current liabilities	216,402	203,564
Long-term debt	729,551	823,013
Deferred income tax liabilities	240	5,547
Long-term income taxes payable		347
Liabilities related to unrecognized tax benefits	2,118	1,912
Deferred compensation payable	19,197	17,167
Deferred credits	1,502	1,605
Long-term operating lease liabilities	54,783	56,259
Other long-term obligations	15,451	13,830
Total liabilities	1,039,244	1,123,244
Commitments and contingencies
Stockholders' equity:
Preferred stock - 5,000 shares authorized; no shares issued as of December 31, 2024 and December 31, 2023	0	0
Common stock, no par value - 100,000 shares authorized; issued and outstanding as of December 31, 2024 - 58,743 and December 31, 2023 - 57,858	703,219	638,150
Retained earnings	695,541	575,184
Accumulated other comprehensive loss	(19,401)	(11,334)
Total stockholders' equity	1,379,359	1,202,000
Total liabilities and stockholders' equity	2,418,603	2,325,244
Developed technology
Other assets:
Intangible assets:	431,766	283,999
Other
Other assets:
Intangible assets:	$ 66,499	$ 41,884

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Current assets:
Trade receivables, allowances	$ 9,729	$ 9,023
Stockholders' equity:
Preferred stock shares authorized (in shares)	5,000,000	5,000,000
Preferred stock shares issued (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0	$ 0
Common stock shares authorized (in shares)	100,000,000	100,000,000
Common stock shares issued (in shares)	58,743,000	57,858,000
Common stock shares outstanding (in shares)	58,743,000	57,858,000
Developed technology
Other assets:
Intangibles, accumulated amortization	$ 377,993	$ 321,488
Other
Other assets:
Intangibles, accumulated amortization	$ 85,343	$ 76,887

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
CONSOLIDATED STATEMENTS OF INCOME
Net sales	$ 1,356,514	$ 1,257,366	$ 1,150,981
Cost of sales	713,181	673,494	631,882
Gross profit	643,333	583,872	519,099
Operating expenses:
Selling, general and administrative	399,731	373,676	342,525
Research and development	87,466	82,728	75,510
Impairment charges		270	2,219
Contingent consideration expense	443	1,704	4,611
Acquired in-process research and development		1,550	6,671
Total operating expenses	487,640	459,928	431,536
Income from operations	155,693	123,944	87,563
Other income (expense):
Interest income	26,230	2,456	439
Interest expense	(31,219)	(15,511)	(6,339)
Other income (expense) - net	(711)	1,200	966
Total other expense - net	(5,700)	(11,855)	(4,934)
Income before income taxes	149,993	112,089	82,629
Income tax expense	29,636	17,678	8,113
Net income	$ 120,357	$ 94,411	$ 74,516
Earnings per common share
Basic (in dollars per share)	$ 2.07	$ 1.64	$ 1.31
Diluted (in dollars per share)	$ 2.03	$ 1.62	$ 1.29
Weighted average shares outstanding
Basic (in shares)	58,218	57,593	56,806
Diluted (in shares)	59,365	58,356	57,671

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
Net Income (Loss)	$ 120,357	$ 94,411	$ 74,516
Other comprehensive income (loss):
Cash flow hedges	1,444	(3,570)	9,007
Income tax benefit (expense)	(341)	866	(2,177)
Foreign currency translation adjustment	(9,224)	2,959	(10,491)
Income tax benefit (expense)	54	(39)	102
Total other comprehensive income (loss)	(8,067)	216	(3,559)
Total comprehensive income	$ 112,290	$ 94,627	$ 70,957

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands	Common Stock	Retained Earnings	Accumulated Other Comprehensive Loss	Total
Beginning balance at Dec. 31, 2021	$ 641,533	$ 406,257	$ (7,991)	$ 1,039,799
Beginning balance (in shares) at Dec. 31, 2021	56,570
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net Income (Loss)		74,516		74,516
Other comprehensive income (loss)			(3,559)	(3,559)
Stock-based compensation expense	$ 16,045			16,045
Options exercised	$ 20,092			20,092
Options exercised (in shares)	703
Issuance of common stock under Employee Stock Purchase Plan	$ 1,118			1,118
Issuance of common stock under Employee Stock Purchase Plan (in shares)	19
Shares issued from time-vested restricted stock units (in shares)	70
Shares surrendered in exchange for payment of payroll tax liabilities	$ (2,474)			(2,474)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)	(38)
Shares surrendered in exchange for exercise of stock options	$ (1,140)			(1,140)
Shares surrendered in exchange for exercise of stock options (in shares)	(18)
Ending balance at Dec. 31, 2022	$ 675,174	480,773	(11,550)	1,144,397
Ending balance (in shares) at Dec. 31, 2022	57,306
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net Income (Loss)		94,411		94,411
Other comprehensive income (loss)			216	216
Stock-based compensation expense	$ 19,043			19,043
Options exercised	$ 20,312			20,312
Options exercised (in shares)	606
Issuance of common stock under Employee Stock Purchase Plan	$ 1,081			1,081
Issuance of common stock under Employee Stock Purchase Plan (in shares)	15
Shares issued from time-vested restricted stock units (in shares)	92
Purchase of capped call option	$ (66,528)			(66,528)
Shares surrendered in exchange for payment of payroll tax liabilities	$ (5,123)			(5,123)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)	(75)
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 Dec. 31, 2023	$ 638,150	575,184	(11,334)	$ 1,202,000
Ending balance (in shares) at Dec. 31, 2023	57,858			57,858
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net Income (Loss)		120,357		$ 120,357
Other comprehensive income (loss)			(8,067)	(8,067)
Stock-based compensation expense	$ 25,753			25,753
Options exercised	$ 39,746			$ 39,746
Options exercised (in shares)	824			824
Issuance of common stock under Employee Stock Purchase Plan	$ 1,162			$ 1,162
Issuance of common stock under Employee Stock Purchase Plan (in shares)	14
Shares issued from time-vested restricted stock units (in shares)	68
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 Dec. 31, 2024	$ 703,219	$ 695,541	$ (19,401)	$ 1,379,359
Ending balance (in shares) at Dec. 31, 2024	58,743			58,743

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
CASH FLOWS FROM OPERATING ACTIVITIES:
Net Income (Loss)	$ 120,357	$ 94,411	$ 74,516
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	102,709	89,985	81,804
(Gain) loss on disposition of business		(431)	1,417
Loss on sale or abandonment of property and equipment	1,490	5,838	380
Write-off of certain intangible assets and other long-term assets	456	506	2,281
Acquired in-process research and development		1,550	6,671
Amortization of right-of-use operating lease assets	12,023	11,307	10,394
Fair value adjustments related to contingent consideration liabilities	443	1,704	4,611
Amortization of deferred credits	(103)	(104)	(107)
Amortization and write-off of long-term debt issuance costs	6,769	1,717	604
Deferred income taxes	(14,873)	(12,643)	(14,924)
Stock-based compensation expense	28,473	21,333	18,042
Changes in operating assets and liabilities, net of acquisitions and divestitures:
Trade receivables	(13,686)	(11,916)	(15,116)
Other receivables	(6,482)	2,429	4,154
Inventories	(2,287)	(32,105)	(47,929)
Prepaid expenses and other current assets	(4,295)	1,281	(1,798)
Prepaid income taxes	709	(92)	(379)
Income tax refund receivables	(1,536)	(58)	1,952
Other assets	(6,066)	(5,976)	657
Trade payables	(2,314)	(7,297)	12,661
Accrued expenses	9,715	(2,484)	(16,379)
Income taxes payable	(1,785)	(1,685)	4,521
Liabilities related to unrecognized tax benefits	206		(45)
Deferred compensation payable	2,030	1,903	(2,848)
Operating lease liabilities	(12,183)	(11,492)	(11,127)
Other long-term obligations	1,029	(2,530)	278
Total adjustments	100,442	50,740	39,775
Net cash, cash equivalents, and restricted cash provided by operating activities	220,799	145,151	114,291
Capital expenditures for:
Property and equipment	(35,140)	(34,290)	(45,029)
Intangible assets	(2,903)	(2,411)	(3,175)
Proceeds from the sale of property and equipment	5	201	65
Proceeds (payments) from disposition of business		431	(971)
Cash paid for notes receivable and other investments	(10,433)	(4,755)	(1,412)
Cash paid in acquisitions, net of cash acquired	(320,182)	(134,523)	(6,875)
Net cash, cash equivalents, and restricted cash used in investing activities	(368,653)	(175,347)	(57,397)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of common stock	40,908	15,584	20,070
Proceeds from issuance of long-term debt		1,199,203	215,205
Payments on long-term debt	(99,063)	(579,624)	(260,143)
Purchase of capped call option		(66,528)
Long-term debt issuance costs		(677)
Contingent payments related to acquisitions	(261)	(3,569)	(32,918)
Payment of taxes related to an exchange of common stock	(1,592)	(5,123)	(2,474)
Net cash, cash equivalents, and restricted cash (used in) provided by financing activities	(60,008)	559,266	(60,260)
Effect of exchange rates on cash, cash equivalents, and restricted cash	(2,515)	(484)	(3,826)
Net increase (decrease) in cash, cash equivalents and restricted cash	(210,377)	528,586	(7,192)
CASH, CASH EQUIVALENTS AND RESTRICTED CASH:
Beginning of period	589,144	60,558	67,750
End of period	378,767	589,144	60,558
RECONCILIATION OF CASH, CASH EQUIVALENTS AND RESTRICTED CASH TO THE CONSOLIDATED BALANCE SHEETS:
Cash and cash equivalents	376,715	587,036	58,408
Restricted cash reported in prepaid expenses and other current assets	$ 2,052	$ 2,108	2,150
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	$ 378,767	$ 589,144	60,558
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION
Interest (net of capitalized interest of $1,005, $1,272 and $858, respectively)	23,244	14,051	6,258
Income taxes	45,047	31,534	17,092
SUPPLEMENTAL DISCLOSURES OF NON-CASH INVESTING AND FINANCING ACTIVITIES
Property and equipment purchases in accounts payable	13,244	8,267	3,702
Acquisition purchases in accrued expenses and other long-term obligations	4,956	3,713	3,526
Merit common stock surrendered (0, 86, and 18 shares, respectively) in exchange for exercise of stock options		5,809	1,140
Right-of-use operating lease assets obtained in exchange for operating lease liabilities	$ 9,947	$ 8,891	$ 11,130

CONSOLIDATED STATEMENTS OF CA_2

CONSOLIDATED STATEMENTS OF CASH FLOWS (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
CONSOLIDATED STATEMENTS OF CASH FLOWS
Net capitalized interest	$ 1,005	$ 1,272	$ 858
Common stock surrendered in exchange for exercise of stock options (in shares)	0	86	18

Organization and Summary of Sig

Organization and Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Summary of Significant Accounting Policies	1. Organization peripheral intervention, cardiac intervention, custom procedural solutions, OEM”) We manufacture our products in plants located in the U.S., Mexico, The Netherlands, Ireland, France, Brazil and Singapore. We export sales to dealers and have direct or modified direct sales forces in the U.S., Canada, Western Europe, Australia, Brazil, Japan, China, Malaysia, South Korea, UAE, India, New Zealand and South Africa (see Note 13 Segment Reporting and Foreign Operations Principles of Consolidation and Basis of Presentation During the year ended December 31, 2024, we elected to change the presentation of investments in privately held companies within the statements of cash flows to be included within Cash paid for notes receivable and other investments Cash paid in acquisitions, net of cash acquired Use of Estimates in Preparing Financial Statements Cash and Cash Equivalents Receivables Inventories of the valuation of inventories includes an assessment of future product demand based on historical sales and raw material usage and product expiration. Goodwill and Intangible Assets Finite-lived intangible assets including developed technology, customer lists, distribution agreements, license agreements, trademarks and patents are subject to amortization. Intangible assets are amortized over their estimated useful life on a straight-line basis, except for customer lists, which are generally amortized on an accelerated basis. Estimated useful lives are determined considering the period the assets are expected to contribute to future cash flows. 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 are largely independent of the cash flows of other assets and liabilities. We compare the carrying value of the asset group to the undiscounted cash flows expected to result from the asset group and determine whether the carrying amount is recoverable. We determine the fair value of each asset group 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. In-process technology intangible assets, which are not subject to amortization until projects reach commercialization, are assessed for impairment at least annually and more frequently if events occur that would indicate a potential reduction in the fair value of the assets below their carrying value. An impairment charge would be recognized to the extent the carrying amount of the in-process technology exceeded its fair value. D December 31, 2022 were restructuring activities and uncertainty about future product development and commercialization associated with certain acquired technologies. Long-Lived Assets Property, Plant and Equipment Property and Equipment ​ ​ ​ ​ Buildings 40 years Manufacturing equipment ​ 4 - 20 years Furniture and fixtures ​ 3 - 20 years Land improvements ​ 10 - 20 years Leasehold improvements ​ 4 - 25 years ​ Depreciation expense related to property and equipment for the years ended December 31, 2024, 2023 and 2022 was $37.2 million, $34.0 million, and $33.4 million, respectively. Deferred Compensation Other Assets ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Investments in privately held companies ​ $ 22,832 ​ $ 19,061 Deferred compensation plan assets ​ ​ 20,716 ​ ​ 18,309 Long-term notes receivable, net ​ ​ 9,423 ​ ​ 3,241 Other ​ 12,365 ​ 14,182 Total ​ $ 65,336 ​ $ 54,793 ​ 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. Our share of earnings associated with equity method investments is reported within other income (expense) in our consolidated statements of income. 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. We paid $3.8 million, $4.0 million, and $1.4 million in the acquisition of additional equity investments and have no cumulative impairments or other fair value adjustments associated with our existing investments. Refer to Note 15, Fair Value Measurements Other Long-term Obligations. ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Contingent consideration liabilities ​ $ 3,128 ​ $ 3,039 Other long-term obligations ​ ​ 12,323 ​ ​ 10,791 Total ​ $ 15,451 ​ $ 13,830 ​ In connection with a business combination, any contingent consideration is recorded at fair value on the acquisition date based upon the consideration expected to be transferred in the future. We re-measure the estimated liability each quarter based upon changes in revenue estimates, changes in the probability of achieving relevant milestones and changes in the discount rate or expected period of payment. Changes in the estimated fair value are recorded through operating expense in our consolidated statements of income. Revenue Recognition Identify the contract with the customer Identify the performance obligations in the contract Determine the transaction price Allocate the transaction price to performance obligations in the contract Recognize revenue when or as we satisfy a performance obligation. Reserves are recorded as a reduction in net sales and are not considered material to our consolidated statements of income for the years ended December 31, 2024, 2023 and 2022. In addition, we invoice our customers for taxes assessed by governmental authorities, such as sales tax and value-added taxes. We present these taxes on a net basis. Shipping and Handling Cost of Sales Research and Development Restructuring. Exit or Disposal Cost Obligations Income Taxes Earnings per Common Share Fair Value Measurements Level 1: Quoted market prices in active markets for identical assets or liabilities. Level 2: Observable market-based inputs or inputs that are corroborated by market data. Level 3: Unobservable inputs that are not corroborated by market data. Stock-Based Compensation Compensation — Stock Compensation Employee Stock Purchase Plan, Stock Options and Warrants Concentration of Credit Risk Foreign Currency Derivatives Debt Derivatives Recently Adopted Financial Accounting Standards. Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting Deferral of the Sunset Date of Topic 848 Derivatives In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures Segment Reporting and Foreign Operations Recently Issued Accounting Standards. Improvements to Income Tax Disclosures Income Taxes (Topic 740) In November 2024, the FASB issued ASU 2024-03, Disaggregation of Income Statement Expenses, for fiscal years beginning after December 15, 2026, and interim periods within fiscal years beginning after December 15, 2027, with early adoption permitted. The provisions within the update may be applied retrospectively for all periods presented in the financial statements. While we are still evaluating the specific impacts and adoption method, we anticipate this guidance will have a significant impact on our consolidated financial statement disclosures. We currently believe there are no other issued and not yet effective accounting standards that are materially relevant to our financial statements.

Revenues

Revenues	12 Months Ended
	Dec. 31, 2024
Revenue from Contract with Customer [Abstract]
Revenues	2. Disaggregation of Revenue. The following table presents sales by operating segment disaggregated based on product category and geographic region for the years ended December 31, 2024, 2023 and 2022 (in thousands). ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year Ended ​ Year Ended ​ Year Ended ​ ​ December 31, 2024 ​ December 31, 2023 ​ December 31, 2022 ​ United States International Total United States International Total United States International Total Cardiovascular ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Peripheral Intervention ​ $ 331,514 ​ $ 220,654 ​ $ 552,168 ​ $ 299,313 ​ $ 202,907 ​ $ 502,220 ​ $ 263,602 ​ $ 176,208 ​ $ 439,810 Cardiac Intervention ​ 147,992 ​ ​ 223,001 ​ 370,993 ​ 143,755 ​ ​ 214,696 ​ 358,451 ​ 128,711 ​ ​ 214,475 ​ 343,186 Custom Procedural Solutions ​ 122,330 ​ ​ 78,871 ​ 201,201 ​ 114,010 ​ ​ 81,323 ​ 195,333 ​ 108,778 ​ ​ 81,416 ​ 190,194 OEM ​ 147,108 ​ ​ 30,274 ​ 177,382 ​ 135,525 ​ ​ 29,031 ​ 164,556 ​ 118,869 ​ ​ 26,165 ​ 145,034 Total ​ 748,944 ​ ​ 552,800 ​ 1,301,744 ​ 692,603 ​ 527,957 ​ 1,220,560 ​ 619,960 ​ 498,264 ​ 1,118,224 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy Devices ​ 51,836 ​ 2,934 ​ 54,770 ​ 34,386 ​ 2,420 ​ 36,806 ​ 30,599 ​ ​ 2,158 ​ 32,757 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ $ 800,780 ​ $ 555,734 ​ $ 1,356,514 ​ $ 726,989 ​ $ 530,377 ​ $ 1,257,366 ​ $ 650,559 ​ $ 500,422 ​ $ 1,150,981 ​

Acquisitions and Other Strategi

Acquisitions and Other Strategic Transactions	12 Months Ended
	Dec. 31, 2024
Business Combinations [Abstract]
Acquisitions and Other Strategic Transactions	3. 2024 Acquisitions On November 1, 2024, pursuant to the terms of the Asset Purchase Agreement (the “Cook Purchase Agreement”) dated September 18, 2024 between Merit and Cook Medical Holdings LLC, (“Cook”), we acquired Cook’s lead management business, which is composed of a comprehensive end-to-end portfolio of medical devices and accessories used in lead management procedures for patients who need a pacemaker or an implantable cardioverter-defibrillator lead removed or replaced. We acquired the portfolio for a purchase price of $210 million, plus the assumption of certain liabilities. We accounted for this transaction under the acquisition method of accounting as a business combination. The sales related to the acquisition have been included in our Cardiovascular segment since the acquisition date and were $5.5 million for the year ended December 31, 2024. It is not practical to separately report earnings related to the 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 transaction, which were included in selling, general and administrative expenses in the consolidated statements of income were approximately $5.4 million. The purchase price was preliminarily allocated as follows (in thousands): ​ ​ ​ ​ ​ Assets Acquired ​ Intangible assets ​ ​ Developed technology ​ $ 126,100 Trademarks ​ ​ 7,100 Customer List ​ ​ 11,100 Goodwill ​ ​ 65,897 Total assets acquired ​ 210,197 ​ ​ ​ ​ Liabilities Assumed ​ Accrued expenses ​ 197 Total liabilities assumed ​ 197 ​ ​ ​ ​ Total net assets acquired ​ $ 210,000 ​ We are amortizing Cook developed technology intangible assets over ten years, the trademark intangible assets over 12 years, and the customer list intangible asset on an accelerated basis over 12 years. We have estimated the weighted average life of the intangible assets acquired from Cook to be 10.3 years. The goodwill consists largely of the synergies expected from combining operations and is expected to be deductible for income tax purposes. The pro forma effects on our consolidated results of operations of the Cook acquisition are not material in relation to reported sales and it was deemed 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 July 1, 2024, we entered into an Asset Purchase Agreement (the “EGS Purchase Agreement”) with EndoGastric Solutions, Inc. (“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. 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 $14.4 million for the year ended December 31, 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 $3.4 million. The purchase price was 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. The goodwill consists largely of the synergies expected from combining operations and is expected to be deductible for income tax purposes. The pro forma effects to our consolidated results of operations of the EGS Acquisition are not material in relation to reported sales. 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. 2023 Acquisitions On June 8, 2023, we entered into an asset purchase agreement with AngioDynamics, Inc. (“AngioDynamics”) to acquire the assets associated with a portfolio of dialysis catheter products and the BioSentry® Biopsy Tract Sealant System for a purchase price of $100 million. We accounted for this transaction under the acquisition method of accounting as a business combination. The sales related to the acquisition have been included in our cardiovascular segment since the acquisition date and were approximately $26.9 million and $14.4 million for the years ended December 31, 2024 and 2023, respectively. It is not practical to separately report earnings related to the acquisition, as we began to immediately integrate the acquisition into existing operations, sales distribution networks and management structure of our cardiovascular business segment. Acquisition-related costs associated with the AngioDynamics acquisition, which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were approximately $4.9 million for the year ended December 31, 2023. 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 due to the unavailability of the information provided to the Company, management’s inability to reasonably estimate the amounts from the carve out of assets and differing fiscal year-end of the acquired business. 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 approximately $32.7 million. Prior to the acquisition, we held an equity investment of 1,251,878 Bluegrass common shares representing approximately 19.5% ownership in Bluegrass. The fair value of this previously held equity investment of approximately $0.2 million is included in the purchase price allocation. We accounted for this transaction under the acquisition method of accounting as a business combination. ​ ​ ​ ​ ​ Assets Acquired ​ Inventories ​ $ 175 Intangible assets ​ ​ Developed technology ​ ​ 28,000 Trademarks ​ ​ 900 Goodwill ​ ​ 3,898 Total net assets acquired ​ $ 32,973 ​ We are amortizing the Bluegrass developed technology intangible asset over 15 years and the related trademarks over 13 years. We have estimated the weighted average life of the intangible assets acquired from Bluegrass to be 14.9 years. On May 1, 2023, we entered into an asset purchase agreement to acquire certain assets from ART, related to intellectual property rights for soft tissue markers. The total purchase price of the ART assets included an up-front payment of $0.8 million, a deferred payment of $0.8 million payable upon the first to occur of (1) shipment and installation of two commercial production winders used to manufacture the product or (2) 30 days after delivery of the winders to Merit, and, a deferred payment of $0.5 million payable upon regulatory approval from the U.S. Food and Drug Administration for Merit to commence commercialization, marketing and sale of the product in the United States. We have accounted for this transaction as an asset purchase and recorded $1.5 million of acquired in-process research and development expense associated with the upfront payment and completion of the milestone related to the installation of the commercial production winders. The final payment will be capitalized as a developed technology intangible asset when paid upon completion of the regulatory approval milestone under the terms of the asset purchase agreement. The payments are reported within operating expenses because the technological feasibility of the underlying research and development project has not yet been reached and such technology has no identified future alternative use as of the date of acquisition. 2022 Acquisitions On October 3, 2022, we entered into an asset purchase agreement with BioTrace Medical, Inc., developer of the Tempo® Temporary Pacing Lead device, W pon achievement of the first device sold in the United States On April 30, 2022, we acquired the Restore Endosystems Bifurcated Stent System pursuant to the terms of a unit purchase agreement we executed with all of the members of Restore Endosystems LLC. Subject to the terms and conditions of the unit purchase agreement, we paid $3 million in cash at closing. We also accrued $3.5 million of other long-term obligations, which represents the fair value of two separate $2 million payments which are payable no later than two

Inventories

Inventories	12 Months Ended
	Dec. 31, 2024
Inventory Disclosure [Abstract]
Inventories	4. Inventories at December 31, 2024 and 2023, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ December 31, 2024 December 31, 2023 Finished goods ​ $ 168,437 ​ $ 158,893 Work-in-process ​ 27,114 ​ 25,420 Raw materials ​ 110,512 ​ 119,558 Total inventories ​ $ 306,063 ​ $ 303,871 ​

Goodwill and Intangible Assets

Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	5. The changes in the carrying amount of goodwill for the years ended December 31, 2024 and 2023, are as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 ​ 2023 ​ Cardiovascular ​ Endoscopy ​ Total Cardiovascular ​ Endoscopy ​ Total Goodwill balance at January 1 ​ $ 382,240 ​ $ — ​ $ 382,240 ​ $ 359,821 ​ $ — ​ $ 359,821 Effect of foreign exchange ​ (1,623) ​ — ​ (1,623) ​ 883 ​ — ​ 883 Additions and adjustments as the result of acquisitions ​ 65,897 ​ 16,997 ​ 82,894 ​ 21,536 ​ — ​ 21,536 Goodwill balance at December 31 ​ $ 446,514 ​ $ 16,997 ​ $ 463,511 ​ $ 382,240 ​ $ — ​ $ 382,240 ​ Total accumulated goodwill impairment losses aggregated to $8.3 million as of December 31, 2024 and 2023. We did not have any goodwill impairments for the years ended December 31, 2024, 2023 and 2022. Other intangible assets at December 31, 2024 and 2023, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 2024 ​ ​ Gross Carrying ​ Accumulated ​ Net Carrying ​ Amount Amortization Amount Patents ​ $ 31,489 ​ $ (12,824) ​ $ 18,665 Distribution agreements ​ 3,250 ​ (2,994) ​ 256 License agreements ​ 11,557 ​ (9,125) ​ 2,432 Trademarks ​ 47,613 ​ (24,177) ​ 23,436 Customer lists ​ 57,933 ​ (36,223) ​ 21,710 Total ​ $ 151,842 ​ $ (85,343) ​ $ 66,499 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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 years ended December 31, 2024, 2023 and 2022 was $65.6 million, $56.1 million, and $48.4 million, respectively. Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of December 31, 2024 (in thousands): ​ ​ ​ ​ Year ending December 31, Estimated Amortization Expense 2025 ​ $ 83,747 2026 ​ 73,155 2027 ​ 69,188 2028 ​ ​ 67,790 2029 ​ 56,115 ​

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Income Taxes	6. The Organization for Economic Cooperation and Development (“OECD”) Pillar 2 global minimum tax rules, which generally provide for a minimum effective tax rate of 15%, are intended to apply for tax years beginning in 2024. On February 2, 2023, the OECD issued administrative guidance providing transition and safe harbor rules around the implementation of the Pillar 2 global minimum tax. Under a transitional safe harbor released July 17, 2023, the undertaxed profits rule top-up tax in the jurisdiction of a company's ultimate parent entity will be zero for each fiscal year of the transition period, if that jurisdiction has a corporate tax rate of at least 20%. The safe harbor transition period will apply to fiscal years beginning on or before December 31, 2025 and ending before December 31, 2026. We are closely monitoring developments and evaluating the impact these new rules are anticipated to have on our tax rate, including eligibility to qualify for these safe harbor rules. Based on the 2024 financial results, we anticipate to meet the safe harbor rules in all jurisdictions and do not anticipate the Pillar 2 laws to have a material impact on our effective tax rate. For the years ended December 31, 2024, 2023 and 2022, income before income taxes is broken out between U.S. and foreign-sourced operations and consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Domestic ​ $ 93,687 ​ $ 60,935 ​ $ 77,562 Foreign ​ 56,306 ​ 51,154 ​ 5,067 Total ​ $ 149,993 ​ $ 112,089 ​ $ 82,629 ​ The components of the provision for income taxes for the years ended December 31, 2024, 2023 and 2022, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Current expense: ​ ​ ​ Federal ​ $ 26,061 ​ $ 15,684 ​ $ 9,584 State ​ 5,286 ​ 3,775 ​ 3,162 Foreign ​ 13,162 ​ 10,862 ​ 10,291 Total current expense ​ 44,509 ​ 30,321 ​ 23,037 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Deferred expense (benefit): ​ ​ ​ Federal ​ (12,609) ​ (11,030) ​ (10,438) State ​ (1,421) ​ (1,699) ​ (3,615) Foreign ​ (843) ​ 86 ​ (871) Total deferred benefit ​ (14,873) ​ (12,643) ​ (14,924) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total income tax expense ​ $ 29,636 ​ $ 17,678 ​ $ 8,113 ​ The difference between the income tax expense reported and amounts computed by applying the statutory federal rate of 21.0% to pretax income for the years ended December 31, 2024, 2023 and 2022, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Computed federal income tax expense at applicable statutory rate of 21% ​ $ 31,499 ​ $ 23,539 ​ $ 17,352 State income tax expense ​ 3,081 ​ 1,627 ​ 35 Tax credits ​ (3,004) ​ (2,412) ​ (1,978) Tax effect of international items ​ (1,870) ​ (3,994) ​ (10,698) Uncertain tax positions ​ 218 ​ 4 ​ (47) Deferred compensation insurance assets ​ (535) ​ (548) ​ 706 Stock-based compensation ​ (1,817) ​ (3,001) ​ (3,423) Valuation allowance ​ ​ — ​ ​ (90) ​ ​ 3,523 Remeasurement of state deferred taxes ​ ​ — ​ ​ (73) ​ ​ (375) Non-deductible expenses ​ ​ 2,454 ​ ​ 2,101 ​ ​ 2,027 Remeasurement of contingent consideration liabilities ​ ​ 108 ​ ​ 317 ​ ​ 1,061 Other — including the effect of graduated rates ​ (498) ​ 208 ​ (70) Total income tax expense ​ $ 29,636 ​ $ 17,678 ​ $ 8,113 ​ Deferred income tax assets and liabilities at December 31, 2024 and 2023, consisted of the following temporary differences and carry-forward items (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Deferred income tax assets: ​ ​ Allowance for credit losses on trade receivables ​ $ 2,215 ​ $ 2,009 Accrued compensation expense ​ 11,701 ​ 10,285 Inventory differences ​ 5,139 ​ 5,477 Net operating loss carryforwards ​ 8,320 ​ 10,007 Stock-based compensation expense ​ 7,569 ​ 7,913 Operating lease assets ​ ​ 11,586 ​ ​ 11,331 State R&D tax credits ​ ​ 5,924 ​ ​ 5,237 IRC section 174 capitalized R&D ​ ​ 35,200 ​ ​ 26,370 Other ​ 10,759 ​ 10,159 Total deferred income tax assets ​ 98,413 ​ 88,788 ​ ​ ​ ​ ​ ​ ​ Deferred income tax liabilities: ​ ​ Prepaid expenses ​ (1,277) ​ (1,123) Property and equipment ​ (22,699) ​ (23,539) Intangible assets ​ (29,440) ​ (34,613) Foreign withholding tax ​ (1,681) ​ (2,005) Operating lease liabilities ​ ​ (11,737) ​ ​ (10,129) Other ​ (1,632) ​ (1,898) Total deferred income tax liabilities ​ (68,466) ​ (73,307) Valuation allowance ​ (14,143) ​ (13,740) Net deferred income tax liabilities ​ $ 15,804 ​ $ 1,741 ​ ​ ​ ​ ​ ​ ​ Reported as: ​ ​ Deferred income tax assets ​ $ 16,044 ​ $ 7,288 Deferred income tax liabilities ​ (240) ​ (5,547) Net deferred income tax liabilities ​ $ 15,804 ​ $ 1,741 ​ Deferred tax assets and liabilities are netted on the balance sheet by separate tax jurisdictions. Deferred income tax balances reflect the temporary differences between the carrying amounts of assets and liabilities and their tax basis and are stated at enacted tax rates expected to be in effect when taxes are actually paid or recovered. The valuation allowance is primarily related to state credit carryforwards, non-US net operating loss carryforwards, and capital loss carryforwards for which we believe it is more likely than not that the deferred tax assets will not be realized. The valuation allowance increased by $0.4 million during the year ended December 31, 2024, increased by $0.2 million during the year ended December 31, 2023, and increased by $2.7 million during the year ended December 31, 2022. As of December 31, 2024, we had U.S federal net operating loss carryforwards of $19.8 million, which were generated by Cianna Medical, DFINE Inc., and Biosphere Medical, Inc., prior to our acquisition of these companies. These net operating loss carryforwards are subject to annual limitations under Internal Revenue Code Section 382. If unused, $19.8 million of the net operating losses will expire between 2030 and 2037. We anticipate that we will utilize all current net operating loss carryforwards prior to their expiration dates over the next 11 years. We utilized a total of $4.8 million in U.S. federal net operating loss carryforwards during the year ended December 31, 2024. As of December 31, 2024, we had $20.9 million of non-U.S. net operating loss carryforwards, of which $19.2 million have no expiration date and $1.7 million expire at various dates through 2036. Non-U.S. net operating loss carryforwards utilized during the year ended December 31, 2024 were not material. We do not consider our foreign earnings to be permanently reinvested. Consequently, we have recorded tax expense of $0.7 million, $0.4 million and $0.3 million for foreign withholding taxes on unremitted foreign earnings during the years ended December 31, 2024, 2023 and 2022, respectively. Additionally, for the year ended December 31, 2022, a tax benefit of $4.3 million was recorded with respect to the restructuring of our foreign entities and the associated change in foreign withholding taxes on the unremitted foreign earnings. We are subject to income taxes in the U.S. and numerous foreign jurisdictions. Significant judgment is required in determining our worldwide provision for income taxes and recording the related assets and liabilities. In the ordinary course of our business, there are many transactions and calculations where the ultimate tax determination is uncertain. In our opinion, we have made adequate provisions for income taxes for all years subject to audit. We are no longer subject to U.S. federal, state, and local income tax examinations by tax authorities for years before 2021. In foreign jurisdictions, we are no longer subject to income tax examinations for years before 2018. Although we believe our estimates are reasonable, the final outcomes of these matters may be different from those which we have reflected in our historical income tax provisions and accruals. Such differences could have a material effect on our income tax provision and operating results in the period in which we make such determination. The total liability for unrecognized tax benefits at December 31, 2024, including interest and penalties, was $2.1 million, of which $2.1 million would favorably impact our effective tax rate if recognized. The total liability for unrecognized tax benefits at December 31, 2023, including interest and penalties, was $1.9 million, of which $1.9 million would favorably impact our effective tax rate if recognized. As of December 31, 2024 and 2023, we had accrued $0.2 million and $0.3 million respectively, in total interest and penalties related to unrecognized tax benefits. We account for interest and penalties for unrecognized tax benefits as part of our income tax provision. During the years ended December 31, 2024, 2023 and 2022, our liability for unrecognized tax benefit was increased (decreased) for interest and penalties by $(52,000), $(46,000), and $14,000, respectively. We estimate it is reasonably possible that within the next 12 months the total liability for unrecognized tax benefits may increase, including expirations related to statutes of limitation, up to $0.1 million. A reconciliation of the beginning and ending amount of liabilities associated with uncertain tax benefits for the years ended December 31, 2024, 2023 and 2022, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Unrecognized tax benefits, opening balance ​ $ 1,622 ​ $ 1,576 ​ $ 1,635 Gross increases (decreases) in tax positions taken in a prior year ​ 70 ​ 112 ​ (10) Gross increases in tax positions taken in the current year ​ 559 ​ 442 ​ 294 Lapse of applicable statute of limitations ​ (371) ​ (508) ​ (343) Unrecognized tax benefits, ending balance ​ $ 1,880 ​ $ 1,622 ​ $ 1,576 ​ The tabular roll-forward ending balance does not include interest and penalties related to unrecognized tax benefits.

Accrued Expenses

Accrued Expenses	12 Months Ended
	Dec. 31, 2024
Payables and Accruals [Abstract]
Accrued Expenses	7. Accrued expenses at December 31, 2024 and 2023, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Payroll and related liabilities ​ $ 73,514 ​ $ 66,929 Current portion of contingent liabilities ​ 358 ​ 408 Advances from employees ​ 158 ​ 285 Accrued rebates payable ​ ​ 11,778 ​ ​ 11,005 Accrued interest ​ ​ 9,531 ​ ​ 1,556 Other accrued expenses ​ 38,738 ​ 40,264 Total ​ $ 134,077 ​ $ 120,447 ​ ​

Debt

Debt	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Debt	8. Principal balances outstanding under our long-term debt obligations as of December 31, 2024 and 2023, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Term loans ​ $ — ​ $ 99,063 Convertible notes ​ ​ 747,500 ​ ​ 747,500 Less unamortized debt issuance costs ​ (17,949) ​ (23,550) Total long-term debt ​ 729,551 ​ 823,013 Less current portion ​ — ​ — Long-term portion ​ $ 729,551 ​ $ 823,013 ​ Future minimum principal payments on our long-term debt as of December 31, 2024, are as follows (in thousands): ​ ​ ​ ​ Year Ending ​ Future Minimum December 31, Principal Payments 2025 $ — 2026 ​ ​ — 2027 ​ ​ — 2028 ​ ​ — 2029 ​ ​ 747,500 Total future minimum principal payments ​ $ 747,500 ​ 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 A&R 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 A&R 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 used in determining the interest rates and amended the financial covenants, all as described below. Term loans made under the Amended Fourth A&R Credit Agreement, as amended 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. As of December 31, 2024, we were in compliance with all covenants set forth in the Amended Fourth A&R Credit Agreement. As of December 31, 2024, we had no outstanding borrowings and issued letter of credit guarantees of $2.9 million under the Amended Fourth A&R Credit Agreement, with available borrowings of approximately $697 million, based on the leverage ratio required pursuant to the Amended Fourth A&R Credit Agreement. As of December 31, 2023, we had outstanding borrowings of $99.1 million with a fixed rate of 3.39% with respect to $75 million of the principal amount, as a result of an interest rate swap (see Note 9, ) and a variable floating rate of 7.21% on $24.1 million, in addition, we had issued letter of credit guarantees of $2.7 million under the Amended Fourth A&R Credit Agreement. 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 are senior unsecured obligations (as defined in the Note Indenture) of the Company and will mature on February 1, 2029, unless earlier 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 transaction, as described below. The initial conversion rate of the notes will be 11.5171 shares of common stock per $1,000 principal amount of notes equivalent 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 governing the Convertible Notes) 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 calendar quarter (and only during such calendar quarter) beginning after March 31, 2024, if, the last reported sale price per share of the Company’s common stock exceeds 130% of the applicable conversion price on each applicable trading day for at least 20 trading days (whether or not consecutive) in the period of the 30 consecutive trading day period ending on, and including, the last trading day of the immediately preceding calendar quarter; or (5) Prior to the related redemption date if the Company calls any Convertible Notes for redemption. As of December 31, 2024, none of the conditions permitting the holders of the Convertible Notes to convert their notes early had been met, therefore, they are classified as long-term. 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 trading days (whether or not consecutive), including the trading day immediately preceding the date on which we provide notice of redemption, during any 30 consecutive trading days ending on, and including, the trading day immediately before the date we send the related notice of the redemption. Upon conversion, the Company 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 its common stock, or a combination of cash and shares of our common stock, at the Company’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 Transaction 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 Merit’s common stock initially underlying the Convertible Notes and are generally expected to reduce potential dilution to Merit’s 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 Merit’s 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 Company's stock. The premiums paid for the Capped Call Transactions have been included as a net reduction to common stock within stockholders' equity.

Derivatives

Derivatives	12 Months Ended
	Dec. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives	9. General. We formally document, designate and assess the effectiveness of transactions that receive hedge accounting initially and on an ongoing basis. For qualifying hedges, the change in fair value is deferred in accumulated other comprehensive income (loss) (“AOCI”), 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 derivatives not designated as hedging instruments are recorded in earnings throughout the term of the derivative. 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 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 At December 31, 2024, we held no interest rate swap qualifying as cash flow hedges. At December 31, 2023, our interest rate swap qualified as a cash flow hedge. The fair value of our interest rate swap at 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 hedges is to reduce the variability of cash flows associated with the forecasted purchase or sale of foreign currencies. As of December 31, 2024 and 2023, we had entered into foreign currency forward contracts, which qualified as cash flow hedges, with aggregate notional amounts of $117.5 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 December 31, 2024 and 2023, we had entered into foreign currency forward contracts related to those balance sheet accounts with aggregate notional amounts of $95.7 million and $108.4 million, respectively. Balance Sheet Presentation of Derivatives. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value of Derivative Instruments Designated as Hedging Instruments Balance Sheet Location December 31, 2024 December 31, 2023 Assets ​ ​ Interest rate swap Prepaid expenses and other assets ​ $ — ​ $ 1,503 Foreign currency forward contracts Prepaid expenses and other assets ​ ​ 3,771 ​ ​ 2,061 Foreign currency forward contracts Other assets (long-term) ​ ​ 1,064 ​ 216 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (1,332) ​ (1,898) Foreign currency forward contracts Other long-term obligations ​ (287) ​ (499) ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value of Derivative Instruments Not Designated as Hedging Instruments Balance Sheet Location December 31, 2024 December 31, 2023 Assets ​ ​ Foreign currency forward contracts Prepaid expenses and other assets ​ $ 2,595 ​ $ 828 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (1,288) ​ (1,463) ​ Income Statement Presentation of Derivatives Derivatives Designated as Cash Flow Hedges Derivative instruments designated as cash flow hedges had the following effects, before income taxes, on other comprehensive income ("OCI") in our consolidated statements of comprehensive income and consolidated balance sheets (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amount of Gain ​ ​ Recognized in OCI ​ ​ Year Ended December 31, Derivative instrument 2024 2023 2022 Interest rate swap ​ $ 152 ​ $ 609 ​ $ 4,879 Foreign currency forward contracts ​ 5,732 ​ 3,909 ​ 6,263 ​ Derivative instruments designated as cash flow hedges had the following effects, before income taxes, on AOCI and net earnings in our consolidated statements of income, consolidated statements of comprehensive income and consolidated balance sheets (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Consolidated Statements ​ ​ Amount of Gain/(Loss) ​ ​ of Income ​ ​ Reclassified from AOCI ​ ​ Year Ended December 31, ​ Year Ended December 31, Location in statements of income 2024 ​ 2023 ​ 2022 2024 2023 2022 Interest expense ​ $ (31,219) ​ $ (15,511) ​ $ (6,339) ​ ​ $ 1,656 $ 2,550 $ (12) Revenue ​ 1,356,514 ​ 1,257,366 ​ 1,150,981 ​ ​ 2,140 ​ 4,081 ​ 3,583 Cost of sales ​ (713,181) ​ (673,494) ​ (631,882) ​ ​ 644 ​ 1,457 ​ (1,436) ​ As of December 31, 2024, $2.7 million or $2.1 million after taxes, was expected to be reclassified from AOCI to earnings in revenue and cost of sales over the succeeding twelve months. Derivatives Not Designated as Hedging Instruments The following gains/(losses) from these derivative instruments were recognized in our consolidated statements of income for the years presented (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year ended December 31, Derivative Instrument Location in statements of income 2024 2023 2022 Foreign currency forward contracts Other income (expense) — net ​ $ 1,961 ​ $ 2,004 ​ $ 1,420 ​ See Note 15, Fair Value Measurements

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	10. We are obligated under non-terminable operating leases for manufacturing facilities, finished good distribution centers, office space, equipment, vehicles, and land. See Note 17, Leases Royalties Fair Value Measurements 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 Commencing in January 2022, 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, investigating the matter and are in discussions with the SEC Staff regarding a potential resolution to 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 discussion 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)	12 Months Ended
	Dec. 31, 2024
Earnings Per Share [Abstract]
Earnings Per Common Share (EPS)	11. The computation of weighted average shares outstanding and the basic and diluted earnings per common share for the years ended December 31, 2024, 2023 and 2022, consisted of the following (in thousands, except per share amounts): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 ​ 2023 ​ 2022 Net income ​ $ 120,357 ​ $ 94,411 ​ $ 74,516 Average common shares outstanding ​ 58,218 ​ 57,593 ​ 56,806 Basic EPS ​ $ 2.07 ​ $ 1.64 ​ $ 1.31 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average common shares outstanding ​ ​ 58,218 ​ ​ 57,593 ​ ​ 56,806 Effect of dilutive stock awards ​ ​ 760 ​ ​ 763 ​ ​ 865 Effect of dilutive convertible notes ​ ​ 387 ​ ​ — ​ ​ — Total potential shares outstanding ​ ​ 59,365 ​ ​ 58,356 ​ ​ 57,671 Diluted EPS ​ $ 2.03 ​ $ 1.62 ​ $ 1.29 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Equity awards excluded as the impact was anti-dilutive (1) ​ ​ 672 ​ ​ 1,143 ​ ​ 1,438 ​ (1) Does not reflect the impact of incremental repurchases under the treasury stock method. Convertible Notes For our Convertible Notes issued in December 2023, 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 Merit’s common stock or a combination of cash and shares of Merit’s 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.

Employee Stock Purchase Plan, S

Employee Stock Purchase Plan, Stock Options and Warrants	12 Months Ended
	Dec. 31, 2024
Share-based Payment Arrangement [Abstract]
Employee Stock Purchase Plan, Stock Options and Warrants	12. Our stock-based compensation primarily consists of the following plans: 2018 Long-Term Incentive Plan basis over a three 2006 Long-Term Incentive Plan Employee Stock Purchase Plan Stock-Based Compensation Expense ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Cost of sales ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ $ 1,229 ​ $ 1,647 ​ $ 1,606 Research and development ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 1,522 ​ ​ 1,739 ​ ​ 1,789 Selling, general and administrative ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 6,206 ​ ​ 7,542 ​ ​ 7,305 Performance-based restricted stock units ​ ​ 12,517 ​ ​ 6,344 ​ ​ 3,509 Restricted stock units ​ ​ 4,279 ​ ​ 1,771 ​ ​ 1,836 Cash-settled performance-based awards ​ ​ 2,720 ​ ​ 2,290 ​ ​ 1,997 Total selling, general and administrative ​ ​ 25,722 ​ ​ 17,947 ​ ​ 14,647 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Stock-based compensation expense before taxes ​ $ 28,473 ​ $ 21,333 ​ $ 18,042 ​ 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 As of December 31, 2024, the total remaining unrecognized compensation cost related to non-vested stock options, net of expected forfeitures, was $11.0 million and is expected to be recognized over a weighted average period of 1.7 years. 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 years ended December 31, 2023 and 2022: ​ ​ ​ ​ ​ ​ 2023 2022 Risk-free interest rate ​ 3.6% - 4.8% ​ 1.4% - 4.3% Expected option term ​ 4.0 years ​ 4.0 years Expected dividend yield ​ — ​ — Expected price volatility ​ 39.6% - 47.1% ​ 46.2% - 47.5% ​ 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 option. We determine the expected term of the stock options using the historical exercise behavior of employees. The expected price volatility was determined based upon the historical volatility for our stock. We recognize compensation expense for options on a straight-line basis over the service period, which corresponds to the vesting period. During the years ended December 31, 2023 and 2022, approximately 444,000 and 251,000 nonqualified stock option grants were made, respectively, for a total fair value of $13.1 million and $6.3 million. The Company did not grant any options during the year ended December 31, 2024. The table below presents information related to stock option activity for the years ended December 31, 2024, 2023 and 2022 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Total intrinsic value of stock options exercised ​ $ 36,431 ​ $ 23,300 ​ $ 27,110 Cash received from stock option exercises ​ 39,746 ​ 14,503 ​ 18,952 Excess tax benefit from the exercise of stock options ​ 1,817 ​ 3,001 ​ 3,423 ​ Changes in stock options for the year ended December 31, 2024, consisted of the following (shares and intrinsic value in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Number ​ Weighted Average ​ Remaining Contractual ​ Intrinsic ​ of Shares Exercise Price Term (in years) Value Beginning balance 2,868 ​ 56.39 ​ Granted — ​ — ​ Exercised (824) ​ 48.21 ​ Forfeited/expired (21) ​ 66.61 ​ Outstanding at December 31 2,023 ​ 59.62 3.05 ​ $ 75,055 Exercisable 1,411 ​ 55.87 2.35 ​ 57,639 Ending vested and expected to vest 1,997 ​ 59.49 3.02 ​ 74,372 ​ The weighted average grant-date fair value of options granted during the years ended December 31, 2023 and 2022 was $29.58 and $24.98, respectively. Stock-Settled Performance-Based Restricted Stock Units (“PSUs”) and Time-Vested Restricted Stock Units (“RSUs”) We have outstanding PSUs which vest at the end of three-year performance periods. T he 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 PSUs linked to total shareholder return. Compensation expense is recognized using the grant-date fair value for the number of shares that are probable of being awarded based on the performance conditions. Each reporting period, this probability assessment is updated, and cumulative catchups are recorded based on the performance metrics that are expected to be achieved. At the end of the performance period, cumulative expense is calculated based on the actual financial performance metrics attained. We have granted RSUs to our employees and non-employee directors, which are subject to continued service through the vesting date, which is between one Changes in PSUs and RSUs for the year ended December 31, 2024, consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ PSUs ​ RSUs ​ ​ ​ ​ Weighted Average ​ ​ ​ Weighted Average ​ ​ Stock Units ​ Grant Date ​ Stock Units ​ Grant Date ​ (In Thousands) (1) Fair Value (In Thousands) Fair Value Beginning nonvested balance 355 ​ 71.15 20 ​ 83.99 Granted 287 ​ 86.79 329 90.54 Vested (47) ​ 76.51 (20) 83.99 Nonvested balance at December 31 595 ​ 82.33 329 ​ 90.54 ​ (1) Based on the maximum payout, excluding the impact of the rTSR multiplier. The actual number of shares which vest is determined based on the satisfaction of performance conditions and the application of an rTSR multiplier between 75% and 125% . The following table summarizes PSUs and RSUs granted during the years ended December 31, 2024, 2023 and 2022 (units and shares in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 PSUs ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Target units granted ​ ​ 144 ​ ​ 115 ​ ​ 48 ​ Maximum units granted (1) ​ ​ 287 ​ ​ 229 ​ ​ 97 ​ Maximum potential shares (1)(2) ​ ​ 359 ​ ​ 287 ​ ​ 121 ​ Weighted average grant date fair value ​ $ 86.79 ​ $ 72.26 ​ $ 64.54 ​ RSUs ​ ​ ​ ​ ​ ​ ​ ​ ​ Units granted ​ ​ 329 ​ ​ 20 ​ ​ 31 ​ Weighted average grant date fair value ​ $ 90.54 ​ $ 83.99 ​ $ 59.02 ​ ​ (1) Based on the maximum payout, excluding the impact of the rTSR multiplier. (2) Includes the impact of the maximum potential rTSR multiplier of 125% . During the years ended December 31, 2024, 2023 and 2022, there were approximately 47,000, 61,000 and 44,000 shares, respectively, that vested under PSUs, prior to the reduction of shares withheld to satisfy tax withholding obligations. Vested shares were calculated based upon achievement of the financial performance multipliers and market conditions related to the rTSR multiplier. During the years ended December 31, 2024, 2023 and 2022, there were approximately 20,000, 31,000 and 26,000 shares, respectively, that vested under RSUs. The fair value of each PSU was estimated as of the grant date using the following assumptions for awards granted in the years ended December 31, 2024, 2023 and 2022: ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Risk-free interest rate 4.4% ​ 3.9% - 4.6% ​ 1.6% - 2.7% Performance period 2.8 years ​ 2.8 years ​ 2.6 - 2.8 years Expected dividend yield — ​ — ​ — Expected price volatility 31.1% ​ 31.4% - 32.6% ​ 38.5% - 46.2% ​ The risk-free interest rate of return was determined using the U.S. Treasury rate at the time of grant with a remaining term equal to the expected term of the award. The expected volatility was based on a weighted average volatility of our stock price and the average volatility of our compensation peer group's volatilities. The expected dividend yield was assumed to be zero because, at the time of the grant, we had no plans to declare a dividend. As of December 31, 2024, the total remaining unrecognized compensation cost related to stock-settled performance stock units and restricted stock units, net of expected forfeitures, was $18.2 million and $23.4 million, respectively, which is expected to be recognized over a weighted average period of 1.7 years and 3.6 years, respectively. Cash-Settled Performance-Based Share-Based Awards (“Liability Awards”) During the years ended December 31, 2024, 2023 and 2022, we granted liability awards to our Chief Executive Officer with total target cash incentives in the amount of $1.6 million, $1.3 million, and $1.0 million, respectively. These awards entitle him to a target cash payment based upon our relative shareholder return as compared to the rTSR and achievement of specified performance metrics, as defined in the award agreements. During the years ended December 31, 2024, 2023 and 2022, we granted additional performance stock units to certain employees that provide for settlement in cash upon our achievement of specified financial metrics. The cash payable upon vesting at the end of the service period is based upon performance against specified financial performance metrics and relative total shareholder return as compared to the rTSR, as defined in the award agreements. Compensation expense is recognized for the cash payment probable of being awarded based on the performance metrics. The potential maximum payout of these liability awards is 250% of the target cash incentive, resulting in a total potential maximum payout of $4.7 million, $4.3 million and $2.5 million for liability awards granted during the years ended December 31, 2024, 2023 and 2022, respectively. 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. These awards are classified as liabilities and reported in accrued expenses and other long-term liabilities within our consolidated balance sheets. The fair value of these awards is remeasured at each reporting period until the awards are settled. As of December 31, 2024, our recorded liabilities associated with these awards was $5.1 million, and we had remaining unrecognized compensation cost related to cash-settled performance-based share-based awards of $3.6 million, which is expected to be recognized over a weighted average period of 1.7 years. During 2024, 2023 and 2022, we paid $1.3 million, $1.7 million and $0.8 million, respectively, in connection with liability awards, and no awards were forfeited.

Segment Reporting and Foreign O

Segment Reporting and Foreign Operations	12 Months Ended
	Dec. 31, 2024
Segment Reporting [Abstract]
Segment Reporting and Foreign Operations	13. We report our operations in two operating segments: cardiovascular and endoscopy. Our cardiovascular segment consists of four product categories: peripheral intervention, cardiac intervention, custom procedural solutions, and OEM. Within these product categories, we sell a variety of products, including cardiology and radiology devices (which assist in diagnosing and treating coronary arterial disease, peripheral vascular disease and other non-vascular diseases), as well as embolotherapeutic, cardiac rhythm management, electrophysiology, critical care, breast cancer localization and guidance, biopsy, and interventional oncology and spine devices. Our endoscopy segment consists of gastroenterology and pulmonology devices which assist in the palliative treatment of expanding esophageal, tracheobronchial and biliary strictures caused by malignant tumors. Our chief operating decision maker is our Chief Executive Officer. Our CODM uses segment profit or loss to assess performance and allocate resources to each segment, primarily through periodic budgeting and segment performance reviews. See Note 2, Revenues to our consolidated financial statements set forth in Item 8 of this report for a detailed breakout of our sales by operating segment and product category, disaggregated between domestic and international sales. Total assets by segment are not used by the CODM to assess performance or allocate resources to the Company’s segments; therefore, total assets by segment are not disclosed. During the years ended December 31, 2024, 2023 and 2022, we had international sales of $555.7 million, $530.4 million and $500.4 million, respectively, or 41.0%, 42.2% and 43.5%, respectively, of net sales. Our largest international markets include China, Japan, Germany, France and the United Kingdom, with China representing our most significant international sales market with sales of $149.8 million, $147.3 million, and $149.3 million for the years ended December 31, 2024, 2023 and 2022, respectively. International sales are attributed based on location of the customer receiving the product. Our long-lived assets (which are comprised of our net property and equipment) by geographic area at December 31, 2024, 2023 and 2022, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 United States ​ $ 271,734 ​ $ 273,105 ​ $ 281,290 Ireland ​ 45,325 ​ 42,333 ​ 40,749 Other foreign countries ​ 69,106 ​ 68,085 ​ 60,937 Total ​ $ 386,165 ​ $ 383,523 ​ $ 382,976 ​ Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the years ended December 31, 2024, 2023 and 2022, are as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year Ended ​ Year Ended ​ Year Ended ​ ​ December 31, 2024 ​ December 31, 2023 ​ December 31, 2022 ​ Cardiovascular Endoscopy Consolidated Cardiovascular Endoscopy Consolidated Cardiovascular Endoscopy Consolidated Net sales $ 1,301,744 $ 54,770 $ 1,356,514 $ 1,220,560 ​ $ 36,806 $ 1,257,366 $ 1,118,224 $ 32,757 $ 1,150,981 Cost of sales standard (1) ​ ​ 549,657 ​ ​ 15,746 ​ ​ ​ ​ ​ 534,826 ​ ​ 12,987 ​ ​ ​ ​ ​ 496,678 ​ ​ 12,739 ​ ​ ​ Cost of sales other (2) ​ 140,948 ​ 6,830 ​ ​ ​ 125,388 ​ 293 ​ ​ ​ 121,045 ​ 1,420 ​ ​ Selling, general and administrative expenses ​ 376,734 ​ 22,997 ​ ​ ​ 362,082 ​ 11,594 ​ ​ ​ 332,012 ​ 10,513 ​ ​ Research and development expenses ​ ​ 83,812 ​ ​ 3,654 ​ ​ ​ ​ ​ 80,300 ​ ​ 2,428 ​ ​ ​ ​ ​ 74,042 ​ ​ 1,468 ​ ​ ​ Other operating expenses (3) ​ ​ 443 ​ ​ — ​ ​ ​ ​ ​ 3,524 ​ ​ — ​ ​ ​ ​ ​ 13,501 ​ ​ — ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Income from operations ​ $ 150,150 ​ $ 5,543 ​ $ 155,693 ​ $ 114,440 ​ $ 9,504 ​ $ 123,944 ​ $ 80,946 ​ $ 6,617 ​ $ 87,563 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total other expense — net ​ ​ ​ ​ ​ ​ ​ ​ (5,700) ​ ​ ​ ​ ​ ​ ​ ​ (11,855) ​ ​ ​ ​ ​ ​ ​ ​ (4,934) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Income before income taxes ​ ​ ​ ​ ​ ​ $ 149,993 ​ ​ ​ ​ ​ ​ $ 112,089 ​ ​ ​ ​ ​ ​ $ 82,629 ​ (1) Cost of sales standard represents costs of goods sold measured at the internal standard cost for production of inventory. Inventory standard costs include material, labor and manufacturing overhead. (2) Cost of sales other for all segments include amortization expense associated with our developed technology and license agreement intangible assets, freight and handling associated with shipments to customers, provisions based on estimated excess, slow moving and obsolete inventories, manufacturing and price variances, and royalties. (3) Other operating expenses include impairment charges, contingent consideration (benefit expense) related to the changes in fair value of contingent payments associated with acquisitions, acquired in-process research and development expense, and certain legal settlements. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Cardiovascular ​ $ 97,749 ​ $ 88,960 ​ $ 80,777 Endoscopy ​ 4,960 ​ 1,025 ​ 1,027 Total ​ $ 102,709 ​ $ 89,985 ​ $ 81,804 Total depreciation and amortization by operating segment for the years ended December 31, 2024, 2023 and 2022, consisted of the following (in thousands): ​ ​

Employee Benefit Plans

Employee Benefit Plans	12 Months Ended
	Dec. 31, 2024
Defined Contribution Plan [Abstract]
Employee Benefit Plans	14. We have defined contribution plans covering all U.S. full-time adult employees and certain of our foreign employees. Our contributions to these plans are discretionary in certain countries, including the U.S. Total expense for contributions made to these plans for the years ended December 31, 2024, 2023 and 2022 was $9.6 million, $8.8 million and $7.7 million, respectively.

Fair Value Measurements

Fair Value Measurements	12 Months Ended
	Dec. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurements	15. Assets (Liabilities) Measured at Fair Value on a Recurring Basis Our financial assets and (liabilities) carried at fair value measured on a recurring basis as of December 31, 2024 and 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 ​ December 31, 2024 (Level 1) (Level 2) (Level 3) Money market funds (1) ​ $ 10,034 ​ $ 10,034 ​ $ — ​ $ — Marketable securities (2) ​ $ 92 ​ $ 92 ​ $ — ​ $ — Foreign currency contract assets, current and long-term (4) ​ $ 7,430 ​ $ — ​ $ 7,430 ​ $ — Foreign currency contract liabilities, current and long-term (5) ​ $ (2,907) ​ $ — ​ $ (2,907) ​ $ — Contingent consideration liabilities ​ $ (3,486) ​ $ — ​ $ — ​ $ (3,486) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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 (2) ​ $ 78 ​ $ 78 ​ $ — ​ $ — Interest rate contract asset, current (3) ​ $ 1,503 ​ $ — ​ $ 1,503 ​ $ — Foreign currency contract assets, current and long-term (4) ​ $ 3,105 ​ $ — ​ $ 3,105 ​ $ — Foreign currency contract liabilities, current and long-term (5) ​ $ (3,860) ​ $ — ​ $ (3,860) ​ $ — Contingent consideration liabilities ​ $ (3,447) ​ $ — ​ $ — ​ $ (3,447) ​ (1) Our money market fund represents a bank-managed money market fund which permits daily redemptions. The fund is recorded as cash equivalents in the consolidated balance sheets. (2) 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. (3) 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 or other long-term assets in the consolidated balance sheets. (4) The fair value of the foreign currency contract assets (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as prepaid and other assets or other long-term assets in the consolidated balance sheets. (5) The fair value of the foreign currency contract liabilities (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as accrued expenses or other long-term obligations in the consolidated balance sheets. Certain of our 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. Contingent consideration liabilities are re-measured to fair value at each reporting period, with the change in fair value recognized within operating expenses in the accompanying consolidated statements of income. 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 years ended December 31, 2024 and 2023, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Beginning balance ​ $ 3,447 ​ $ 18,073 Contingent consideration expense ​ 443 ​ 1,704 Contingent payments made ​ (404) ​ (16,330) Ending balance ​ $ 3,486 ​ $ 3,447 ​ As of December 31, 2024, $3.1 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 related to contingent liabilities. 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 related to contingent liabilities. Cash payments related to the settlement of the contingent consideration liability recognized at fair value as of the applicable acquisition date 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 $12.8 million for the years ended December 31, 2024 and 2023 are reflected as operating cash flows. The recurring Level 3 measurement of our contingent consideration liabilities includes the following significant unobservable inputs at December 31, 2024 and 2023 (amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ Contingent consideration ​ December 31, ​ Valuation ​ ​ ​ ​ ​ Weighted liability 2024 technique Unobservable inputs Range ​ Average (1) Revenue-based royalty payments contingent liability ​ $ 2,217 Discounted cash flow Discount rate ​ 14.0% - 16.0% ​ 14.6% ​ ​ ​ Projected year of payments ​ 2025-2034 ​ 2028 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue milestones contingent liability ​ $ 88 Monte Carlo simulation Discount rate ​ 13.0% ​ ​ ​ ​ ​ Projected year of payments ​ 2025-2040 ​ 2039 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Regulatory approval contingent liability ​ $ 1,181 ​ Scenario-based method ​ Discount rate ​ 6.0% ​ ​ ​ ​ ​ ​ ​ ​ ​ Probability of milestone payment ​ 50.0% ​ ​ ​ ​ ​ ​ ​ ​ ​ Projected year of payment ​ 2025-2026 ​ 2025 (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. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ Contingent consideration ​ December 31, ​ Valuation ​ ​ ​ ​ ​ Weighted 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 liabilities are re-measured to fair value each reporting period using projected revenues, discount rates, probabilities of payment, and projected payment dates. Projected contingent payment amounts are discounted back to the current period using a discounted cash flow model. Projected revenues are based on our most recent internal operational budgets and long-range strategic plans. An increase (decrease) in either the discount rate or the time to payment, in isolation, may result in a significantly lower (higher) fair value measurement. A decrease (increase) in the probability of any milestone payment may result in lower (higher) fair value measurements. Our determination of the fair value of contingent consideration liabilities could change in future periods based upon our ongoing evaluation of these significant unobservable inputs. We intend to record any such change in fair value to operating expenses in our consolidated statements of income. Contingent Payments to Related Parties. As a former shareholder of Cianna Medical, a former Merit director was eligible for payments for the achievement of sales milestones specified in our merger agreement with Cianna Medical completed in 2018. The terms of the acquisition, including contingent consideration payments, were determined prior to the appointment of the former Cianna Medical shareholder as a Merit director. During 2023, we made the final contingent payment to Cianna Medical Shareholders, including $0.9 million paid to the former Merit director who is a former Cianna Medical shareholder. During the year ended December 31, 2022, we made contingent payments of approximately $1.6 million to the former director Fair Value of Other Financial Instruments 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. The fair value our long-term debt under our convertible notes was $945.6 million as of December 31, 2024 and was determined based on quoted prices in markets that are not active, which is considered a Level 2 valuation input. The fair value of assets and liabilities whose carrying value approximates fair value is determined using Level 2 inputs, with the exception of cash and cash equivalents, which are Level 1 inputs. Impairment Charges We recognize or disclose the fair value of certain assets, such as non-financial assets, primarily property and equipment, right-of-use operating lease assets, equity investments in privately held companies, intangible assets and goodwill in connection with impairment evaluations. All of our nonrecurring valuations use significant unobservable inputs and therefore fall under Level 3 of the fair value hierarchy. Intangible Assets. intangible assets Organization and Summary of Significant Accounting Policies Equity Investments, Purchase Options and Notes Receivable. During the year ended December 31, 2023, we recorded impairment charges of $0.3 million associated with our previously held equity investment in Bluegrass in connection with the Bluegrass asset acquisition completed on May 4, 2023 (see Note 3 Acquisitions and Other Strategic Transactions ). During the year ended December 31, 2022, we recognized $0.5 million of impairment expense related to our equity method investment in XableCath, as business ceased operations. We had no such losses during the year ended December 31, 2024. 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 our allowance for current expected credit losses, were $9.4 million and $3.2 million, as of December 31, 2024 and 2023, respectively. As of December 31, 2024 and 2023, we had an allowance for current expected credit losses of $1.4 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. The table below presents a rollforward of the allowance for current expected credit losses on our notes receivable for the years ended December 31, 2024 and 2023 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 ​ 2023 Beginning balance ​ $ 568 ​ $ 281 Provision for credit loss expense ​ ​ 798 ​ ​ 287 Ending balance ​ $ 1,366 ​ $ 568 ​

Accumulated Other Comprehensive

Accumulated Other Comprehensive Income (Loss)	12 Months Ended
	Dec. 31, 2024
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest [Abstract]
Accumulated Other Comprehensive Income (Loss)	16. The changes in each component of accumulated other comprehensive income (loss) for the years ended December 31, 2024, 2023 and 2022 were as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash Flow Hedges Foreign Currency Translation Total BALANCE — January 1, 2022 $ (2,464) ​ ​ (5,527) ​ ​ (7,991) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 11,142 ​ ​ (10,491) ​ ​ 651 Income taxes (2,177) ​ ​ 102 ​ ​ (2,075) Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (3,583) ​ ​ ​ ​ ​ (3,583) Cost of sales ​ 1,436 ​ ​ ​ ​ ​ 1,436 Interest expense ​ 12 ​ ​ ​ ​ ​ 12 Net other comprehensive income (loss) ​ 6,830 ​ ​ (10,389) ​ ​ (3,559) ​ ​ ​ ​ ​ ​ ​ ​ ​ BALANCE — December 31, 2022 ​ 4,366 ​ ​ (15,916) ​ ​ (11,550) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income 4,518 ​ ​ 2,959 ​ ​ 7,477 Income taxes 866 ​ ​ (39) ​ ​ 827 Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (4,081) ​ ​ ​ ​ ​ (4,081) Cost of sales ​ (1,457) ​ ​ ​ ​ ​ (1,457) Interest expense ​ (2,550) ​ ​ ​ ​ ​ (2,550) Net other comprehensive income (loss) ​ (2,704) ​ ​ 2,920 ​ ​ 216 ​ ​ ​ ​ ​ ​ ​ ​ ​ BALANCE — December 31, 2023 ​ 1,662 ​ ​ (12,996) ​ ​ (11,334) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 5,884 ​ ​ (9,224) ​ ​ (3,340) Income taxes (341) ​ ​ 54 ​ ​ (287) Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (2,140) ​ ​ ​ ​ ​ (2,140) Cost of sales ​ (644) ​ ​ ​ ​ ​ (644) Interest expense ​ (1,656) ​ ​ ​ ​ ​ (1,656) Net other comprehensive income (loss) ​ 1,103 ​ ​ (9,170) ​ ​ (8,067) ​ ​ ​ ​ ​ ​ ​ ​ ​ BALANCE — December 31, 2024 $ 2,765 ​ $ (22,166) ​ $ (19,401) ​

Leases

Leases	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Leases	17. We have operating leases for facilities used for manufacturing, research and development, sales and distribution, and office space, as well as leases for manufacturing and office equipment, vehicles, and land. Our leases have remaining terms ranging from less than one year to approximately 25 years . A number of our lease agreements contain options to renew at our discretion for periods of up to 15 years and options to terminate the leases within one year . The lease term used to calculate ROU assets and lease liabilities includes renewal and termination options that are deemed reasonably certain to be exercised. Lease agreements with lease and non-lease components are generally accounted for as a single lease component. We do not have any bargain purchase options in our leases. For leases with an initial term of one year or less, we do not record a ROU asset or lease liability on our consolidated balance sheet. Substantially all of the ROU assets and lease liabilities as of December 31, 2024 recorded on our consolidated balance sheet are related to our cardiovascular segment. From time to time, we enter into agreements to sublease a portion of our facilities to third parties. Such sublease income is not material. We also lease certain hardware consoles to customers and record rental revenue as a component of net sales. Rental revenue under such console leasing arrangements for the years ended December 31, 2024, 2023 and 2022 was not significant. The following was included in our consolidated balance sheet as of December 31, 2024 and 2023 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Assets ​ ​ ROU operating lease assets ​ $ 65,508 ​ $ 63,047 ​ ​ ​ ​ ​ ​ ​ Liabilities ​ ​ Short-term operating lease liabilities ​ $ 10,331 ​ $ 12,087 Long-term operating lease liabilities ​ 54,783 ​ 56,259 Total operating lease liabilities ​ $ 65,114 ​ $ 68,346 ​ We recognize lease expense for operating leases on a straight-line basis over the term of the lease. Net lease cost for the years ended December 31, 2024, 2023 and 2022 was $15.4 million, $14.4 million, and $13.8 million, respectively. The components of lease costs for the years ended December 31, 2024, 2023 and 2022 were as follows, in thousands: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Lease Cost ​ Classification ​ 2024 ​ 2023 ​ 2022 Operating lease cost (a) Selling, general and administrative expenses ​ $ 15,885 ​ $ 14,879 ​ $ 14,219 Sublease (income) (b) Selling, general and administrative expenses ​ (462) ​ (488) ​ (409) Net lease cost ​ $ 15,423 ​ $ 14,391 ​ $ 13,810 ​ (a) Includes expense related to short-term leases and variable payments, which were not significant. (b) Does not include rental revenue from leases of hardware consoles to customers, which was not significant. Supplemental cash flow information for the years ended December 31, 2024, 2023 and 2022 was as follows, in thousands: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 ​ 2023 ​ 2022 Cash paid for amounts included in the measurement of lease liabilities ​ $ 14,529 ​ $ 13,804 ​ $ 13,710 Right-of-use assets obtained in exchange for lease obligations ​ $ 9,947 ​ $ 8,891 ​ $ 11,130 ​ Generally, our lease agreements do not specify an implicit rate. Therefore, we estimate our incremental borrowing rate, which is defined as the interest rate we would pay to borrow on a collateralized basis, considering such factors as length of lease term and the risks of the economic environment in which the leased asset operates. As of December 31, 2024, 2023 and 2022, our lease agreements had the following remaining lease term and discount rates: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 ​ ​ 2023 ​ ​ 2022 Weighted average remaining lease term ​ 9.6 years ​ ​ 9.6 years ​ ​ 10.4 years Weighted average discount rate ​ 3.5% ​ ​ 3.4% ​ ​ 3.4% ​ As of December 31, 2024, maturities of operating lease liabilities were as follows, in thousands: ​ ​ ​ ​ Year ending December 31, Amounts due under operating leases 2025 ​ $ 11,915 2026 ​ 10,067 2027 ​ 8,726 2028 ​ 6,948 2029 ​ 6,258 Thereafter ​ 32,692 Total lease payments ​ 76,606 Less: Imputed interest ​ (11,492) Total ​ $ 65,114 ​

Schedule II - Valuation and qua

Schedule II - Valuation and qualifying accounts	12 Months Ended
	Dec. 31, 2024
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
Schedule II - Valuation and qualifying accounts	(2) Financial Statement Schedules. Years Ended December 31, 2024, 2023 and 2022 (In thousands) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance at ​ ​ Additions Charged to ​ ​ ​ ​ ​ Balance at Allowance for Credit Losses: ​ Beginning of Year ​ Costs and Expenses (a) ​ ​ Deduction (b) ​ End of Year 2022 $ (6,767) $ (1,858) ​ $ 202 $ (8,423) 2023 $ (8,423) $ (1,772) ​ $ 1,172 $ (9,023) 2024 $ (9,023) $ (1,425) ​ $ 719 $ (9,729) (a) We record a provision for credit losses based upon historical bad debt experience, current economic conditions, expectations of future economic conditions, and management’s evaluation of our ability to collect individual outstanding balances. (b) When an individual customer balance becomes impaired and is deemed uncollectible, a deduction is made against the allowance for credit losses. ​ Years Ended December 31, 2024, 2023 and 2022 (In thousands) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance at ​ ​ Additions Charged to ​ ​ ​ ​ ​ Balance at Tax Valuation Allowance: ​ Beginning of Year ​ Costs and Expenses (a) ​ Deduction ​ End of Year 2022 $ (10,786) $ (2,741) $ - $ (13,527) 2023 $ (13,527) $ (213) $ - $ (13,740) 2024 $ (13,740) $ (403) $ - $ (14,143) (a) We record a valuation allowance against a deferred tax asset when it is determined that it is more likely than not that the deferred tax asset will not be realized.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net Income (Loss)	$ 120,357	$ 94,411	$ 74,516

Insider Trading Arrangements

Insider Trading Arrangements - Neil Peterson [Member]	3 Months Ended
	Dec. 31, 2024 shares
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On November 6, 2024, Neil Peterson, our Chief Operating Officer, adopted a trading arrangement (the “Peterson Rule 10b5-1 Trading Plan”) for the sale of shares of our common stock that is intended to satisfy the affirmative defense conditions of Exchange Act Rule 10b5-1(c). The term of the Peterson Rule 10b5-1 Trading Plan will terminate on April 24, 2026, unless terminated earlier pursuant to the terms of the Plan. The Peterson Rule 10b5-1 Trading Plan provides for sales of up to 15,000 shares of our common stock pursuant to the terms of the plan.
Name	Neil Peterson
Title	Chief Operating Officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	Nov. 06, 2024
Expiration Date	Apr. 24, 2026
Aggregate Available	15,000

Insider Trading Policies and Pr

Insider Trading Policies and Procedures	12 Months Ended
	Dec. 31, 2024
Insider Trading Policies and Procedures [Line Items]
Insider Trading Policies and Procedures Adopted	true

Cybersecurity Risk Management a

Cybersecurity Risk Management and Strategy Disclosure	12 Months Ended
	Dec. 31, 2024
Cybersecurity Risk Management, Strategy, and Governance [Line Items]
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]	We maintain strong cybersecurity systems to guard against unauthorized access, malicious software, corruption of data, disruption of our networks and systems and unauthorized release of confidential information. We employ an experienced and dedicated information security team, strive to follow industry best practices, and work with our employees globally to create awareness and mitigate cyber risk. On an ongoing basis, we assess risks (including our exposure from significant information technology suppliers, significant software as a service providers and major vendors with access to our information technology systems) and implement procedures and practices designed to improve the security, confidentiality, integrity and availability of our systems. We voluntarily engage third-party security auditors to test our systems and controls at least annually against the most widely recognized security standards and regulations. We have developed and continue to implement a continuing cyber awareness training program which is designed to increase awareness of cybersecurity threats throughout our company and reduce the risk of human error. We conduct periodic phishing testing on all our employees with e-mail access and emphasize information security in training events and programs we host throughout the year.
Cybersecurity Risk Management Processes Integrated [Flag]	true
Cybersecurity Risk Management Processes Integrated [Text Block]	We maintain strong cybersecurity systems to guard against unauthorized access, malicious software, corruption of data, disruption of our networks and systems and unauthorized release of confidential information. We employ an experienced and dedicated information security team, strive to follow industry best practices, and work with our employees globally to create awareness and mitigate cyber risk. On an ongoing basis, we assess risks (including our exposure from significant information technology suppliers, significant software as a service providers and major vendors with access to our information technology systems) and implement procedures and practices designed to improve the security, confidentiality, integrity and availability of our systems.
Cybersecurity Risk Management Third Party Engaged [Flag]	true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag]	true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag]	false
Cybersecurity Risk Board of Directors Oversight [Text Block]	We have established controls and procedures to escalate enterprise-level issues, including cybersecurity matters, to the appropriate management levels within our organization and our Board of Directors, or members or committees thereof, as appropriate. Our Board of Directors provides oversight of our enterprise risk management, including our approach to managing cybersecurity risk, and has delegated responsibility for review of information security risks to its Audit Committee. The Audit Committee regularly reviews information security risks and receives reports from our Chief Information Officer and other members of the Company’s management regarding those risks. Our cybersecurity program is managed by a dedicated Chief Information Officer whose global team, including the Vice President, Information Security, is responsible for leading enterprise-wide cybersecurity strategy, policy, standards, architecture and processes. Our Chief Information Officer has over 29 years of relevant industry experience, including 18 years with Merit. Our Vice President, Information Security, functions as our senior information security officer and has over 18 years of relevant industry experience. Further, team members who support our cybersecurity program have relevant educational and industry experience through various roles involving information technology, security, auditing, compliance, systems and programming, as well as cybersecurity certifications such as Certified Information Systems Security Professional.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]	Audit Committee
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block]	Our Board of Directors provides oversight of our enterprise risk management, including our approach to managing cybersecurity risk, and has delegated responsibility for review of information security risks to its Audit Committee.
Cybersecurity Risk Role of Management [Text Block]	The Audit Committee regularly reviews information security risks and receives reports from our Chief Information Officer and other members of the Company’s management regarding those risks. Our cybersecurity program is managed by a dedicated Chief Information Officer whose global team, including the Vice President, Information Security, is responsible for leading enterprise-wide cybersecurity strategy, policy, standards, architecture and processes. Our Chief Information Officer has over 29 years of relevant industry experience, including 18 years with Merit. Our Vice President, Information Security, functions as our senior information security officer and has over 18 years of relevant industry experience. Further, team members who support our cybersecurity program have relevant educational and industry experience through various roles involving information technology, security, auditing, compliance, systems and programming, as well as cybersecurity certifications such as Certified Information Systems Security Professional.
Cybersecurity Risk Management Positions or Committees Responsible [Flag]	true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]	Our cybersecurity program is managed by a dedicated Chief Information Officer whose global team, including the Vice President, Information Security, is responsible for leading enterprise-wide cybersecurity strategy, policy, standards, architecture and processes.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block]	Our Chief Information Officer has over 29 years of relevant industry experience, including 18 years with Merit. Our Vice President, Information Security, functions as our senior information security officer and has over 18 years of relevant industry experience. Further, team members who support our cybersecurity program have relevant educational and industry experience through various roles involving information technology, security, auditing, compliance, systems and programming, as well as cybersecurity certifications such as Certified Information Systems Security Professional.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block]	Matters determined to present potential material impacts to the Company’s financial results, operations, and/or reputation are immediately reported by management to our Board of Directors or the Audit Committee, as appropriate, in accordance with our escalation framework.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag]	true

Organization and Summary of S_2

Organization and Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Principles of Consolidation and Basis of Presentation	Principles of Consolidation and Basis of Presentation During the year ended December 31, 2024, we elected to change the presentation of investments in privately held companies within the statements of cash flows to be included within Cash paid for notes receivable and other investments Cash paid in acquisitions, net of cash acquired
Use of Estimates in Preparing Financial Statements	Use of Estimates in Preparing Financial Statements
Cash and Cash Equivalents	Cash and Cash Equivalents
Receivables	Receivables
Inventories	Inventories of the valuation of inventories includes an assessment of future product demand based on historical sales and raw material usage and product expiration.
Goodwill and Intangible Assets	Goodwill and Intangible Assets Finite-lived intangible assets including developed technology, customer lists, distribution agreements, license agreements, trademarks and patents are subject to amortization. Intangible assets are amortized over their estimated useful life on a straight-line basis, except for customer lists, which are generally amortized on an accelerated basis. Estimated useful lives are determined considering the period the assets are expected to contribute to future cash flows. 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 are largely independent of the cash flows of other assets and liabilities. We compare the carrying value of the asset group to the undiscounted cash flows expected to result from the asset group and determine whether the carrying amount is recoverable. We determine the fair value of each asset group 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. In-process technology intangible assets, which are not subject to amortization until projects reach commercialization, are assessed for impairment at least annually and more frequently if events occur that would indicate a potential reduction in the fair value of the assets below their carrying value. An impairment charge would be recognized to the extent the carrying amount of the in-process technology exceeded its fair value. D December 31, 2022 were restructuring activities and uncertainty about future product development and commercialization associated with certain acquired technologies.
Long-Lived Assets	Long-Lived Assets Property, Plant and Equipment
Property and Equipment	Property and Equipment ​ ​ ​ ​ Buildings 40 years Manufacturing equipment ​ 4 - 20 years Furniture and fixtures ​ 3 - 20 years Land improvements ​ 10 - 20 years Leasehold improvements ​ 4 - 25 years ​ Depreciation expense related to property and equipment for the years ended December 31, 2024, 2023 and 2022 was $37.2 million, $34.0 million, and $33.4 million, respectively.
Deferred Compensation	Deferred Compensation
Other Assets	Other Assets ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Investments in privately held companies ​ $ 22,832 ​ $ 19,061 Deferred compensation plan assets ​ ​ 20,716 ​ ​ 18,309 Long-term notes receivable, net ​ ​ 9,423 ​ ​ 3,241 Other ​ 12,365 ​ 14,182 Total ​ $ 65,336 ​ $ 54,793 ​ 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. Our share of earnings associated with equity method investments is reported within other income (expense) in our consolidated statements of income. 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. We paid $3.8 million, $4.0 million, and $1.4 million in the acquisition of additional equity investments and have no cumulative impairments or other fair value adjustments associated with our existing investments. Refer to Note 15, Fair Value Measurements
Other Long-term Obligations	Other Long-term Obligations. ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Contingent consideration liabilities ​ $ 3,128 ​ $ 3,039 Other long-term obligations ​ ​ 12,323 ​ ​ 10,791 Total ​ $ 15,451 ​ $ 13,830 ​ In connection with a business combination, any contingent consideration is recorded at fair value on the acquisition date based upon the consideration expected to be transferred in the future. We re-measure the estimated liability each quarter based upon changes in revenue estimates, changes in the probability of achieving relevant milestones and changes in the discount rate or expected period of payment. Changes in the estimated fair value are recorded through operating expense in our consolidated statements of income.
Revenue Recognition/Shipping and Handling/Cost of Sales	Revenue Recognition Identify the contract with the customer Identify the performance obligations in the contract Determine the transaction price Allocate the transaction price to performance obligations in the contract Recognize revenue when or as we satisfy a performance obligation. Reserves are recorded as a reduction in net sales and are not considered material to our consolidated statements of income for the years ended December 31, 2024, 2023 and 2022. In addition, we invoice our customers for taxes assessed by governmental authorities, such as sales tax and value-added taxes. We present these taxes on a net basis. Shipping and Handling Cost of Sales
Research and Development	Research and Development
Restructuring	Restructuring. Exit or Disposal Cost Obligations
Income Taxes	Income Taxes
Earnings per Common Share	Earnings per Common Share
Fair Value Measurements	Fair Value Measurements Level 1: Quoted market prices in active markets for identical assets or liabilities. Level 2: Observable market-based inputs or inputs that are corroborated by market data. Level 3: Unobservable inputs that are not corroborated by market data.
Stock-Based Compensation	Stock-Based Compensation Compensation — Stock Compensation Employee Stock Purchase Plan, Stock Options and Warrants
Concentration of Credit Risk	Concentration of Credit Risk
Foreign Currency	Foreign Currency
Derivatives	Derivatives Debt Derivatives
Recently Issued Accounting Standards	Recently Adopted Financial Accounting Standards. Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting Deferral of the Sunset Date of Topic 848 Derivatives In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures Segment Reporting and Foreign Operations Recently Issued Accounting Standards. Improvements to Income Tax Disclosures Income Taxes (Topic 740) In November 2024, the FASB issued ASU 2024-03, Disaggregation of Income Statement Expenses, for fiscal years beginning after December 15, 2026, and interim periods within fiscal years beginning after December 15, 2027, with early adoption permitted. The provisions within the update may be applied retrospectively for all periods presented in the financial statements. While we are still evaluating the specific impacts and adoption method, we anticipate this guidance will have a significant impact on our consolidated financial statement disclosures. We currently believe there are no other issued and not yet effective accounting standards that are materially relevant to our financial statements.

Organization and Summary of S_3

Organization and Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Property and Equipment	Depreciation is computed using the straight-line method over estimated useful lives as follows: ​ ​ ​ ​ Buildings 40 years Manufacturing equipment ​ 4 - 20 years Furniture and fixtures ​ 3 - 20 years Land improvements ​ 10 - 20 years Leasehold improvements ​ 4 - 25 years
Other assets	Other assets as of December 31, 2024 and 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Investments in privately held companies ​ $ 22,832 ​ $ 19,061 Deferred compensation plan assets ​ ​ 20,716 ​ ​ 18,309 Long-term notes receivable, net ​ ​ 9,423 ​ ​ 3,241 Other ​ 12,365 ​ 14,182 Total ​ $ 65,336 ​ $ 54,793
Other Long-term Obligations	Other long-term obligations as of December 31, 2024 and 2023 consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Contingent consideration liabilities ​ $ 3,128 ​ $ 3,039 Other long-term obligations ​ ​ 12,323 ​ ​ 10,791 Total ​ $ 15,451 ​ $ 13,830

Revenues (Tables)

Revenues (Tables)	12 Months Ended
	Dec. 31, 2024
Revenue from Contract with Customer [Abstract]
Schedule of Disaggregation of Revenue	The following table presents sales by operating segment disaggregated based on product category and geographic region for the years ended December 31, 2024, 2023 and 2022 (in thousands). ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year Ended ​ Year Ended ​ Year Ended ​ ​ December 31, 2024 ​ December 31, 2023 ​ December 31, 2022 ​ United States International Total United States International Total United States International Total Cardiovascular ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Peripheral Intervention ​ $ 331,514 ​ $ 220,654 ​ $ 552,168 ​ $ 299,313 ​ $ 202,907 ​ $ 502,220 ​ $ 263,602 ​ $ 176,208 ​ $ 439,810 Cardiac Intervention ​ 147,992 ​ ​ 223,001 ​ 370,993 ​ 143,755 ​ ​ 214,696 ​ 358,451 ​ 128,711 ​ ​ 214,475 ​ 343,186 Custom Procedural Solutions ​ 122,330 ​ ​ 78,871 ​ 201,201 ​ 114,010 ​ ​ 81,323 ​ 195,333 ​ 108,778 ​ ​ 81,416 ​ 190,194 OEM ​ 147,108 ​ ​ 30,274 ​ 177,382 ​ 135,525 ​ ​ 29,031 ​ 164,556 ​ 118,869 ​ ​ 26,165 ​ 145,034 Total ​ 748,944 ​ ​ 552,800 ​ 1,301,744 ​ 692,603 ​ 527,957 ​ 1,220,560 ​ 619,960 ​ 498,264 ​ 1,118,224 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Endoscopy Devices ​ 51,836 ​ 2,934 ​ 54,770 ​ 34,386 ​ 2,420 ​ 36,806 ​ 30,599 ​ ​ 2,158 ​ 32,757 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ $ 800,780 ​ $ 555,734 ​ $ 1,356,514 ​ $ 726,989 ​ $ 530,377 ​ $ 1,257,366 ​ $ 650,559 ​ $ 500,422 ​ $ 1,150,981 ​

Acquisitions and Other Strate_2

Acquisitions and Other Strategic Transactions (Tables)	12 Months Ended
	Dec. 31, 2024
Cook Medical
Business Acquisition [Line Items]
Schedule of Purchase price allocation	The purchase price was preliminarily allocated as follows (in thousands): ​ ​ ​ ​ ​ Assets Acquired ​ Intangible assets ​ ​ Developed technology ​ $ 126,100 Trademarks ​ ​ 7,100 Customer List ​ ​ 11,100 Goodwill ​ ​ 65,897 Total assets acquired ​ 210,197 ​ ​ ​ ​ Liabilities Assumed ​ Accrued expenses ​ 197 Total liabilities assumed ​ 197 ​ ​ ​ ​ Total net assets acquired ​ $ 210,000
EGS
Business Acquisition [Line Items]
Schedule of Purchase price allocation	The purchase price was 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
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)	12 Months Ended
	Dec. 31, 2024
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventories at December 31, 2024 and 2023, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ December 31, 2024 December 31, 2023 Finished goods ​ $ 168,437 ​ $ 158,893 Work-in-process ​ 27,114 ​ 25,420 Raw materials ​ 110,512 ​ 119,558 Total inventories ​ $ 306,063 ​ $ 303,871 ​

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Changes in carrying amount of goodwill	The changes in the carrying amount of goodwill for the years ended December 31, 2024 and 2023, are as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 ​ 2023 ​ Cardiovascular ​ Endoscopy ​ Total Cardiovascular ​ Endoscopy ​ Total Goodwill balance at January 1 ​ $ 382,240 ​ $ — ​ $ 382,240 ​ $ 359,821 ​ $ — ​ $ 359,821 Effect of foreign exchange ​ (1,623) ​ — ​ (1,623) ​ 883 ​ — ​ 883 Additions and adjustments as the result of acquisitions ​ 65,897 ​ 16,997 ​ 82,894 ​ 21,536 ​ — ​ 21,536 Goodwill balance at December 31 ​ $ 446,514 ​ $ 16,997 ​ $ 463,511 ​ $ 382,240 ​ $ — ​ $ 382,240
Other intangible assets	Other intangible assets at December 31, 2024 and 2023, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 2024 ​ ​ Gross Carrying ​ Accumulated ​ Net Carrying ​ Amount Amortization Amount Patents ​ $ 31,489 ​ $ (12,824) ​ $ 18,665 Distribution agreements ​ 3,250 ​ (2,994) ​ 256 License agreements ​ 11,557 ​ (9,125) ​ 2,432 Trademarks ​ 47,613 ​ (24,177) ​ 23,436 Customer lists ​ 57,933 ​ (36,223) ​ 21,710 Total ​ $ 151,842 ​ $ (85,343) ​ $ 66,499 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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 the developed technology and other intangible assets for the next five years consists of the following as of December 31, 2024 (in thousands): ​ ​ ​ ​ Year ending December 31, Estimated Amortization Expense 2025 ​ $ 83,747 2026 ​ 73,155 2027 ​ 69,188 2028 ​ ​ 67,790 2029 ​ 56,115 ​

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Schedule of Income before Income Tax, Domestic and Foreign	For the years ended December 31, 2024, 2023 and 2022, income before income taxes is broken out between U.S. and foreign-sourced operations and consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Domestic ​ $ 93,687 ​ $ 60,935 ​ $ 77,562 Foreign ​ 56,306 ​ 51,154 ​ 5,067 Total ​ $ 149,993 ​ $ 112,089 ​ $ 82,629
Schedule of Components of Income Tax Expense (Benefit)	The components of the provision for income taxes for the years ended December 31, 2024, 2023 and 2022, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Current expense: ​ ​ ​ Federal ​ $ 26,061 ​ $ 15,684 ​ $ 9,584 State ​ 5,286 ​ 3,775 ​ 3,162 Foreign ​ 13,162 ​ 10,862 ​ 10,291 Total current expense ​ 44,509 ​ 30,321 ​ 23,037 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Deferred expense (benefit): ​ ​ ​ Federal ​ (12,609) ​ (11,030) ​ (10,438) State ​ (1,421) ​ (1,699) ​ (3,615) Foreign ​ (843) ​ 86 ​ (871) Total deferred benefit ​ (14,873) ​ (12,643) ​ (14,924) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total income tax expense ​ $ 29,636 ​ $ 17,678 ​ $ 8,113
Schedule of Effective Income Tax Rate Reconciliation	The difference between the income tax expense reported and amounts computed by applying the statutory federal rate of 21.0% to pretax income for the years ended December 31, 2024, 2023 and 2022, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Computed federal income tax expense at applicable statutory rate of 21% ​ $ 31,499 ​ $ 23,539 ​ $ 17,352 State income tax expense ​ 3,081 ​ 1,627 ​ 35 Tax credits ​ (3,004) ​ (2,412) ​ (1,978) Tax effect of international items ​ (1,870) ​ (3,994) ​ (10,698) Uncertain tax positions ​ 218 ​ 4 ​ (47) Deferred compensation insurance assets ​ (535) ​ (548) ​ 706 Stock-based compensation ​ (1,817) ​ (3,001) ​ (3,423) Valuation allowance ​ ​ — ​ ​ (90) ​ ​ 3,523 Remeasurement of state deferred taxes ​ ​ — ​ ​ (73) ​ ​ (375) Non-deductible expenses ​ ​ 2,454 ​ ​ 2,101 ​ ​ 2,027 Remeasurement of contingent consideration liabilities ​ ​ 108 ​ ​ 317 ​ ​ 1,061 Other — including the effect of graduated rates ​ (498) ​ 208 ​ (70) Total income tax expense ​ $ 29,636 ​ $ 17,678 ​ $ 8,113 ​
Schedule of Deferred Tax Assets and Liabilities	Deferred income tax assets and liabilities at December 31, 2024 and 2023, consisted of the following temporary differences and carry-forward items (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Deferred income tax assets: ​ ​ Allowance for credit losses on trade receivables ​ $ 2,215 ​ $ 2,009 Accrued compensation expense ​ 11,701 ​ 10,285 Inventory differences ​ 5,139 ​ 5,477 Net operating loss carryforwards ​ 8,320 ​ 10,007 Stock-based compensation expense ​ 7,569 ​ 7,913 Operating lease assets ​ ​ 11,586 ​ ​ 11,331 State R&D tax credits ​ ​ 5,924 ​ ​ 5,237 IRC section 174 capitalized R&D ​ ​ 35,200 ​ ​ 26,370 Other ​ 10,759 ​ 10,159 Total deferred income tax assets ​ 98,413 ​ 88,788 ​ ​ ​ ​ ​ ​ ​ Deferred income tax liabilities: ​ ​ Prepaid expenses ​ (1,277) ​ (1,123) Property and equipment ​ (22,699) ​ (23,539) Intangible assets ​ (29,440) ​ (34,613) Foreign withholding tax ​ (1,681) ​ (2,005) Operating lease liabilities ​ ​ (11,737) ​ ​ (10,129) Other ​ (1,632) ​ (1,898) Total deferred income tax liabilities ​ (68,466) ​ (73,307) Valuation allowance ​ (14,143) ​ (13,740) Net deferred income tax liabilities ​ $ 15,804 ​ $ 1,741 ​ ​ ​ ​ ​ ​ ​ Reported as: ​ ​ Deferred income tax assets ​ $ 16,044 ​ $ 7,288 Deferred income tax liabilities ​ (240) ​ (5,547) Net deferred income tax liabilities ​ $ 15,804 ​ $ 1,741
Schedule of reconciliation of the beginning and ending amount of liabilities associated with uncertain tax benefits	A reconciliation of the beginning and ending amount of liabilities associated with uncertain tax benefits for the years ended December 31, 2024, 2023 and 2022, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Unrecognized tax benefits, opening balance ​ $ 1,622 ​ $ 1,576 ​ $ 1,635 Gross increases (decreases) in tax positions taken in a prior year ​ 70 ​ 112 ​ (10) Gross increases in tax positions taken in the current year ​ 559 ​ 442 ​ 294 Lapse of applicable statute of limitations ​ (371) ​ (508) ​ (343) Unrecognized tax benefits, ending balance ​ $ 1,880 ​ $ 1,622 ​ $ 1,576

Accrued Expenses (Tables)

Accrued Expenses (Tables)	12 Months Ended
	Dec. 31, 2024
Payables and Accruals [Abstract]
Schedule of Accrued Liabilities	Accrued expenses at December 31, 2024 and 2023, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Payroll and related liabilities ​ $ 73,514 ​ $ 66,929 Current portion of contingent liabilities ​ 358 ​ 408 Advances from employees ​ 158 ​ 285 Accrued rebates payable ​ ​ 11,778 ​ ​ 11,005 Accrued interest ​ ​ 9,531 ​ ​ 1,556 Other accrued expenses ​ 38,738 ​ 40,264 Total ​ $ 134,077 ​ $ 120,447 ​ ​

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Schedule of Long-term Debt Instruments	Principal balances outstanding under our long-term debt obligations as of December 31, 2024 and 2023, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Term loans ​ $ — ​ $ 99,063 Convertible notes ​ ​ 747,500 ​ ​ 747,500 Less unamortized debt issuance costs ​ (17,949) ​ (23,550) Total long-term debt ​ 729,551 ​ 823,013 Less current portion ​ — ​ — Long-term portion ​ $ 729,551 ​ $ 823,013
Schedule of Maturities of Long-term Debt	Future minimum principal payments on our long-term debt as of December 31, 2024, are as follows (in thousands): ​ ​ ​ ​ Year Ending ​ Future Minimum December 31, Principal Payments 2025 $ — 2026 ​ ​ — 2027 ​ ​ — 2028 ​ ​ — 2029 ​ ​ 747,500 Total future minimum principal payments ​ $ 747,500
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)	12 Months Ended
	Dec. 31, 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 is as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value of Derivative Instruments Designated as Hedging Instruments Balance Sheet Location December 31, 2024 December 31, 2023 Assets ​ ​ Interest rate swap Prepaid expenses and other assets ​ $ — ​ $ 1,503 Foreign currency forward contracts Prepaid expenses and other assets ​ ​ 3,771 ​ ​ 2,061 Foreign currency forward contracts Other assets (long-term) ​ ​ 1,064 ​ 216 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (1,332) ​ (1,898) Foreign currency forward contracts Other long-term obligations ​ (287) ​ (499) ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value of Derivative Instruments Not Designated as Hedging Instruments Balance Sheet Location December 31, 2024 December 31, 2023 Assets ​ ​ Foreign currency forward contracts Prepaid expenses and other assets ​ $ 2,595 ​ $ 828 ​ ​ ​ ​ ​ ​ ​ ​ ​ (Liabilities) ​ ​ Foreign currency forward contracts Accrued expenses ​ (1,288) ​ (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") in our consolidated statements of comprehensive income and consolidated balance sheets (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amount of Gain ​ ​ Recognized in OCI ​ ​ Year Ended December 31, Derivative instrument 2024 2023 2022 Interest rate swap ​ $ 152 ​ $ 609 ​ $ 4,879 Foreign currency forward contracts ​ 5,732 ​ 3,909 ​ 6,263 ​ Derivative instruments designated as cash flow hedges had the following effects, before income taxes, on AOCI and net earnings in our consolidated statements of income, consolidated statements of comprehensive income and consolidated balance sheets (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Consolidated Statements ​ ​ Amount of Gain/(Loss) ​ ​ of Income ​ ​ Reclassified from AOCI ​ ​ Year Ended December 31, ​ Year Ended December 31, Location in statements of income 2024 ​ 2023 ​ 2022 2024 2023 2022 Interest expense ​ $ (31,219) ​ $ (15,511) ​ $ (6,339) ​ ​ $ 1,656 $ 2,550 $ (12) Revenue ​ 1,356,514 ​ 1,257,366 ​ 1,150,981 ​ ​ 2,140 ​ 4,081 ​ 3,583 Cost of sales ​ (713,181) ​ (673,494) ​ (631,882) ​ ​ 644 ​ 1,457 ​ (1,436)
Derivative Instruments, Gain (Loss)	The following gains/(losses) from these derivative instruments were recognized in our consolidated statements of income for the years presented (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year ended December 31, Derivative Instrument Location in statements of income 2024 2023 2022 Foreign currency forward contracts Other income (expense) — net ​ $ 1,961 ​ $ 2,004 ​ $ 1,420

Earnings Per Common Share (EP_2

Earnings Per Common Share (EPS) (Tables)	12 Months Ended
	Dec. 31, 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 years ended December 31, 2024, 2023 and 2022, consisted of the following (in thousands, except per share amounts): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 ​ 2023 ​ 2022 Net income ​ $ 120,357 ​ $ 94,411 ​ $ 74,516 Average common shares outstanding ​ 58,218 ​ 57,593 ​ 56,806 Basic EPS ​ $ 2.07 ​ $ 1.64 ​ $ 1.31 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average common shares outstanding ​ ​ 58,218 ​ ​ 57,593 ​ ​ 56,806 Effect of dilutive stock awards ​ ​ 760 ​ ​ 763 ​ ​ 865 Effect of dilutive convertible notes ​ ​ 387 ​ ​ — ​ ​ — Total potential shares outstanding ​ ​ 59,365 ​ ​ 58,356 ​ ​ 57,671 Diluted EPS ​ $ 2.03 ​ $ 1.62 ​ $ 1.29 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Equity awards excluded as the impact was anti-dilutive (1) ​ ​ 672 ​ ​ 1,143 ​ ​ 1,438 ​ (1) Does not reflect the impact of incremental repurchases under the treasury stock method.

Employee Stock Purchase Plan,_2

Employee Stock Purchase Plan, Stock Options and Warrants (Tables)	12 Months Ended
	Dec. 31, 2024
Share-based Payment Arrangement [Abstract]
Schedule of Employee Service Share-based Compensation, Allocation of Recognized Period Costs	The stock-based compensation expense before income tax expense for the years ended December 31, 2024, 2023 and 2022, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Cost of sales ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ $ 1,229 ​ $ 1,647 ​ $ 1,606 Research and development ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 1,522 ​ ​ 1,739 ​ ​ 1,789 Selling, general and administrative ​ ​ ​ ​ ​ ​ ​ ​ ​ Nonqualified stock options ​ ​ 6,206 ​ ​ 7,542 ​ ​ 7,305 Performance-based restricted stock units ​ ​ 12,517 ​ ​ 6,344 ​ ​ 3,509 Restricted stock units ​ ​ 4,279 ​ ​ 1,771 ​ ​ 1,836 Cash-settled performance-based awards ​ ​ 2,720 ​ ​ 2,290 ​ ​ 1,997 Total selling, general and administrative ​ ​ 25,722 ​ ​ 17,947 ​ ​ 14,647 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Stock-based compensation expense before taxes ​ $ 28,473 ​ $ 21,333 ​ $ 18,042
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions	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 years ended December 31, 2023 and 2022: ​ ​ ​ ​ ​ ​ 2023 2022 Risk-free interest rate ​ 3.6% - 4.8% ​ 1.4% - 4.3% Expected option term ​ 4.0 years ​ 4.0 years Expected dividend yield ​ — ​ — Expected price volatility ​ 39.6% - 47.1% ​ 46.2% - 47.5%
Schedule of Share-based Compensation, Stock Option Activity	The table below presents information related to stock option activity for the years ended December 31, 2024, 2023 and 2022 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Total intrinsic value of stock options exercised ​ $ 36,431 ​ $ 23,300 ​ $ 27,110 Cash received from stock option exercises ​ 39,746 ​ 14,503 ​ 18,952 Excess tax benefit from the exercise of stock options ​ 1,817 ​ 3,001 ​ 3,423
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Outstanding and Exercisable	Changes in stock options for the year ended December 31, 2024, consisted of the following (shares and intrinsic value in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Number ​ Weighted Average ​ Remaining Contractual ​ Intrinsic ​ of Shares Exercise Price Term (in years) Value Beginning balance 2,868 ​ 56.39 ​ Granted — ​ — ​ Exercised (824) ​ 48.21 ​ Forfeited/expired (21) ​ 66.61 ​ Outstanding at December 31 2,023 ​ 59.62 3.05 ​ $ 75,055 Exercisable 1,411 ​ 55.87 2.35 ​ 57,639 Ending vested and expected to vest 1,997 ​ 59.49 3.02 ​ 74,372
Schedule of Share-based Compensation, PSUs and RSUs, Activity	Changes in PSUs and RSUs for the year ended December 31, 2024, consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ PSUs ​ RSUs ​ ​ ​ ​ Weighted Average ​ ​ ​ Weighted Average ​ ​ Stock Units ​ Grant Date ​ Stock Units ​ Grant Date ​ (In Thousands) (1) Fair Value (In Thousands) Fair Value Beginning nonvested balance 355 ​ 71.15 20 ​ 83.99 Granted 287 ​ 86.79 329 90.54 Vested (47) ​ 76.51 (20) 83.99 Nonvested balance at December 31 595 ​ 82.33 329 ​ 90.54 ​ (1) Based on the maximum payout, excluding the impact of the rTSR multiplier. The actual number of shares which vest is determined based on the satisfaction of performance conditions and the application of an rTSR multiplier between 75% and 125% .
Schedule of Share-based Compensation, PSUs and RSUs Granted	The following table summarizes PSUs and RSUs granted during the years ended December 31, 2024, 2023 and 2022 (units and shares in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 PSUs ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Target units granted ​ ​ 144 ​ ​ 115 ​ ​ 48 ​ Maximum units granted (1) ​ ​ 287 ​ ​ 229 ​ ​ 97 ​ Maximum potential shares (1)(2) ​ ​ 359 ​ ​ 287 ​ ​ 121 ​ Weighted average grant date fair value ​ $ 86.79 ​ $ 72.26 ​ $ 64.54 ​ RSUs ​ ​ ​ ​ ​ ​ ​ ​ ​ Units granted ​ ​ 329 ​ ​ 20 ​ ​ 31 ​ Weighted average grant date fair value ​ $ 90.54 ​ $ 83.99 ​ $ 59.02 ​ ​ (1) Based on the maximum payout, excluding the impact of the rTSR multiplier. (2) Includes the impact of the maximum potential rTSR multiplier of 125% .
Schedule of Share-based Payment Award, PSUs, Valuation Assumptions	The fair value of each PSU was estimated as of the grant date using the following assumptions for awards granted in the years ended December 31, 2024, 2023 and 2022: ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Risk-free interest rate 4.4% ​ 3.9% - 4.6% ​ 1.6% - 2.7% Performance period 2.8 years ​ 2.8 years ​ 2.6 - 2.8 years Expected dividend yield — ​ — ​ — Expected price volatility 31.1% ​ 31.4% - 32.6% ​ 38.5% - 46.2%

Segment Reporting and Foreign_2

Segment Reporting and Foreign Operations (Tables)	12 Months Ended
	Dec. 31, 2024
Segment Reporting [Abstract]
Schedule of Long-lived Assets by Geographic Area	Our long-lived assets (which are comprised of our net property and equipment) by geographic area at December 31, 2024, 2023 and 2022, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 United States ​ $ 271,734 ​ $ 273,105 ​ $ 281,290 Ireland ​ 45,325 ​ 42,333 ​ 40,749 Other foreign countries ​ 69,106 ​ 68,085 ​ 60,937 Total ​ $ 386,165 ​ $ 383,523 ​ $ 382,976
Schedule of Segment Reporting Information, by Segment	Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the years ended December 31, 2024, 2023 and 2022, are as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year Ended ​ Year Ended ​ Year Ended ​ ​ December 31, 2024 ​ December 31, 2023 ​ December 31, 2022 ​ Cardiovascular Endoscopy Consolidated Cardiovascular Endoscopy Consolidated Cardiovascular Endoscopy Consolidated Net sales $ 1,301,744 $ 54,770 $ 1,356,514 $ 1,220,560 ​ $ 36,806 $ 1,257,366 $ 1,118,224 $ 32,757 $ 1,150,981 Cost of sales standard (1) ​ ​ 549,657 ​ ​ 15,746 ​ ​ ​ ​ ​ 534,826 ​ ​ 12,987 ​ ​ ​ ​ ​ 496,678 ​ ​ 12,739 ​ ​ ​ Cost of sales other (2) ​ 140,948 ​ 6,830 ​ ​ ​ 125,388 ​ 293 ​ ​ ​ 121,045 ​ 1,420 ​ ​ Selling, general and administrative expenses ​ 376,734 ​ 22,997 ​ ​ ​ 362,082 ​ 11,594 ​ ​ ​ 332,012 ​ 10,513 ​ ​ Research and development expenses ​ ​ 83,812 ​ ​ 3,654 ​ ​ ​ ​ ​ 80,300 ​ ​ 2,428 ​ ​ ​ ​ ​ 74,042 ​ ​ 1,468 ​ ​ ​ Other operating expenses (3) ​ ​ 443 ​ ​ — ​ ​ ​ ​ ​ 3,524 ​ ​ — ​ ​ ​ ​ ​ 13,501 ​ ​ — ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Income from operations ​ $ 150,150 ​ $ 5,543 ​ $ 155,693 ​ $ 114,440 ​ $ 9,504 ​ $ 123,944 ​ $ 80,946 ​ $ 6,617 ​ $ 87,563 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total other expense — net ​ ​ ​ ​ ​ ​ ​ ​ (5,700) ​ ​ ​ ​ ​ ​ ​ ​ (11,855) ​ ​ ​ ​ ​ ​ ​ ​ (4,934) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Income before income taxes ​ ​ ​ ​ ​ ​ $ 149,993 ​ ​ ​ ​ ​ ​ $ 112,089 ​ ​ ​ ​ ​ ​ $ 82,629 ​ (1) Cost of sales standard represents costs of goods sold measured at the internal standard cost for production of inventory. Inventory standard costs include material, labor and manufacturing overhead. (2) Cost of sales other for all segments include amortization expense associated with our developed technology and license agreement intangible assets, freight and handling associated with shipments to customers, provisions based on estimated excess, slow moving and obsolete inventories, manufacturing and price variances, and royalties. (3) Other operating expenses include impairment charges, contingent consideration (benefit expense) related to the changes in fair value of contingent payments associated with acquisitions, acquired in-process research and development expense, and certain legal settlements. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 2022 Cardiovascular ​ $ 97,749 ​ $ 88,960 ​ $ 80,777 Endoscopy ​ 4,960 ​ 1,025 ​ 1,027 Total ​ $ 102,709 ​ $ 89,985 ​ $ 81,804 Total depreciation and amortization by operating segment for the years ended December 31, 2024, 2023 and 2022, consisted of the following (in thousands):

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 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 measured on a recurring basis as of December 31, 2024 and 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 ​ December 31, 2024 (Level 1) (Level 2) (Level 3) Money market funds (1) ​ $ 10,034 ​ $ 10,034 ​ $ — ​ $ — Marketable securities (2) ​ $ 92 ​ $ 92 ​ $ — ​ $ — Foreign currency contract assets, current and long-term (4) ​ $ 7,430 ​ $ — ​ $ 7,430 ​ $ — Foreign currency contract liabilities, current and long-term (5) ​ $ (2,907) ​ $ — ​ $ (2,907) ​ $ — Contingent consideration liabilities ​ $ (3,486) ​ $ — ​ $ — ​ $ (3,486) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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 (2) ​ $ 78 ​ $ 78 ​ $ — ​ $ — Interest rate contract asset, current (3) ​ $ 1,503 ​ $ — ​ $ 1,503 ​ $ — Foreign currency contract assets, current and long-term (4) ​ $ 3,105 ​ $ — ​ $ 3,105 ​ $ — Foreign currency contract liabilities, current and long-term (5) ​ $ (3,860) ​ $ — ​ $ (3,860) ​ $ — Contingent consideration liabilities ​ $ (3,447) ​ $ — ​ $ — ​ $ (3,447) ​ (1) Our money market fund represents a bank-managed money market fund which permits daily redemptions. The fund is recorded as cash equivalents in the consolidated balance sheets. (2) 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. (3) 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 or other long-term assets in the consolidated balance sheets. (4) The fair value of the foreign currency contract assets (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as prepaid and other assets or other long-term assets in the consolidated balance sheets. (5) The fair value of the foreign currency contract liabilities (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as accrued expenses or other long-term obligations in the consolidated balance sheets.
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	Changes in the fair value of our contingent consideration liabilities during the years ended December 31, 2024 and 2023, consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Beginning balance ​ $ 3,447 ​ $ 18,073 Contingent consideration expense ​ 443 ​ 1,704 Contingent payments made ​ (404) ​ (16,330) Ending balance ​ $ 3,486 ​ $ 3,447
Fair Value Inputs, Liabilities, Quantitative Information	The recurring Level 3 measurement of our contingent consideration liabilities includes the following significant unobservable inputs at December 31, 2024 and 2023 (amounts in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ Contingent consideration ​ December 31, ​ Valuation ​ ​ ​ ​ ​ Weighted liability 2024 technique Unobservable inputs Range ​ Average (1) Revenue-based royalty payments contingent liability ​ $ 2,217 Discounted cash flow Discount rate ​ 14.0% - 16.0% ​ 14.6% ​ ​ ​ Projected year of payments ​ 2025-2034 ​ 2028 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue milestones contingent liability ​ $ 88 Monte Carlo simulation Discount rate ​ 13.0% ​ ​ ​ ​ ​ Projected year of payments ​ 2025-2040 ​ 2039 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Regulatory approval contingent liability ​ $ 1,181 ​ Scenario-based method ​ Discount rate ​ 6.0% ​ ​ ​ ​ ​ ​ ​ ​ ​ Probability of milestone payment ​ 50.0% ​ ​ ​ ​ ​ ​ ​ ​ ​ Projected year of payment ​ 2025-2026 ​ 2025 (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. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair value at ​ ​ ​ ​ ​ ​ ​ Contingent consideration ​ December 31, ​ Valuation ​ ​ ​ ​ ​ Weighted 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 rollforward of the allowance for current expected credit losses on our notes receivable for the years ended December 31, 2024 and 2023 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 ​ 2023 Beginning balance ​ $ 568 ​ $ 281 Provision for credit loss expense ​ ​ 798 ​ ​ 287 Ending balance ​ $ 1,366 ​ $ 568 ​

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Income (Loss) (Tables)	12 Months Ended
	Dec. 31, 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 years ended December 31, 2024, 2023 and 2022 were as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash Flow Hedges Foreign Currency Translation Total BALANCE — January 1, 2022 $ (2,464) ​ ​ (5,527) ​ ​ (7,991) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 11,142 ​ ​ (10,491) ​ ​ 651 Income taxes (2,177) ​ ​ 102 ​ ​ (2,075) Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (3,583) ​ ​ ​ ​ ​ (3,583) Cost of sales ​ 1,436 ​ ​ ​ ​ ​ 1,436 Interest expense ​ 12 ​ ​ ​ ​ ​ 12 Net other comprehensive income (loss) ​ 6,830 ​ ​ (10,389) ​ ​ (3,559) ​ ​ ​ ​ ​ ​ ​ ​ ​ BALANCE — December 31, 2022 ​ 4,366 ​ ​ (15,916) ​ ​ (11,550) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income 4,518 ​ ​ 2,959 ​ ​ 7,477 Income taxes 866 ​ ​ (39) ​ ​ 827 Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (4,081) ​ ​ ​ ​ ​ (4,081) Cost of sales ​ (1,457) ​ ​ ​ ​ ​ (1,457) Interest expense ​ (2,550) ​ ​ ​ ​ ​ (2,550) Net other comprehensive income (loss) ​ (2,704) ​ ​ 2,920 ​ ​ 216 ​ ​ ​ ​ ​ ​ ​ ​ ​ BALANCE — December 31, 2023 ​ 1,662 ​ ​ (12,996) ​ ​ (11,334) ​ ​ ​ ​ ​ ​ ​ ​ ​ Other comprehensive income (loss) 5,884 ​ ​ (9,224) ​ ​ (3,340) Income taxes (341) ​ ​ 54 ​ ​ (287) Reclassifications to: ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ (2,140) ​ ​ ​ ​ ​ (2,140) Cost of sales ​ (644) ​ ​ ​ ​ ​ (644) Interest expense ​ (1,656) ​ ​ ​ ​ ​ (1,656) Net other comprehensive income (loss) ​ 1,103 ​ ​ (9,170) ​ ​ (8,067) ​ ​ ​ ​ ​ ​ ​ ​ ​ BALANCE — December 31, 2024 $ 2,765 ​ $ (22,166) ​ $ (19,401) ​

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Schedule of Consolidated Balance Sheet Information and Supplemental Information	The following was included in our consolidated balance sheet as of December 31, 2024 and 2023 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ 2024 2023 Assets ​ ​ ROU operating lease assets ​ $ 65,508 ​ $ 63,047 ​ ​ ​ ​ ​ ​ ​ Liabilities ​ ​ Short-term operating lease liabilities ​ $ 10,331 ​ $ 12,087 Long-term operating lease liabilities ​ 54,783 ​ 56,259 Total operating lease liabilities ​ $ 65,114 ​ $ 68,346
Components of Lease Costs	We recognize lease expense for operating leases on a straight-line basis over the term of the lease. Net lease cost for the years ended December 31, 2024, 2023 and 2022 was $15.4 million, $14.4 million, and $13.8 million, respectively. The components of lease costs for the years ended December 31, 2024, 2023 and 2022 were as follows, in thousands: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Lease Cost ​ Classification ​ 2024 ​ 2023 ​ 2022 Operating lease cost (a) Selling, general and administrative expenses ​ $ 15,885 ​ $ 14,879 ​ $ 14,219 Sublease (income) (b) Selling, general and administrative expenses ​ (462) ​ (488) ​ (409) Net lease cost ​ $ 15,423 ​ $ 14,391 ​ $ 13,810 ​ (a) Includes expense related to short-term leases and variable payments, which were not significant. (b) Does not include rental revenue from leases of hardware consoles to customers, which was not significant. Supplemental cash flow information for the years ended December 31, 2024, 2023 and 2022 was as follows, in thousands: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 ​ 2023 ​ 2022 Cash paid for amounts included in the measurement of lease liabilities ​ $ 14,529 ​ $ 13,804 ​ $ 13,710 Right-of-use assets obtained in exchange for lease obligations ​ $ 9,947 ​ $ 8,891 ​ $ 11,130 ​ Generally, our lease agreements do not specify an implicit rate. Therefore, we estimate our incremental borrowing rate, which is defined as the interest rate we would pay to borrow on a collateralized basis, considering such factors as length of lease term and the risks of the economic environment in which the leased asset operates. As of December 31, 2024, 2023 and 2022, our lease agreements had the following remaining lease term and discount rates: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2024 ​ ​ 2023 ​ ​ 2022 Weighted average remaining lease term ​ 9.6 years ​ ​ 9.6 years ​ ​ 10.4 years Weighted average discount rate ​ 3.5% ​ ​ 3.4% ​ ​ 3.4%
Maturities of Operating Lease Liabilities	As of December 31, 2024, maturities of operating lease liabilities were as follows, in thousands: ​ ​ ​ ​ Year ending December 31, Amounts due under operating leases 2025 ​ $ 11,915 2026 ​ 10,067 2027 ​ 8,726 2028 ​ 6,948 2029 ​ 6,258 Thereafter ​ 32,692 Total lease payments ​ 76,606 Less: Imputed interest ​ (11,492) Total ​ $ 65,114 ​

Organization and Summary of S_4

Organization and Summary of Significant Accounting Policies - Organization (Details)	12 Months Ended
	Dec. 31, 2024 segment item
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of Operating Segments | segment	2
Number of Product Categories | item	5

Organization and Summary of S_5

Organization and Summary of Significant Accounting Policies - Cash and Cash Equivalents (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Cash and Cash Equivalents
Restricted cash	$ 2.1	$ 2.1
Restricted Cash, Current, Statement of Financial Position [Extensible Enumeration]	Prepaid Expense and Other Assets, Current	Prepaid Expense and Other Assets, Current

Organization and Summary of S_6

Organization and Summary of Significant Accounting Policies - Goodwill and Intangible Assets (Details) $ in Millions	12 Months Ended
	Dec. 31, 2024 USD ($) segment	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Reporting units | segment	4
Impairment of intangible assets | $	$ 0	$ 0	$ 1.7
Impairment, Intangible Asset, Finite-Lived, Statement of Income or Comprehensive Income [Extensible Enumeration]			Asset Impairment Charges

Organization and Summary of S_7

Organization and Summary of Significant Accounting Policies - Property and Equipment (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Depreciation	$ 37.2	$ 34	$ 33.4
Buildings
Property, Plant and Equipment [Line Items]
Useful life	40 years
Manufacturing equipment | Minimum
Property, Plant and Equipment [Line Items]
Useful life	4 years
Manufacturing equipment | Maximum
Property, Plant and Equipment [Line Items]
Useful life	20 years
Furniture and fixtures | Minimum
Property, Plant and Equipment [Line Items]
Useful life	3 years
Furniture and fixtures | Maximum
Property, Plant and Equipment [Line Items]
Useful life	20 years
Land improvements | Minimum
Property, Plant and Equipment [Line Items]
Useful life	10 years
Land improvements | Maximum
Property, Plant and Equipment [Line Items]
Useful life	20 years
Leasehold improvements | Minimum
Property, Plant and Equipment [Line Items]
Useful life	4 years
Leasehold improvements | Maximum
Property, Plant and Equipment [Line Items]
Useful life	25 years

Organization and Summary of S_8

Organization and Summary of Significant Accounting Policies - Deferred Compensation (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Cash surrender value of life insurance	$ 20,700	$ 18,300
Deferred compensation cost	$ 19,197	$ 17,167

Organization and Summary of S_9

Organization and Summary of Significant Accounting Policies - Other Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Other Assets
Investments in privately held companies	$ 22,832	$ 19,061
Deferred compensation plan assets	20,716	18,309
Long-term notes receivable, net	9,423	3,241
Other	12,365	14,182
Total Other Assets	65,336	54,793
Payments to acquire additional equity investments	$ 3,800	$ 4,000	$ 1,400

Organization and Summary of _10

Organization and Summary of Significant Accounting Policies - Other Long-term Obligations (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Contingent consideration liabilities	$ 3,128	$ 3,039
Other long-term obligations	12,323	10,791
Total	$ 15,451	$ 13,830

Organization and Summary of _11

Organization and Summary of Significant Accounting Policies - Restructuring (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Restructuring charges	$ 3.1	$ 2.7	$ 7.2
Restructuring Charges, Statement of Income or Comprehensive Income [Extensible Enumeration]	Selling, General and Administrative Expense	Selling, General and Administrative Expense	Selling, General and Administrative Expense
Restructuring reserve balance	$ 1.1	$ 4.1

Organization and Summary of _12

Organization and Summary of Significant Accounting Policies - Stock Based Compensation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Allocated share-based compensation	$ 28,473	$ 21,333	$ 18,042

Revenues - Disaggregation of Re

Revenues - Disaggregation of Revenue (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) item segment	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Disaggregation of Revenue [Line Items]
Number of operating segments | segment	2
Number of product categories | item	5
Net sales	$ 1,356,514	$ 1,257,366	$ 1,150,981
United States
Disaggregation of Revenue [Line Items]
Net sales	800,780	726,989	650,559
International
Disaggregation of Revenue [Line Items]
Net sales	$ 555,734	530,377	500,422
Cardiovascular
Disaggregation of Revenue [Line Items]
Number of product categories | item	4
Net sales	$ 1,301,744	1,220,560	1,118,224
Cardiovascular | Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	552,168	502,220	439,810
Cardiovascular | Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	370,993	358,451	343,186
Cardiovascular | Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	201,201	195,333	190,194
Cardiovascular | OEM
Disaggregation of Revenue [Line Items]
Net sales	177,382	164,556	145,034
Cardiovascular | United States
Disaggregation of Revenue [Line Items]
Net sales	748,944	692,603	619,960
Cardiovascular | United States | Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	331,514	299,313	263,602
Cardiovascular | United States | Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	147,992	143,755	128,711
Cardiovascular | United States | Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	122,330	114,010	108,778
Cardiovascular | United States | OEM
Disaggregation of Revenue [Line Items]
Net sales	147,108	135,525	118,869
Cardiovascular | International
Disaggregation of Revenue [Line Items]
Net sales	552,800	527,957	498,264
Cardiovascular | International | Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	220,654	202,907	176,208
Cardiovascular | International | Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	223,001	214,696	214,475
Cardiovascular | International | Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	78,871	81,323	81,416
Cardiovascular | International | OEM
Disaggregation of Revenue [Line Items]
Net sales	30,274	29,031	26,165
Endoscopy
Disaggregation of Revenue [Line Items]
Net sales	54,770	36,806	32,757
Endoscopy | Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	54,770	36,806	32,757
Endoscopy | United States | Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	51,836	34,386	30,599
Endoscopy | International | Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	$ 2,934	$ 2,420	$ 2,158

Acquisitions and Other Strate_3

Acquisitions and Other Strategic Transactions - Cook Medical, LLC (Details) - Cook Medical - USD ($) $ in Millions		12 Months Ended
	Nov. 01, 2024	Dec. 31, 2024
Asset Acquisition [Line Items]
Total purchase price	$ 210
Net sales related to acquisition		$ 5.5
Acquisition-related costs		$ 5.4
Weighted Average
Asset Acquisition [Line Items]
Amortization period	10 years 3 months 18 days
Developed technology
Asset Acquisition [Line Items]
Amortization period	10 years
Trademarks
Asset Acquisition [Line Items]
Amortization period	12 years
Customer Lists
Asset Acquisition [Line Items]
Amortization period	12 years

Acquisitions and Other Strate_4

Acquisitions and Other Strategic Transactions - EGS Purchase Agreement (Details) - EGS - USD ($) $ in Millions		6 Months Ended	12 Months Ended
	Jul. 01, 2024	Dec. 31, 2024	Dec. 31, 2024
Asset Acquisition [Line Items]
Purchase price	$ 105
Net sales related to acquisition		$ 14.4
Acquisition-related costs			$ 3.4
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 Other Strate_5

Acquisitions and Other Strategic Transactions - 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 Other Strate_6

Acquisitions and Other Strategic Transactions - Angio Dynamics, Inc (Details) - Angio Dynamics Inc - USD ($) $ in Thousands		12 Months Ended
	Jun. 08, 2023	Dec. 31, 2024	Dec. 31, 2023
Asset Acquisition [Line Items]
Total purchase price	$ 100,000
Net sales related to acquisition		$ 26,900	$ 14,400
Acquisition-related costs			$ 4,900
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 Other Strate_7

Acquisitions and Other Strategic Transactions - Bluegrass Vascular Technologies (Details) - USD ($) $ in Millions	May 04, 2023	May 03, 2023
Bluegrass Vascular Technologies, Inc
Business Acquisition [Line Items]
Total purchase price	$ 32.7
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		$ 0.2

Acquisitions and Other Strate_8

Acquisitions and Other Strategic Transactions - Advanced Radiation Therapy (Details) - Advanced Radiation Therapy, LLC $ in Millions	May 01, 2023 USD ($)
Asset Acquisition [Line Items]
Purchase price	$ 0.8
Payment period	30 days
Acquired in-process research and development expense	$ 1.5
First Payment
Asset Acquisition [Line Items]
Deferred payment	0.5
Second Payment
Asset Acquisition [Line Items]
Deferred payment	$ 0.8

Acquisitions and Other Strate_9

Acquisitions and Other Strategic Transactions - BioTrace (Details) - BioTrace $ in Millions	Oct. 03, 2022 USD ($) item
Asset Acquisition [Line Items]
Purchase price | $	$ 2.5
Number of annual payments | item	6
Minimum
Asset Acquisition [Line Items]
Net sales revenue (as a percent)	5%
Maximum
Asset Acquisition [Line Items]
Net sales revenue (as a percent)	10%
Developed technology
Asset Acquisition [Line Items]
Amortization period	10 years

Acquisitions and Other Strat_10

Acquisitions and Other Strategic Transactions - Restore Endosystems (Details) - Restore Endosystems $ in Millions	Apr. 30, 2022 USD ($)
Asset Acquisition [Line Items]
Purchase price	$ 3
Additional payments upon the achievement of specified milestones	3.5
In-process technology
Asset Acquisition [Line Items]
Acquired intangible assets	6.5
First Payment
Asset Acquisition [Line Items]
Additional payments upon the achievement of specified milestones	$ 2
Payment period	2 years
Second Payment
Asset Acquisition [Line Items]
Additional payments upon the achievement of specified milestones	$ 2
Payment period	4 years

Acquisitions and Other Strat_11

Acquisitions and Other Strategic Transactions - Purchase Price Allocation (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Nov. 01, 2024	Jul. 01, 2024	Dec. 31, 2023	Jun. 08, 2023	May 04, 2023	Dec. 31, 2022
Assets Acquired
Goodwill	$ 463,511			$ 382,240			$ 359,821
Cook Medical
Assets Acquired
Goodwill		$ 65,897
Total assets acquired		210,197
Liabilities Assumed
Accrued expenses		197
Total liabilities assumed		197
Total net assets acquired		210,000
Cook Medical | Developed technology
Assets Acquired
Intangible assets		126,100
Cook Medical | Trademarks
Assets Acquired
Intangible assets		7,100
Cook Medical | Customer Lists
Assets Acquired
Intangible assets		$ 11,100
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
Property and equipment			72,800
EGS | Trademarks
Assets Acquired
Property and equipment			5,400
EGS | Customer Lists
Assets Acquired
Property and equipment			$ 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 | Trade Names
Assets Acquired
Intangible assets					4,000
Angio Dynamics Inc | Customer Lists
Assets Acquired
Intangible assets					$ 5,800
Bluegrass Vascular Technologies, Inc
Assets Acquired
Inventories						$ 175
Goodwill						3,898
Liabilities Assumed
Total net assets acquired						32,973
Bluegrass Vascular Technologies, Inc | Developed technology
Assets Acquired
Intangible assets						28,000
Bluegrass Vascular Technologies, Inc | Trade Names
Assets Acquired
Intangible assets						$ 900

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Finished goods	$ 168,437	$ 158,893
Work-in-process	27,114	25,420
Raw materials	110,512	119,558
Total Inventories	$ 306,063	$ 303,871

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Goodwill [Roll Forward]
Goodwill balance at beginning of period	$ 382,240	$ 359,821
Effect of foreign exchange	(1,623)	883
Additions and adjustments as the result of acquisitions	82,894	21,536
Goodwill balance at end of period	463,511	382,240
Cardiovascular
Goodwill [Roll Forward]
Goodwill balance at beginning of period	382,240	359,821
Effect of foreign exchange	(1,623)	883
Additions and adjustments as the result of acquisitions	65,897	21,536
Goodwill balance at end of period	446,514	$ 382,240
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	Dec. 31, 2024	Dec. 31, 2023
Other
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 151,842	$ 118,771
Accumulated Amortization	(85,343)	(76,887)
Net Carrying Amount	66,499	41,884
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	31,489	28,877
Accumulated Amortization	(12,824)	(10,916)
Net Carrying Amount	18,665	17,961
Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	3,250	3,250
Accumulated Amortization	(2,994)	(2,919)
Net Carrying Amount	256	331
License agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	11,557	11,142
Accumulated Amortization	(9,125)	(8,327)
Net Carrying Amount	2,432	2,815
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	47,613	35,135
Accumulated Amortization	(24,177)	(20,804)
Net Carrying Amount	23,436	14,331
Customer Lists
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	57,933	40,367
Accumulated Amortization	(36,223)	(33,921)
Net Carrying Amount	$ 21,710	$ 6,446

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Accumulated goodwill impairment losses	$ 8.3	$ 8.3
Goodwill impairment loss	0	0	$ 0
Aggregate amortization expense	$ 65.6	$ 56.1	$ 48.4

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Future Amortization Expense (Details) $ in Thousands	Dec. 31, 2024 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2025	$ 83,747
2026	73,155
2027	69,188
2028	67,790
2029	$ 56,115

Income Taxes - Domestic and For

Income Taxes - Domestic and Foreign (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Domestic	$ 93,687	$ 60,935	$ 77,562
Foreign	56,306	51,154	5,067
Income before income taxes	$ 149,993	$ 112,089	$ 82,629

Income Taxes - Components of In

Income Taxes - Components of Income Tax Expense (Benefit) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Current expense:
Federal	$ 26,061	$ 15,684	$ 9,584
State	5,286	3,775	3,162
Foreign	13,162	10,862	10,291
Total current expense	44,509	30,321	23,037
Deferred expense (benefit):
Federal	(12,609)	(11,030)	(10,438)
State	(1,421)	(1,699)	(3,615)
Foreign	(843)	86	(871)
Total deferred benefit	(14,873)	(12,643)	(14,924)
Total income tax expense	$ 29,636	$ 17,678	$ 8,113

Income Taxes - Effective Income

Income Taxes - Effective Income Tax Rate Reconciliation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Statutory federal rate (as a percent)	21%	21%	21%
Computed federal income tax expense (benefit) at applicable statutory rate of 21%	$ 31,499	$ 23,539	$ 17,352
State income tax expense	3,081	1,627	35
Tax credits	(3,004)	(2,412)	(1,978)
Tax effect of international items	(1,870)	(3,994)	(10,698)
Uncertain tax positions	218	4	(47)
Deferred compensation insurance assets	(535)	(548)	706
Stock-based compensation	(1,817)	(3,001)	(3,423)
Valuation allowance		(90)	3,523
Remeasurement of state deferred taxes		(73)	(375)
Non-deductible expenses	2,454	2,101	2,027
Remeasurement of contingent consideration liabilities	108	317	1,061
Other - including the effect of graduated rates	(498)	208	(70)
Total income tax expense	$ 29,636	$ 17,678	$ 8,113

Income Taxes - Deferred Tax Ass

Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Deferred income tax assets:
Allowance for credit losses on trade receivables	$ 2,215	$ 2,009
Accrued compensation expense	11,701	10,285
Inventory differences	5,139	5,477
Net operating loss carryforwards	8,320	10,007
Stock-based compensation expense	7,569	7,913
Operating lease assets	11,586	11,331
State R&D tax credits	5,924	5,237
IRC section 174 capitalized R&D	35,200	26,370
Other	10,759	10,159
Total deferred income tax assets	98,413	88,788
Deferred income tax liabilities:
Prepaid expenses	(1,277)	(1,123)
Property and equipment	(22,699)	(23,539)
Intangible assets	(29,440)	(34,613)
Foreign withholding tax	(1,681)	(2,005)
Operating lease liabilities	(11,737)	(10,129)
Other	(1,632)	(1,898)
Total deferred income tax liabilities	(68,466)	(73,307)
Valuation allowance	(14,143)	(13,740)
Net deferred income tax assets	15,804	1,741
Reported as:
Deferred income tax assets	16,044	7,288
Deferred income tax liabilities	(240)	(5,547)
Net deferred income tax assets	$ 15,804	$ 1,741

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Increase (Decrease) in valuation allowance	$ 400,000	$ 200,000	$ 2,700,000
Foreign withholding tax	700,000	400,000	300,000
Tax benefit from restructuring of foreign entities			4,300,000
Unrecognized tax benefits including interest and penalties	2,100,000	1,900,000
Unrecognized tax benefits that would impact effective rate	2,100,000	1,900,000
Accrued interest and penalties	200,000	300,000
Increase (decrease) of uncertain tax benefits related to certain liabilities for unrecognized tax benefits	(52,000)	$ (46,000)	$ 14,000
Estimated increase in unrecognized tax liability in next twelve months	100,000
Domestic
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Net operating loss carryforwards	19,800,000
Operating loss carryforward, expiring	$ 19,800,000
Period to utilize the net operating loss carryforwards	11 years
NOL carryforward used in period	$ 4,800,000
Foreign
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Operating loss carryforward, expiring	1,700,000
Operating loss carryforward, no expiration	19,200,000
Foreign operating loss carryforwards	$ 20,900,000

Income Taxes - Summary of Incom

Income Taxes - Summary of Income Tax Contingencies (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Unrecognized tax benefits, opening balance	$ 1,622	$ 1,576	$ 1,635
Gross increases in tax positions taken in a prior year	70	112
Gross decreases in tax positions taken in a prior year			(10)
Gross increases in tax positions taken in the current year	559	442	294
Lapse of applicable statute of limitations	(371)	(508)	(343)
Unrecognized tax benefits, ending balance	$ 1,880	$ 1,622	$ 1,576

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Payroll and related liabilities	$ 73,514	$ 66,929
Current portion of contingent liabilities	358	408
Advances from employees	158	285
Accrued rebates payable	11,778	11,005
Accrued interest	9,531	1,556
Other accrued expenses	38,738	40,264
Total	$ 134,077	$ 120,447

Debt - Principal Balances under

Debt - Principal Balances under Long-term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Long-term debt	$ 747,500
Less unamortized debt issuance costs	(17,949)	$ (23,550)
Total long-term debt	729,551	823,013
Long-term portion	729,551	823,013
Term Loan
Debt Instrument [Line Items]
Long-term debt		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	Dec. 31, 2024 USD ($)
Debt Disclosure [Abstract]
2029	$ 747,500
Total future minimum principal payments	$ 747,500

Debt - Financial Covenants (Det

Debt - Financial Covenants (Details) - Credit Agreement	12 Months Ended
	Dec. 31, 2024
Debt Instrument [Line Items]
Consolidated Total Net Leverage Ratio	5
Consolidated Senior Secured Net Leverage Ratio	3
Consolidated Interest Coverage Ratio	3

Debt - Narrative (Details)

Debt - Narrative (Details)	1 Months Ended	12 Months Ended
	Dec. 31, 2023 USD ($) $ / shares $ / derivative shares	Dec. 31, 2023 USD ($) $ / shares $ / derivative	Dec. 31, 2024 USD ($)	Jun. 06, 2023 USD ($)
Debt Instrument [Line Items]
Outstanding borrowings			$ 747,500,000
Number of consecutive days last reported sales price exceeding the percentage of conversion price for redemption		30 days
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
Credit Agreement
Debt Instrument [Line Items]
Outstanding borrowings	$ 99,100,000	$ 99,100,000	0
Letter of credit guarantees	$ 2,700,000	$ 2,700,000	2,900,000
Available borrowing capacity			$ 697,000,000
Fixed interest rate percent	3.39%	3.39%
Debt subject to fixed interest rate	$ 75,000,000	$ 75,000,000
Variable interest rate percent	7.21%	7.21%
Debt subject to variable interest rate	$ 24,100,000	$ 24,100,000
Convertible debt
Debt Instrument [Line Items]
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
Term Loan
Debt Instrument [Line Items]
Outstanding borrowings	$ 99,063,000	$ 99,063,000
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%	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	$ 1,000
Senior unsecured convertible notes | Convertible debt | Call option
Debt Instrument [Line Items]
Cap price | $ / derivative	114.68	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

Derivatives - Narrative (Detail

Derivatives - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 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	$ 2.7
Amount expected to be reclassified from accumulated other comprehensive income to earnings (loss) in next twelve months, net of tax	$ 2.1
Interest rate swap | Designated as hedging instrument
Derivative [Line Items]
Fair value of derivative asset		$ 1.5
Deferred tax asset 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	Dec. 31, 2024	Dec. 31, 2023
Designated as hedging instrument | Derivatives designated as cash flow hedges
Derivative [Line Items]
Aggregate notional amount of derivative	$ 117.5	$ 141.1
Not designated as hedging instrument
Derivative [Line Items]
Aggregate notional amount of derivative	$ 95.7	$ 108.4

Derivatives - Fair Value of Der

Derivatives - Fair Value of Derivative Instruments (Details) - USD ($) $ in Thousands	Dec. 31, 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	$ 3,771	2,061
Designated as hedging instrument | Foreign currency forward contracts | Other assets (long-term)
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	1,064	216
Designated as hedging instrument | Foreign currency forward contracts | Accrued expenses
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(1,332)	(1,898)
Designated as hedging instrument | Foreign currency forward contracts | Other long-term obligations
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(287)	(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	2,595	828
Not designated as hedging instrument | Foreign currency forward contracts | Accrued expenses
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	$ (1,288)	$ (1,463)

Derivatives - Amount of Gain (L

Derivatives - Amount of Gain (Loss) Recognized in OCI and Income Statement (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	$ 1,444	$ (3,570)	$ 9,007
Interest expense	(31,219)	(15,511)	(6,339)
Net sales	1,356,514	1,257,366	1,150,981
Cost of sales	(713,181)	(673,494)	(631,882)
Derivatives designated as cash flow hedges | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	1,656	2,550	(12)
Derivatives designated as cash flow hedges | Revenue
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	2,140	4,081	3,583
Derivatives designated as cash flow hedges | Cost of sales
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	644	1,457	(1,436)
Derivatives designated as cash flow hedges | Interest rate swap
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	152	609	4,879
Derivatives designated as cash flow hedges | Foreign currency forward contracts
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	$ 5,732	$ 3,909	$ 6,263

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	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Derivative [Line Items]
Gain (loss) on derivative	$ 1,961	$ 2,004	$ 1,420
Derivative, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Other Nonoperating Income (Expense)	Other Nonoperating Income (Expense)	Other Nonoperating Income (Expense)

Commitments and Contingencies -

Commitments and Contingencies - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Cost of sales
Other Commitments [Line Items]
Royalty expense	$ 8.7	$ 8.6	$ 7.3

Earnings Per Common Share (EP_3

Earnings Per Common Share (EPS) - Basic EPS (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Earnings Per Share [Abstract]
Net income (loss)	$ 120,357	$ 94,411	$ 74,516
Average common shares outstanding (in shares)	58,218	57,593	56,806
Basic EPS (in dollars per share)	$ 2.07	$ 1.64	$ 1.31

Earnings Per Common Share (EP_4

Earnings Per Common Share (EPS) - Diluted EPS (Details) - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Earnings Per Share [Abstract]
Average common shares outstanding (in shares)	58,218	57,593	56,806
Effect of dilutive stock awards (in shares)	760	763	865
Effect of dilutive convertible notes (in Shares)	387
Total potential shares outstanding (in shares)	59,365	58,356	57,671
Diluted EPS (in dollars per share)	$ 2.03	$ 1.62	$ 1.29
Equity awards excluded as the impact was anti-dilutive (in shares)	672	1,143	1,438

Earnings Per Common Share (EP_5

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

Employee Stock Purchase Plan,_3

Employee Stock Purchase Plan, Stock Options and Warrants - Narrative (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted in period (in shares)	0	444	251
Compensation cost not yet recognized	$ 11
Compensation cost not yet recognized, period of recognition	1 year 8 months 12 days
Fair value of options, net of forfeitures		$ 13.1	$ 6.3
Options granted in period, weighted average grant date fair value (in dollars per share)		$ 29.58	$ 24.98
Stock-Settled Performance-Based Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
Compensation cost not yet recognized	$ 18.2
Compensation cost not yet recognized, period of recognition	1 year 8 months 12 days
Vested (in shares)	47	61	44
Stock-Settled Performance-Based Restricted Stock Units | rTSR | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Multiplying factor	75%
Stock-Settled Performance-Based Restricted Stock Units | rTSR | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Multiplying factor	125%
Cash-Settled Performance-Based Share-Based Awards (Liability Awards)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
Target cash incentive	$ 1.6	$ 1.3	$ 1
Liabilities associated with awards	5.1
Compensation cost not yet recognized	$ 3.6
Compensation cost not yet recognized, period of recognition	1 year 8 months 12 days
Amount paid in connection with liability awards	$ 1.3	1.7	0.8
Forfeited (in shares)	0
Cash-Settled Performance-Based Share-Based Awards (Liability Awards) | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Target cash incentive	$ 4.7	$ 4.3	$ 2.5
Multiplying factor	250%
Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Compensation cost not yet recognized	$ 23.4
Compensation cost not yet recognized, period of recognition	3 years 7 months 6 days
Vested (in shares)	20	31	26
Restricted Stock Units | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	1 year
Restricted Stock Units | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	4 years
2018 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for grant (in shares)	3,026
2018 Incentive Plan | Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period	7 years
2018 Incentive Plan | Employee Stock Option | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
2018 Incentive Plan | Employee Stock Option | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	5 years
ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Purchase price for ESPP, percent of market price	95%
Shares available for grant (in shares)	74

Employee Stock Purchase Plan,_4

Employee Stock Purchase Plan, Stock Options and Warrants - Allocation of Recognized Period Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 28,473	$ 21,333	$ 18,042
Cost of sales | Employee Stock Option
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	1,229	1,647	1,606
Research and development | Employee Stock Option
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	1,522	1,739	1,789
Selling, general and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	25,722	17,947	14,647
Selling, general and administrative | Employee Stock Option
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	6,206	7,542	7,305
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	12,517	6,344	3,509
Selling, general and administrative | Restricted Stock Units
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	4,279	1,771	1,836
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	$ 2,720	$ 2,290	$ 1,997

Employee Stock Purchase Plan,_5

Employee Stock Purchase Plan, Stock Options and Warrants - Option Granted Fair Value Calculation Assumptions (Details)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected dividend yield	0%	0%
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum		3.60%	1.40%
Risk-free interest rate, maximum		4.80%	4.30%
Expected option term / Performance Period		4 years	4 years
Expected price volatility, minimum		39.60%	46.20%
Expected price volatility, maximum		47.10%	47.50%

Employee Stock Purchase Plan,_6

Employee Stock Purchase Plan, Stock Options and Warrants - Stock Option Activity (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Payment Arrangement [Abstract]
Total intrinsic value of stock options exercised	$ 36,431	$ 23,300	$ 27,110
Cash received from stock option exercises	39,746	14,503	18,952
Excess tax benefit from the exercise of stock options	$ 1,817	$ 3,001	$ 3,423
Number of Shares
Beginning balance (in shares)	2,868
Exercised (in shares)	(824)
Forfeited/expired (in shares)	(21)
Outstanding at December 31 (in shares)	2,023	2,868
Exercisable (in shares)	1,411
Ending vested and expected to vest (in shares)	1,997
Weighted Average Exercise Price
Beginning balance (in dollars per share)	$ 56.39
Exercised (in dollars per share)	48.21
Forfeited/expired (in dollars per share)	66.61
Outstanding at December 31 (in dollars per share)	59.62	$ 56.39
Exercisable (in dollars per share)	55.87
Ending vested and expected to vest (in dollars per share)	$ 59.49
Outstanding, remaining contractual term	3 years 18 days
Exercisable, remaining contractual term	2 years 4 months 6 days
Ending vested and expected to vest, remaining contractual term	3 years 7 days
Outstanding, intrinsic value	$ 75,055
Exercisable, intrinsic value	57,639
Ending vested and expected to vest, intrinsic value	$ 74,372

Employee Stock Purchase Plan,_7

Employee Stock Purchase Plan, Stock Options and Warrants - Changes in PSUs and RSUs (Details) - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Stock-Settled Performance-Based Restricted Stock Units
Stock Units
Beginning balance (in shares)	355
Granted (in shares)	287
Vested (in shares)	(47)	(61)	(44)
Balance at December 31 (in shares)	595	355
Weighted Average Grant Date Fair Value
Beginning balance (in dollars per share)	$ 71.15
Granted (in dollars per share)	86.79	$ 72.26	$ 64.54
Vested (in dollars per share)	76.51
Balance at December 31 (in dollars per share)	$ 82.33	$ 71.15
Stock-Settled Performance-Based Restricted Stock Units | Target units granted
Stock Units
Granted (in shares)	144	115	48
Stock-Settled Performance-Based Restricted Stock Units | Maximum units granted
Stock Units
Granted (in shares)	287	229	97
Stock-Settled Performance-Based Restricted Stock Units | Maximum potential shares
Stock Units
Granted (in shares)	359	287	121
Stock-Settled Performance-Based Restricted Stock Units | rTSR | Minimum
Stock Units
Multiplying factor	75%
Stock-Settled Performance-Based Restricted Stock Units | rTSR | Maximum
Stock Units
Multiplying factor	125%
Restricted Stock Units
Stock Units
Beginning balance (in shares)	20
Granted (in shares)	329	20	31
Vested (in shares)	(20)	(31)	(26)
Balance at December 31 (in shares)	329	20
Weighted Average Grant Date Fair Value
Beginning balance (in dollars per share)	$ 83.99
Granted (in dollars per share)	90.54	$ 83.99	$ 59.02
Vested (in dollars per share)	83.99
Balance at December 31 (in dollars per share)	$ 90.54	$ 83.99

Employee Stock Purchase Plan,_8

Employee Stock Purchase Plan, Stock Options and Warrants - PSUs Fair Value Calculation Assumptions (Details)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected dividend yield	0%	0%
Stock-Settled Performance-Based Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum		3.90%	1.60%
Risk-free interest rate, maximum		4.60%	2.70%
Risk-free interest rate	4.40%
Expected option term / Performance Period	2 years 9 months 18 days	2 years 9 months 18 days
Expected price volatility, minimum		31.40%	38.50%
Expected price volatility, maximum		32.60%	46.20%
Expected price volatility	31.10%
Stock-Settled Performance-Based Restricted Stock Units | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected option term / Performance Period			2 years 7 months 6 days
Stock-Settled Performance-Based Restricted Stock Units | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected option term / Performance Period			2 years 9 months 18 days

Segment Reporting and Foreign_3

Segment Reporting and Foreign Operations - Narrative (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) item segment	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Segment Reporting Information [Line Items]
Number of operating segments | segment	2
Number of Product Categories | item	5
Net sales	$ 1,356,514	$ 1,257,366	$ 1,150,981
International
Segment Reporting Information [Line Items]
Net sales	$ 555,734	$ 530,377	$ 500,422
International | Sales Revenue | Geographic Concentration
Segment Reporting Information [Line Items]
Concentration for geographic sales	41%	42.20%	43.50%
CHINA
Segment Reporting Information [Line Items]
Net sales	$ 149,800	$ 147,300	$ 149,300
Cardiovascular
Segment Reporting Information [Line Items]
Number of Product Categories | item	4
Net sales	$ 1,301,744	1,220,560	1,118,224
Cardiovascular | International
Segment Reporting Information [Line Items]
Net sales	$ 552,800	$ 527,957	$ 498,264

Segment Reporting and Foreign_4

Segment Reporting and Foreign Operations - Long-lived Assets by Geographic Area (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	$ 386,165	$ 383,523	$ 382,976
United States
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	271,734	273,105	281,290
Ireland
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	45,325	42,333	40,749
Other foreign countries
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	$ 69,106	$ 68,085	$ 60,937

Segment Reporting and Foreign_5

Segment Reporting and Foreign Operations - Operating Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Segment Reporting Information [Line Items]
Net sales	$ 1,356,514	$ 1,257,366	$ 1,150,981
Selling, general and administrative expenses	399,731	373,676	342,525
Income from operations	155,693	123,944	87,563
Total other expense - net	(5,700)	(11,855)	(4,934)
Income before income taxes	149,993	112,089	82,629
Cardiovascular
Segment Reporting Information [Line Items]
Net sales	1,301,744	1,220,560	1,118,224
Cost of sales standard	549,657	534,826	496,678
Cost of sales other	140,948	125,388	121,045
Selling, general and administrative expenses	376,734	362,082	332,012
Research and development expenses	83,812	80,300	74,042
Other operating expenses	443	3,524	13,501
Income from operations	150,150	114,440	80,946
Endoscopy
Segment Reporting Information [Line Items]
Net sales	54,770	36,806	32,757
Cost of sales standard	15,746	12,987	12,739
Cost of sales other	6,830	293	1,420
Selling, general and administrative expenses	22,997	11,594	10,513
Research and development expenses	3,654	2,428	1,468
Income from operations	$ 5,543	$ 9,504	$ 6,617

Segment Reporting and Foreign_6

Segment Reporting and Foreign Operations - Assets, Depreciation, Amortization and Capital Expenditures (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Segment Reporting, Asset Reconciling Item [Line Items]
Depreciation and amortization	$ 102,709	$ 89,985	$ 81,804
Cardiovascular
Segment Reporting, Asset Reconciling Item [Line Items]
Depreciation and amortization	97,749	88,960	80,777
Endoscopy
Segment Reporting, Asset Reconciling Item [Line Items]
Depreciation and amortization	$ 4,960	$ 1,025	$ 1,027

Employee Benefit Plans (Details

Employee Benefit Plans (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Defined Contribution Plan [Abstract]
Total expense for contributions made	$ 9.6	$ 8.8	$ 7.7

Fair Value Measurements - Finan

Fair Value Measurements - Financial Assets and (Liabilities) Carried at Fair Value (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liabilities	$ (3,128)	$ (3,039)
Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market funds	10,034
Marketable securities	92	78
Fair Value, Measurements, Recurring | 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	7,430	3,105
Foreign currency contract liabilities, current and long-term	(2,907)	(3,860)
Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liabilities	(3,486)	(3,447)
Estimate of Fair Value, Fair Value Disclosure | Fair Value, Measurements, Recurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market funds	10,034
Marketable securities	92	78
Interest rate contract asset, current		1,503
Foreign currency contract assets, current and long-term	7,430	3,105
Foreign currency contract liabilities, current and long-term	(2,907)	(3,860)
Contingent consideration liabilities	$ (3,486)	$ (3,447)

Fair Value Measurements - Liabi

Fair Value Measurements - Liability Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - Contingent Consideration - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 3,447	$ 18,073
Contingent consideration expense	$ 443	$ 1,704
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
Contingent payments made	$ (404)	$ (16,330)
Ending balance	$ 3,486	$ 3,447

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 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, Operating activities	$ 100	$ 12,800
Impairment of intangible assets	0	0	$ 1,700
Impairment, Intangible Asset, Finite-Lived, Statement of Income or Comprehensive Income [Extensible Enumeration]			Asset Impairment Charges
Impairment of equity method investment	0
Investments in privately held companies	22,832	19,061
Long-term notes receivable, net	9,423	3,241
Allowance for expected credit losses	1,366	568	$ 281
Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Convertible debt	945,600
XableCath
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of equity method investment			500
Bluegrass Vascular Technologies, Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of equity method investment		300
Selio
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Long-term notes receivable, net	9,400	3,200
Allowance for expected credit losses	1,400	600
Director | Cianna Medical
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent payments related to acquisition		900	$ 1,600
Other long-term obligations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability, noncurrent	3,100	3,000
Accrued expenses
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability, current	$ 400	$ 400

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value Inputs, Liabilities, Quantitative Information (Details) $ in Thousands	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	$ 3,128	$ 3,039
Revenue-based royalty | Fair Value, Inputs, Level 3
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	2,217	2,945
Revenue milestones | Fair Value, Inputs, Level 3
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	88	93
Regulatory approval | Fair Value, Inputs, Level 3
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	$ 1,181	$ 409
Discount rate | Revenue-based royalty | Minimum | Discounted Cash Flow | Fair Value, Inputs, Level 3
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.14	0.12
Discount rate | Revenue-based royalty | Maximum | Discounted Cash Flow | Fair Value, Inputs, Level 3
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.16	16
Discount rate | Revenue-based royalty | Weighted Average | Discounted Cash Flow | Fair Value, Inputs, Level 3
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.146	0.146
Discount rate | Revenue milestones | Minimum | Discounted Cash Flow | Fair Value, Inputs, Level 3
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.13	0.13
Discount rate | Regulatory approval | Discounted Cash Flow | Fair Value, Inputs, Level 3
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.06	5.5
Probability of milestone payment | Regulatory approval | Discounted Cash Flow | Fair Value, Inputs, Level 3
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.50	0.50

Fair Value Measurements - Allow

Fair Value Measurements - Allowance for Credit Losses (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 568	$ 281
Provision for credit loss expense	798	287
Ending balance	$ 1,366	$ 568

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive Income (Loss) - Changes in AOCI (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Accumulated other comprehensive income (loss)
Beginning balance	$ 1,202,000	$ 1,144,397	$ 1,039,799
Reclassifications to:
Revenue	1,356,514	1,257,366	1,150,981
Cost of sales	(713,181)	(673,494)	(631,882)
Interest expense	(31,219)	(15,511)	(6,339)
Ending balance	1,379,359	1,202,000	1,144,397
Accumulated Other Comprehensive Loss
Accumulated other comprehensive income (loss)
Beginning balance	(11,334)	(11,550)	(7,991)
Other comprehensive income (loss)	(3,340)	7,477	651
Income taxes	(287)	827	(2,075)
Reclassifications to:
Net other comprehensive income (loss)	(8,067)	216	(3,559)
Ending balance	(19,401)	(11,334)	(11,550)
Accumulated Other Comprehensive Loss | Reclassification out of Accumulated Other Comprehensive Income
Reclassifications to:
Revenue	(2,140)	(4,081)	(3,583)
Cost of sales	(644)	(1,457)	1,436
Interest expense	(1,656)	(2,550)	12
Cash Flow Hedges
Accumulated other comprehensive income (loss)
Beginning balance	1,662	4,366	(2,464)
Other comprehensive income (loss)	5,884	4,518	11,142
Income taxes	(341)	866	(2,177)
Reclassifications to:
Net other comprehensive income (loss)	1,103	(2,704)	6,830
Ending balance	2,765	1,662	4,366
Cash Flow Hedges | Reclassification out of Accumulated Other Comprehensive Income
Reclassifications to:
Revenue	(2,140)	(4,081)	(3,583)
Cost of sales	(644)	(1,457)	1,436
Interest expense	(1,656)	(2,550)	12
Foreign Currency Translation
Accumulated other comprehensive income (loss)
Beginning balance	(12,996)	(15,916)	(5,527)
Other comprehensive income (loss)	(9,224)	2,959	(10,491)
Income taxes	54	(39)	102
Reclassifications to:
Net other comprehensive income (loss)	(9,170)	2,920	(10,389)
Ending balance	$ (22,166)	$ (12,996)	$ (15,916)

Leases - Narrative (Details)

Leases - Narrative (Details)	12 Months Ended
	Dec. 31, 2024
Lessee, Lease, Description [Line Items]
Renewal term (up to)	15 years
Termination option (within)	1 year
Minimum
Lessee, Lease, Description [Line Items]
Remaining lease term	1 year
Maximum
Lessee, Lease, Description [Line Items]
Remaining lease term	25 years

Leases - Schedule of Consolidat

Leases - Schedule of Consolidated Balance Sheet Information (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Leases [Abstract]
ROU operating lease assets	$ 65,508	$ 63,047
Short-term operating lease liabilities	10,331	12,087
Long-term operating lease liabilities	54,783	56,259
Total operating lease liabilities	$ 65,114	$ 68,346

Leases - Components of Lease Co

Leases - Components of Lease Cost (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Operating lease cost	$ 15,885	$ 14,879	$ 14,219
Sublease (income)	(462)	(488)	(409)
Net lease cost	$ 15,423	$ 14,391	$ 13,810

Leases - Supplemental Cash Flow

Leases - Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Cash paid for amounts included in the measurement of lease liabilities	$ 14,529	$ 13,804	$ 13,710
Right-of-use assets obtained in exchange for lease obligations	$ 9,947	$ 8,891	$ 11,130

Leases - Supplemental Disclosur

Leases - Supplemental Disclosure (Details)	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Weighted average remaining lease term	9 years 7 months 6 days	9 years 7 months 6 days	10 years 4 months 24 days
Weighted average discount rate	3.50%	3.40%	3.40%

Leases - Maturities of Operatin

Leases - Maturities of Operating Lease Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Leases [Abstract]
2025	$ 11,915
2026	10,067
2027	8,726
2028	6,948
2029	6,258
Thereafter	32,692
Total lease payments	76,606
Less: Imputed interest	(11,492)
Total	$ 65,114	$ 68,346

Schedule II - Valuation and q_2

Schedule II - Valuation and qualifying accounts (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Allowance for Doubtful Accounts
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Year	$ (9,023)	$ (8,423)	$ (6,767)
Additions Charged to Costs and Expenses	(1,425)	(1,772)	(1,858)
Deduction	719	1,172	202
Balance at End of Year	(9,729)	(9,023)	(8,423)
Tax Valuation Allowance
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Year	(13,740)	(13,527)	(10,786)
Additions Charged to Costs and Expenses	(403)	(213)	(2,741)
Balance at End of Year	$ (14,143)	$ (13,740)	$ (13,527)