Penumbra Inc (PEN) 2023 Q1 法說會逐字稿

Good afternoon. My name is Julianne, and I will be your conference operator today. At this time, I would like to welcome everyone to Penumbra's First Quarter 2023 Conference Call. (Operator Instructions)

下午好。我叫 Julianne，今天我將擔任你們的會議運營商。此時，我想歡迎大家參加 Penumbra 的 2023 年第一季度電話會議。 （操作員說明）

I would now like to introduce Ms. Jee Hamlyn-Harris, Investor Relations for Penumbra. Ms. Hamlyn-Harris, you may now begin your conference.

我現在想介紹一下 Penumbra 投資者關係部的 Jee Hamlyn-Harris 女士。 Hamlyn-Harris 女士，您現在可以開始您的會議了。

Thank you, operator, and thank you all for joining us on today's call to discuss Penumbra's earnings release for the first quarter of 2023. A copy of the press release and financial tables, which includes a GAAP to non-GAAP reconciliation, can be viewed under the Investors tab on our company website at www.penumbrainc.com.

謝謝接線員，也感謝大家參加今天的電話會議，討論 Penumbra 2023 年第一季度的收益發布。可以查看新聞稿和財務表的副本，其中包括 GAAP 與非 GAAP 對賬在我們公司網站 www.penumbrainc.com 的“投資者”選項卡下。

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, 2022, filed with the SEC.

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、監管狀況、質量合規性和商業趨勢。由於某些風險和不確定性，包括我們向美國證券交易委員會提交的截至 2022 年 12 月 31 日止年度的 10-K 中提及的風險和不確定性，實際結果可能與我們的前瞻性陳述中明示或暗示的結果存在重大差異。

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. Penumbra disclaims any duty to update or revise our forward-looking statements as a result of new information, future events, developments or otherwise.

因此，我們告誡您不要過分依賴這些前瞻性陳述，我們鼓勵您查看我們定期向美國證券交易委員會提交的文件，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。 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。

On this call, certain financial measures are presented 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.

在這次電話會議上，某些財務措施是在非 GAAP 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 財務措施的調節。

Adam Elsesser, Penumbra's Chairman and CEO, will provide a business update. Maggie Yuen, our Chief Financial Officer, will then discuss our financial results for the first quarter. And Jason Mills, our Executive Vice President of Strategy, will discuss our 2023 guidance. Sandra Lesenfants, our President of Interventional, will join the team for questions.

Penumbra 的董事長兼首席執行官 Adam Elsesser 將提供業務更新。我們的首席財務官 Maggie Yuen 隨後將討論我們第一季度的財務業績。我們的戰略執行副總裁 Jason Mills 將討論我們的 2023 年指導方針。我們的介入總裁 Sandra Lesenfants 將加入團隊提問。

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 First Quarter 2023 Conference Call. Our total revenues for the first quarter were $241.4 million, a year-over-year increase of 18.4% as reported and 19.7% on a constant currency basis. Our first quarter revenue increased sequentially by $20 million, the fastest sequential dollar growth in our company's history, excluding the COVID-related second to third quarter of 2020.

謝謝你，吉。下午好。感謝您加入 Penumbra 的 2023 年第一季度電話會議。我們第一季度的總收入為 2.414 億美元，同比增長 18.4%，按固定匯率計算增長 19.7%。我們第一季度的收入環比增長了 2000 萬美元，這是我們公司歷史上最快的環比美元增長，不包括 2020 年第二至第三季度與 COVID 相關的收入。

The Lightning Flash launch in the first quarter exceeded our high expectations, becoming the biggest product launch in the company's history, even with limited supply through the quarter. Lightning Flash is driving acceleration in our U.S. vascular business, which grew 23% year-over-year, and our U.S. vascular thrombectomy franchise, which grew 26% year-over-year in the first quarter.

第一季度 Lightning Flash 的發布超出了我們的高預期，成為公司歷史上最大的產品發布，即使整個季度的供應有限。 Lightning Flash 正在推動我們美國血管業務的加速發展，該業務同比增長 23%，而我們的美國血管血栓切除術特許經營權在第一季度同比增長 26%。

We are following this up with the recent launch of Lightning Bolt 7, for which cases to date have gone extremely well. The launches of RED 72 with our proprietary [inner] SENDit technology, RED 43 and BMX81 have added significant momentum to our market-leading ischemic stroke business. Therefore, we are raising our 2023 revenue forecast significantly, and we see a robust growth trajectory over the next 5-plus years. Jason will discuss our forecast in more detail later in this call.

我們正在跟進最近推出的 Lightning Bolt 7，到目前為止，它的案例非常順利。採用我們專有[內部] SENDit 技術的 RED 72、RED 43 和 BMX81 的推出為我們市場領先的缺血性中風業務增添了巨大動力。因此，我們顯著提高了 2023 年的收入預測，並且我們看到未來 5 年多的強勁增長軌跡。 Jason 將在本次電話會議的稍後部分更詳細地討論我們的預測。

Gross margins met our expectations for the first quarter, and we expect gross margin expansion through 2023. We continue to target 70% plus gross margins within a few years. Non-GAAP operating income increased to $10.4 million, representing 4.3% of revenue in the first quarter, notwithstanding traditionally higher payroll taxes and sales meeting expenses at the beginning of each year. With strong revenue growth, expanding gross margins and disciplined operating spending, we expect to significantly increase our operating profits and cash flow in 2023 and beyond.

毛利率符合我們對第一季度的預期，我們預計毛利率將在 2023 年之前擴大。我們的目標是在幾年內將毛利率提高到 70% 以上。非 GAAP 營業收入增加至 1040 萬美元，佔第一季度收入的 4.3%，儘管傳統上每年年初的工資稅和銷售會議費用較高。憑藉強勁的收入增長、不斷擴大的毛利率和嚴格的運營支出，我們預計 2023 年及以後的運營利潤和現金流量將大幅增加。

Lightning Flash has arrived at a consequential moment in the thrombectomy market. And based on our initial launch, we believe this product will transform PE and venous thrombectomy to the ultimate benefit of hundreds of thousands of patients not just in 2023 but for at least the next 5-plus years.

Lightning Flash 已經到了取栓市場的重要時刻。基於我們最初的發布，我們相信該產品將改變 PE 和靜脈血栓切除術，不僅在 2023 年，而且至少在未來 5 年多的時間裡，最終造福數十萬患者。

During the first quarter, we grew our actual PE and DVT procedures in the U.S. by more than 30% sequentially. We saw acceleration of cases through the quarter as the conversion from other mechanical thrombectomy products and lytics to Lightning Flash gain momentum. Acceleration of Flash demand was evident from both new customers as well as existing customers. In fact, the majority of these customers have already reordered Flash, and the rate of reorders is the same for new customers and existing customers.

在第一季度，我們在美國的實際 PE 和 DVT 程序連續增長了 30% 以上。隨著從其他機械血栓切除術產品和 lytics 到 Lightning Flash 的轉換獲得動力，我們看到本季度病例加速增長。新客戶和現有客戶都清楚地看到了閃存需求的加速增長。事實上，這些客戶中的大多數已經重新訂購了 Flash，並且新客戶和現有客戶的重新訂購率是相同的。

Again, we think this momentum could continue longer than a typical product launch for us given the propriety of this technology, the size of this opportunity and the current state of this field. Some of the largest hospital systems in the country have just put Lightning Flash on contract in April, which allows our team to start the individual hospital Value Analysis Committee process for Lightning Flash.

同樣，我們認為，鑑於這項技術的適用性、機會的規模和該領域的現狀，這種勢頭可能會比我們的典型產品發布持續更長時間。該國一些最大的醫院系統剛剛在 4 月份將 Lightning Flash 與合同簽訂，這使我們的團隊能夠啟動針對 Lightning Flash 的個別醫院價值分析委員會流程。

Lightning Bolt 7 arriving just 1 quarter after Lightning Flash makes this an unprecedented moment in time for Penumbra as well as for thrombectomy patients in the United States. We have received extraordinary feedback from physicians who have used Lightning Bolt 7. And even though it is early, we are already starting to see conversion to Lightning Bolt 7 from physicians who might historically have performed open surgery or used lytics.

Lightning Bolt 7 在 Lightning Flash 之後僅 1 個季度到達，這對 Penumbra 以及美國的血栓切除術患者來說是一個前所未有的時刻。我們從使用過 Lightning Bolt 7 的醫生那裡收到了非凡的反饋。儘管現在還早，但我們已經開始看到從歷史上可能進行過開放手術或使用過裂解術的醫生轉向 Lightning Bolt 7。

A great example of the benefit of Lightning Bolt 7 occurred about 3 weeks ago. A patient presented to the hospital with severe leg pain and necrotic toes. The patient had an SFA stent placed about 3 months prior. A CT scan showed complete blockage of the SFA to the popliteal. The patient was scheduled for an above-the-knee amputation. But the day prior, the physician, who is new to Penumbra's thrombectomy devices, had heard about Lightning Bolt 7. He decided to try it prior to the scheduled surgery. Lightning Bolt 7 cleared the thrombus completely in about 2 minutes of device time, and the patient will likely keep her foot and leg.

Lightning Bolt 7 的好處的一個很好的例子發生在大約 3 週前。一名患者因嚴重的腿部疼痛和腳趾壞死入院。患者在大約 3 個月前放置了 SFA 支架。 CT 掃描顯示 SFA 完全阻塞到膕窩。患者計劃進行膝上截肢。但前一天，這位剛接觸 Penumbra 血栓切除術設備的醫生聽說了 Lightning Bolt 7。他決定在預定的手術前試用一下。 Lightning Bolt 7 在大約 2 分鐘的設備時間內完全清除了血栓，患者可能會保住她的腳和腿。

With this breakthrough technology, we have a rare opportunity to convert a large number of physicians to Lightning Bolt 7 from traditional modes of treating arterial thrombus. But we understand that we have a lot of work ahead of us. This work will take time, and we are off to a great start, including the hospital contracting and value analysis process we mentioned earlier for Flash.

憑藉這項突破性技術，我們有難得的機會讓大量醫生從傳統的動脈血栓治療模式轉向 Lightning Bolt 7。但我們明白，我們還有很多工作要做。這項工作需要時間，但我們有了一個良好的開端，包括我們之前提到的 Flash 醫院承包和價值分析流程。

Hearing about the differentiated success for both Lightning Flash and Lightning Bolt 7 so far gives our team an extraordinary amount of motivation to get these technologies to every physician treating the 800,000-plus venous, PE and arterial patients in the United States. Add to this the successful product launches in stroke, and we fully understand that there is a lot of excitement among our physician customers that is also spread to the investment community. We obviously share that excitement.

聽到 Lightning Flash 和 Lightning Bolt 7 迄今為止取得的差異化成功，給了我們團隊極大的動力，讓他們將這些技術帶給美國治療 800,000 多名靜脈、PE 和動脈患者的每一位醫生。再加上中風產品的成功發布，我們完全理解我們的醫生客戶中的興奮情緒也蔓延到了投資界。我們顯然也有同樣的興奮。

However, let me take a step back from the near term and state that this work will be our main focus over the next 5-plus years. With this focus, we believe that these amazing proprietary technologies will reach a significant percentage of these patients. The building blocks that are necessary to achieve our plans are important. They include continuing to scale manufacturing to meet increasing demand, demonstrating value to hospital customers, increasing physician awareness and training and generating additional clinical evidence.

然而，讓我從近期退一步說，這項工作將是我們未來 5 年多的主要重點。有了這個重點，我們相信這些驚人的專有技術將惠及這些患者中的很大一部分。實現我們的計劃所必需的基石很重要。它們包括繼續擴大製造規模以滿足不斷增長的需求、向醫院客戶展示價值、提高醫生意識和培訓以及產生更多臨床證據。

Every one of our functional teams from R&D to regulatory, manufacturing to marketing, clinical to commercial and national accounts have evolved in profound ways over the past 2 years and are now fully prepared and focused on the work ahead. We believe computer-orchestrated thrombectomy will prosper near term and will have a long tail and become the ultimate paradigm in thrombectomy.

從研發到監管、製造到營銷、臨床到商業和國民賬戶，我們的每一個職能團隊在過去 2 年中都發生了深刻的變化，現在已做好充分準備並專注於未來的工作。我們相信，計算機控制的血栓切除術將在短期內蓬勃發展，並將有長長的尾巴，成為血栓切除術的終極典範。

Turning to our neuro franchise. The acceleration in our stroke business, which was up 6% sequentially in the U.S., was driven by the launches of RED 72 with our proprietary inner catheter SENDit technology and RED 43. These products represent meaningful advances in both trackability of 0.072 sized aspiration catheters as well as distal clot removal.

轉向我們的神經專營權。我們的中風業務加速增長，在美國連續增長 6%，這得益於採用我們專有的內導管 SENDit 技術的 RED 72 和 RED 43 的推出。這些產品代表了 0.072 尺寸抽吸導管的可跟踪性的重大進步，以及以及遠端血塊清除。

As we build more inventory of these 2 important products, we think they, coupled with the recently launched BMX81, will continue to increase our growth and market share in neuro, particularly as physicians continue to realize the trade-off with oversized aspiration catheters that have entered the market in the past several years. Our newest products are critical as we lay a strong foundation in anticipation of Thunderbolt, our computer-orchestrated platform for stroke.

隨著我們增加這兩種重要產品的庫存，我們認為它們與最近推出的 BMX81 一起，將繼續增加我們在神經領域的增長和市場份額，特別是當醫生繼續意識到與超大抽吸導管的權衡時在過去幾年進入市場。我們的最新產品至關重要，因為我們為 Thunderbolt 奠定了堅實的基礎，Thunderbolt 是我們的計算機編排中風平台。

Turning to our international business. We are proud of the work our global teams have done, growing revenue 8% sequentially, taking our international business to a revenue run rate that exceeds $0.25 billion annually. We are even more excited about what's to come in ensuing years.

轉向我們的國際業務。我們為我們的全球團隊所做的工作感到自豪，收入環比增長 8%，使我們的國際業務的年收入運行率超過 2.5 億美元。我們對接下來幾年的發展感到更加興奮。

We recently launched our RED catheter for stroke and our first-generation computer-orchestrated thrombectomy products, Lightning 12 and 7, in Europe. And we have added significant expertise and capacity to our sales, regulatory and reimbursement capabilities internationally.

我們最近在歐洲推出了用於中風的 RED 導管和我們的第一代計算機編排血栓切除術產品 Lightning 12 和 7。我們在國際銷售、監管和報銷能力方面增加了重要的專業知識和能力。

In sum, we think, within 3-plus years, we can bring our franchise products like RED catheters and CAT RX together with all of our most advanced products, Lightning Flash, Lightning Bolt 7 and Thunderbolt, to our global teams. Over this time period, we expect to materially increase both revenue and profitability in our international business.

總之，我們認為，在 3 年多的時間裡，我們可以將我們的特許產品（如 RED 導管和 CAT RX）與我們所有最先進的產品 Lightning Flash、Lightning Bolt 7 和 Thunderbolt 一起帶到我們的全球團隊中。在此期間，我們預計將大幅增加國際業務的收入和盈利能力。

Our Immersive Healthcare business is making significant progress as well. We are both proud and excited to have recently established a multiyear collaboration with the Department of Veteran Affairs Office of Healthcare Innovation and Learning to test, co-develop and scale virtual reality solutions for veterans in multiple health care settings, including the home. We are so impressed with both the VHA's vision and its commitment to expanding access to high-quality care to veterans.

我們的沉浸式醫療保健業務也取得了重大進展。我們感到非常自豪和興奮，最近與退伍軍人事務部醫療保健創新和學習辦公室建立了多年合作關係，以便在包括家庭在內的多種醫療保健環境中為退伍軍人測試、共同開發和擴展虛擬現實解決方案。我們對 VHA 的願景及其致力於擴大退伍軍人獲得優質護理的機會印象深刻。

This collaboration, coupled with other important work we are doing with large private health care systems in the United States, is teaching us so much about the myriad ways our technology can improve health care across rehab mental and cognitive health and aging while also helping develop the business model to scale this business in the years ahead to the ultimate benefit of many patients.

這種合作，再加上我們與美國大型私人醫療保健系統所做的其他重要工作，正在教會我們很多關於我們的技術可以通過康復心理和認知健康以及老齡化來改善醫療保健的無數方式，同時也有助於發展未來幾年擴大這項業務的商業模式，最終使許多患者受益。

I'll now turn the call over to Maggie to go over our financial results for the first quarter of 2023.

我現在將電話轉給瑪吉，讓她回顧一下我們 2023 年第一季度的財務業績。

Thank you, Adam. Good afternoon, everyone. Today, I will discuss the financial results for the first quarter of 2023. Financial results on this quarter 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 2023 年第一季度的財務業績。本季度的收入和毛利率財務業績基於 GAAP，而營業費用和營業收入則基於非 GAAP。我們發布的新聞稿中提供了相應的 GAAP 措施以及 GAAP 與非 GAAP 財務措施的調節。

For the first quarter ended March 31, 2023, our total revenues were $241.4 million, an increase of 18.4% reported and 19.7% in constant currency compared to the first quarter of 2022. Our geographic mix of sales in the quarter was 71.2% in the U.S. and 28.8% international. U.S. reported growth of 19.1%, and our international regions increased 16.7% reported and 21% in constant currency. Sequential growth of 9.1% was primarily driven by strong momentum in our U.S. vascular thrombectomy business.

截至 2023 年 3 月 31 日的第一季度，我們的總收入為 2.414 億美元，與 2022 年第一季度相比報告增長 18.4%，按固定匯率計算增長 19.7%。我們本季度的銷售地域組合為 71.2%美國和國際 28.8%。美國報告增長 19.1%，我們的國際地區報告增長 16.7%，按固定匯率計算增長 21%。 9.1% 的連續增長主要是由我們美國血管血栓切除術業務的強勁勢頭推動的。

Moving to revenue by franchise. Revenue from our vascular business grew to $142.8 million in the first quarter of 2023, an increase of 16.3% reported and 17.2% in constant currency compared to the same period last year. Worldwide vascular revenue was primarily driven by strong growth in the U.S., which increased 23% year-over-year, partially offset by variability in international distributor region revenue compared to the same quarter a year ago.

通過特許經營轉向收入。 2023 年第一季度，我們血管業務的收入增長至 1.428 億美元，與去年同期相比增長 16.3%，按固定匯率計算增長 17.2%。全球血管收入主要受到美國強勁增長的推動，美國同比增長 23%，部分被國際分銷商地區收入與去年同期相比的變化所抵消。

Revenue from our neuro business was $98.5 million in the first quarter of 2023, an increase of 21.5% reported and 23.4% in constant currency compared to the same period a year ago, driven by new product launches in the U.S., continued momentum in Europe and positive variability in international distributor region revenue compared to the same quarter a year ago.

2023 年第一季度，我們的神經業務收入為 9850 萬美元，與去年同期相比增長 21.5%，按固定匯率計算增長 23.4%，這主要得益於美國新產品的推出、歐洲和歐洲的持續增長勢頭與去年同期相比，國際分銷商區域收入的正變化。

Turning to gross margin. Gross margin for the first quarter of 2023 is 62.6% compared to 62.5% for the first quarter of 2022 and 62.6% last quarter. Gross margin performance were driven by approximately a 1 point improvement from higher vascular thrombectomy product mix sales, offset by higher start-up costs associated with multiple new product launches and regional mix. We are on track to improve our margins throughout 2023 and expect to see continued favorable product mix, improvement in productivity and fixed cost leverage as new product volumes continues to accelerate for the rest of the year.

轉向毛利率。 2023 年第一季度的毛利率為 62.6%，而 2022 年第一季度為 62.5%，上一季度為 62.6%。較高的血管血栓切除術產品組合銷售額提高了約 1 個百分點，這推動了毛利率表現，但被與多個新產品發布和區域組合相關的較高啟動成本所抵消。我們有望在整個 2023 年提高我們的利潤率，並預計隨著今年剩餘時間新產品銷量的持續增長，我們將看到持續有利的產品組合、生產力和固定成本槓桿的改善。

Now on to our non-GAAP operating expenses, which exclude the amortization of acquired intangible assets of $2.4 million and $1.8 million for this quarter, last quarter and for the same quarter last year, respectively. Total operating expense for the quarter was $140.7 million or 58.3% of revenue compared to $129.7 million or 63.6% of revenue for the same quarter last year. We have been effectively scaling our business while leveraging minimal headcount investment compared to last year.

現在來看我們的非 GAAP 運營費用，其中不包括本季度、上季度和去年同期分別獲得的 240 萬美元和 180 萬美元的無形資產攤銷。本季度總運營費用為 1.407 億美元，佔收入的 58.3%，而去年同期為 1.297 億美元，佔收入的 63.6%。與去年相比，我們一直在有效地擴展我們的業務，同時利用最少的員工投資。

Our research and development expenses for Q1 2023 were $20 million compared to $20.6 million for Q1 2022. SG&A expenses for Q1 2023 were $120.7 million or 50% of revenue compared to $109.1 million or 53.5% of revenue for Q1 2022 and $113.3 million or 51.2% of revenue last quarter.

我們 2023 年第一季度的研發費用為 2000 萬美元，而 2022 年第一季度為 2060 萬美元。2023 年第一季度的 SG&A 費用為 1.207 億美元，佔收入的 50%，而 2022 年第一季度為 1.091 億美元，佔收入的 53.5%，1.133 億美元，佔收入的 51.2%上個季度的收入。

We have higher seasonality expenditures in the first quarter but continue to be disciplined in discretionary spending. We recorded operating income of $10.4 million or 4.3% of revenue in the first quarter of 2023 compared to an operating loss of $2.3 million for the same period last year.

我們在第一季度有較高的季節性支出，但在可自由支配的支出方面繼續受到約束。我們在 2023 年第一季度錄得營業收入 1040 萬美元，佔收入的 4.3%，而去年同期營業虧損為 230 萬美元。

Turning to cash flow and balance sheet. We ended the first quarter with cash, cash equivalents and marketable securities balance of $199.1 million, which is an increase of $11.1 million from last quarter. We expect positive operating cash flow trends to continue the rest of the year driven by improvement in profitability and working capital.

轉向現金流和資產負債表。第一季度結束時，我們的現金、現金等價物和有價證券餘額為 1.991 億美元，比上一季度增加 1110 萬美元。我們預計，在盈利能力和營運資本改善的推動下，積極的經營現金流趨勢將在今年餘下時間繼續。

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, everybody. For 2023, we are increasing our revenue guidance to a range of $1.04 billion to $1.06 billion, representing year-over-year growth of 23% to 25% versus 2022 total revenue of $847.1 million. This compares to our previous guidance, which solely specified a lower limit of $1 billion.

謝謝你，Maggie，大家下午好。對於 2023 年，我們將收入指引上調至 10.4 億美元至 10.6 億美元，與 2022 年 8.471 億美元的總收入相比，同比增長 23% 至 25%。相比之下，我們之前的指南僅規定了 10 億美元的下限。

We expect our global revenue growth rates to accelerate on a year-over-year basis through 2023 to the low 20% range in the second quarter and mid- to high 20% range in the second half of 2023. Relative to our total revenue guidance range of 23% to 25% year-over-year growth for 2023, we expect growth in our vascular business to be slightly above this range and growth in our neuro business to be below this range.

我們預計到 2023 年，我們的全球收入增長率將同比加速，在第二季度達到 20% 的低水平，在 2023 年下半年達到 20% 的中高水平。相對於我們的總收入指導2023 年同比增長 23% 至 25%，我們預計血管業務的增長將略高於該範圍，而神經業務的增長將低於該範圍。

Moving down the P&L. We expect to expand gross margins as we move through 2023, and we continue to target over 70% gross margins within a few years. Finally, we are increasing our expectations for non-GAAP operating margins and now expect to exceed 10% by the end of the year, with further operating margin expansion expected in subsequent years.

向下移動損益表。我們預計到 2023 年毛利率將擴大，我們的目標是在幾年內毛利率超過 70%。最後，我們正在提高對非 GAAP 營業利潤率的預期，現在預計到今年年底將超過 10%，預計隨後幾年營業利潤率將進一步擴大。

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

我現在將把電話轉回給亞當，讓他發表結束語。

Thank you, Jason, Maggie and Jee. We are obviously extremely excited about the launches of Lightning Flash and LIGHTNING BOLT. These types of transformational product launches don't happen often in the medical device field. We're also extremely excited about the product launches in our stroke franchise. With that excitement comes a clear understanding honed over decades of experience in our company of the critical work ahead over the next several years to take full advantage of this world-class technology and make it available to everyone whom it could benefit.

謝謝杰森、瑪姬和吉。我們顯然對 Lightning Flash 和 LIGHTNING BOLT 的發布感到非常興奮。這些類型的轉型產品發佈在醫療設備領域並不常見。我們也對中風系列產品的推出感到非常興奮。伴隨著這種興奮，我們清楚地了解了我們公司在未來幾年的關鍵工作中磨練了數十年的經驗，以充分利用這項世界一流的技術，並將其提供給所有可能受益的人。

Our entire team knows and understands the work ahead. I believe they are energized and ready to do that work to make sure our physician customers and their patients have this technology. From everyone I've spoken to on the team, every morning, they know that they got to get up and try and try and try. With that effort and the teamwork we have shown, we will bring the wave of computer-orchestrated aspiration to our customers around the world. I think they're ready.

我們整個團隊都知道並理解未來的工作。我相信他們充滿活力並準備好開展這項工作，以確保我們的醫生客戶和他們的患者擁有這項技術。從我在團隊中交談過的每個人那裡，每天早上，他們都知道他們必須起床並嘗試嘗試。通過這種努力和我們所展示的團隊合作精神，我們將為世界各地的客戶帶來計算機精心策劃的熱潮。我認為他們已經準備好了。

Thank you, and we can open the call to questions.

謝謝，我們可以打開問題電話。

(Operator Instructions) Our first question comes from Robbie Marcus from JPMorgan.

（操作員說明）我們的第一個問題來自摩根大通的羅比馬庫斯。

Congrats on a nice quarter. Maybe to start, I wanted to spend some time on the peripheral thrombectomy line, particularly Flash. You gave a couple of numbers in there, but really, the question is 2-part. One, how are you thinking about the adoption of Flash relative to market expansion versus share gains? And how can we think about Flash's impact in terms of the updated guidance range? How much of it was from Flash and the upcoming arterial product launch versus neuro?

祝賀一個不錯的季度。也許首先，我想花一些時間在外周血栓切除術線上，尤其是 Flash。你在那裡給出了幾個數字，但實際上，這個問題分為兩部分。第一，相對於市場擴張和份額增長，您如何看待 Flash 的採用？在更新的指導範圍方面，我們如何考慮 Flash 的影響？其中有多少來自 Flash 和即將推出的動脈產品與神經產品？

Yes, Robbie, first of all, thanks for the -- I was going to say 2-part question, but I think it's a 3- or 4-part question. The -- let me try to articulate this way. I think you can tell from our prepared remarks that we're in a pretty good spot right now. We feel like with the product launches of Flash, the product launch of Lightning Bolt 7 and the product launches in neuro, we're seeing a lot of momentum.

是的，羅比，首先，謝謝你——我本來想說一個由 2 部分組成的問題，但我認為這是一個由 3 部分或 4 部分組成的問題。讓我試著用這種方式表達。我想你可以從我們準備好的評論中看出我們現在處於一個非常好的位置。我們覺得隨著 Flash 的產品發布、Lightning Bolt 7 的產品發布和神經產品的發布，我們看到了很多動力。

So we went out of our way to say that just from a pure number standpoint, the peripheral thrombectomy tools, both Flash and LIGHTNING BOLT are going to have a larger role in that growth. Obviously, the numbers support that. And that just makes sense given that 800,000-patient target that we put out there, which everyone seems to think is on the conservative side. So that's our goal.

因此，我們不遺餘力地說，僅從純粹的數字角度來看，外周血栓切除術工具，包括 Flash 和 LIGHTNING BOLT 都將在這一增長中發揮更大的作用。顯然，數字支持這一點。考慮到我們提出的 800,000 名患者的目標，這是有道理的，每個人似乎都認為這是保守的。這就是我們的目標。

As it relates to the question -- the first question of market expansion versus share gain and so on, that depends on which product we're talking about and the definition of market expansion versus share gain. Obviously, in stroke, we want to keep treating more and more people. But at the same time, over the past little bit of time when the market has slowed growth, share gain was sort of the primary focus.

因為它涉及到這個問題——市場擴張與份額收益的第一個問題等等，這取決於我們談論的是哪種產品以及市場擴張與份額收益的定義。顯然，在中風方面，我們希望繼續治療越來越多的人。但與此同時，在市場增長放緩的過去一段時間裡，份額增長是主要關注點。

Now we're seeing a bit of a renewed interest in stroke. There's a lot of energy around it. So I think we're going to see both in stroke. As it relates to LIGHTNING BOLT, you could argue, depending on how you define share gain versus market expansion, you don't really have other mechanical products that we are competing against for the most part. You're talking about other procedures, whether it's open surgery or lytic. Is that market share gain from those diseases? Or is the market growth -- I'm not sure it matters. That's our main focus, is going after those areas where physicians are using that -- those modes of treating those patients.

現在我們看到人們對中風有了新的興趣。它周圍有很多能量。所以我認為我們會看到兩者都中風。由於它與 LIGHTNING BOLT 相關，您可能會爭辯說，根據您如何定義份額增長與市場擴張，您實際上並沒有我們在大多數情況下與之競爭的其他機械產品。你說的是其他手術，無論是開放手術還是溶解手術。這些市場份額是從這些疾病中獲得的嗎？或者是市場增長——我不確定這是否重要。這是我們的主要重點，是追踪醫生正在使用的那些領域——治療這些患者的那些模式。

And as it relates to the venous side, both PE and DVT, it's going to be both how fast share shifts and how fast we then go after the rest of those patients, the DVT patients and the PE. That's really the work we have ahead of us this year and the following year and the following year as we really focus our attention on getting to those 800,000 patients.

由於它與靜脈側有關，包括 PE 和 DVT，這將是份額變化的速度以及我們隨後對其他患者、DVT 患者和 PE 的處理速度。這確實是我們今年、明年和下一年要做的工作，因為我們真正將注意力集中在接觸這 800,000 名患者上。

Yes. And Robbie, just to the latter part of your question on guidance and contribution, I think we said in our prepared remarks that our U.S. vascular thrombectomy business was the vast majority of that $20 million sequential increase. And of course, that was primarily Flash. And as we move forward, as Adam mentioned, we expect Flash and Lightning Bolt 7 to hold similar sort of share of the growth we're going to -- an acceleration we're expecting.

是的。羅比，關於你關於指導和貢獻的問題的後半部分，我想我們在準備好的評論中說過，我們的美國血管血栓切除術業務是這 2000 萬美元連續增長的絕大部分。當然，這主要是 Flash。隨著我們向前邁進，正如 Adam 提到的那樣，我們預計 Flash 和 Lightning Bolt 7 將在我們將要實現的增長中佔據類似的份額——我們期待的加速。

Just a couple of other reminders to help you out. We mentioned that on the venous and PE side, just from a procedural volume standpoint, we believe we increased over 30% sequentially from the fourth quarter in our U.S. venous franchise.

只是一些其他提醒可以幫助您。我們提到，在靜脈和 PE 方面，僅從程序數量的角度來看，我們認為我們在美國靜脈特許經營中的第四季度連續增長超過 30%。

Really helpful. If I could sneak one more in. This was probably the best stroke or neuro quarter you've had in a really long time. Just any -- how sustainable is this and? Any onetime items to call out there?

真的很有幫助。如果我能再偷偷進去一次。這可能是你很長一段時間以來最好的中風或神經四分之一。只是任何 - 這有多可持續？有什麼一次性物品可以叫出來嗎？

Yes. It's a great question. Really, there's no onetime sort of distributor order per se that's out of sort of cycle. The real issue that we highlighted comes from the launch of -- the continued launch of RED in Europe but really a pretty remarkable launch of what we call SENDit, which is our inner catheter technology for RED 72 and the real continued launch of RED 43. We're starting to get more inventory to support that, and the reaction has been pretty remarkable.

是的。這是一個很好的問題。真的，沒有一次性的分銷商訂單本身是不合時宜的。我們強調的真正問題來自於在歐洲繼續推出 RED，但我們稱之為 SENDit 的推出確實非常了不起，這是我們用於 RED 72 的內導管技術和 RED 43 的真正持續推出。我們開始獲得更多庫存來支持這一點，而且反應非常顯著。

So I think you add to that what we're starting to see -- and again, I don't want to jinx it by saying we have massive visibility on it, but we're starting to see a fairly renewed excitement in the field around treating stroke and getting back to the work that's necessary to grow that.

所以我認為你添加了我們開始看到的東西——再說一次，我不想說我們對它有很大的了解，但我們開始在這個領域看到一個相當新的興奮圍繞治療中風並回到發展中風所必需的工作。

So we're optimistic about it. We think we're in a pretty good spot on our stroke business. But again, obviously, the main topic that we've been getting from most people [out quarter] is around Flash and Bolt. And again, those products are performing unbelievably well and gives us an incredible amount of confidence. Frankly, it's just been a lot of fun to see the cases, to see the reaction from customers that we've had for a long time but also the myriad of customers that aren't -- that are new to our thrombectomy tools. It's just a lot of fun.

所以我們對此持樂觀態度。我們認為我們在中風業務上處於一個非常好的位置。但同樣，很明顯，我們從大多數人那裡得到的主要話題 [out quarter] 是關於 Flash 和 Bolt 的。再一次，這些產品表現得非常好，給了我們難以置信的信心。坦率地說，看到這些案例，看到我們已經有很長時間的客戶的反應以及無數客戶的反應非常有趣 - 他們是我們血栓切除術工具的新手。這很有趣。

Yes. And just to add to that, repeating a little bit about what Adam said about the energy around stroke, it's fair to also say that the year-over-year comparisons in the stroke business were a little easier. And we also said sort of separately that we expected, notwithstanding a really strong quarter out of our U.S. vascular thrombectomy business,that the vascular business globally writ large, we expect to accelerate through the year to sort of continue the momentum we've shown in the first quarter, just to comment a bit on both sides of it.

是的。除此之外，再重複一下亞當所說的關於中風周圍能量的話，公平地說，中風業務的同比比較要容易一些。我們還分別表示，儘管我們的美國血管血栓切除術業務的季度表現非常強勁，但我們預計全球血管業務規模很大，我們預計今年將加速增長，以延續我們在第一季，就兩邊稍微評論一下吧。

Our next question comes from Larry Biegelsen from Wells Fargo.

我們的下一個問題來自 Wells Fargo 的 Larry Biegelsen。

Adam, I was curious about your comments on the arterial side for Bolt. We -- you have a very strong position there. I don't know if there's any significant competition in mechanical thrombectomy. So I saw this as more of kind of maybe a mix benefit. But you talked about getting procedures from lytics and open procedures. The last slide, the last numbers you presented on this is about 50,000 procedures out of about 260,000 patients or 20% penetration.

亞當，我很好奇你對博爾特主動脈側的評論。我們 - 你在那裡擁有非常強大的地位。我不知道機械血栓切除術是否有任何重大競爭。所以我認為這更像是一種混合收益。但是您談到了從 lytics 和開放程序中獲取程序。最後一張幻燈片，你在這張幻燈片上展示的最後一個數字是大約 260,000 名患者中的大約 50,000 次手術或 20% 的滲透率。

So how are you -- I guess, how are you thinking about converting lytics and open procedures? Kind of what's driving that? And what do you think you need to do in addition to offering a better product here to drive that conversion? And I had one follow-up.

那麼你怎麼樣 - 我猜你是如何考慮轉換 lytics 和開放程序的？是什麼推動了它？除了在這裡提供更好的產品來推動這種轉化之外，您認為您還需要做什麼？我有一個後續行動。

Yes. Larry, thank you. That's a really, really great question. And it's early on, and we will sort of share our strategy as we sort of get into executing it over the next couple of quarters as opposed to in advance. I think you can understand that. But the real -- the most important fact there is what we described. If this product continues to do what it's done, and we've done enough cases to be way past worrying that it's -- we don't know. We know.

是的。拉里，謝謝你。這是一個非常非常好的問題。而且它還很早，我們將在接下來的幾個季度而不是提前執行它時分享我們的戰略。我想你可以理解這一點。但真實的 - 最重要的事實是我們所描述的。如果這個產品繼續做它已經完成的事情，而且我們已經做了足夠多的案例，那麼我們就不必擔心了——我們不知道。我們知道。

If it's as simple as putting the catheter in the clot or in front of the clot, pushing the button and the clot tends to come out pretty quickly in most of these cases, that is fairly compelling to either an interventionalist or a vascular surgeon who has used another technique because that's pretty fast. That's pretty safe. That's pretty easy. And it's sort of causing a reaction that we're seeing.

如果它像將導管放入血塊或血塊前面一樣簡單，按下按鈕，在大多數情況下血塊往往很快就會出來，這對於介入醫生或血管外科醫生來說是相當有說服力的使用了另一種技術，因為那非常快。那很安全。這很容易。它正在引起我們所看到的反應。

Now how long does it take to get that word out to have people try it, to have people have that same experience? We'll see. That's the question. And obviously, we're focused with all of our energy, and I said that over and over on the call, to do that. But that's really what happens. Will we have additional work to do to show that, to bring people together to share that experience? Of course.

現在需要多長時間才能讓人們嘗試，讓人們擁有同樣的體驗？我們拭目以待。這就是問題所在。顯然，我們全神貫注，我在電話中一遍又一遍地說過要做到這一點。但這確實發生了。我們是否需要做更多的工作來證明這一點，讓人們聚在一起分享這種體驗？當然。

But the most important thing is the product is doing exactly what we had hoped it would do, and it's having a very positive reception particularly -- we knew it would have a positive reception with our current customers, but with people who otherwise weren't using our tool but using either open surgery or lytics, and that to me is what gives us the confidence that we have a freely -- a long runway with this product.

但最重要的是該產品完全按照我們希望的方式運行，而且它受到了特別積極的歡迎——我們知道它會受到我們現有客戶的積極歡迎，但對於那些原本不會接受的人使用我們的工具，但使用開放式手術或裂解術，對我來說，這讓我們有信心，我們有一個自由的 - 這個產品的長跑道。

That's helpful. Just two quick ones, and I mean very quick ones. One, on Flash, are you no longer supply constrained? And the second is on the THUNDER trial. Just any update on the enrollment and when you expect to complete.

這很有幫助。只有兩個快速的，我的意思是非常快的。第一，在 Flash 上，您是否不再供應受限？第二個是關於 THUNDER 試驗。只是關於註冊和您預計何時完成的任何更新。

Yes. Well, let me start on the THUNDER trial. Enrollment is still going. The cases are going well. We'll get an update on completion dates as we can in the next quarter or so. What we're seeing is a lot more increased energy around it, which is really good.

是的。好吧，讓我開始進行 THUNDER 試驗。報名還在進行中。案件進展順利。我們將在下個季度左右獲得完成日期的更新。我們看到的是它周圍的能量增加了很多，這真的很好。

I think that comes from our sense that the markets -- people are focused again on stroke and so on. We do see part of the measures. We see an awful lot more screen failures not because those patients aren't ultimately treated usually with our product, but because we are -- the trials have an 8-hour window in it. So I think that's actually a positive that there's energy around focusing on the trial ongoing. But again, so far, very optimistic, and we'll give you more of a definitive update as soon as we have a better sense of that.

我認為這是因為我們認為市場——人們再次關注中風等問題。我們確實看到了部分措施。我們看到更多的篩選失敗不是因為這些患者通常沒有最終使用我們的產品進行治療，而是因為我們是——試驗有一個 8 小時的窗口。所以我認為這實際上是積極的，因為人們有精力專注於正在進行的試驗。但同樣，到目前為止，非常樂觀，一旦我們對此有了更好的了解，我們會盡快為您提供更多明確的更新。

As it relates to supply constrained for Flash, we're in a much better spot. We've been working really hard to get on top of that. And I don't think we feel that we're supply constrained for either Flash or Bolt at this point.

由於它涉及到 Flash 的供應限制，我們處於一個更好的位置。我們一直在努力做到這一點。而且我不認為我們認為我們在這一點上對 Flash 或 Bolt 有供應限制。

Our next question comes from Joanne Wuensch from Citi.

我們的下一個問題來自花旗銀行的 Joanne Wuensch。

A couple of questions. I want to make sure I got these numbers right. Total vascular was up 17.2% constant currency, U.S. up 23%. What was OUS?

幾個問題。我想確保這些數字是正確的。總血管按固定匯率計算增長 17.2%，美國增長 23%。 OUS是什麼？

OUS, we didn't give that number, but obviously, it was less than that, less than the total number, just as averages work. And just to sort of give you some broader answer to that question, clearly, the vascular number globally was driven by the U.S. vascular thrombectomy franchise. It drove the majority of that $20 million sequential increase in our global quarterly revenue. We mentioned our U.S. vascular business grew 23%. I think we also mentioned that our U.S. vascular thrombectomy piece specifically grew 26% on a year-over-year basis.

OUS，我們沒有給出那個數字，但顯然，它小於那個數字，小於總數，就像平均數一樣。為了給你一些更廣泛的答案，很明顯，全球血管數量是由美國血管血栓切除術特許經營權驅動的。它推動了我們全球季度收入連續增長 2000 萬美元的大部分。我們提到我們的美國血管業務增長了 23%。我想我們還提到了我們的美國血管血栓切除術同比增長了 26%。

So what you're seeing there is the building momentum in the vascular franchise and the strength in the first quarter when you look at the growth and excluding the distributor variance that we saw year-over-year in vascular internationally that Maggie alluded to. And there was a bit of a distributor variance where vascular was strong first quarter last year in a couple of distributor markets and just the way the trajectory goes different this year that made that different, which is why we thought it was important to call out the U.S. to give you a true sense for the growth in that vascular business where the new products are.

所以你看到的是血管特許經營的發展勢頭和第一季度的實力，當你看到增長並排除我們在國際血管中看到的同比分銷商差異時，Maggie 提到了。分銷商存在一些差異，去年第一季度，血管在幾個分銷商市場表現強勁，而今年的發展軌跡不同，這使得情況有所不同，這就是為什麼我們認為重要的是要指出美國讓您真正了解新產品所在的血管業務的增長。

Got it. As a follow-up, Thunderbolt is still on track to be approved at the end of the year? And if so or if not, what are your expectations for uptake of that particular product?

知道了。作為後續，Thunderbolt 是否仍有望在年底獲批？如果是或不是，您對該特定產品的採用有何期望？

Yes. As I said just now to Larry, we'll give a more thoughtful update on exactly the timing of that as we go over the next quarter or so when we get a better sense, as I said. With a renewed level of sort of interest in the stroke field, we sort of want to play that out over a bit to give you a more accurate. Notwithstanding that, what we've said over and over again is that product, we're excited about it. We can't wait for it.

是的。正如我剛才對拉里所說的那樣，正如我所說的那樣，我們將在下個季度左右的時間裡對確切的時間進行更深思熟慮的更新。隨著人們對划水領域的興趣重新燃起，我們有點想稍微研究一下，以便為您提供更準確的信息。儘管如此，我們一遍又一遍地說的是那個產品，我們對此感到興奮。我們等不及了。

But in the meantime, we're doing a lot of work in the stroke field with RED 43 and SENDit. And I think that's time well spent to lay the foundation for Thunderbolt. And also, again, we have the wonderful benefit of having Flash and LIGHTNING BOLT here and now. And between all of that, we're in really good shape right now.

但與此同時，我們正在使用 RED 43 和 SENDit 在筆劃領域做很多工作。我認為花時間為 Thunderbolt 打下基礎是值得的。而且，再一次，我們在這里和現在擁有 Flash 和 LIGHTNING BOLT 的美妙好處。在所有這些之間，我們現在的狀態非常好。

Yes. And just to add to that, Joanne, just to reiterate that point, I think the most important point here is the renewed energy around stroke. And then this new product, SENDit, is really doing quite well with 43. And the other fact just to remind you of is that we did not and continue to not have any expectation for Thunderbolt revenue in our 2023 guidance. That having been said, SENDit and 43 is performing very, very well. So we're excited about that.

是的。 Joanne 補充一點，重申這一點，我認為這裡最重要的一點是中風帶來的新能量。然後這個新產品，SENDit，在 43 上確實做得很好。另一個提醒你的事實是，我們在 2023 年的指導中沒有並且繼續沒有對 Thunderbolt 收入的任何期望。話雖如此，SENDit 和 43 的表現非常非常好。所以我們對此感到興奮。

Our next question comes from Imron Zafar from Deutsche Bank.

我們的下一個問題來自德意志銀行的 Imron Zafar。

Jason, I wanted to first ask about blood loss. One of your competitors commented on the performance of your 16 French catheter, aka Lightning Flash, and talked about the big rates of blood loss in their data set. I just wondered, with the benefit of having a presumably much bigger data set, what you're seeing in your commercial experience specifically on this endpoint of blood loss with Flash.

傑森，我想先問一下失血的問題。您的一位競爭對手評論了您的 16 French 導管（又名 Lightning Flash）的性能，並談到了他們數據集中的高失血率。我只是想知道，憑藉可能擁有更大數據集的好處，您在商業體驗中看到了什麼，特別是在 Flash 失血端點上。

Yes. I mean thanks for the question. Obviously, for people who use the product on a regular basis, no one's seen that or has commented on that. And I think most people understand that.

是的。我的意思是謝謝你的問題。顯然，對於定期使用該產品的人來說，沒有人看到或評論過。我想大多數人都明白這一點。

Okay. And then just in terms of gross margin, I think last time you talked about 1 to 2 points of year-over-year improvement this year. But now that we have better volume leverage, inflationary pressures seem to be abating a little bit. I just wonder, is the year-over-year improvement therefore going to be materially better than that 100 to 200 basis points that you talked about last quarter? And then when do you think you can get to that 70% gross margin level in terms of time frame?

好的。然後就毛利率而言，我想你上次談到今年同比提高 1 到 2 個百分點。但現在我們有了更好的交易量槓桿，通脹壓力似乎有所減輕。我只是想知道，同比改善是否會比你上個季度談到的 100 到 200 個基點好得多？然後你認為你什麼時候可以在時間範圍內達到 70% 的毛利率水平？

Thanks for the question. Yes. So far, we see a pretty positive trend in the first quarter. We're excited to see that all the new product launch have accretive to the gross margin. And we are on track to all of our productivity progress. We are seeing more margin improvement opportunities.

謝謝你的問題。是的。到目前為止，我們在第一季度看到了相當積極的趨勢。我們很高興看到所有新產品的推出都增加了毛利率。我們正在朝著我們所有的生產力進步邁進。我們看到了更多提高利潤率的機會。

In the near term, we will primarily focus on meeting increasing demand and quality of new product launches. As I mentioned in the prepared remarks, we do see some higher start-up costs with all the new product launches, but we are still on track to our target of 100 and 200 basis point improvement for the year.

在短期內，我們將主要關注滿足不斷增長的需求和新產品發布的質量。正如我在準備好的評論中提到的，我們確實看到所有新產品發布的啟動成本都更高，但我們仍有望實現今年提高 100 和 200 個基點的目標。

Okay. And then when do you think -- do you have a time frame of when do you think you can achieve that 70% aspirational target for gross margin?

好的。然後你認為什麼時候 - 你有一個時間框架，你認為你什麼時候可以實現 70% 的毛利率理想目標？

Yes. We'll continue to see favorable mix and productivity improvement in the next few years. So within a few years, we are still on track to the 70-plus percent gross margin target.

是的。未來幾年，我們將繼續看到有利的組合和生產力的提高。因此，在幾年內，我們仍有望實現 70% 以上的毛利率目標。

Our next question comes from Margaret Kaczor from William Blair.

我們的下一個問題來自威廉·布萊爾的瑪格麗特·卡佐爾。

I'm not going to try to do Larry and mention everyone just in the sake of time, but appreciate it. Maybe the first one just on reorder rates as a follow-up for the new and existing accounts. So you mentioned you're saying those go up. Specifically for existing, can you give us a sense of how much that's going up and maybe how that might compare to the potential addressable markets in some of these existing accounts? Maybe you're 10% within that 100 etc.

我不會為了時間而嘗試做 Larry 並提及每個人，但我很感激。也許第一個只是關於再訂購率，作為新賬戶和現有賬戶的後續行動。所以你提到你說那些上升了。特別是對於現有的，你能告訴我們有多少正在上升，以及與其中一些現有賬戶的潛在可尋址市場相比可能如何？也許你是那 100 人中的 10% 等等。

Yes. So Margaret, I apologize for not fully understanding, you're saying with our existing accounts, how much that has gone up?

是的。所以瑪格麗特，我很抱歉沒有完全理解，你是說我們現有的賬戶，已經上漲了多少？

Yes.

是的。

Yes. So with Flash, what we're talking to -- let's talk about Flash versus Lightning Bolt 7. With Flash, the first bit of work in the first quarter, again, was getting the product into people's hands, getting them to order it, use it. And so there -- it's hard to sort of quantify that people who otherwise were using Lightning 12 now were using Flash and how many more cases they did that they would have used something else. That's probably a pretty small category of people.

是的。因此，對於 Flash，我們正在談論的是——讓我們來談談 Flash 與 Lightning Bolt 7。對於 Flash，第一季度的首要工作再次是將產品交到人們手中，讓他們訂購，用它。因此 - 很難量化那些原本使用 Lightning 12 的人現在正在使用 Flash，以及他們使用其他東西的情況還有多少。這可能是一小部分人。

So I wouldn't probably have quantified that. I don't know that. I think we're looking at people who used our products and then people who didn't use our products. People who didn't use our products, that's sort of the most important number. Some of those people used other means like lytics. Others used other mechanical tools, devices on the market.

所以我可能不會量化它。我不知道。我認為我們正在尋找使用過我們產品的人，然後是沒有使用過我們產品的人。沒有使用我們產品的人，這是最重要的數字。其中一些人使用其他方式，如 lytics。其他人使用市場上的其他機械工具、設備。

The rate of reuse and reorder is very high, and it's the same between those new customers and customers who used Lightning 12 before. And I -- we wanted to share that because that's a huge important fact that gives us the confidence that this is sticky even with customers who didn't use us before this launch.

重複使用率和重新訂購率非常高，新客戶和之前使用過 Lightning 12 的客戶之間是一樣的。我——我們想分享這一點，因為這是一個非常重要的事實，它讓我們相信，即使對於在此次發布之前沒有使用過我們的客戶來說，這也是有吸引力的。

So that was the point that we were making. We're not seeing -- I'm sure you can come up with one person who didn't do that, but the vast majority have. And that level of sort of engagement and reorder is significant, both from existing but more importantly for purposes of growth of new customers.

這就是我們要表達的觀點。我們沒有看到——我敢肯定你能想出一個人沒有這樣做，但絕大多數人都這樣做了。這種程度的參與和重新訂購是重要的，無論是從現有的角度來看，但更重要的是為了新客戶的增長。

Okay. And I think part of it, from my perspective, was utilization as well. So we can talk about that later. The second question, you mentioned the PE, DVT grew 30% sequentially. Obviously, that seems like a pretty big number. Can you give us any sense around scale between the January and March? And can that trajectory, I guess, keep going in April and beyond?

好的。從我的角度來看，我認為其中一部分也是利用率。所以我們可以稍後再談。第二個問題，你提到了 PE，DVT 環比增長了 30%。顯然，這似乎是一個相當大的數字。你能告訴我們 1 月和 3 月之間的規模嗎？我想，這種軌跡能否在 4 月及以後繼續發展？

Yes. So the most important thing here is to -- again, without taking away any of the excitement and enthusiasm that we feel or anyone else feels, these things aren't 100% linear. And we'll, I'm sure, spend the next better part of time walking through how launches work and so on because they're not just straight line, linear thing. But obviously, you can tell from our updated guidance that we have a lot of belief that we can do this and that these products will be adopted over the course of this year in pretty significant numbers.

是的。所以這裡最重要的是——再一次，在不帶走我們或其他任何人感受到的任何興奮和熱情的情況下，這些事情並不是 100% 線性的。我敢肯定，我們將花更多的時間來了解發射的工作原理等等，因為它們不僅僅是直線，線性的東西。但很明顯，您可以從我們更新的指南中看出，我們非常相信我們可以做到這一點，並且這些產品將在今年的過程中被大量採用。

So that's the most important message that we're trying to convey, that these products work. They're relatively -- they're transformational at a scale that you don't typically see. It's pretty rare. And not only do we worry about this quarter and next, but what we've done and what we now can do and we've now had this conversation with dozens and dozens of physicians, is we're now getting closer to having the products that can go out there and fundamentally be viable to treat everybody that should be treated.

所以這是我們試圖傳達的最重要的信息，即這些產品有效。它們是相對的——它們正在以你通常看不到的規模進行變革。這是非常罕見的。我們不僅擔心這個季度和下個季度，而且擔心我們已經做了什麼以及我們現在可以做什麼，我們現在已經與數十名醫生進行了對話，我們現在是否越來越接近擁有這些產品可以走出去，從根本上可行地治療每個應該接受治療的人。

And that's the work ahead. That's sort of the focus that we, as a company, now feel we can put on these products because of the reception that we've got so far. And that's really exciting. That's sort of why we're here, to make products that can remove clot, whether it's in your arteries in your leg, in your veins or your lungs, in a manner that is bordering on routine. So that's what we're trying to do, and I think we're getting really close to that, and that's what the excitement is about right now. So we're getting to work.

這就是未來的工作。這就是我們作為一家公司現在認為我們可以投入這些產品的重點，因為到目前為止我們已經收到了這些產品。這真的很令人興奮。這就是我們來這裡的原因，以一種接近常規的方式製造可以去除血栓的產品，無論是在你腿部的動脈、靜脈還是肺部。所以這就是我們正在努力做的事情，我認為我們真的很接近這一點，這就是現在令人興奮的地方。所以我們開始工作了。

Our next question comes from Michael Sarcone from Jefferies.

我們的下一個問題來自 Jefferies 的 Michael Sarcone。

So just a quick follow-up on Margaret's question. You talked about that over 30% quarter-over-quarter growth for PE and DVT procedures. Can you give us any color on what that looked like on a year-over-year basis?

所以只是快速跟進瑪格麗特的問題。您談到 PE 和 DVT 手術的環比增長超過 30%。你能給我們一些顏色，說明它與去年同期相比是什麼樣子的嗎？

It was significant, but I don't have those numbers in front of me. It was significant. Obviously, we had a pretty good fourth quarter, and fourth quarter is generally one of our strongest quarters. So I don't think we've quoted that number, and I don't have it in front of me, but it was a significant growth on a year-over-year basis for that business and for the vascular business -- U.S. vascular thrombectomy business as we quoted. So it was higher than that number that we gave you for the total U.S. thrombectomy business is a fair way to put it.

這很重要，但我面前沒有這些數字。這很重要。顯然，我們的第四季度表現相當不錯，而且第四季度通常是我們最強勁的季度之一。所以我不認為我們已經引用了這個數字，而且我沒有在我面前看到它，但對於該業務和血管業務 - 美國來說，這是一個同比顯著增長。我們引用的血管血栓切除術業務。所以它高於我們給你的美國血栓切除術總量的數字是一個公平的說法。

Okay. That's helpful. And then I was just curious, in arterial for Lightning Bolt, for the use case for docs, you talked about it being fast, safe and easy. Can you also talk about what the economic case looks like for using Bolt versus open or lytics?

好的。這很有幫助。然後我只是好奇，在 Lightning Bolt 的主幹中，對於文檔的用例，你談到它快速、安全和簡單。您能否也談談使用 Bolt 與 open 或 lytics 的經濟案例？

Yes, it's a good -- really good question for Lightning Bolt 7. There are different -- if you just look at material cost, obviously, the cost of Lightning Bolt is more than what you would do from a "materials cost" in open surgery. But if you look at it the way most hospital administrators look at it, when you're looking at the total cost to the hospital, the OR, which many of them are billed sort of by the hour, you look at post stay and how long that is, if you have those kind of open surgeries versus interventional surgeries, same with lytic, 2 days in ICU on average, we have a pretty compelling argument that we are significantly more cost-effective on a total cost basis than either of those 2.

是的，對於 Lightning Bolt 7，這是一個很好的問題。有不同的 - 如果你只看材料成本，顯然，Lightning Bolt 的成本比你從開放的“材料成本”中所做的要多外科手術。但是，如果您以大多數醫院管理者的方式來看待它，當您查看醫院的總成本時，OR，其中許多按小時計費，您會查看住院後以及如何也就是說，如果你有那種開放手術與介入手術，與溶血性手術一樣，平均在 ICU 待 2 天，我們有一個非常有說服力的論點，即在總成本基礎上，我們的成本效益明顯高於其中任何一種2.

So I think we're going to get some real traction. Again, the first step is to get everyone to order it and get through it and try it. What I'm excited about is just like Flash, there is a lot of interest in that. There is a lot of we're not -- there's going to be a group that we probably have to convince. But so far, we have a lot of momentum with folks willing to engage with us on the process to get the product going and in and starting to use it. And again, that comes from the successful cases that we're seeing every day.

所以我認為我們將獲得一些真正的吸引力。同樣，第一步是讓每個人都訂購它並通過它並嘗試它。令我興奮的是 Flash，人們對此很感興趣。有很多我們不是——我們可能必須說服一個小組。但到目前為止，我們有很大的動力，人們願意與我們合作，讓產品投入使用並開始使用。同樣，這來自我們每天看到的成功案例。

Our next question comes from Shagun Singh from RBC Capital Markets.

我們的下一個問題來自 RBC Capital Markets 的 Shagun Singh。

Congratulations on a good quarter. I just was looking for some clarification here. I thought it was interesting that the beat relative to expectations was driven by neurovascular and not peripheral. And you did call out that U.S. thrombectomy uptake, it sounds like it was better than at least what we were expecting. So were there any offset on the vascular side for us to consider either internationally or elsewhere?

祝賀一個好的季度。我只是想在這裡尋找一些澄清。我認為有趣的是，相對於預期的節拍是由神經血管而不是外周驅動的。你確實提到了美國血栓切除術的採用，聽起來至少比我們預期的要好。那麼，在國際上或其他地方，我們可以考慮血管方面的任何補償嗎？

And then on guidance, also just as a clarification, I was wondering, how much of Bolt is in guidance? Is the guidance increase mostly Flash? You did call out that there's not much for Thunderbolt in it, but what about LIGHTNING BOLT? How much of that is in it? And then I have a follow-up.

然後關於指導，也只是作為一個澄清，我想知道，博爾特在指導中有多少？指導漲幅主要是Flash嗎？你確實說 Thunderbolt 裡面沒有太多內容，但是 LIGHTNING BOLT 呢？裡面有多少？然後我有一個後續行動。

Yes. Thank you, Shagun. Please chime in if I missed any of this, but I'll try to address both the vascular question and the guidance question. So first on vascular, as I look at it, I don't think -- I agree with the premise. I know it looks like that neuro drove the upside to what your consensus expectations were, but we didn't give guidance specific to neuro versus vascular. And there was upside to the U.S. vascular business relative to what you were modeling.

是的。謝謝你，沙根。如果我錯過了任何一個，請補充，但我會嘗試解決血管問題和指導問題。所以首先在血管方面，當我看到它時，我不認為 - 我同意這個前提。我知道看起來神經推動了你的共識期望的上升，但我們沒有給出特定於神經與血管的指導。相對於你所建模的，美國血管業務有優勢。

And the international business, as Maggie pointed out, there was a distributor variances that was favorable to neuro and the opposite is favorable to vascular, which is why we called out our U.S. vascular business and our U.S. vascular thrombectomy business, so you can get a sense for that. So -- and we also said that Flash drove the majority of that $20 million sequential increase. So if you put those facts together, I think the conclusion you draw is that the strength in the quarter was driven by U.S. vascular thrombectomy.

而國際業務，正如 Maggie 指出的那樣，分銷商的差異有利於神經系統，相反有利於血管系統，這就是為什麼我們召集了我們的美國血管業務和我們的美國血管血栓切除術業務，所以你可以得到一個對此有感覺。所以 - 我們還說過，Flash 推動了 2000 萬美元連續增長的大部分。因此，如果將這些事實放在一起，我認為您得出的結論是，該季度的實力是由美國血管血栓切除術推動的。

As it relates to the guidance, certainly, as Adam mentioned, going forward, we've commented that our vascular business will accelerate. We've also said that vascular growth globally will be slightly above the top end of that global revenue guidance range. That should give you, I think, enough guidance to draw the conclusion that Flash and Bolt will drive a significant portion of the growth that we're seeing on a year-over-year basis, which year-over-year in dollar terms is now in and around $200 million.

正如 Adam 提到的那樣，當然，與指導有關，展望未來，我們評論說我們的血管業務將加速發展。我們還表示，全球血管增長將略高於全球收入指導範圍的上限。我認為，這應該給你足夠的指導來得出結論，即 Flash 和 Bolt 將推動我們看到的同比增長的很大一部分，以美元計算的同比增長是現在大約有 2 億美元。

Got it. And then just in terms of your commentary here, you guys have been talking about your portfolio of products in '23 and that they're transformational. You're guiding to 24% growth in '23. I'm just wondering, what does that mean for your sales growth trajectory beyond 2023? Is there -- should we think of you as a plus/minus 20% grower? Just any floor you're willing to put out there.

知道了。然後就你們在這裡的評論而言，你們一直在談論你們在 23 世紀的產品組合，它們是變革性的。您正在引導 23 年實現 24% 的增長。我只是想知道，這對您 2023 年以後的銷售增長軌跡意味著什麼？我們是否應該將您視為正負 20% 的種植者？只要你願意放在那裡的任何地板。

And then also on margins, you talked about exiting at plus 10%. Should we think of a similar magnitude of increase in '24 as we saw in '20 -- as we are looking for in '23?

然後在利潤率方面，你談到了 10% 的退出。我們是否應該考慮與我們在 20 年看到的類似的 24 年增長幅度——正如我們在 23 年所期待的那樣？

I really appreciate the questions. I love that you're trying to get us to give 2024 guidance already. I respect that immensely. That having been said, I don't think we want to give 2024 guidance quite yet. We've done, of course, a lot of work on what our business looks like, not just in 2024. I think Adam might have mentioned 3 or 4 times 5-plus years.

我真的很感激這些問題。我喜歡你試圖讓我們已經給出 2024 年的指導。我非常尊重這一點。話雖如此，我認為我們還不想給出 2024 年的指導。當然，我們已經為我們的業務做了很多工作，不僅僅是在 2024 年。我認為亞當可能已經提到 3 或 4 次 5 年以上。

So clearly, that is not just said flippantly but said with a good degree of conversation with our entire team about what this looks like this year and over that 5-plus years. And we do expect strong growth going forward, strong double-digit growth, but not to put any sort of quantitative sort of figure on that just quite yet.

很明顯，這不僅僅是輕率地說，而是與我們整個團隊就今年和 5 年多的情況進行了很好的對話。我們確實預計未來會出現強勁增長，兩位數的強勁增長，但目前還沒有給出任何數量的數字。

From an operating income perspective, I think we went out of our way at least qualitatively to give you some sense that we -- with strong revenue growth, our gross margin expansion expectations and our disciplined spending that we do expect our operating margins to expand not just this year but next year. And to frame that on a quantitative basis, again, it's a little too early, but we're excited about the leverage that exists in 2024 and frankly beyond that.

從營業收入的角度來看，我認為我們至少在質量上竭盡全力讓你感覺到我們 - 憑藉強勁的收入增長、我們的毛利率擴張預期和我們的紀律支出，我們確實預計我們的營業利潤率不會擴大只是今年但明年。並且再次在定量基礎上構建它還為時過早，但我們對 2024 年存在的槓桿作用感到興奮，坦率地說，超越這一點。

Our next question comes from Bill Plovanic from Canaccord Genuity.

我們的下一個問題來自 Canaccord Genuity 的 Bill Plovanic。

Just a couple of things. One, at this point in the launch, do you think that you've gotten Lightning Flash and Bolt to all the accounts? So I think on the last call, you're still kind of in the LMR on Bolt. And then kind of a follow-up to that is, are you seeing an acceleration of the Bolt launch or benefit? Because I think we talked about going to the VAC committees with both products at the same time. Just trying to figure out where you are in the launch at this point.

只是幾件事。第一，在發布的這一點上，你認為你已經為所有帳戶提供了 Lightning Flash 和 Bolt 嗎？所以我認為在最後一次通話中，你仍然在博爾特的 LMR 中。然後是後續行動，您是否看到 Bolt 發布或收益的加速？因為我想我們談到了同時帶著這兩種產品去 VAC 委員會。只是想弄清楚此時您在發布中的位置。

Yes. So with LIGHTNING BOLT, we launched the product. What is it? May 2, we launched the product within 3 weeks ago or something like that. I've lost the exact track of time. So I think you can be pretty confident in understanding that we have not gone to every account in the United States with that and have it on the shelf yet. That would be amazing.

是的。因此，我們推出了 LIGHTNING BOLT 產品。它是什麼？ 5 月 2 日，我們在 3 週前或類似時間推出了該產品。我已經忘記了準確的時間軌跡。所以我認為你可以非常有信心地理解我們還沒有去美國的每個賬戶並把它放在貨架上。這將是驚人的。

It takes a while. As you heard, one of the largest systems in the country just put Flash on contract, which allows us to start the individual hospital VAC committees in each of their hospitals. And that's in April, and we launched that in January. So the process takes time. That being said, we're pretty darn excited about the reaction to it.

這需要一段時間。正如您所聽說的，該國最大的系統之一剛剛與 Flash 簽訂了合同，這使我們能夠在他們的每家醫院啟動單獨的醫院 VAC 委員會。那是在四月份，我們在一月份推出了它。所以這個過程需要時間。話雖這麼說，我們對它的反應非常興奮。

And without a positive reaction, you can have all the time in the world, no one's going to care. People care. They're excited about it. And I think we kind of went out of our way on this call to be clear that we have a fairly long tail on these products, and that's pretty exciting for us. And I think, hopefully, our physicians and the customers are going to get the product.

如果沒有積極的反應，你可以擁有世界上所有的時間，沒有人會在意。人們關心。他們對此很興奮。而且我認為我們在這次電話會議上有點特意表明我們在這些產品上有相當長的尾巴，這對我們來說非常令人興奮。我認為，希望我們的醫生和客戶能夠獲得該產品。

Great. And if I could, on the real product, given your recently announced agreement with the VA for real, how should we think about the revenue contribution both near term and longer term from this product? Does it -- should we kind of bring it back into the discussion or still hold off maybe until next year to start really thinking about it?

偉大的。如果我可以，在實際產品上，鑑於您最近宣布與 VA 達成真實協議，我們應該如何考慮該產品的近期和長期收入貢獻？是否——我們應該將其重新納入討論，還是仍然推遲到明年才開始真正考慮它？

Yes. There's a lot of work to be done. I can't wait to share some of what is happening in that. Some of it, we will be able to share. But some of it, I can't yet share. I got to tell you, I'm really confident and excited about finding this partner, finding their passion for this, the possibility -- or actually the reality now of helping a lot of veterans, which also then allows us to really have a model that can be rolled out throughout the country.

是的。有很多工作要做。我迫不及待地想分享其中發生的一些事情。其中一些，我們將能夠分享。但其中一些，我還不能分享。我得告訴你，我真的很自信也很興奮能找到這個合作夥伴，找到他們對此的熱情，幫助很多退伍軍人的可能性——或者實際上是現在的現實，這也讓我們真正擁有了一個模型可以在全國推廣。

So I'm very excited about it, very optimistic. But from a contributing revenue standpoint, particularly on a year like this where we have Lightning Bolt 7, Lightning Flash in our neuro business, it's not going to be the thing we're talking about from a revenue standpoint. But from a laying the groundwork for the future, it couldn't be better right now.

所以我對此非常興奮，非常樂觀。但從貢獻收入的角度來看，特別是在這樣的一年，我們的神經業務中有 Lightning Bolt 7，Lightning Flash，從收入的角度來看，這不會成為我們談論的事情。但從為未來打下基礎來看，現在再好不過了。

Our next question comes from Richard Newitter from Truist Securities.

我們的下一個問題來自 Truist Securities 的 Richard Newitter。

I was just wondering, just following up to an earlier question, the question -- you had 30% sequential growth, I believe, in your thrombectomy -- venous thrombectomy. And I'm just curious to know how much of that maybe came from March. I know that the launch wasn't the entire quarter or not full scale the entire quarter. So can you just characterize that for us?

我只是想知道，只是跟進一個較早的問題，這個問題——我相信，在你的血栓切除術中，你有 30% 的連續增長——靜脈血栓切除術。我只是想知道其中有多少可能來自三月份。我知道發布不是整個季度，也不是整個季度的全面發布。那麼你能為我們描述一下嗎？

Yes. Look, what we said is -- and I want to be crystal clear. We said 30% increase in cases done. Obviously, we're getting product out there. We're having orders. We were pretty clear that we were talking about cases, and that's an important piece of information. We also said we were seeing acceleration throughout the quarter. So that would tell you that March was better than February, and February is better than January. And I think that is pretty clear that there is momentum here on this product.

是的。看，我們說的是——我想說得很清楚。我們說完成的案件增加了 30%。顯然，我們正在推出產品。我們有訂單。我們很清楚我們在談論案例，這是一條重要的信息。我們還說我們看到整個季度都在加速。所以這會告訴你三月好於二月，二月好於一月。我認為很明顯，該產品的發展勢頭強勁。

Okay. That's helpful. And then just as I think about the range that you provided, thanks for that, for the guidance, the $1.04 billion to $1.06 billion. I'm just curious if there's any benchmarks that you can give us for kind of how you came up with those upper and lower bounds. What does it take to get you to the upper end? I know someone asked about Bolt and contribution in there. It sounds like Bolt is in there. But would love to just hear how you came up with that.

好的。這很有幫助。然後就在我考慮你提供的範圍時，謝謝你的指導，10.4 億美元到 10.6 億美元。我只是想知道您是否可以提供任何基準來說明您是如何得出這些上限和下限的。怎樣才能讓你達到更高的境界？我知道有人問過博爾特和那裡的貢獻。聽起來博爾特就在裡面。但很想听聽你是怎麼想出來的。

Yes. Well, we know our business very well. We've been giving guidance now for 8 years. I don't mean to come across as, but that is important to note. And we take into account lots of things. And our vascular business, we expect to grow slightly faster than that, our neuro business a little bit below that. We do a lot of work on that and came to this conclusion. Obviously, it's accelerating growth for the year and a lot higher than what we did in the first quarter. So we feel good about where we are now with that guidance.

是的。好吧，我們非常了解我們的業務。 8 年來，我們一直在提供指導。我並不是要給人留下印象，但這很重要。我們考慮了很多事情。而我們的血管業務，我們預計增長速度略快於此，我們的神經業務略低於此。我們為此做了很多工作並得出了這個結論。顯然，它今年正在加速增長，並且比我們在第一季度所做的要高得多。因此，在該指導下，我們對我們現在所處的位置感到滿意。

Our next question comes from Mike Matson from Needham & Company.

我們的下一個問題來自 Needham & Company 的 Mike Matson。

I just want to ask one about the Value Analysis Committee process. Kind of how long does it typically take? How receptive have they been to Flash and Bolt? And do they ask for data? I mean I don't think you have much kind of human data on these products, but...

我只想問一個關於價值分析委員會流程的問題。一般需要多長時間？他們對 Flash 和 Bolt 的接受程度如何？他們會要求數據嗎？我的意思是我不認為你有很多關於這些產品的人類數據，但是......

Yes. That's a great question. Someday, I should -- we should have a little class on how these product -- these things launch and sell and so on. It's a pretty diverse process. Some hospitals are pretty straightforward. Others are not. Scheduling the meeting sometimes is the biggest issue.

是的。這是一個很好的問題。總有一天，我應該——我們應該上一堂關於這些產品如何推出和銷售等等的小課。這是一個相當多樣化的過程。有些醫院很簡單。其他人不是。有時安排會議是最大的問題。

I could go through all kinds of stuff. None of those are excuses. We are doing fine. This is working. I just -- there is a gate here that everyone just has to remember. You can't just sell to everyone who wants it immediately. And that process is just -- we're talking about it simply to remind everyone that there's a process here.

我可以經歷各種各樣的事情。這些都不是藉口。我們做得很好。這是工作。我只是 - 這裡有一扇門，每個人都必須記住。您不能立即賣給所有想要的人。這個過程只是——我們談論它只是為了提醒大家這裡有一個過程。

That being said, yes, things are working really well. The physicians are advocates. They want us -- they want the product. We know how to go through this. We've been selling product now. The company has for well over a decade, and we know how to do this.

話雖這麼說，是的，一切都運作良好。醫生是倡導者。他們想要我們——他們想要產品。我們知道如何度過難關。我們現在一直在銷售產品。公司已有十多年的歷史，我們知道如何做到這一點。

And so there's nothing unusual about this process than any other product that we've ever launched, and we launched dozens and dozens and dozens of products over the course of the year. So nothing other than the process. It means we have to go through it over time.

因此，與我們推出的任何其他產品相比，這個過程沒有什麼不尋常的，我們在一年中推出了數十種產品。所以除了過程之外別無其他。這意味著我們必須隨著時間的推移經歷它。

Okay. I understand. And then just one last one on China. Just curious. I didn't really hear any comments about that market in the quarter. And then just curious if you're seeing any impact from the VBP stuff over there.

好的。我明白。然後是關於中國的最後一個。只是好奇。我在本季度沒有真正聽到有關該市場的任何評論。然後很好奇你是否看到了 VBP 的影響。

Yes. Thanks for the question, Mike. Yes, we certainly, like other companies, have seen the VBP process starting to play out. And that's playing out as we expected. I just got to have to say again that our partnership with Genesis is important. It's going very well. It's generally fairly early still with respect to what products we are in partnership with them both on the neuro and the vascular side. So all of that taken together, I think the future is bright in China for Genesis and therefore as their partner for us.

是的。謝謝你的問題，邁克。是的，我們當然和其他公司一樣，已經看到 VBP 流程開始發揮作用。這正如我們所料。我不得不再次強調，我們與 Genesis 的合作非常重要。進展順利。關於我們在神經和血管方面與他們合作的產品通常還為時過早。因此，所有這些加在一起，我認為 Genesis 在中國的未來是光明的，因此作為我們的合作夥伴。

Our next question comes from Matt O'Brien from Piper Sandler.

我們的下一個問題來自 Piper Sandler 的 Matt O'Brien。

This is Sam on for Matt. I guess one of my questions, we just wanted to follow up on -- you mentioned the rate of reorders. Maybe could you provide a little bit more color and maybe put it into context with historical launches?

這是山姆代替馬特。我想我的問題之一，我們只是想跟進——你提到了再訂購率。也許您可以提供更多顏色，並將其與歷史發布結合起來？

So historical, it depends -- we've had so many products over the years. So it's hard to do that with any validity. If you look back on Lightning 12, maybe the best example, the rate of reorder from new customers seems higher. I don't have the numbers in front of me, so I can't quote with specificity. If I did have that number, you would think something's wrong that I would walk around with that in my head. I just don't.

如此具有歷史意義，這取決於 - 多年來我們擁有如此多的產品。所以很難以任何有效性做到這一點。如果你回顧 Lightning 12，也許是最好的例子，新客戶的重新訂購率似乎更高。我面前沒有數字，所以我不能具體引用。如果我確實有那個號碼，你會認為我會帶著這個號碼走來走去。我只是不知道。

But what we were really pleased about is the reception this product has had and how customers who were not using our products before reordered the product because they really liked it. And that's an important metric for us to get out there so that you know, as we put out guidance and we talk about it, what's behind it and how confident we are that over the course of the next years, we can go after all these patients. So that's why we talked about it. It obviously is something that is notably higher than in the past, but I can't quantify it because I don't have -- of the dozens of products we've launched, I don't know that.

但我們真正感到高興的是該產品的反響以及之前未使用我們產品的客戶如何重新訂購該產品，因為他們真的很喜歡它。這對我們來說是一個重要的指標，這樣你就知道，當我們發布指導並討論它時，它背後的原因以及我們有多大信心在接下來的幾年裡，我們可以追求所有這些患者。所以這就是我們談論它的原因。它顯然比過去高得多，但我無法量化它，因為我沒有——在我們推出的數十種產品中，我不知道。

Our last question will come from Ryan Zimmerman from BTIG.

我們的最後一個問題將來自 BTIG 的 Ryan Zimmerman。

I promise this will not be a 30-part question squeezed into one question. This will be a one question squeezed into one question. So just -- I want to talk about Lightning Flash briefly. The one thing we didn't talk about was pricing. And I know you're not going to give pricing, Adam, but I'd love for you just to talk qualitatively about unit growth versus pricing as Lightning Flash does commercialize and what impact that pricing could have relative to the unit growth or the market expansion and how important that is to kind of what you're implying in your guidance.

我保證這不會是一個 30 部分的問題被壓縮成一個問題。這將是一個問題被壓縮成一個問題。所以 - 我想簡單談談 Lightning Flash。我們沒有談論的一件事是定價。我知道你不會給出定價，亞當，但我希望你能定性地談談單位增長與定價的關係，因為 Lightning Flash 確實商業化了，以及定價相對於單位增長或市場可能產生的影響擴展以及這對您在指導中暗示的內容有多重要。

Yes. It's really -- I really appreciate the question. It's a great question. There's been some misinformation out there on our pricing. What we've done is priced Flash sort of below what was then the sort of market-leading price. When you look at Flash versus Lightning 12 and the need for a separator, we're not talking fundamentally different price. They're very close to the price, not exactly, but close enough that you're not going to see significant gain just because of mix or price between the 2.

是的。這真的 - 我真的很感激這個問題。這是一個很好的問題。我們的定價存在一些錯誤信息。我們所做的是將 Flash 的價格定得低於當時市場領先的價格。當您查看 Flash 與 Lightning 12 以及對分離器的需求時，我們並不是在談論根本不同的價格。它們非常接近價格，但不完全接近，但足夠接近以至於你不會僅僅因為兩者之間的混合或價格而看到顯著的收益。

So this is real gain. This is products that are being used in cases that we wouldn't otherwise have necessarily done. And that's really important here. Our price isn't -- this is not all price gain from existing customers. In fact, it's very, very minimal part of the mix, if at all. Again, we haven't quantified it.

所以這是真正的收穫。這些產品在我們本來不一定會做的情況下使用。這在這裡非常重要。我們的價格不是——這不是現有客戶的所有價格收益。事實上，如果有的話，它只是組合中非常非常小的一部分。同樣，我們還沒有量化它。

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

目前沒有其他問題。 Hamlyn-Harris 女士，我把電話轉給你。

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

謝謝你，運營商。代表我們的管理團隊，再次感謝大家今天加入我們以及您對 Penumbra 的興趣。我們期待在第二季度的電話會議上向您通報最新情況。

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。