Penumbra Inc (PEN) 2022 Q2 法說會逐字稿

Good afternoon. My name is Angela, and I will be the conference operator today. At this time, I would like to welcome everyone to Penumbra's Second Quarter 2022 Conference Call. (Operator Instructions). I would like to introduce Ms. Jee Hamlyn Harris, Investor Relations for Penumbra. Ms. Hamlyn-Harris, you may begin your conference.

下午好。我的名字是安吉拉，今天我將擔任會議接線員。在這個時候，我想歡迎大家參加 Penumbra 的 2022 年第二季度電話會議。 （操作員說明）。我想介紹一下 Penumbra 投資者關係部的 Jee Hamlyn Harris 女士。 Hamlyn-Harris 女士，你可以開始你的會議了。

Thank you, operator, and thank you all for joining us on today's call to discuss Penumbra's earnings release for the second quarter of 2022. A copy of the press release and financial tables, which includes the GAAP to non-GAAP reconciliation can be viewed under the Investors tab on our company website at www.penumbrainc.com. During the course of this conference call, the company will make forward-looking statements pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, including statements regarding our financial performance, commercialization, clinical trials, regulatory status, quality, compliance and business trends. Actual results could differ materially from those stated or implied by our forward-looking statements due to certain risks and uncertainties, including those referenced in our 10-K for the year ended December 31, 2021, filed with the SEC. As a result, we caution you against placing undue reliance on these forward-looking statements, and we encourage you to review our periodic filings with the SEC, including the 10-K previously mentioned, for a more complete discussion of these factors and other risks that may affect our future results or the market price of our stock, including, but not limited to, the impact of the COVID-19 pandemic on our business, results of operations and financial conditions.

謝謝你，運營商，感謝大家今天加入我們，討論 Penumbra 2022 年第二季度的收益發布。新聞稿和財務表的副本，其中包括 GAAP 與非 GAAP 對賬，可以在下面查看我們公司網站 www.penumbrainc.com 上的“投資者”標籤。在本次電話會議期間，公司將根據 1995 年《私人證券訴訟改革法案》的安全港條款作出前瞻性陳述，包括關於我們的財務業績、商業化、臨床試驗、監管狀態、質量、合規性的陳述和商業趨勢。由於某些風險和不確定性，包括我們向 SEC 提交的截至 2021 年 12 月 31 日止年度的 10-K 中引用的那些，實際結果可能與我們的前瞻性陳述中所述或暗示的結果存在重大差異。因此，我們告誡您不要過度依賴這些前瞻性陳述，我們鼓勵您查看我們向 SEC 提交的定期文件，包括前面提到的 10-K，以便更全面地討論這些因素和其他風險這可能會影響我們未來的業績或我們股票的市場價格，包括但不限於 COVID-19 大流行對我們的業務、經營業績和財務狀況的影響。

Penumbra disclaims any duty to update or revise our forward-looking statements as a result of new information, future events, developments or otherwise. On this call, certain financial measures are presented on a non-GAAP basis. The corresponding GAAP measures and the reconciliation of GAAP to non-GAAP financial measures are provided in our posted press release.

Penumbra 不承擔因新信息、未來事件、發展或其他原因而更新或修改我們的前瞻性陳述的任何義務。在這次電話會議上，某些財務指標是在非公認會計原則的基礎上提出的。我們發布的新聞稿中提供了相應的 GAAP 措施以及 GAAP 與非 GAAP 財務措施的對賬。

Adam Elsesser, Penumbra's Chairman and CEO; and Sandra Lesenfants, President of Interventional will provide a business update. Maggie Yuen, our Chief Financial Officer, will then discuss our financial results for the second quarter. And Jason Mills, our Executive Vice President of Strategy, will discuss our 2022 guidance.

Penumbra 董事長兼首席執行官 Adam Elsesser； Interventional 總裁 Sandra Lesenfants 將提供業務更新。然後，我們的首席財務官 Maggie Yuen 將討論我們第二季度的財務業績。我們的戰略執行副總裁 Jason Mills 將討論我們的 2022 年指導方針。

With that, I would like to turn over the call to Adam Elsesser.

有了這個，我想把電話轉給 Adam Elsesser。

Thank you, Jee. Good afternoon. Thank you for joining Penumbra's Second Quarter 2022 Conference Call. Our total revenues for the second quarter were $208.3 million, a year-over-year increase of 13.1% as reported and 15.3% in constant currency. Global vascular revenue grew 22.7% and global neuro revenue increased 1.5% compared to the same quarter a year ago. We expanded gross margins 180 basis points sequentially to 64.3%. We recorded non-GAAP operating income of $1.6 million or 0.8% of revenue in the second quarter.

謝謝你，傑。下午好。感謝您參加 Penumbra 的 2022 年第二季度電話會議。我們第二季度的總收入為 2.083 億美元，同比增長 13.1%，按固定匯率計算增長 15.3%。與去年同期相比，全球血管收入增長 22.7%，全球神經收入增長 1.5%。我們將毛利率連續擴大 180 個基點至 64.3%。我們在第二季度記錄了 160 萬美元或收入的 0.8% 的非公認會計原則營業收入。

Looking forward, we expect to increase our revenue in the second half of the year and accelerate growth in 2023 with 4 significant catalysts, three major product launches and the presentation of significant clinical data. Sandra will also speak about these catalysts in a few minutes.

展望未來，我們預計下半年的收入將增加，並在 2023 年加速增長，其中包括 4 個重要催化劑、三個主要產品發布和重要臨床數據的呈現。 Sandra 還將在幾分鐘內談到這些催化劑。

Equally important in this economic climate, we expect to continue to expand gross margins with 70% plus as the goal within a few years, and we plan to increase operating profitability through discipline and operational improvements, notwithstanding the prevailing downturn in the macro economy. These catalysts, which include both Neuro and Vascular as well as our work on gross margins and operating profitability will, I believe, make the next 12 to 18 months, one of the most robust eras ever for Penumbra.

在這種經濟環境下同樣重要的是，我們預計將在幾年內以 70% 以上的目標繼續擴大毛利率，並且我們計劃通過紀律和運營改進來提高運營盈利能力，儘管宏觀經濟普遍低迷。我相信，這些催化劑，包括 Neuro 和 Vascular 以及我們在毛利率和運營盈利能力方面的工作，將使未來 12 到 18 個月成為 Penumbra 有史以來最強勁的時代之一。

Turning back to the second quarter. I am proud of how our team executed, notwithstanding a very difficult operating environment, primarily in the United States. U.S. growth of 10.2% year-over-year was lower than we had anticipated and lower than we expect in future periods. The specific challenge is most evident in our sector over the past few months included persistent staffing shortages, which challenged our hospital partners' workflow; contrast supply issues, which we think have receded, but are still watching in certain geographies around the world; and supply chain challenges, which our team continues to address with success and resolve, but not without significant effort. These challenges were and still are evident, but we are getting better at addressing them, and we expect to further mitigate their impact in the second half of the year, during which we think growth in our U.S. business will accelerate.

回到第二季。我為我們團隊的執行方式感到自豪，儘管運營環境非常困難，主要是在美國。美國同比增長 10.2% 低於我們的預期，也低於我們未來期間的預期。在過去幾個月中，我們行業面臨的具體挑戰最為明顯，包括持續的人員短缺，這對我們醫院合作夥伴的工作流程提出了挑戰；對比供應問題，我們認為這些問題已經消退，但在全球某些地區仍在關注；和供應鏈挑戰，我們的團隊繼續以成功和決心解決這些挑戰，但並非沒有付出巨大的努力。這些挑戰過去和現在都很明顯，但我們在應對這些挑戰方面做得越來越好，我們預計下半年將進一步減輕它們的影響，我們認為在此期間我們美國業務的增長將加速。

Our International business grew 20% year-over-year and is starting to reach scale. However, foreign currency fluctuations impacted our second quarter results, and we expect FX to weigh on reported revenue in the second half of 2022 as well. Jason will address this later in the call.

我們的國際業務同比增長 20%，並開始達到規模。然而，外匯波動影響了我們第二季度的業績，我們預計外匯也會對 2022 年下半年的報告收入構成壓力。 Jason 將在稍後的電話會議中解決這個問題。

All of that said, the combination of our U.S. and international businesses and the 2 large areas, Neuro and Vascular, in which we participate, gives us a broad-based product portfolio and geographic platform to succeed in virtually any macro environment -- macroeconomic environment.

綜上所述，我們的美國和國際業務以及我們參與的兩大領域神經和血管的結合，為我們提供了一個基礎廣泛的產品組合和地理平台，可以在幾乎任何宏觀環境——宏觀經濟環境中取得成功.

Turning to our Vascular business, we reported growth of 22.7% year-over-year to $123.5 million in the second quarter. We grew our vascular thrombectomy revenue 30.3% year-over-year and our vascular embolization revenue 11.8% year-over-year. Our U.S. vascular growth was driven primarily by increased utilization within existing accounts who already believe in thrombectomy, but were early in the phases of trying our technology. This is in contrast with sales stocking in new accounts that primarily use lytics. In fact, based on our analysis, we believe we won competitively in both venous and arterial thrombectomy during Q2. While some of the macro factors that I discussed earlier clearly had an impact on our Q2 vascular growth in the U.S., we have seen a strong resurgence in the trends in our vascular thrombectomy business over the past month.

談到我們的血管業務，我們報告第二季度同比增長 22.7% 至 1.235 億美元。我們的血管血栓切除術收入同比增長 30.3%，血管栓塞收入同比增長 11.8%。我們在美國的血管增長主要是由現有客戶的利用率增加推動的，這些客戶已經相信血栓切除術，但處於嘗試我們技術的早期階段。這與主要使用裂解劑的新賬戶中的銷售庫存形成對比。事實上，根據我們的分析，我們相信我們在第二季度的靜脈和動脈血栓切除術中都贏得了競爭優勢。雖然我之前討論的一些宏觀因素顯然對我們在美國的第二季度血管增長產生了影響，但我們看到過去一個月我們血管血栓切除術業務的趨勢強勁復甦。

Our current technology in venous and arterial disease, Lightning 12 and Lightning 7, represents a new treatment paradigm in both of these vascular anatomies, in which we have started to eliminate the typical trade-offs in performing mechanical thrombectomy. Looking forward, we believe our 2 new vascular products, Lightning Flash and Lightning Bolt, will take us to another level of technology leadership in both markets. Lighting Flash introduces a new advanced catheter and incorporates a next-generation Lightning algorithm that utilizes an extremely novel way to selectively control aspiration, which we think will increase the amount of clot we aspirate, further reduce the time it takes to do the procedure and further optimize blood loss mitigation, while also reducing the risk of vessel lumen damage.

我們目前在靜脈和動脈疾病方面的技術，Lightning 12 和 Lightning 7，代表了這兩种血管解剖結構的新治療模式，我們已經開始消除在進行機械血栓切除術時的典型權衡。展望未來，我們相信我們的 2 款新血管產品 Lightning Flash 和 Lightning Bolt 將把我們帶到兩個市場的另一個技術領先水平。 Lighting Flash 引入了一種新的先進導管，並結合了下一代 Lightning 算法，該算法利用一種極其新穎的方式來選擇性地控制抽吸，我們認為這將增加我們抽吸的凝塊量，進一步減少進行手術所需的時間，並進一步優化失血緩解，同時降低血管腔損傷的風險。

Just as potentially important as Lightning Flash to be in the venous market, we are equally excited about the potential for Lightning Bolt in the arterial anatomy. Lightning Bolt is designed with an extremely sophisticated algorithm. The technology incorporates both dual pressure sensors in the parent and our current Lightning algorithm that helps mitigate blood loss, as well as the clock extraction technology inherent in Thunderbolt for ischemic stroke, which I will discuss in a few minutes. Moreover, our team, along with key opinion leaders, are advancing significant clinical work and building proof that our proprietary innovations improve outcomes, reduce complications and are advancing the field overall. We expect much more discussion of important clinical work at medical meetings going forward as many physicians collect and present their experiences using our technology versus the competition.

正如閃電閃電在靜脈市場中的潛在重要性一樣，我們對閃電閃電在動脈解剖中的潛力同樣感到興奮。 Lightning Bolt 採用極其複雜的算法設計。該技術結合了雙壓力傳感器和我們當前的有助於減少失血的閃電算法，以及用於缺血性中風的 Thunderbolt 固有的時鐘提取技術，我將在幾分鐘內討論。此外，我們的團隊與主要意見領袖正在推進重要的臨床工作，並證明我們的專有創新可改善結果、減少並發症並推動整個領域的發展。隨著許多醫生使用我們的技術與競爭對手收集並展示他們的經驗，我們希望在未來的醫學會議上對重要的臨床工作進行更多討論。

For example, at the recent VTE Summit in San Diego, independent data was presented on 85 DVT patients treated with current thrombectomy systems, including Lightning 12 which comparatively produced superior results. We look forward to these data and other independent data sets being presented, published and discussed going forward. Further, we expect presentation of the first 60 patients enrolled in our STRIDE PE trial at the PERT symposium in October, which we think will highlight our position in the PE market.

例如，最近在聖地亞哥舉行的 VTE 峰會上，提供了 85 名接受當前血栓切除術系統治療的 DVT 患者的獨立數據，其中包括相對產生更好結果的 Lightning 12。我們期待著這些數據和其他獨立數據集在未來被呈現、發布和討論。此外，我們預計在 10 月的 PERT 研討會上介紹我們 STRIDE PE 試驗的前 60 名患者，我們認為這將突出我們在 PE 市場的地位。

On the arterial side, we expect to finish enrollment in our STRIDE study by year-end with acute results expected to be presented next spring, which we believe will increase awareness and adoption of Lightning 7 in acute limb ischemia. In addition, Sandra will discuss 2 new randomized clinical trials that we plan to conduct in vascular thrombectomy in the near term as well.

在動脈方面，我們預計將在年底前完成 STRIDE 研究的註冊，預計將在明年春天公佈急性結果，我們相信這將提高 Lightning 7 在急性肢體缺血中的認識和採用。此外，Sandra 還將討論我們計劃在近期進行的兩項新的隨機臨床試驗，用於血管血栓切除術。

In coronary, CAT RX continued a strong growth trajectory in the U.S. as did our vascular embolization business even though we did see an impact to the latter from the macro dynamics during the quarter. We also initiated a successful launch of both Lightning 12 and Lightning 7 in the European market. Moreover, the introduction of our original Indigo thrombectomy products into China was successful, and we expect strong growth going forward. We also are working towards an introduction of our vascular thrombectomy products into the Japanese market.

在冠狀動脈方面，CAT RX 在美國繼續保持強勁的增長軌跡，我們的血管栓塞業務也是如此，儘管我們確實看到了本季度宏觀動態對後者的影響。我們還在歐洲市場成功推出了 Lightning 12 和 Lightning 7。此外，我們最初的 Indigo 血栓切除術產品成功引入中國，我們預計未來將實現強勁增長。我們還致力於將我們的血管血栓切除術產品引入日本市場。

Turning to our Neurovascular business. Our revenue grew to $84.8 million in the second quarter, up 1.5% on a year-over-year basis and 4.6% sequentially. Our U.S. stroke business grew strong double digits again year-over-year, while our neuro embolization and international stroke business offset this growth. We are excited to announce FDA approval of our IDE for the THUNDER trial, effectively starting the Thunderbolt era in stroke therapy. The excitement among the neurovascular community about this technology and this trial is palpable. We expect enrollment to be brisk and believe Thunderbolt could be launched in the United States in the second half of 2023. We have said it before and physicians who have now seen them both agreed, this technology could completely change the paradigm on ischemic stroke treatment by both improving patient outcomes as well as potentially allowing neuro physicians to treat more ischemic stroke patients safely, efficaciously and expediently.

轉向我們的神經血管業務。第二季度我們的收入增長到 8480 萬美元，同比增長 1.5%，環比增長 4.6%。我們的美國中風業務同比再次強勁增長，而我們的神經栓塞和國際中風業務抵消了這一增長。我們很高興地宣布 FDA 批准我們的 IDE 用於 THUNDER 試驗，有效地開啟了中風治療的 Thunderbolt 時代。神經血管界對這項技術和這項試驗的興奮是顯而易見的。我們預計入學人數會很活躍，並相信 Thunderbolt 可能會在 2023 年下半年在美國推出。我們之前已經說過，現在看到他們的醫生都同意，這項技術可以徹底改變缺血性中風治療的範式既可以改善患者的治療效果，也可以讓神經內科醫生安全、有效和方便地治療更多的缺血性卒中患者。

Since the Thunderbolt trial is underway, this is an appropriate time to spend a few minutes explaining what Thunderbolt is and how it works. Thunderbolt is a microprocessor controlled, advanced software algorithm, integrated into the tubing that sits between the engine pump and the red catheter. It does not go into the patient's body directly. Thunderbolt orchestrates modulating aspiration, which is proprietary to this technology. Two valves are integrated into Thunderbolt, one valve directly connects the red catheter of choice, 62, 68 or 72 to our engine pump. The second valve connects the red catheter to a non-pressurized [sailing] bag. The Thunderbolt algorithms orchestrate the opening and closing of each valve up to 12 times per second once clot engagement is detected. This modulated aspiration disrupts the friction between the clot and the tip of the catheter. Eliminating this friction, we believe, will allow the red catheters to ingest the clot the vast majority of the time. This compares to the current practice with aspiration, which ingestion incurs a small percentage of the time, even with larger board catheters that are much more challenging to track to the clot.

由於 Thunderbolt 試驗正在進行中，現在是花幾分鐘解釋 Thunderbolt 是什麼以及它是如何工作的適當時間。 Thunderbolt 是一種微處理器控制的高級軟件算法，集成到位於發動機泵和紅色導管之間的管道中。它不會直接進入患者體內。 Thunderbolt 協調調節抽吸，這是該技術專有的。 Thunderbolt 中集成了兩個閥門，一個閥門直接將選擇的紅色導管 62、68 或 72 連接到我們的發動機泵。第二個閥門將紅色導管連接到非加壓 [航行] 袋子。一旦檢測到凝塊接合，Thunderbolt 算法每秒最多可協調每個閥門的打開和關閉 12 次。這種調節的抽吸破壞了凝塊和導管尖端之間的摩擦。我們相信，消除這種摩擦將允許紅色導管在絕大多數時間攝入凝塊。這與目前的抽吸實踐相比，即使使用更大的板導管，也更難追踪凝塊，但吸食只需要一小部分時間。

Because of this, we expect Thunderbolt to change another existing paradigm in interventional stroke. We believe it will allow doctors to use smaller catheters while getting the unique benefits of modulating aspiration faster, more complete, cloud removal. This could have the added benefit of increasing the number of treatable patients by allowing for the routine treatment of more distal occlusions.

正因為如此，我們期望 Thunderbolt 能夠改變介入卒中的另一種現有範式。我們相信它將允許醫生使用更小的導管，同時獲得更快、更完整、更徹底地去除雲霧的獨特優勢。通過允許對更多遠端閉塞進行常規治療，這可能具有增加可治療患者數量的額外好處。

In our U.S. stroke business, Thunderbolt is the clear priority. That said, we are also -- we also expect to launch an additional Red catheter in the second half of the year, which we believe will be a very important addition to our market-leading portfolio. We also expect to launch the Red catheter family into the European market during Q3, which will help us revitalize our European neuro business.

在我們的美國中風業務中，Thunderbolt 顯然是首要任務。也就是說，我們也 - 我們還預計在今年下半年推出額外的 Red 導管，我們相信這將是我們市場領先產品組合的一個非常重要的補充。我們還預計在第三季度將 Red 導管系列推向歐洲市場，這將有助於我們振興我們的歐洲神經業務。

I'll now turn the call over to Sandra Lesenfants, President of our Interventional business, to give her perspective on our new product pipeline and clinical trial strategy.

現在，我將把電話轉給我們的介入業務總裁 Sandra Lesenfants，讓她對我們的新產品管道和臨床試驗戰略發表看法。

Good afternoon. It is a pleasure to join my first Penumbra earnings call. I have spent most of my career in the interventional space and was drawing to join Penumbra because of its unique cultural innovation and because of its commitment to put patients first. Penumbra's strong culture of innovation and built-in comprehensive product portfolios has stood the test of time and proven successful in multiple markets over the past 18 years, and I do believe the new product launches and supporting clinical data will start another transformative period in Penumbra's history.

下午好。很高興參加我的第一次 Penumbra 收益電話會議。我職業生涯的大部分時間都在介入領域度過，並且由於其獨特的文化創新和將患者放在首位的承諾而加入 Penumbra。 Penumbra 強大的創新文化和內置的全面產品組合經受住了時間的考驗，並在過去 18 年中在多個市場證明是成功的，我相信新產品的推出和支持的臨床數據將開啟 Penumbra 歷史上的另一個變革時期.

I am excited about both developments because the number of patients we can help across our core interventional markets represent one of the largest most underpenetrated opportunities I have seen in my career. I have spent many years leading some of the largest and fastest-growing businesses in the interventional medical device field. And I can say without equivocation that the culture of innovation at Penumbra is truly at a completely different level. The innovation culture here is unique, it's continuous and, most importantly, it is impactful.

我對這兩項發展感到興奮，因為我們可以在我們的核心介入市場上幫助的患者數量代表了我在職業生涯中看到的最大、最未被充分利用的機會之一。我多年來一直領導介入醫療器械領域的一些規模最大、發展最快的企業。我可以毫不含糊地說，Penumbra 的創新文化確實處於完全不同的水平。這裡的創新文化是獨一無二的，它是持續的，最重要的是，它具有影響力。

Adam already outlined the 3 specific technologies that we believe can be truly paradigm changing to their respective fields: Thunderbolt for ischemic stroke; Lightning Flash for the venous thromboembolism; and Lightning Bolt for peripheral arterial disease. Thunderbolt, Lightning Flash and Lightning Bolt, in addition to Lighting 12 and Lightning 7, are all proprietary systems. The development of this transformational technology has been years in the making, and they are protected by strong intellectual property portfolio.

Adam 已經概述了我們認為可以真正改變各自領域範式的 3 種特定技術：用於缺血性中風的 Thunderbolt；靜脈血栓栓塞的閃電;和 Lightning Bolt 治療外周動脈疾病。除了 Lighting 12 和 Lightning 7，Thunderbolt、Lightning Flash 和 Lightning Bolt 都是專有系統。這種變革性技術的開發已經進行了多年，並且受到強大的知識產權組合的保護。

The common denominator across all these products is the microprocessor controlled advanced software algorithms that integrate into the system, orchestrating the action of our pump and our catheters. The algorithms inherent in Lightning Flash, Lightning Bolt and Thunderbolt are customized to each catheter family, which we developed based on the most optimal solution for each specific anatomy, arterial, venous or neuro. We have a clear strategic plan to accelerate the paradigm change in mechanical thrombectomy to intelligent exploration from traditional lytics or surgery. The proprietary, simplicity and the effectivity of our technology makes the difference. And we expect these products will help physicians treat significantly more patients effectively and less invasively in the months and years ahead.

所有這些產品的共同點是微處理器控制的高級軟件算法，這些算法集成到系統中，協調我們的泵和導管的動作。 Lightning Flash、Lightning Bolt 和 Thunderbolt 中固有的算法是針對每個導管系列定制的，我們基於每個特定解剖結構、動脈、靜脈或神經的最佳解決方案開發了這些導管系列。我們有一個明確的戰略計劃來加速機械血栓切除術的範式轉變，從傳統的溶栓或手術到智能探索。我們技術的專有性、簡單性和有效性使我們與眾不同。我們預計這些產品將幫助醫生在未來數月和數年內以更少的侵入性有效地治療更多的患者。

Further, generating new scientific evidence will be critical to achieve our objectives. On that front, I'm happy to say that we are also embarking on the most robust era of clinical evidence generation in our company's history.

此外，產生新的科學證據對於實現我們的目標至關重要。在這方面，我很高興地說，我們也正在進入我們公司歷史上最強大的臨床證據生成時代。

In addition to the (inaudible) trial for Thunderbolt in ischemic stroke, which Adam mentioned, we have 5 additional trials currently enrolling or recently completed in stroke, arterial, PE, DVT and ambulation. In addition, we are nearing completion of STRIDE designs for 2 randomized controlled trials, one in PE and the other in coronary, which we expect to commence within the next few quarters. We will give you more details on these 2 important, randomized studies in the near future.

除了亞當提到的 Thunderbolt 在缺血性中風中的（聽不清）試驗外，我們還有 5 項額外的試驗目前正在招募或最近完成，涉及中風、動脈、PE、DVT 和步行。此外，我們即將完成兩項隨機對照試驗的 STRIDE 設計，一項在 PE 中，另一項在冠狀動脈中，我們預計將在未來幾個季度內開始。我們將在不久的將來為您提供有關這兩項重要的隨機研究的更多詳細信息。

Combined, our pipeline of breakthrough technologies and unmatched clinical portfolio sets us up exceptionally well to treat many more patients within our target markets, expand our leadership positions in each of these markets and to deliver strong growth for years in the future.

結合起來，我們的突破性技術管道和無與倫比的臨床產品組合使我們能夠在目標市場中治療更多患者，擴大我們在這些市場中的領導地位，並在未來幾年實現強勁增長。

I will now turn the call back to Adam.

我現在將電話轉回給亞當。

Thank you, Sandra. Before I turn the call over to Maggie, I'd like to give an update on our immersive health care business. The idea of using immersive computing or virtual reality for health care is continuing to gain momentum with health care professionals and validates our decision to invest in this business. We have seen an uptick in interest and use of our recently launched Real y-series for rehabilitation, using our updated hardware and myriad new experiences that we unveiled at our Investor Day last year.

謝謝你，桑德拉。在我將電話轉給 Maggie 之前，我想先介紹一下我們沉浸式醫療保健業務的最新情況。將沉浸式計算或虛擬現實用於醫療保健的想法繼續受到醫療保健專業人員的歡迎，並驗證了我們投資該業務的決定。我們看到人們對我們最近推出的用於康復的 Real y 系列的興趣和使用有所增加，使用我們去年在投資者日推出的更新硬件和無數新體驗。

In addition, a significant event took place this quarter to further the interest and momentum regarding the use of virtual reality for health care. The Veterans Administration hosted a multi-day summit on the use of virtual reality to help our veterans. I had the honor of joining a keynote panel with senior members of the VA to discuss this important work. I was extremely impressed with their overall knowledge and understanding as well as their willingness to validate and bring this technology to help not only veterans, but the huge number of other patients that can benefit as well.

此外，本季度還舉辦了一項重大活動，進一步激發了人們對使用虛擬現實進行醫療保健的興趣和勢頭。退伍軍人管理局舉辦了一次為期多天的峰會，主題是使用虛擬現實幫助我們的退伍軍人。我有幸與 VA 的高級成員一起參加了一個主題小組討論這項重要的工作。我對他們的整體知識和理解以及他們願意驗證和使用這項技術來幫助不僅是退伍軍人，而且還有大量其他可以受益的患者的意願印象深刻。

Even with that confidence in the long-term benefit and likely success of our immersive health care platform, obviously the macroeconomic environment has changed recently. Because of that, we are focusing our efforts on the most immediate use cases, which has allowed us to recalibrate our quarterly spend rate in immersive health care to realign with our discipline, to increase the profitability of the company. Over the next 12 months, we expect to trim over $10 million in operating expense from our business, while we maintain investments that we think will drive progress towards scaling this business over the long term.

即使對我們的沉浸式醫療保健平台的長期利益和可能的成功充滿信心，但最近宏觀經濟環境顯然已經發生了變化。因此，我們將精力集中在最直接的用例上，這使我們能夠重新調整沉浸式醫療保健的季度支出率，以重新調整我們的紀律，以提高公司的盈利能力。在接下來的 12 個月中，我們預計將從我們的業務中削減超過 1000 萬美元的運營費用，同時我們保持投資，我們認為這些投資將推動該業務在長期擴展方面取得進展。

I'll now turn the call over to Maggie to go over our financial results for the quarter.

我現在將電話轉給 Maggie，以了解我們本季度的財務業績。

Thank you, Adam. Good afternoon, everyone. Today, I will discuss the financial results for the second quarter of 2022. Consistent with previous quarter's financial results on this call for revenue and gross margin are on a GAAP basis, while operating expenses and operating income are on a non-GAAP basis. The corresponding GAAP measures and a reconciliation of GAAP to non-GAAP financial measures are provided in our posted press release.

謝謝你，亞當。大家下午好。今天，我將討論 2022 年第二季度的財務業績。與上一季度關於收入和毛利率的財務業績一致，收入和毛利率是基於公認會計原則的，而運營費用和營業收入是基於非公認會計原則的。我們發布的新聞稿中提供了相應的 GAAP 措施以及 GAAP 與非 GAAP 財務措施的對賬。

For the second quarter ended June 30, 2022, our total revenues were $208.3 million, an increase of 13.1% reported and 15.3% in constant currency compared to the second quarter of 2021. Our geographic mix of sales in the quarter were 67.9% U.S. and 32.1% international. The United States, we reported growth of 10.2%, and in our international regions, we increased revenue 19.8% as reported and 27.2% in constant currency.

截至 2022 年 6 月 30 日的第二季度，我們的總收入為 2.083 億美元，與 2021 年第二季度相比增長了 13.1%，按固定匯率計算增長了 15.3%。我們在該季度的銷售地域組合為 67.9%，美國和32.1% 國際。在美國，我們報告了 10.2% 的增長，在我們的國際地區，我們報告的收入增長了 19.8%，按固定匯率計算增長了 27.2%。

Moving to revenue by franchise. Revenue from our vascular business grew to $123.5 million in the second quarter of 2022, an increase of 22.7% reported and 24.5% in constant currency compared to the same period last year. We saw double-digit growth across U.S., EMEA, Asia and Latin America regions. Revenue from our neuro business was $84.8 million in the second quarter of 2022, an increase of 1.5% reported and 4.3% in constant currency compared to the same period a year ago. Sequentially, revenue from our Neuro business grew by 4.6% reported and 5.8% in constant currency driven by stronger growth in neuro thrombectomy across international regions.

通過特許經營轉向收入。 2022 年第二季度，我們血管業務的收入增長至 1.235 億美元，與去年同期相比增長 22.7%，按固定匯率計算增長 24.5%。我們在美國、歐洲、中東和非洲地區、亞洲和拉丁美洲地區看到了兩位數的增長。 2022 年第二季度，我們神經業務的收入為 8480 萬美元，與去年同期相比增長 1.5%，按固定匯率計算增長 4.3%。隨後，由於國際地區神經血栓切除術的強勁增長，我們的神經業務收入增長了 4.6%，按固定匯率計算增長了 5.8%。

Moving to gross margin and operating expenses. Gross margin in the second quarter was relatively flat at 64.3% compared to 64.4% in the same quarter last year and continues to improve sequentially from 62.5% last quarter. Our investment in capacity, labor force and productivity efforts in the last 18 months have begun to pay off in terms of driving margin expansion as well as enabling us to navigate through some macro labor shortage, inflation and supply chain headwinds. Looking forward to the balance of this year, we expect to see continued productivity improvements to offset heightened inflation and supply chain pressures. And we have several programs in place to continue to drive gross margin improvements in the future.

轉向毛利率和運營費用。第二季度毛利率為 64.3%，與去年同期的 64.4% 相比相對持平，並從上一季度的 62.5% 繼續提高。在過去 18 個月中，我們在產能、勞動力和生產力方面的投資已經開始獲得回報，這有助於擴大利潤率，並使我們能夠度過一些宏觀勞動力短缺、通貨膨脹和供應鏈逆風。展望今年的餘額，我們預計生產力將繼續提高，以抵消通脹加劇和供應鏈壓力。我們有幾個計劃來繼續推動未來毛利率的提高。

Now on to our non-GAAP operating expenses, excluding the quarter's amortization of acquired intangible assets of $1.8 million. Total operating expense for the quarter was $132.4 million, or 64% of revenue compared to $108.4 million or 59% of revenue for the same quarter last year. Our research and development expenses for Q2 2022 were $19.6 million compared to $17.7 million for Q2 2021. SG&A expenses for Q2 2022 were $112.8 million or 54.2% of revenue compared to $90.6 million for Q2 2021 and $109.1 million compared to last quarter. We made additional investment in commercial channels and temporary resources to support our ERP system migration in the second quarter.

現在是我們的非公認會計原則運營費用，不包括本季度收購的 180 萬美元無形資產的攤銷。本季度總運營費用為 1.324 億美元，佔收入的 64%，而去年同期為 1.084 億美元，佔收入的 59%。我們 2022 年第二季度的研發費用為 1960 萬美元，而 2021 年第二季度為 1770 萬美元。2022 年第二季度的 SG&A 費用為 1.128 億美元，佔收入的 54.2%，而 2021 年第二季度為 9060 萬美元，與上一季度相比為 1.091 億美元。我們在商業渠道和臨時資源方面進行了額外投資，以支持我們在第二季度的 ERP 系統遷移。

We recorded operating income of $1.6 million or 0.8% of revenue in second quarter 2022, excluding the amortization of acquired intangible assets, compared to an operating income of $10.3 million for the same period last year. For the back half of 2022, we will be more disciplined in our discretionary spending and together with over $10 million reduction in immersive health care operating expenses in the next 12 months, we expect continued operating margin expansion in sequential quarters.

我們在 2022 年第二季度錄得 160 萬美元的營業收入或收入的 0.8%，不包括收購的無形資產的攤銷，而去年同期的營業收入為 1030 萬美元。在 2022 年下半年，我們將在可自由支配的支出方面更加自律，再加上未來 12 個月內沉浸式醫療保健運營費用減少超過 1000 萬美元，我們預計連續幾個季度的營業利潤率將繼續擴大。

We ended the second quarter with cash, cash equivalents and marketable security balance of $204.4 million. Although we experienced some receivable collection delay related to the migration of our new ERP system during the quarter, our team has made great progress to recent back to normal collection cycle.

我們在第二季度結束時的現金、現金等價物和有價證券餘額為 2.044 億美元。儘管我們在本季度經歷了與新 ERP 系統遷移相關的一些應收賬款收款延遲，但我們的團隊在最近恢復正常收款週期方面取得了很大進展。

And now I'd like to turn the call over to Jason to discuss our guidance.

現在我想把電話轉給 Jason 來討論我們的指導。

Thank you, Maggie, and good afternoon, everyone. Foreign currency translations impacted our reported revenue in the second quarter and first half of 2022 by $4 million and $6 million, respectively. For the full year 2022, we anticipate the FX impact to be approximately $10 million to $15 million. We are maintaining our guidance of $860 million to $875 million. But due to these FX headwinds, we are more comfortable with expectations at the lower end of this range.

謝謝你，瑪吉，大家下午好。外幣折算對我們在 2022 年第二季度和上半年的報告收入分別產生了 400 萬美元和 600 萬美元的影響。對於 2022 年全年，我們預計外匯影響約為 1000 萬至 1500 萬美元。我們維持 8.6 億至 8.75 億美元的指引。但由於這些外匯逆風，我們對這個範圍低端的預期更加滿意。

That said, on a constant currency basis, we continue to expect our revenue growth to be 15% to 17% compared to 2021. Looking into 2023, Lighting Flash, Lightning Bolt and Thunderbolt represent 3 paradigm-changing technologies in arterial, venous and neuro thrombectomy respectively. These products, coupled with multiple international growth opportunities and strong clinical evidence pipeline underline our confidence in future growth. Consequently, we reiterate our belief that we can accelerate our revenue growth in 2023, both on a reported and constant currency basis.

也就是說，按固定匯率計算，我們繼續預計與 2021 年相比，我們的收入增長將達到 15% 至 17%。展望 2023 年，Lighting Flash、Lightning Bolt 和 Thunderbolt 代表了動脈、靜脈和神經領域的 3 種範式改變技術分別取栓。這些產品，加上多個國際增長機會和強大的臨床證據管道，突顯了我們對未來增長的信心。因此，我們重申我們的信念，即我們可以在 2023 年加速我們的收入增長，無論是在報告的貨幣基礎上還是固定貨幣基礎上。

I will now turn the call back to Adam for closing remarks.

我現在將電話轉回給 Adam 以結束髮言。

Thank you, Jason, Maggie, Sandra, and Jee. I'd like to conclude this quarter's earnings call by acknowledging the world-class work that the Penumbra team did this quarter in very challenging circumstances. I am so proud to work with this team. They have shown time and time again their talent and perseverance by pulling together to tackle whatever comes our way.

謝謝你，傑森、瑪吉、桑德拉和吉。我想通過承認 Penumbra 團隊本季度在非常具有挑戰性的情況下所做的世界級工作來結束本季度的收益電話會議。我很自豪能與這個團隊一起工作。他們一次又一次地展示了他們的才華和毅力，齊心協力應對我們遇到的任何事情。

I also want to quickly summarize how our team of Penumbra runs the business. We are developing products that can help a significant number of patients, many of whom are not getting the most advanced treatment today. Our technology has always been unique and transformational. But at this moment, we have 4 significant catalysts coming, 3 products plus supporting clinical data that will allow us to help more and more patients for many years to come. This, coupled with our disciplined planning and execution gives us confidence that we will deliver strong double-digit growth, increase gross margins materially and significantly expand operating profitability, all while investing proportionate to the large opportunities in front of us.

我還想快速總結一下我們的 Penumbra 團隊是如何運營業務的。我們正在開發可以幫助大量患者的產品，其中許多患者今天沒有得到最先進的治療。我們的技術一直是獨一無二的，具有變革性。但目前，我們有 4 個重要的催化劑、3 個產品以及支持性臨床數據，這將使我們能夠在未來很多年幫助越來越多的患者。這一點，再加上我們嚴謹的規劃和執行，讓我們有信心實現強勁的兩位數增長，大幅提高毛利率並顯著擴大運營盈利能力，同時根據擺在我們面前的巨大機會進行投資。

Thank you. We'll now take questions.

謝謝你。我們現在來提問。

(Operator Instructions)

（操作員說明）

Your first question comes from the line of Robbie Marcus with JP Morgan.

您的第一個問題來自摩根大通的 Robbie Marcus。

This is actually Lily on for Robbie today. Is there any way that you can quantify the magnitude of the contrast shortage in the quarter? And how are you thinking about this and other challenges like staffing, China, impacting your growth over the rest of the year?

這實際上是今天為羅比準備的莉莉。有什麼方法可以量化本季度對比度短缺的程度？您如何看待這一挑戰以及其他挑戰，例如人員配備、中國，這些挑戰會影響您在今年餘下時間的增長嗎？

Yes. It's a great question. I wish there was an easy way to quantify, contrast and the impact. There really isn't. I would say that there was a lot more discussion about it earlier in the quarter. I really haven't, as I said in my prepared remarks, we haven't really seen it as much as an issue right now.

是的。這是一個很好的問題。我希望有一種簡單的方法來量化、對比和影響。真的沒有。我想說，本季度早些時候有更多關於它的討論。正如我在準備好的評論中所說，我真的沒有，我們現在還沒有真正將其視為一個問題。

Sort of persistent staffing issues really have been the bigger impact, we think, if we were to pick what was driving the challenges and some of the headwinds. That being said, and I said it in my prepared remarks, the last month, the first month of this quarter, the last 30 days has -- we've seen a pretty strong resurgence.

我們認為，如果我們要選擇推動挑戰和一些不利因素的因素，那麼持續存在的人員配備問題確實會產生更大的影響。話雖如此，我在準備好的講話中說過，上個月，本季度的第一個月，過去 30 天 - 我們已經看到了相當強勁的複蘇。

And so whether hospitals are dealing with their staffing issues are finding a way to operate within this environment in a more long-term basis. I think it's a combination of those. We have a lot of optimism for what we've seen in the first month so far.

因此，醫院是否正在處理他們的人員配備問題，正在尋找一種在這種環境下更長期地運作的方法。我認為這是這些的結合。到目前為止，我們對第一個月所看到的情況非常樂觀。

Yes, Lily, just to add a little bit of that. As Adam said, quantitative specificity is very difficult. We tried to ascertain that. It was certainly a number of million dollars, we think. But it's hard to quantify much further than that, just to try to put a finer point on it.

是的，莉莉，只是補充一點。正如亞當所說，定量特異性是非常困難的。我們試圖確定這一點。我們認為，這肯定是數百萬美元。但是很難進一步量化，只是為了嘗試對其進行更詳細的說明。

Got it. That's really helpful. And just as a follow-up, did the U.S. peripheral business grow sequentially? And how are you thinking about that segment in the back half of the year?

知道了。這真的很有幫助。而作為後續，美國周邊業務是否有環比增長？您如何看待下半年的這一細分市場？

Sorry, just so I heard your question correctly, did you ask U.S. or international?

抱歉，我沒聽錯你的問題，你問的是美國的還是國際的？

U.S. peripheral.

美國周邊。

Yes. So our U.S. business in the first half of the year grew about 15%. And certainly we saw, as Adam mentioned, staffing shortage, the macro economic challenges impact our U.S. business in the second quarter, more than it did in the first. We expect acceleration in that business in the back half of the year. We think it will step up in the third and even step up more in the fourth quarter.

是的。所以上半年我們的美國業務增長了15%左右。正如亞當所說，我們當然看到了人員短缺，宏觀經濟挑戰在第二季度對我們美國業務的影響比第一季度更大。我們預計該業務將在今年下半年加速發展。我們認為它會在第三季度加速，甚至在第四季度進一步加速。

And then if you look at the second half growth on a year-over-year basis in the U.S., we think it will be similar actually to the first half, which, as I mentioned, was in the mid-teens.

然後，如果你看一下美國下半年的同比增長，我們認為它實際上與上半年相似，正如我所提到的，上半年是在十幾歲左右。

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

你的下一個問題來自富國銀行的拉里·比格爾森。

This is Lei calling in for Larry. Adam, you talked about -- you mentioned a rebound in the vascular thrombectomy business in the past month. Can you just give a little more color on how that trended through Q2, did worsen from April to June, and there was a big rebound in July? And also any commentary along the trend line in neuro? And I have a follow-up.

這是雷叫拉里來的。亞當，你談到了——你提到了過去一個月血管血栓切除術業務的反彈。您能否就第二季度的趨勢提供更多色彩，從 4 月到 6 月惡化，以及 7 月出現大幅反彈？還有任何沿著神經趨勢線的評論嗎？我有一個後續行動。

Yes. Starting with peripheral on the thrombectomy business, what I was alluding to is really in the last month to this -- the month of July, we saw the strong resurgence probably started a little bit into the end of June as well.

是的。從血栓切除業務的外圍開始，我所暗示的實際上是在上個月到這個 - 7 月份，我們看到強勁的複蘇可能也開始到 6 月底。

Some of that, I think, is the hospitals are getting more organized around the staffing issues. And I think -- they've been working really hard to do that. And some of it might be a competitive share. As I alluded to, we're seeing a lot more conversation doctors are bringing up about some of that issue, particularly on the DVT side. And I think that's a bigger topic that we're going to be talking about and addressing going forward. But I think the combination of those things are seeing the acceleration.

我認為，其中一些原因是醫院在人員配備問題上變得更有條理。我認為——他們一直在努力做到這一點。其中一些可能是競爭份額。正如我所提到的，我們看到越來越多的醫生就其中的一些問題提出了對話，特別是在 DVT 方面。我認為這是一個更大的話題，我們將在未來討論和解決。但我認為這些東西的結合正在加速。

On the neuro side, I we'll tell you the excitement around Thunderbolt as more and more folks see it, there's a large presentation at SNIS with a demonstration from a physician who's part of the trial. We had a lot of conversation about that, folks throughout the week coming up and talking about it. And so I think there's a real excitement around that. And of course, the red catheters are part of that success right now.

在神經方面，隨著越來越多的人看到它，我會告訴你關於 Thunderbolt 的興奮，在 SNIS 上有一個大型演示文稿，來自一名參與試驗的醫生的演示。我們對此進行了很多交談，整個星期的人們都來談論它。所以我認為這真的很令人興奮。當然，紅色導管是目前成功的一部分。

Yes. Just to add to that, Lei, the underlying fundamentals of our peripheral thrombectomy business, and we look at them very carefully are actually quite healthy and has been through the second quarter. We just saw continued improvement of an already strong fundamental base in July. Generally speaking, we expect to see that continue here in the second half of the year.

是的。補充一點，雷，我們外周血栓切除術業務的基本面，我們非常仔細地觀察它們實際上是相當健康的，並且已經度過了第二季度。我們剛剛看到 7 月份已經強勁的基本面持續改善。一般來說，我們希望看到這種情況在下半年繼續。

Great. And then as far as gross margin, can you talk about what we should expect a sequential improvement in second half? And any comments around key drivers to get to the 70% plus gross margin in the next few years?

偉大的。然後就毛利率而言，你能談談我們應該期待下半年的連續改善嗎？對未來幾年毛利率達到 70% 以上的關鍵驅動因素有何評論？

Yes. Thanks for the question. Yes, we're very excited to see all the momentum in productivity improvement, especially in our [Grosville] site and the manufacturing transfer effort. So a lot of the productivities we see in this quarter is driven by those productivity initiatives. And sequentially, there's still some low-hanging fruits and a lot of other initiatives that we're working on. We will continue to see improvement and continue to navigate through the foreign exchange inflation and supply chain pressures.

是的。謝謝你的問題。是的，我們很高興看到生產力提高的所有勢頭，特別是在我們的 [格羅斯維爾] 工廠和製造轉移工作中。因此，我們在本季度看到的許多生產力都是由這些生產力舉措推動的。接下來，我們仍然在努力實現一些唾手可得的成果和許多其他舉措。我們將繼續看到改善，並繼續應對外匯通脹和供應鏈壓力。

In the longer term, definitely continue driving improvement, new product launches to drive favorable mix and a lot of the other bigger programs we have in place will get us in the right path towards the 70% plus gross margin target.

從長遠來看，肯定會繼續推動改進，推出新產品以推動有利的組合，我們實施的許多其他更大的計劃將使我們朝著 70% 以上的毛利率目標邁進。

Your next question comes from the line of Bill Plovanic with Canaccord.

您的下一個問題來自 Canaccord 的 Bill Plovanic。

It's John on for Bill Tonight. So I just -- you had a really good OUS quarter, and I just wanted to dive a little bit more into that. Is this really from the launch of the Lightning 7 and 12 in Europe? And how should we think about OUS contribution in the second half of the year towards the overall revenue targets?

今晚是約翰的比爾。所以我只是 - 你有一個非常好的 OUS 季度，我只是想更深入一點。這真的是來自歐洲推出的 Lightning 7 和 12 嗎？我們應該如何看待下半年 OUS 對整體收入目標的貢獻？

Yes. Thanks for the question, Josh. Great question. The growth in contribution was broad based in the quarter from our international business. Certainly, the Lightning launches in Europe and EMEA broadly contribute to that. We're looking forward to the Red launches this quarter in that same region.

是的。謝謝你的問題，喬希。好問題。我們的國際業務在本季度的貢獻增長廣泛。當然，Lightning 在歐洲和歐洲、中東和非洲地區的發布廣泛地促成了這一點。我們期待本季度在同一地區推出 Red。

We also saw broad-based growth across Asia Pacific, including China, and look forward to continued growth there as well as Japan. Obviously, we mentioned where we could have our vascular thrombectomy products there maybe earlier than we thought. So things internationally look like they're on a solid trajectory.

我們還看到了包括中國在內的整個亞太地區的廣泛增長，並期待那里以及日本的持續增長。顯然，我們提到的血管血栓切除術產品可能比我們想像的更早。因此，國際上的事情看起來正處於穩固的軌道上。

Great. And just on the call itself, obviously, you've highlighted all the macro environment challenges and FX. What's your comfort level around hitting that $1 billion in sales target for 2023 still? Do you think you could still hit it with what anything that's going on now?

偉大的。顯然，就電話本身而言，您已經強調了所有宏觀環境挑戰和外匯。對於 2023 年達到 10 億美元的銷售目標，您的舒適程度如何？你認為你仍然可以用現在發生的任何事情來擊中它嗎？

Yes.

是的。

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

您的下一個問題來自德意志銀行的 Pito Chickering。

A few follow-ups for you on the revenues. Did you see a difference in demand between urban hospitals versus sort of smaller hospitals as it relates to staffing? Can you also provide color on how Vascular and Neuro grew in the U.S. versus international?

關於收入的一些後續行動。您是否看到城市醫院與小型醫院之間在人員配備方面的需求差異？您能否提供有關 Vascular 和 Neuro 在美國與國際上的增長情況的顏色？

Yes. So let's start with the first one. Pito, (inaudible). We didn't see a discernible difference. I think what we've heard from customers, be it small institutions or larger academic institutions, they're both dealing with the same macroeconomic headwinds, be they nursing or tech, staffing issues or otherwise.

是的。所以讓我們從第一個開始。皮托，（聽不清）。我們沒有看到明顯的區別。我認為我們從客戶那裡聽到的消息，無論是小型機構還是大型學術機構，他們都在應對相同的宏觀經濟逆風，無論是護理還是技術、人員配備問題或其他問題。

And the same was true when contrast was more of an issue earlier in the quarter, generally speaking. With respect to your second question on U.S. versus international, we're obviously not giving granularity to the breakout between -- in our business as U.S. international. But I think the important salient point is the underlying fundamentals in our -- I think you asked about thrombectomy businesses, in both Neuro frankly and Peripheral Vascular are very strong. Neurothrombectomy growth is obviously slower right now. The momentum with Thunderbolt, we're really excited about.

一般來說，當對比度在本季度早些時候更成為一個問題時，情況也是如此。關於您關於美國與國際的第二個問題，我們顯然沒有詳細說明我們作為美國國際業務之間的突破。但我認為重要的一點是我們的基本面——我想你問到血栓切除術業務，坦率地說，神經和外周血管都非常強大。現在神經血栓切除術的增長明顯較慢。迅雷的勢頭，我們真的很興奮。

Okay. Fair enough. And a follow-up for you on the gross margin, specifically on the interventional side. I guess, how different are they versus your pure-play competitor? And any color specifically on what you're seeing on inflation pressures, again, within the interventional side, when you include immersive health? And how should we think about the inflationary pressures offset with the efficiencies from the Roseville manufacturing facility coming online?

好的。很公平。並為您跟進毛利率，特別是在干預方面。我想，他們與你的純競爭對手有多大不同？當您包括身臨其境的健康時，再次在干預方面，您在通脹壓力方面看到的任何顏色？我們應該如何考慮通脹壓力被羅斯維爾製造工廠上線的效率所抵消？

Yes, thanks for the question. I think in terms of the margin of thrombectomy, I mean relatively, I think the biggest difference competitive-wise is just on the price element in general, within our business, thrombectomies have a higher margin than our embolization business. But then going forward, we do see continued productivity improvement that we have been working on in the last 12 to 18 months to offset the foreseeable macro headwinds that we expect in the second half.

是的，謝謝你的提問。我認為就血栓切除術的利潤率而言，我的意思是相對而言，我認為競爭方面最大的差異只是在價格因素上，總的來說，在我們的業務中，血栓切除術的利潤率高於我們的栓塞業務。但展望未來，我們確實看到我們在過去 12 到 18 個月一直在努力提高生產力，以抵消我們預計在下半年出現的可預見的宏觀逆風。

Your next question comes from the line of David Rescott with Truist Securities.

您的下一個問題來自 Truist Securities 的 David Rescott。

First, on the U.S. Jason, Adam. First, on the U.S. peripheral thrombectomy business. Obviously, over the past several years had success kind of building that market up from the ground and especially good success in the quarter with the headwinds in that segment.

首先，關於美國的傑森、亞當。首先，關於美國外周血栓切除術業務。顯然，在過去的幾年裡，在從頭開始建立這個市場方面取得了成功，尤其是在該領域遇到逆風的情況下，本季度取得了成功。

I'm just wondering if now or at some point in the future, we could think about maybe getting some more granularity around the individual segments within that business as it relates to arterial or coronary PE, DVT as far as how they've been progressing relative to each other, as well as relative to the rest of the overall market.

我只是想知道現在或將來的某個時候，我們是否可以考慮在該業務中與動脈或冠狀動脈 PE、DVT 相關的各個細分市場獲得更多的粒度，就它們的進展而言相對於彼此，以及相對於整個市場的其餘部分。

Yes. It's a good question. I'll start. Jason can add to the answer. As it relates to arterial versus the larger venous, there's some way to sort of describe that. I think it's premature to start breaking that up, just given the way we're thinking about and running those businesses, as we try to go out and build all of them at the same time. I think that will be more helpful as the business matures.

是的。這是個好問題。我會開始的。傑森可以補充答案。由於它涉及動脈與較大的靜脈，因此有某種方式可以描述這一點。我認為現在開始打破它還為時過早，考慮到我們正在考慮和經營這些業務的方式，因為我們試圖同時建立所有這些業務。我認為隨著業務的成熟，這將更有幫助。

Eventually though, as it related to DVT and PE, its going to be hard because the products will be the same and it becomes a lot harder to sort of know that answer. It would be different if we had different products, obviously. But we'll give you the kind of color commentary we can around the success we're having. I alluded to that on this call, particularly as it relates to some of the competitive success. So we'll continue to do that as best we can.

但最終，由於它與 DVT 和 PE 相關，它會變得很困難，因為產品將是相同的，而且要知道答案變得更加困難。顯然，如果我們有不同的產品，情況會有所不同。但我們會圍繞我們所取得的成功為您提供我們所能提供的那種色彩評論。我在這次電話會議上提到了這一點，特別是因為它與一些競爭成功有關。因此，我們將繼續盡我們所能做到這一點。

Yes. And David, just to add to that. If you look at the segments of the market or the patient populations inherent in each one of those spaces, and you go back to what we said on the -- in the prepared remarks about the technologies we're bringing to bear that are specific for each one of those anatomies.

是的。還有大衛，只是補充一下。如果您查看每個空間中固有的市場細分或患者群體，然後您會回到我們在準備好的評論中所說的關於我們正在採用的專門針對的技術的評論中這些解剖結構中的每一個。

And you couple that last thing, the relatively low penetration, where we are in penetrating or helping the patients within those markets, that's why we said on the call that we think we're about to enter the most robust era in Penumbra's history. As we -- with the microprocessor controlled algorithms that are inherent in each of these technologies, and we announced the Lightning Flash for venous thromboembolism, for example, allows us to deliver the most advanced therapy the industry has ever seen in thrombectomy in venous thromboembolism. Same can be said for Lighting Bolt in arterial, CAT RX and coronary. So we feel really good about that and supporting it with clinical evidence, true clinical evidence, we feel very good about where we're going.

最後一件事，相對較低的滲透率，我們在這些市場中滲透或幫助患者，這就是為什麼我們在電話會議上說我們認為我們即將進入 Penumbra 歷史上最強勁的時代。當我們使用這些技術中固有的微處理器控制算法時，我們宣布了用於靜脈血栓栓塞的閃電閃光，例如，使我們能夠提供業界在靜脈血栓栓塞的血栓切除術中看到的最先進的治療方法。動脈、CAT RX 和冠狀動脈中的 Lighting Bolt 也可以這樣說。所以我們對此感覺非常好，並用臨床證據支持它，真正的臨床證據，我們對我們要去的地方感覺非常好。

Okay. I guess just as it relates to the spend in this year and spend over the next 2 or 3 next couple of years. How are you thinking about -- I know in the past, you've talked about kind of focusing on growth as opposed to or relative to margin expansion.

好的。我想這與今年的支出以及未來 2 到 3 年的支出有關。你是怎麼想的——我知道過去，你談到過關注增長而不是利潤擴張。

But when you think about the spend over the next several years, I mean, where do you think that the largest amount or the greatest dollar per spend is coming from as it relates to either Thunderbolt, the VR opportunity just expanding the neurovascular and peripheral businesses. Just would love to get a sense on the kind of longer-term outlook of the spend.

但是當你考慮未來幾年的支出時，我的意思是，你認為最大金額或最大的美元來自哪裡，因為它與 Thunderbolt 相關，VR 機會只是擴大了神經血管和外圍業務.只是很想了解支出的長期前景。

Okay. I'll start on that, thanks for the question. I think on the overall operating expense standpoint, I think, especially looking back the last 12 months, we have had pretty balanced investment across all product development, sales force, international and then also overall infrastructure. So I think we're at a pretty good level now to start scaling the opportunities and even be a little bit more disciplined in some of the discretionary spending.

好的。我會從這個開始，謝謝你的問題。我認為從整體運營費用的角度來看，尤其是回顧過去 12 個月，我們在所有產品開發、銷售隊伍、國際以及整體基礎設施方面的投資都相當平衡。所以我認為我們現在處於一個相當不錯的水平，可以開始擴大機會，甚至在一些可自由支配的支出方面更加自律。

But as Adam mentioned earlier, I mean, even with some of the cost savings area, if we are not going to -- at the cost of the pipeline development.

但正如亞當之前提到的，我的意思是，即使有一些成本節約領域，如果我們不打算這樣做——以管道開發為代價。

Your next question comes from the line of Mike Matson with Needham & Company.

您的下一個問題來自於 Needham & Company 的 Mike Matson。

I want to ask about Lightning Flash and Bolt. Having both of those products available, it sounds like they have some different kind of capabilities. And then I guess you have kind of the older original Lightning as well.

我想問一下Lightning Flash and Bolt。擁有這兩種產品，聽起來它們具有某種不同的功能。然後我猜你也有一種較舊的原始閃電。

So how are they going to be priced kind of at different levels? Is it going to have a tiered offering or something? And where do you see the Flash versus Bolt getting used? Is it targeting different types of procedures or something?

那麼它們將如何在不同的水平上定價呢？它會提供分層產品嗎？您在哪裡看到 Flash 與 Bolt 的使用情況？它是針對不同類型的程序還是什麼？

Yes. It's a great question. As I said in the prepared remarks, Lightning Bolt is primarily designed for use on the arterial side, and Lightning Flash is primarily on the venous side. And so that's sort of the fundamental difference. The arteries and veins, as you know, are extremely different. They operate differently. You have to treat them differently. They're different sizes as well.

是的。這是一個很好的問題。正如我在準備好的評論中所說，Lightning Bolt 主要用於動脈側，而 Lightning Flash 主要用於靜脈側。這就是根本的區別。如您所知，動脈和靜脈非常不同。它們的運作方式不同。你必須以不同的方式對待他們。它們的大小也不同。

That being said, the next question around price and all that, let's get the products cleared through the FDA and out there, and then we'll address questions around how we price it and how we think about it. I will tell you, though, having been part of the almost 20-year journey now in stroke and watching sort of the arc of innovation happen in stroke, and all the things we used to do as a field and even as a company to try to get caught out and to where we're now about to be with Thunderbolt, it brings the same sort of type of feeling around in the peripheral side, too, that we can really sort of get to the point where we're not doing the kind of things that we kind of almost had to do to get the clot out before and bring long-term, sort of, risk to the vessel walls and things.

話雖如此，下一個關於價格和所有其他問題的問題，讓我們通過 FDA 批准產品，然後我們將解決有關我們如何定價以及我們如何看待它的問題。不過，我會告訴你，我已經參與了將近 20 年的中風之旅，並觀察了中風發生的某種創新弧線，以及我們過去作為一個領域甚至作為一家公司所做的所有事情被抓住並到達我們現在將要使用 Thunderbolt 的地方，它在外圍也帶來了同樣的感覺，我們真的可以達到我們不做的地步之前我們幾乎不得不做的事情來清除凝塊並給血管壁和其他東西帶來長期的風險。

So this technology across all of these has a lot of meaning to people here. It is the kind of thing we do where we really sort of finish the arc of innovation that we've started in trying to get clot out of the body. So there's a lot of passion, a lot of extraordinary work put into these, and we'll deal with price when we get about in the market. But exciting times, thanks for the question, Mike.

所以這項跨越所有這些的技術對這裡的人們來說意義重大。這是我們所做的那種事情，我們真正完成了我們已經開始嘗試將凝塊排出體外的創新弧。所以有很多熱情，很多非凡的工作投入到這些中，當我們進入市場時，我們會處理價格問題。但激動人心的時刻，謝謝你的問題，邁克。

Yes. And then just a follow-up on the REAL System. So just given the -- you're trying to focus that on you said immediate use cases. Can you maybe talk about what those are? And then what is your current pricing scheme? And I'm not asking for dollar amounts, but I think in the past, you've talked about kind of a rental model. But it seems like more recently, you've talked about more of like a capital sale model. Maybe just any color there would be helpful.

是的。然後只是對真實係統的跟進。因此，只要考慮到 - 您正試圖將其重點放在您所說的即時用例上。你能談談那些是什麼嗎？那麼您目前的定價方案是什麼？而且我不是要美元金額，但我認為在過去，你已經談到了一種租賃模式。但似乎最近，您談論的更像是一種資本出售模式。也許那裡的任何顏色都會有所幫助。

Yes, so it's a great question. The -- there will be time in place to talk about the models. I've been clear that we'll do our best to update people on the models as we do our work to try to figure out the right way to do this for the field.

是的，所以這是一個很好的問題。 - 將有時間談論模型。我很清楚，我們會盡最大努力讓人們了解模型，因為我們會努力找出正確的方法來為該領域做到這一點。

What I think we need to focus on right now is what is -- where can we be helpful, where do people need this product? And I got to just -- if you can indulge me for one moment. I mentioned the meeting that the VA hosted. It was an extraordinary event. I was proud to have been invited and really blown away that the Veterans Administration was doing this.

我認為我們現在需要關注的是——我們可以在哪裡提供幫助，人們在哪裡需要這個產品？我必須——如果你能放縱我片刻。我提到了 VA 主持的會議。這是一個非同尋常的事件。我很自豪能被邀請，並且對退伍軍人管理局正在這樣做感到非常震驚。

They had an awful lot of people there, both in person and virtually. They talked about and they had a number of other vendors and so on. It was a pretty broad meeting. But being able to share and talk about how to not only figure out what applications, because they kind of already know that to some degree. But how do you implement this? What's the workflow look like inside a health care system? And obviously, VA is the largest health care system in the U.S.

他們在那裡有很多人，無論是親自還是虛擬地。他們談到，他們有許多其他供應商等等。這是一次相當廣泛的會議。但是能夠分享和討論如何不僅要弄清楚哪些應用程序，因為他們在某種程度上已經知道這一點。但是你如何實現呢？醫療保健系統內部的工作流程是什麼樣的？顯然，弗吉尼亞州是美國最大的醫療保健系統。

I got to tell you, then listening to a panel after our panel of veterans, and having the veterans share their personal experiences, having used VR and what did that do for them and how that opened up the beginning of not only therapy with VR, but therapy in other ways, there is a huge opportunity, of course, to help everyone. But if we can help our veterans, we've done some good work together. And I think it motivated us to be efficient in how we focus and focus our spend in a way so we can be really, really helpful to these people.

我得告訴你，然後在我們的退伍軍人小組之後聽一個小組，讓退伍軍人分享他們的個人經歷，他們使用過 VR 以及這對他們有什麼作用，以及這如何開啟了不僅是 VR 治療的開端，但是在其他方面的治療，當然有很大的機會可以幫助到每個人。但是，如果我們可以幫助我們的退伍軍人，我們已經一起做了一些很好的工作。而且我認為這促使我們高效地專注於我們的支出，以便我們能夠真正、真正地幫助這些人。

So that's the most important thing right now. And we're pretty committed to that.

所以這是目前最重要的事情。我們非常致力於這一點。

Your next question comes from the line of Shagun Singh with RBC.

您的下一個問題來自 RBC 的 Shagun Singh。

This is Avi on for Shagun. Just a follow-up on immersive health care and all the virtual reality platform. It's great that you've been getting a lot of good feedback, but what metrics do you plan to share on REAL in the quarters ahead? Could you remind us how we should think about the reimbursement as you roll out the platform? And what gives you the confidence that REAL will be your largest business in the next 5 to 6 years?

這是 Shagun 的 Avi。只是對沉浸式醫療保健和所有虛擬現實平台的跟進。很高興您得到了很多良好的反饋，但是您計劃在未來幾個季度在 REAL 上分享哪些指標？您能否提醒我們在您推出平台時應該如何考慮報銷？是什麼讓您有信心在未來 5 到 6 年內 REAL 將成為您最大的業務？

So as I've said, as soon as we're able with the kind of certainty and specificity that you deserve, we will share that information with you. Right now, and I've learned this many years ago when we first started the company, just to remind everyone, when we started thinking about doing a stroke product, there was no reimbursement, no one wanted to treat stroke, there was no infrastructure for it.

因此，正如我所說，一旦我們能夠獲得您應得的那種確定性和特異性，我們就會與您分享這些信息。現在，很多年前我們剛開公司的時候就知道了，只是提醒大家，當我們開始考慮做中風產品的時候，沒有報銷，沒有人想治療中風，沒有基礎設施為了它。

And none of that deterred us. We just went for it because we followed the most important thing and that's -- there are patients that were having strokes, and we thought we could do something to help. That's the same exact thing here. And that's why that summit at the VA was reaffirming, and particularly the patients that are being benefited from immersive therapy at this point. So we will, as soon as possible and is prudent, we will get you that information. But what gives us the confidence is that we already see people benefiting.

這些都沒有阻止我們。我們之所以這麼做，是因為我們遵循了最重要的事情，那就是——有些患者中風，我們認為我們可以做點什麼來幫助。這是同樣的事情。這就是為什麼在 VA 舉行的峰會重申了這一點，特別是此時正在從沉浸式治療中受益的患者。因此，我們將盡快且謹慎地為您提供該信息。但讓我們充滿信心的是，我們已經看到人們從中受益。

And now we just have to figure out how to deliver and how to add this to the workflow of complicated health care systems. And that is not easy. That is hard work, has some uncertainty to it. It is exactly like everything else we've ever done that's had uncertainty to it. And I think we're incredibly well suited, and we have the mindset to not sort of follow the lead of others, but to brave new spaces with the goal of helping people, particularly our veterans.

現在我們只需要弄清楚如何交付以及如何將其添加到復雜的醫療保健系統的工作流程中。這並不容易。這是一項艱苦的工作，有一些不確定性。就像我們做過的所有其他事情一樣，都有不確定性。而且我認為我們非常適合，我們有一種心態，不追隨他人，而是勇於開拓新領域，以幫助人們，尤其是我們的退伍軍人為目標。

Yes. Just to add too, this is Jason. The guidance information, both quantitative guidance that we've given for this year, and to some extent qualitative guidance that we've given for 2023, just as a reminder, is really our interventional business alone. And I just wanted to make sure that, that was clear.

是的。還要補充一點，這是傑森。指導信息，無論是我們今年給出的定量指導，還是在某種程度上我們為 2023 年給出的定性指導，都只是提醒一下，實際上是我們的干預業務。我只是想確保這一點很清楚。

The financial model, the business model for immersive health care, as we'll talk about more in the future, is and can be a very good lucrative model for the company. It is different than other prototypical medical device models, to be sure. But nonetheless, opportunistic in terms of the opportunity, not only from a top line perspective, but margins and profitability over the longer term. And so I just wanted to add to that.

財務模式，沉浸式醫療保健的商業模式，我們將在未來更多地討論，對公司來說是並且可能是一個非常有利可圖的模式。可以肯定的是，它不同於其他原型醫療設備模型。但儘管如此，就機會而言，不僅從頂線的角度來看，而且從長期的利潤率和盈利能力來看，都是機會主義的。所以我只是想補充一點。

(Operator Instructions) Your next question comes from the line of Brandon Vazquez with William Blair.

（操作員說明）您的下一個問題來自 Brandon Vazquez 和 William Blair 的台詞。

I wanted to ask -- on the vascular business, you talked a little bit about staffing shortages and how that kind of impacted the quarter. I was kind of curious comment, to me, because it seemed like through COVID, one of the great things about the Vascular business was that you guys were kind of a solution to the problem, right? There was overwhelming hospitals. And you guys could come in there with Lightning, or it used to be Indigo, and get patients out of there quicker and safer than previously.

我想問 - 關於血管業務，您談到了人員短缺以及這種情況如何影響本季度。對我來說，我的評論有點奇怪，因為似乎通過 COVID，血管業務的一大優點是你們可以解決問題，對吧？有壓倒性的醫院。你們可以帶著 Lightning 進入那裡，或者它曾經是 Indigo，讓病人比以前更快、更安全地離開那裡。

And I thought that might be a trend that could continue with less staff, they may still need to rely on someone like you. Is there something I'm missing there? And maybe talk about why that dynamic wouldn't have played out in Q2 and why staffing shortages had a more acute impact this quarter?

我認為這可能是一種趨勢，隨著員工人數的減少，他們可能仍然需要依賴像你這樣的人。那裡有我想念的東西嗎？也許可以談談為什麼這種動態不會在第二季度發揮作用，以及為什麼人員短缺對本季度的影響更為嚴重？

Yes, absolutely. That's a great question, and thanks for giving us a chance to clarify that. The staffing shortages that we are dealing with frankly, the others in the field of not only into vascular med tech, but in broader spaces in med tech, but really procedural staffing shortages.

是的，一點沒錯。這是一個很好的問題，感謝您給我們機會澄清這一點。坦率地說，我們正在處理的人員短缺，不僅涉及血管醫療技術領域，還涉及更廣泛的醫療技術領域，但實際上是程序性人員短缺。

And so if you don't have the staff to do the procedure or to do as many procedures as you would otherwise like to, you can't do them. I think what you're referring to is certainly there was an onus on the health care system and our health care professionals at large during COVID to keep these patients out of the ICU. And certainly, that helped the thrombectomy business, generally speaking, because we can keep patients out of the ICU, at least reduce their time there at the very least. And so I think there are 2 different challenges that you're talking about, not similar.

因此，如果您沒有工作人員來執行程序或執行您希望執行的程序，那麼您將無法執行它們。我認為您所指的是，在 COVID 期間，醫療保健系統和我們的整個醫療保健專業人員肯定有責任將這些患者排除在 ICU 之外。當然，這有助於血栓切除術業務，一般來說，因為我們可以讓患者遠離 ICU，至少減少他們在那裡的時間。所以我認為你所說的有兩個不同的挑戰，並不相似。

Okay. And then as you do start to -- correct me if I'm wrong, but my understanding on the prepared remarks was that there was a little bit less new account openings in the quarter on the vascular side. And so -- but it did rebound as you exited the quarter, started in Q3.

好的。然後正如你開始 - 如果我錯了，請糾正我，但我對準備好的評論的理解是，本季度血管方面的新賬戶開立少一點。所以 - 但它確實在你退出本季度時反彈，從第三季度開始。

Can you talk about how long did it take some of these new accounts to ramp? And in part asking does the little pocket of less account openings or lower account openings create kind of a pocket of growth in the next 1 or 2 quarters as you get back on the offensive, open new accounts and ramp those up?

你能談談這些新帳戶中的一些增加了多長時間嗎？並且在一定程度上詢問開戶減少或開戶減少的小口袋是否會在接下來的 1 或 2 個季度內創造一種增長的口袋，因為你重新開始進攻，開設新賬戶並增加賬戶？

Yes, it's a great question. I just wanted to add something that I think the broader answer from Adam. Just as a reminder, the first quarter, I believe we commented on this was the strongest quarter that we had had since we launched the Lightning 12 in new account adds in the United States. So there's somewhat of a bit of consolidating those. But just to point that out, Adam, maybe you can continue that answer.

是的，這是一個很好的問題。我只是想添加一些我認為來自亞當的更廣泛的答案。提醒一下，第一季度，我相信我們評論說這是自我們在美國推出 Lightning 12 以來最強勁的季度。所以有一些鞏固這些。但只是指出這一點，亞當，也許你可以繼續這個答案。

Yes. I think the point of account openings and all of that, what I wanted to make sure was clear that what we did this quarter was driven by usage of our product, not stocking of new accounts. And that was the really most important point.

是的。我認為開戶的意義和所有這一切，我想確保清楚的是，我們本季度所做的事情是由我們的產品的使用驅動的，而不是新賬戶的庫存。這才是真正最重要的一點。

We paid a lot of attention to customers. As I said, there was some interest amongst a number of them to -- who are just starting out with our product that already using mechanical thrombectomy to try ours and that required obviously, attention as they sort of move to the sort of the next thing that works. So I want to be clear about exactly my words around new accounts versus stocking.

我們非常關注客戶。正如我所說，他們中的一些人有一些興趣 - 他們剛剛開始使用我們的產品，已經使用機械血栓切除術來嘗試我們的產品，顯然需要注意，因為他們有點轉向下一個事情這樣可行。因此，我想明確我在新帳戶與庫存方面的確切言論。

Yes. And that's generally the philosophy, Brandon, of the company. So the new account openings in the first quarter, for example, was utilization as well. And just to be clear, just about our common practice.

是的。這通常是公司的理念，布蘭登。因此，例如，第一季度的新開戶數也是利用率。為了清楚起見，只是關於我們的常見做法。

Your next question comes from Pito Chickering with Deutsche Bank.

您的下一個問題來自德意志銀行的 Pito Chickering。

Thanks for taking a quick follow-up here. What percent of your stroke respiration today is red versus JET (inaudible)? And as the reordering from doctors been different using Red than it was previously? And so what market share do you guys think you have at this point today versus a year ago? .

感謝您在這裡快速跟進。今天你的中風呼吸中有多少百分比是紅色的而不是 JET（聽不清）？並且由於使用 Red 的醫生重新排序與以前不同？那麼你們認為與一年前相比，你們現在的市場份額是多少？ .

There's a bunch of questions in there, so I'll start. I would -- I don't have a percentage in my head of Red versus the other. I would -- in the U.S. the majority, the vast majority, I can't give you an exact number, but it's certainly the vast majority of current usage is switched to the Red series.

裡面有一堆問題，所以我會開始。我會 - 我的頭腦中沒有紅色與其他的百分比。我會——在美國，大多數，絕大多數，我不能給你一個確切的數字，但現在絕大多數的使用肯定是切換到紅色系列。

And we're seeing a broad range between 62, 68 and 72. There's still a lot of people like them all depending on preference and so on. So that's -- most of that switch of our current customers. I think we've seen a rebound certainly as our numbers indicate and share. And I think we're continuing to see that as I very clearly said coming out of SNIS in the month of July, continuing on a lot of excitement. Because the Thunderbolt and of course, Thunderbolt connects to Red catheters and so on.

我們看到的範圍很廣，介於 62、68 和 72 之間。仍然有很多人喜歡他們，這取決於偏好等等。這就是我們當前客戶的大部分轉換。我認為，正如我們的數據所顯示和分享的那樣，我們肯定已經看到了反彈。而且我認為我們將繼續看到這一點，正如我在 7 月份從 SNIS 中非常清楚地說出來的那樣，繼續充滿興奮。因為 Thunderbolt，當然，Thunderbolt 連接到 Red 導管等等。

So I think we're in a pretty good spot right now, and I can't wait to start talking about and showing you guys Thunderbolt in action.

所以我認為我們現在處於一個非常好的位置，我迫不及待地開始談論並向你們展示 Thunderbolt 的實際應用。

There are no further questions at this time. Ms. Hamlyn-Harris, I'll turn the call back over to you.

目前沒有其他問題。 Hamlyn-Harris 女士，我會把電話轉給你。

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

謝謝你，接線員。代表我們的管理團隊，再次感謝您今天加入我們並感謝您對 Penumbra 的興趣。我們期待在第三季度電話會議上更新您的信息。

This concludes today's conference call. You may now disconnect.

今天的電話會議到此結束。您現在可以斷開連接。