PEN - Earnings call transcript Q3 2024

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Operator

Hello, good afternoon. My name is Jeremy, and I will be your conference operator today. At this time, I would like to welcome everyone to Penumbra's Third Quarter 2024 Conference Call. [Operator Instructions]. I would like to introduce Ms. Cecilia Furlong, Business Development and Investor Relations for Penumbra. Ms. your begin may you conference. Furlong,

Cecilia Furlong

A and Thank be website which us the includes all press viewed XXXX. joining a company GAAP reconciliation, the you today's you, third and call can tables, of for under operator, our on release to for earnings Investors at the on non-GAAP thank www.penumbrainc.com. discuss financial of copy to quarter release Penumbra's tab

safe of this XXXX, statements conference call, provisions will Securities company Private forward-looking the our and including financial for of with course the the implied pursuant including December performance, and trials, make trends. those uncertainties, filed Litigation to results compliance forward-looking the from XX, commercialization, referenced the quality, harbor XXXX, regarding Act certain materially the stated by our of clinical During Reform status, regulatory in year risks business those or ended XX-K could statements Actual SEC. differ our due to statements

otherwise. that caution stock. or undue statements the the results of XX-K review for a with our factors affect price including our SEC, you of to As more result of complete to market a as events, our risks the a future or revise future against other Penumbra and developments periodic you these we need reliance may forward-looking previously and encourage any forward-looking placing these result, filings disclaims we or statements, discussion on update our information, new mentioned,

$X $XX.X non-GAAP for of in XXXX are of third non-GAAP revenue million wind XXXX. expenses, in $XX.X a and will the guidance. With basis. down provide amortization, a business Yuen, press of update. Chief our the quarter income release. measures Non-GAAP of turn quarter quarter income stock in the IPR&D that, measures down discuss of of on quarter and Elsesser, XXXX the of GAAP quarter GAAP of taxes associated million XXXX acquisition Financial Maggie operating a the XXXX, financial posted the Jason operating over on operating third corresponding and reconciliation of On expenses expenses. Adam Executive of our expense, discuss million expenses, would are will acquired presented financial results in a our Chairman GAAP for for the and of wind EBITDA exclude XXXX our basis, I a like $X.X with operating adjusted call Strategy, Officer, results and provided of will the to excludes gross President The million, Penumbra's this are for our onetime Adjusted of our amortization Adam margin provision interest depreciation and and then Healthcare call, and Mills, to intangible Immersive while to and of business expense assets third related expenses financial third third income Vice CEO, Elsesser. income EBITDA to compensation the presented

Adam Elsesser

total Quarter Penumbra's constant afternoon. revenue a XX.X% In quarter, increase basis. of of and Conference Call. third Good you, currency Thank generated you million, a Cecilia. the on year-over-year joining we basis Third Thank a XX.X% $XXX representing for reported XXXX on

sequentially. and by Lightning million, $XXX.X CAVT portfolio, quarter by Bolt current Flash U.S. our strong XX.X% XX% XX% market to reflect year-over-year our with thrombectomy and and VTE U.S. delivering our revenue grew driven results Our growth thrombectomy year-over-year another X. third further of U.S. performance business, adoption of penetration Lightning franchise continued X.X

provide comprehensive Lightning X FDA on build enhance which increasingly and additional CAVT further The thrombectomy quarter, new balance perform these my XX, franchise to and in continued products, portfolio. Bolt the of out U.S. remarks. received clearance will I expectations. in products very well line our Lightning In our an prepared details XX with later for Bolt we CAVT

we Mark Lightning gross in trend the in and Lightning X our gross year-over-year. of XX.X% product positive non-GAAP the XX Bolt the basis efficiencies, quarter, to early to continued a income third of are CE XX phases we over expanding markets. to mid-September in XXX in third to continue improving margin operating up non-GAAP In the X.X received $XX.X transformative margin prior and the profitability margin outpace gross or margins up million XX% to and expansion year revenue with period, Flash to the The over technology for XX.X%, within shift for expansion operating operating path Behind European points addition, and of of quarter, introducing XX foreseeable future. and mix basis a see next months expect profile points of

Additionally, include expanding you before backed quarter, gross margins disciplined this our spend million impact by and the in revenue operating growth, $XX.X buyback. generated $XXX million we stock operating cash strong of

our our future. Within in the peripheral the increase X.X. cash of well Flash are consistently clots X.X quarter, to Lightning profitability blood flow We removes patients than considerably operating faster standout products. to positioned older and U.S. was the Flash VTE business, continue into all

blood older like procedure speed is longer feel Flash to return technology make technology blood to X.X, that there need the clots the X.X the they blood Flash now to no very physicians to compares loss. This loss patients. with favorably with other to remove takes Given significant enough of blood companies' much

ever continues market full procedure As technology strong quarter command our continue with reflect a gain Flash of September of physician and as representing latest third on results VTE the first highest result, we share. Flash its adoption X.X's market, our our in quarter VTE to interest, to volumes performance month

discharged a a patient Flash was being from a was the was by of procedure who for a of weeks was of the case pregnant with baby a and firefighters in speed treated privilege hospital. when and video had her X.X. X.X this the firefighter, her watching being XX a baby. of PE I the her saved serious she greeted line extremely evident quarter very PE speed The The of where Flash

with In XX VTE modulated proprietary addition, anatomy. the CAVT catheter strong a The Bolt venous received VTE. aspiration clearance by for smaller gone FDA technology engineered we Lightning validated well. our technology our have expands patients of X products Lightning address portfolio technology. combines clinical XX, to our Lightning of very parts Bolt expanding number we address latest-generation initial cases to designed of can size this outcomes CAVT And with the treat Bolt

we management. contributions focused other lytics products, demonstrated conversion in mechanical fourth expect comprehensive looking CAVT's from CAVT to and helping view While proposition the XXXX and accelerate value beyond, our we thrombectomy VTE increasingly modest portfolio, initial catheter and medical quarter,

procedure Bolt to continued to by in well Lightning Bolt further Our our of deliver perform Bolt our XX occlusions, introduction Lightning improved arterial reach CAVT's including catheters quarter. September benefits, FDA reduction the are the third arteries, advanced XX times below-the-knee where and U.S. led portion X, the in currently smaller technology expands to used arterial of treat CAV of legacy clearance business, in patients. to procedure will a a population. The patient efficiency of these

surgery XX arterial to quarter to the arterial over Bolt XX That expect to see of Similar the we Lightning XXX,XXX including CAVT open Bolt and of suffer conversion remain to in Bolt we opportunity fourth XX, X meaningful currently Despite a helping annually from early in a use said, we U.S. clot. arterial the CAVT approach or to from with accelerate technology. physician our as we portfolio, from computer-assisted focused endovascular-first patients significant lytics VTE proprietary stages for clot, the who treating date, progress and modest in commercialization. commence contributions the

Turning Neurovascular to the business.

Our team delivered performance another in double-digit stroke thrombectomy. solid

our SENDit we well by aspiration most prepare switched our XXX interest to wanes As neurovascular very technology of them and portfolio, XX bring RED to catheters, catheters. technology products aspiration market-leading to in and positions as RED as the with This proprietary super the those the CAVT as field. us companies the benefits catheters large-bore with guide positioning our led with Thunderbolt of XX have

As completed the we the with enrollment trial end our by completed year. announced, scheduled of previously be THUNDER to follow-up recently

clinical our bringing are clinical and update advantages and field markets, the X, region. the but neurovascular given our for latest received have European work expanding to Flash we will in CAVT CAVT reimbursement CAVT across provide thrombectomy. Shifting future over demonstrated we its of technology we're We additional to say, we in in about the doing the initial Bolt backed commenced international revenue fashion, benefits by position solidifying further supported evidence Physician further contributions market-leading appropriate, by and interest technology. see to strong September, opportunity prospect That In generation enhancing as Lightning business. in Mark and and reach landscape execution. we currently time, X.X global Lightning excited our the and expect the the And for high. field, in international of needless commercial CE said, in reimbursement current the of measured procedural markets a stroke while we to scale sales, is

As we the significant towards for globally are view blood and look we transform opportunity XXXX way beyond, and to CAVT addressed treated. a clots

benefits awareness, our patient out. but swiftly able enhance generation to safely, on to and with studies economic market not proposition real-world and strategy are the to further constant trials, and effectively, and simply. Over hospital to data our population focusing burden one, -- two, also of of clinical term, and initiatives executing we therapy X-pronged the clinical clot CAVT's expand benefit systems. previously we near a randomized treated only CAVT Number the via that increase with be further laid outcomes Number value CAVT's health global economic innovation comprehensive access

and go focus realize for computer-assisted our with able our the number Maggie the profile. I'll third annually in in from investment our call on three, benefit four, support approach. CAVT's operating profitability And over interventional number efficiencies of a quarter. sustainable over Number improving and and to market growth executing to strategy driving turn fully a now teams financial disciplined in access results to potential to commercial strong patients the

Maggie Yuen

basis. on the and Thank margin you, operating non-GAAP quarter Today, a GAAP results while press will financial I measures for for of everyone. third measures call GAAP release. Good are discuss I on are XXXX. Financial basis, of to a revenue financial a operating our afternoon, and income GAAP on Adam. results posted expenses gross non-GAAP provided corresponding and reconciliation in this The the

currency compared September quarter XX.X% ended total XXXX, XX.X% $XXX to revenues quarter the in of and third XX, constant our increase million, an third of were XXXX. reported the For

geographic was of third Our international. XX.X% XXXX sales XX.X% quarter and U.S. mix for the

driven franchise. growth Our thrombectomy by U.S. in XX.X% region growth our reported of XX.X%,

X.X% regions international and regions. reported by in constant by all $X.X in in in million, million. China offset China revenue was international revenues thrombectomy flat revenue U.S. The our million X.X% other an $XX.X total by which in increase decreased to $XX.X currency, of Europe our Our increase primarily of due X.X% in in reduction of decline growth revenue by sequential and revenue offset of relatively an $X.X primarily of was a driven a million,

million XX% to Revenue XXXX, the to of quarter by third year. increase same revenue and compared XX.X% from products. thrombectomy in reported global grew constant to last in Moving the currency period an $XXX.X of business

CAVT. is of Our adoption primarily U.S. continuous growth XX.X% driven of by

primarily China year. business as Our by compared driven an was in regions international declined which decrease period last international a other to offset by revenue, X.X%, in all by increase same the

Revenue of X.X% $XX.X primarily and basis third an regions compared XX productivity expectations Gross for in is favorable increase was in quarter and million improvements and with X.X% and XXXX. constant business reported third driven our third mix line XXXX strong U.S. the in from of to which currency, quarter across of product increase of is margin We the delivered improvements. in all XX.X% for point XX.X% an driven quarter embolization the access by by XXXX, thrombectomy the

gross distributor second thrombectomy Healthcare a point our had and in million in favorable basis mix $XX quarter Immersive XXX of which Additionally, write-off product reflects the we the margin, XXXX, improvement onetime sequentially, excluding inventory higher mix.

focus on launches quarter. our and volume, ramping for driving our while will our the efficiency team in product new up manufacturing fourth Our productivity

of for and million XXXX revenue the million [ ] QX QX Research Total adjusted or for on compared savings million wound to $XXX revenue revenue XX.X% million. or down recorded half for revenue or revenue year. $XXX.X to expenses $XXX.X expense XX.X% GAAP resulting last in expense of compared quarter third [ $XXX.X of year. our same $XX.X quarter compared revenue development of million [ XX.X% same approximately XX.X% of were expenses million quarter in operating million or $XXX.X third or $XX.X to $XX $X of the for Immersive XXXX ] the quarter for million million We Now (sic) EBITDA. the operating income ] later non-GAAP (sic) business margin $XX.X in and last $XXX.X or compared the and of out (sic) operating an SG&A million of operating million for QX million the operating $XX.X operating period of XXXX, XX.X% were income XX.X% was XXXX. income for of the to XXXX. We of quarter, Healthcare non-GAAP expenses, the of to

We to moving expense operating GAAP million approximately forward. expect create a of year savings $XX

full the we expect to XX% third quarter With to total We our year. EBITDA margin quarter the of into revenue last XX.X% sequential Immersive continue $XX.X million in or of XXXX. savings, QX or compared of posted expansion $XX.X million adjusted

repurchase $XX.X XXXX. cash, stock sequentially third $XXX $XXX cash QX ended balance million We to flow of cash is no decrease million and which of Turning of quarter and the to debt, during with due equivalents security and the marketable balance million sheet. a

repurchase, increased Excluding capital the and improvement operation management. working operating profitability $XX.X by our by in stock driven cash million

to rest now continue trends call turn flow for XXXX operating over discuss and positive of the like to I'd We cash to expect our to guidance. the Jason beyond. And

Jason Mills

and remaining of which XXXX expectations in XXXX [ the of are lower we to to this good $X.XX We billion thrombectomy XX% everyone. were year, we where coming With XX% with to from Furthermore, into is Maggie, our range quarter XX% XX% revenue this total middle you, of raising guidance end U.S. they for previously. billion range $X.X the growth call. range, guidance reiterate ]. are afternoon, X for our to comfortable at the Thank

the Moving statement. income down

We margin we to to sequentially. consistent and in quarter quarter fourth gross with expect levels, expand non-GAAP be operating expect the margin third

we of Excluding points basis to would points basis questions. in impairments, to your guidance margin. Operator, the in call improvement impact these correlate full Healthcare the from open the margin XXX Immersive now and metrics improvement operating XXX year with gross XXX our can for XXX

Operator

Your comes line first Richard question the Instructions] Newitter from [Operator from of Truist Securities.

Richard Newitter

the healthy off just on U.S. thrombectomy. a Maybe It was start to XX%.

piece. And U.S. I XX%. the about -- think over going third is how pretty a your neurothrombectomy trend just that you my quarter, deceleration it forward? was calculation, wrong, that By it you suggest go think should Maybe or the VTE Venous said right? big there be but U.S. and can might would in the we

Adam Elsesser

Yes. Thanks for appreciate I it. question. the

high double-digit stroke growth. sort Our good business had a really of

that deceleration. So as think I I qualify don't would a

VTE. single have for we that arterial, thrombectomy, years remember you as coronary in If been which obviously, coronary, elements our U.S. there the And go into peripheral many arterial, have neuro, has as the with well digits. we out product legacy is

delta. I So that's did neuro quarter. think really well this the But

Richard Newitter

Okay.

Sorry, that's my math.

So very we to do I to what U.S. the regions into just unpredictable. those continues rate. business neuro as on and your China, and there. Congrats, seems the it's growth recovery piece be international maybe I 'XX, for solid apologize view look the this international a somewhat forward does of it guess, like

some to you're just of in product new the what's in product contribution with So offset think visibility areas And that? the launching do we there? new how about your that

Adam Elsesser

Yes.

it's question. great a think I

about look, happening licensing China of our that's last talked walking a particularly that. the for of model the what's sort deal. to time lot spent quarter quarter from think, I and we part We last model, as revenue distribution we've our us, of through go --

just now really, So That's changed. showing up. has nothing

there. that new So into no we've There's information taken of account. sort

lot states Obviously, a physicians there's And in be we call some There's we're conversations spots half a of between well. whether X.X Flash the really in an certainly of And that I that or out on using -- markets. it of will of roll internationally. than with part that interest. the we future, of recovers, as China There's headwinds European launch are as well business see XXXX in XXXX Lightning out, the lot significantly to there beyond. the called really, that real this their that's in X. as as here Bolt to colleagues fewer in back Obviously, as bright were upside do the going or there's XXXX think in XXXX

playing So we markets. talked for new of how on a there's while. news about is not had a This out international our lot it

Operator

from line next Robbie comes Marcus question from JPMorgan. Our the of

Robert Marcus

for Congrats Two quarter a nice me. on here.

Is margin about First, should think I EPS. this drive especially at in Or levels? on something it came again upside How the It margin to expansion. one wanted points long nice, to continues things to to there, ask XXX saw these your grow 'XX? good on once there continue of expansion? the is that range in onetime some is to we so basis ability thrombectomy XXX to as a elevated use

Adam Elsesser

Yes.

that -- a it's of is coming shift for about If a is, combination with process platform. longer-term together which laid our we from toward a a move business we you're as that talking bigger that of the margin, efficiencies out chunk now, CAVT we've while product gross

So that continue. will

commercial innovation, clearly laid as out of X-pronged a in the of that of that investments gross a this the and talking of well we doing can focused If invest also growth that here. you're very, variety about a we operating time, both on in again, has growth where business. like things. in -- shown the We the quarters outpace same past some again I few can is the the that clinical fashions, business and quarter margin, sort profitable we'll will have is we teams, a as do all very in in in data invest we strategy this margin. And profitable we market those can of And at the think that invest obviously really access think our

that It's think that, this a changed on about the ever clear now. hasn't puts So past. think pretty point fine quarter clearer than that. the remarks I pretty just I we were And in prepared from

Robert Marcus

operating thinking was margin. I

appreciate And both I that. So of them. then... you got

Adam Elsesser

it be for to sure, Just I covered you. all

Robert Marcus

used and yesterday by And question going clinical just appreciate as that's to I competitor. you the thrombectomy we PEERLESS translate your and be think do to guess from as in be that's TCT it. specific general came Or is, your competitor? you going back to community the business well? do from to then applied your And to I the today, saw data think

Adam Elsesser

details surprising inappropriate, not older their pretty with true procedure physicians, from it's that aren't duration there we've really reaction muted -- all being the that the were bleeding that the and some without not Look, devices X.X. Obviously, most Yes. rates and heard given with we procedure hope of certainly products. for Flash seen of viewed given the the the now

I Flash I to and on there think are think from So of that. X.X CAVT are the as well a attention. talked everyone -- ground commanding reading who we've as lot And

think real particular anti-coagulation is I type that's like the where that's put more which all and important the in where interest and comparison, the field, past we're to energy I running that is. STORM looking we're the study. in against our is study And of think

So, surprised negative I think I guess, given don't reaction, somewhat those of a at issues, it's for but the all. with we us weren't muted

Operator

Our Biegelsen Larry of from Wells line Fargo. next from question the comes

Lei Huang

calling in Larry. for It's Lei

bit you starting with size Just our -- that little the sample endpoint size changed. enrollment, the patient on ClinicalTrials.gov It's patient And we a THUNDER with. sample less has trial. than the has changed. what on started Congratulations completing the saw

FDA follow-up. And One have if those safety I on agreed Can those has to of endpoints the changes? just changed. and the comment a you

Adam Elsesser

agree did FDA the accurate. those changes. is to Yes, That

Lei Huang

changes? both of For those

Adam Elsesser

Yes.

Lei Huang

few mentioned you versus elaborate what away go before you and there we which on this times 'XX Can can headwinds And in just Adam, a would in in again additional 'XX? see then, on And headwinds are 'XX. fewer that call versus Perfect. that 'XX tailwinds 'XX? Okay.

Adam Elsesser

question. good a That's Yes.

move the had of selling embolization about this down certain of the be significant reimbursement some beginning and things over recalibrating we've wasn't issue we recalibrating, as the to point in markets products about obviously China the in couple of products at business. talked the getting we where of internationally the that our viable bit some XXXX. of about will access year that year, sort -- talked So our where to gone phase. calls next the prevalent not it That's We a one talked last a and

and you will, And so delay, -- if getting also, the in in Europe. CAVT

XXXX. dealing and for that sort are the big those most topics those internationally, So were really the in part we with go away of

things coming. talked of also Some are the that positive, obviously, about we've product are looking new launches

movement what the like gain of in continued have products quarter just share Flash pretty just saw sort shift share yet again with consistent so there. X.X, existing with significant We another we pretty

I looking up, those you to well. forward add XXXX as think when we're

Operator

Our from the comes Joanne question from Citi. line next Wuensch of

Joanne Wuensch

you us through X or from actually much [indiscernible] front. next else? How that goals something the to coming XX I the that months. or XX% label get to quick your is Can your of questions walk gross have margin renamed steps over for real

my with steps second -- has the uptake? the about that you curious the to of then how filing. trial Congratulations And question think on and But about clinical completion on Thunderbolt. do to I'm commercialization and

Adam Elsesser

Yes. you. maybe misheard Good I questions.

what gross XX% XX%. asked said think opposed margins. was them out had as we you And think getting to which I about there, I you said to

So I the not heard efficiencies, shift go And the different just CAVT to to deeper make are margins, want might But issue I and I products, sure driver we think, into can as and that. gross primary have. continued big product XX%. there drives the right. is but margins above further is the we it get just

the that's primary the So -- margin the you or number about about sort talked that Thunderbolt, to of we gross driver related question the to talked that. On getting was above commercialization.

XX and and the finished trial excited we more and you with give on, products that certainly this of let's That's for before But follow-up how move through of we that end after information until obviously, wait certainly the about get know get And it then -- should we'll are by pretty let's we'll due updated follow-up that. the ourselves, complete Let's it. submit formally point. we then and We to years, at we launch -- can that. year. ahead go the do

Joanne Wuensch

Sorry, your high. too set I if goals

Adam Elsesser

good just goal. No, a it's internal joking. I'm Well,

Operator

comes the question Michael Jefferies. from line of Sarcone next from Our

Michael Sarcone

growth to out where share DVT U.S. your nice one for Really and about first me. Just PE think you VTE. Could both maybe days? us you across in these talk is shaking

Adam Elsesser

has think sort year, that premature. shift I consider did finish already PE We seen it, the like a again to a this a of DVT after quarter what seen We'll we doing year and toward pretty think share of year terms of us. it we'll in on of part huge do it's we of the we've it I But The been end exact a as PE it's of comes year. recalibration. of we've sort sharing significant. last XX-XX, I the were but quarter shift sort pretty successful numbers do probably in Maybe business said. at that down the to in putting premature. change that really lot Obviously,

us other worry and have blood using in so better That's excited get known to Flash goes of of product applaud the dramatically the hope on of And the to And faster be definition, so stabilize patient. patients by get much in better. the you really the back loss to have sort different, having to bodes been put products same don't past have for able and all blood the same constantly that the innovation are anything X.X fast. better need the fields. the clot out it that's And about I issue years. anxiety, really, much just of just think I that faster. It's to that. products so Therefore, for, -- that's future. And for at all XX is time the you we've don't of obviously procedure, frankly, these any in, much point well need again, put and no it innovating if that The to change, loss of can back The do blood that. for Things all. significant you and

Michael Sarcone

And helpful, got Bolt just That's my XX, clearance. it. follow-up, XX Adam. FDA just Bolt and Got

just Can process? on start maybe pricing ] to selling to you then P&L? for [ You through for the each does have those. account what economics that talk and go about processes anything VAC it And on

Adam Elsesser

the point a Well, on price than couple the products Yes. of products just first a non-CAVT CAVT bit price. have things do. different Obviously, little

So which to obviously the there they're to a legacy in and be literally comparison are the going catheter pump, just original products, is difference.

terms not process new through products, process. yes, and not of having products launched we go obviously I'm and we'll how think for do going. having new to These VAC multiple have do it, years In that go with again, year And through we'll of aware are go many every process. to many, they a the products. blanket process, know the to through free But pass I the now, keep

Operator

Our next Piper O'Brien line from from question Sandler. the of comes Matthew

Samantha Kurtz

want just talk a little Samantha new starting and more I the bit you on is more about We the This just for Matt XX devices. Bolt today. Can ask XX And, to XX. guess, specifically with market, the below-the-knee different? then it's [ size ] the too. talk competitive about maybe APR X arterial between the the versus about the the in of the on dynamics catheter And of going catheter difference some

Adam Elsesser

X -- smaller numbers French catheter, further on the smaller. are that distal it go. connote it's it French, the not Yes. of There's obviously X The the a can little -- is, size the

we the track to the into but to that's So not XX And neuro the X knee, parts and part well, the as call prepared distal smaller tool really SENDit just in to bring arteries of CAVT natural body I mentioned just below the other remarks. it of evolution which in we similar is help get catheter places. a it in the space, other more where The places. of what we the as

we into But you've got further the I So just goes gist overall, the so and it's clot. think product. of tracking of that It remove really can on. ease vasculature, the so

was around Your of that the second apologize, XX What again, question what part was or? question. second was I it

Samantha Kurtz

Well, just in the dynamic arterial. competitive

Adam Elsesser

apologize. sorry, I'm I In arterial.

There's there's everyone various VAC. competition think with sort knows of gizmos a of lot of of companies not I lot a and things.

I think we've sort in brain for stroke happened in years. seen This many game out in for years the stroke. this of play

works. Aspiration

understood that have is space. now science whole pretty clear, folks the behind in think Aspiration, the neuro aspiration I

are think I that's in that pretty starting understand space the people arterial And vascular clearly to the and on side. working

there's companies on the total we with if of sort you So is a a game creates will, it Bolt which of focusing of aspiration them certainly have that. that really modulated lot not bring of XX And that are none new whole changer, X class, Bolt a technology. and Lightning Lightning

fight competition, is the anti-coagulation and for you also will, if lytic. open So really, us, surgery and the

growth sort that's that business and put that is of our of has that's quarter-over-quarter. and been, where where All focus we what's of the energy, seen continued our really

Samantha Kurtz

more Great. know to from follow-up a THUNDER with we for expect the when times And end data of that could touched of couple when -- call trial? a year, quick the I see different at point, in we one. on the ending the trial one

Adam Elsesser

going not end out trial a -- few mistake a so for putting in in to years I'm all. back, made obviously, I to times a

I'm have we're trial. as get do let answer not we'll that way, pretty know. out we very soon But frame, we to with everyone going will information specific in know excited there. So have more Obviously, we the time to as specific when to we a -- finish specific when time. that Obviously, that the that a update

Operator

line Mathew Blackman next the Our of Stifel. question from from comes

Mathew Blackman

have of stroke questions. a I couple

us stroke Philips announced I'll Medtronic lob week, first the curious, we give the awareness. sustainable current Thunderbolt. think stroke get in the rate you can follow-up. of U.S. partnership, until just a of -- And and I then Just all, high Last targeting as sort growth

in your of And that thoughts teaming have thoughts it be Just impact, doesn't imaging provider up what but there an a market the competitive time. interested provider? could on any, any on if it, are seem on like hearing that. your with Just implications device over

Adam Elsesser

me mean go definitively growth our to many stroke of trials. to randomized intervening and first, Well, sort XX-plus back is that we awareness stroke. the that should the bringing was ago The patients. sustainability see in this Yes. of thrilled then that. let now shown different I that years folks answer something I'll to in are I be idea on more was

think has device-specific impact. So don't I think it great. it's any I

all big with many, some of you see and and bring applaud working best should the to applaud to many all hospital in anything that I device I out kinds get think in it, product as say to patients. of over to than the physicians mean, think know, We've we imaging the I been societies pick the awareness fastest. get clot awareness. of whether programs, the the going I And I helps ahead companies, everybody, other bringing pick I'm glad it's and community involved it this, that there's think local we stroke, companies, -- it, And the don't of know works are lots years. systems

So I'm in. all

it in As business. growth to relates stroke the our

spot. I think in a really, good we're really

focused lot I call, a clearly lot to business than better stroke are mentioned, in of these on is run the an thing of that's laid think be as space a as pretty think aspiration well. As bringing the neuro our move there it good waning catheter. different we Thunderbolt toward companies really what I and people catheters as on they the maybe that for interest a sort foundation that understand which of very And catheters, I as super excitement bore will a guide and are with realize is

Operator

the Our from next from Leerink. Mike question Kratky comes line of

Michael Kratky

recent was U.S. continued? date really specifics segment And provide any? any XQ in And out follow-up, specific there may that that side, if a to as just you you've call in anything on arterial growth to strong deviation in led have that seen, the then the thrombectomy On momentum during the some you've more seen if arterial in XQ? growth can to segment

Adam Elsesser

-- No. the Lightning launch the The with Bolt grew high from teens challenging business with prior year X. in of the comps pretty arterial off

business. Lightning mean, just So There's the really issues easily. arterial X Bolt product guy, it's it's the there. that the simple. clot works, really, good I a Lightning getting That's about we works. lot quickly the Bolt works. not really of of out really growth felt XX And

seeing So that I think continue. we're

this guys again, business in really continuing work have ever field of continue right products to now. their launch field we innovative just some products, the most that about are seen. But the And launching hands penetrate talking X. solid The doing brand X.X, new full to between with the is has the really,

Michael Kratky

Then just one one. quick maybe

probably that Or to a market more the be is going is of world, of about utilization? as an do think that expansion side terms the you of you something BTK more think In story? that increased of

Adam Elsesser

now, catheter -- a the we to X. you go became size them on didn't if which when dial what little knee, below a because CAVT, that you use. think really is question. we as you go that to really below would catheter Right about size the the if like we It backwards had just before doesn't is not the is or really only CAVT had But knee whatever could a catheters, clot size it the more Bolt get you

we're on it have CAVT. that knee, we that bringing that and down go Now catheter a below the further can

the to continue every blood there. CAVT be is And helpful. the body done to we're has can bring goal innovating that not of technology then fully where And clot part Our CAV from yet.

one. We're the clear. CAV always the to made I part so can we're So X-pronged why much clearly, it been underway every getting out that and laid to to is strategy of that Penumbra. crystal was pretty we continue body on safer. much clot has the And going bring that sure Innovation out so from benefit faster technology well in number that's plan. Again, innovation for #X

Operator

from next question Our Chickering from Bank. Pito of Deutsche comes line the

Pito Chickering

on guidance. A quick one here

guidance? You're there the other U.S. maintaining [ changes of the guidance segments other above thrombectomy overall any your Are your raising add ] your Street but revenue guidance. to to

Adam Elsesser

so. think I don't No,

Jason Mills

No.

that laid midpoint So would least XX% at we in the be comfortable of new the of at that the to midpoint, reflective fourth quarter, range said I out, XX%. obviously, of

in quarter midpoint already we're U.S. guidance, implied being at Street growth reflective rest talked about especially business, is thrombectomy appropriately. and is around the at somewhat internationally, international the fourth and the up what XX% seeing the But the think, thrombectomy of modeling that is I of ends of obviously, out for in so And guidance. the the of the midpoint we've model you headwinds that's that. China, business, As the

Pito Chickering

margins. One more on

leverage positive be can this the that I margin lot how basis X though like is we the look investments should drive a as of gross expanding as growth there year to at seems point years? next balance growth? over to margin afford per thinking you be specifically you next I that revenue understand SG&A a the leverage, with It SG&A So about expansion can much SG&A X mix a How leverage if couple Is offers those over of over years. how tailwinds. on years? XX-plus of next couple But

Adam Elsesser

to do the to the really thrombectomy team And profitable team drive kind both. been that clear continuing well going that continued that can we're specific that, forward. that grow this you a again, as do We the we've continue I Yes, the go data be market continue business giving shows innovation, matter. to can pretty access pretty think significantly really to And to really is pretty will strategy, we a will invest things relevant forward, without number, growth business. which run and of commercial by as quarter and going the significantly that think market in back going those I X-pronged do and that the to

Operator

Andrew comes of next Blair. question line Our from from Malgorzata William Kaczor the

Macauley Kilbane

product around of It's on data the Malgorzata. longer-term look for at ultimately, that that tie a thrombectomy obviously, I market towards the to how into understand work the I think specific. week. CAVT as the the you discussion of There's guidelines, Macauley do But about work is guideline-changing And you've this TCT particular, on in lot does and adoption following changing guess, it continuing in been background? how been recommendations? And we access

Adam Elsesser

Yes.

think it about. depends the you're vascular really on I bed talking

patients talking number arterial, well larger I'll in but patients on PE. second, also about you larger PE. as there's DVT, Obviously, lot, as a than obviously, know, and are of which think I also focusing which we're that PE address You're a is as of number

issues most really and or think, numbers are if think of getting lysis. just are mechanical the think legitimately, are pool add So X%, getting numbers, patients XX% And I patients acute the about getting PE XX% anti-coagulation. PE. right my are the up catheter-directed balance, you of if now around guideline the I so thrombectomy in still

not product, not particularly be physicians X%, X% X%, guideline for somewhat how So the change reaction change to to that most -- for the the specific -- it you're would data. a isn't the relevant around and relevant to given particularly really guidelines X%, around

then the endpoints. really looking think out the think field will And I change. trials I that guidelines is with come anti-coagulation to likely

think do no will be you to to that specific, stop years there to stroke really and on the unlikely trials and wants it's product, is innovation. move the concept to and get to innovation. the it I and better. and product if desire stop was think out, continue that innovation, when real prove one XX-plus even I we're And stops better came innovate ago, back want no What

using it still what today are XX they people So ago what stroke holds. the was interventional means are used point but dramatically versus different in years

So I at look the going think that's how forward. would field I

Macauley Kilbane

the Select a driver great. itself. receptivity Plus acknowledge we've is And of a of then as But the I heard also positive platform launch the just larger week. CAVT bit follow-up, quite That's this

similar any first a kind growth of So SENDit to launched incremental has as comparator? drive to when that been able

Adam Elsesser

for the even of and talk they're faster it. Select lot make of People the the inner in like about case definitely the it you of like a really the Select catheters typically We -- sort case. of cases thank Plus, yes, has attention and raising to caught Well, access just don't faster terms and they're people's Plus, made easier.

inside really X.X. of it's Flash So the umbrella

X.X that getting If you're just faster, making clot getting there Flash start fast. much a it to now finish, from extremely faster, out

really for a going to continue to great that's All to adds impression this be to of think case. quite was really, an a And people while. I what that up that gravitate

Operator

of Research. line the from Pasquale comes Nephron question next from Chris Our

Christopher Pasquale

are Adam, vessels clots that in and to Bolt venous you Can about in And reach? small you question today need and patients do arterial what to I products? treated those follow or with X with wanted Bolt involved those Or occur give surgery? XX cases on or Flash guys rough non-CAVT too the a up XX. percentage are get else something to of for sense with

Adam Elsesser

it's have don't a really numbers. I question. Yes, good good

take if the to out XX, space. of on within -- So just sort of you the percentages sort of throw venous more I don't guesstimates sort want

cath answer in mechanical, well. the it's they smaller catheter They're I to need the are using a think if would just significant Most and cases smaller-sized those cases. And to product. question certain like more is, But People today? case preference on. in some a we so non-CAVT of the the extent in as are those the we're the the of -- that time, they using --

-- them those gives in the beds. opportunity those the physicians And arterial vascular and to and have so our the to products already venous most CAVT move experienced And side. both with us systems, that of on an bring larger time,

CAVT all benefit they're vascular smaller of getting the So beds. excited in those about

provide patients just it's pretty understanding And think will make again, it straightforward So the vascular it. -- the I in will think I benefit it of with CAVT. beds smaller a to those

Christopher Pasquale

nature? clinical you of constraints helpful. any or studies mentioned maybe And through a more you Flash that and reimbursement in things could to Bolt. reimbursement Do of see uptake push then in-country measured that incremental Europe some That's additional opportunities lead for to

Adam Elsesser

Yes.

come word you're like don't appropriate a When So every to catheter adding a have more I these want chip, different not concerns. of for syringe cost. products. Obviously, we it's you an product. We get to the used. with it's want or or a something, to really computer clarify just reimbursement maybe We just they sure much make reimbursement type

work more and to to of sort requires that definition, prove that by get that. So reimbursement

opportunities that we there of go in sort with sure. data, do of drive this. I be again, of continue the the sort that for to if forms, to including of that growth innovation so data is different to yes, strategy that And to back you generation to are -- And the going in will addition X-pronged mentioned

So that of it fits bucket. into sort

Operator

the Needham. Our from Mike of line question comes from Matson final

Michael Matson

on couple a Thunderbolt. Just

in tell we'll sort going you're know maybe to I with pricing you THUNDER us So year venous premium is it we've And the is, what not point at similar the on then some side? think what Thunderbolt, at going to trial, on but just what the a seen half of to before the be see it you the next first it do of submit data FDA? to

Adam Elsesser

again, around meetings. think Well, those about significant would let's exact updates But the we published begun to timing and one done -- of and do good hope But getting the haven't of data excited we give Yes, the trial through haven't that first, on appreciate be we about you the timing. Usually, specific sort done. I'm can questions. that. I you are the getting you presented. when then that and it neuro get And even of

the price, structure In to within of be of terms confines the of be of a it other structure matched obviously a they're premium. based dollar-for-dollar I reimbursement the likely CAVT product, sort hospitals. the can't this we'll price for to reimbursement particular those would different profitable tell vascular that be procedure all will yes, a neuro, on of But you a little there beds.

Operator

turn back There over you. are to time. no this I further Ms. call Furlong, the questions at

Cecilia Furlong

in you for interest for our Penumbra. look your behalf On quarter and you us forward on fourth Thank thank joining We to team, you, of again today management call. updating our operator. all

Operator

call. today's concludes This

may disconnect. You now

Penumbra (PEN) 30 Oct 242024 Q3 Earnings call transcript