Penumbra Inc (PEN) 2024 Q4 法說會逐字稿

Good afternoon. My name is Rob, and I will be your conference operator today.

午安.我叫羅布，今天我將擔任您的會議主持人。

At this time, I would like to welcome everyone to Penumbra's fourth-quarter 2024 conference call.

現在，我歡迎大家參加 Penumbra 2024 年第四季電話會議。

(Operator Instructions)

（操作員指令）

I would like to introduce Ms. Cecilia Furlong, Business Development and Investor Relations for Penumbra. Ms. Furlong, you may begin your conference.

我想介紹 Penumbra 業務發展和投資者關係主管 Cecilia Furlong 女士。弗隆女士，您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 fourth quarter and full year 2024.

謝謝接線員，也感謝大家參加今天的電話會議，討論 Penumbra 2024 年第四季和全年的收益報告。

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. 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, 2024, which is scheduled to be filed with the SEC on February 18, 2025.

新聞稿和財務表的副本（包括 GAAP 與非 GAAP 的對帳）可在我們公司網站 www.penumbrainc.com 的「投資者」標籤下查看。在本次電話會議期間，本公司將根據 1995 年私人證券訴訟改革法的安全港規定做出前瞻性聲明，包括有關我們的財務業績、商業化、臨床試驗、監管狀況、品質、合規性和業務趨勢的聲明。由於某些風險和不確定性，實際結果可能與我們的前瞻性陳述中明示或暗示的結果有重大差異，包括我們截至 2024 年 12 月 31 日的年度 10-K 中提及的風險和不確定性，該報告計劃於 2025 年 2 月 18 日向美國證券交易委員會提交。

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，我們告誡您不要過度依賴這些前瞻性陳述，並鼓勵您查看我們向美國證券交易委員會提交的定期文件，包括前面提到的 10-K 文件，以便更全面地討論這些因素和其他可能影響我們未來業績或股票市場價格的風險。Penumbra 不承擔因新資訊、未來事件、發展或其他原因更新或修改我們的前瞻性聲明的任何義務。

On this call, Q4 2024 and full year 2024 financial results are on a non-GAAP basis. Non-GAAP revenue, gross profit, gross margin, operating income, and operating margin exclude a $5.8 million reserve pertaining to Italian payback legislation. In addition, the full year 2024 non-GAAP operating expenses, operating income, and operating margin exclude expenses associated with Immersive Healthcare impairment charges of $76.9 million, wind down of Immersive Healthcare business expenses of $5 million, non-recurring litigation expenses of $4.8 million, and amortization of finite lived intangible assets of $4.8 million. The corresponding GAAP measures and reconciliation of GAAP to non-GAAP financial measures are provided in our posted press release.

在本次電話會議上，2024 年第四季和 2024 年全年財務業績均採用非 GAAP 基礎。非公認會計準則收入、毛利、毛利率、營業收入和營業利潤率不包括與義大利償還法規相關的 580 萬美元儲備金。此外，2024 年全年非 GAAP 營業費用、營業收入和營業利潤率不包括與 Immersive Healthcare 減損費用 7,690 萬美元、Immersive Healthcare 業務清盤費用 500 萬美元、非經常性訴訟費用 480 萬美元以及有限壽命無形資產攤銷 480 萬美元相關的費用。我們在發布的新聞稿中提供了相應的 GAAP 指標以及 GAAP 與非 GAAP 財務指標的對帳。

Adjusted EBITDA for Q4 2024 and full year 2024 respectively excludes the Italian payback reserve, one-time Immersive Healthcare impairment charges, Immersive Healthcare wind down expenses, non-recurring litigation-related expenses, stock compensation expense, depreciation and amortization, provision for income taxes and interest income expenses.

2024 年第四季和 2024 年全年調整後 EBITDA 分別不包括義大利償還準備金、一次性 Immersive Healthcare 減損費用、Immersive Healthcare 清算費用、非經常性訴訟相關費用、股票薪資費用、折舊和攤提、所得稅準備金和利息收入費用。

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 fourth quarter and full year 2024, and Jason Mills, our Executive Vice President of Strategy, will discuss our 2025 guidance.

Penumbra 董事長兼執行長 Adam Elsesser 將提供業務最新進展。然後，我們的財務長 Maggie Yuen 將討論我們 2024 年第四季和全年的財務業績，我們的策略執行副總裁 Jason Mills 將討論我們的 2025 年指引。

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

說到這裡，我想把電話轉給亞當·埃爾塞瑟 (Adam Elsesser)。

Thank you, Cecilia. Good afternoon. Thank you for joining Penumbra's fourth quarter and full year 2024 conference call.

謝謝你，塞西莉亞。午安.感謝您參加 Penumbra 2024 年第四季和全年電話會議。

In the fourth quarter, we generated revenue of $321.3 million when excluding the Italian payback adjustment, representing underlying year over year growth of 12.9% on an adjusted basis and 13% on a constant currency basis.

第四季度，若不包括義大利的償還調整，我們的營收為 3.213 億美元，按調整後基礎年增 12.9%，以固定匯率計算成長 13%。

Our US thrombectomy business continued to lead our growth with our comprehensive and proprietary CAVT portfolio delivering another dominant performance, gaining momentum throughout the quarter, and exiting the year in a strong position.

我們的美國血栓切除術業務繼續引領我們的成長，我們全面而專有的 CAVT 產品組合再次呈現主導表現，在整個季度獲得發展勢頭，並在年底保持強勁地位。

Fourth quarter US thrombectomy sales increased 27.3% year over year to $180.6 million with our US VTE franchise delivering robust year over year revenue growth of 41%. The balance of our US thrombectomy franchise continued to perform very well, in line with our expectations.

第四季美國血栓切除術銷售額年增 27.3% 至 1.806 億美元，其中美國 VTE 特許經營權收入年增 41%。我們在美國血栓切除術特許經營權的平衡繼續表現良好，符合我們的預期。

Our fourth quarter capped an overall solid 2024 performance, with full year revenue increasing 13.4% year over year to over $1.2 billion and our US thrombectomy business delivering revenue of $646.7 million, 26.8% increase versus 2023.

我們第四季的業績為 2024 年整體穩健的業績畫上了句號，全年營收年增 13.4%，超過 12 億美元，其中美國血栓切除業務收入達 6.467 億美元，較 2023 年增長 26.8%。

During the year, we evolved and expanded our commercial team, concentrated and enhanced our focus on our interventional business via our exit from Immersive Healthcare, and invested in generating high quality clinical and health economic data to further support and highlight CAVT's value, all while continuing to prioritize innovation.

在這一年中，我們發展並擴大了我們的商業團隊，透過退出Immersive Healthcare集中並加強了對介入業務的關注，並投資產生高品質的臨床和健康經濟數據，以進一步支持和突出CAVT的價值，同時繼續優先考慮創新。

We introduced nine new products to the US commercial market, including the new CAVT products, Flash 2.0, Lightning Bolt 6x with TraX, and Lightning Bolt 12. Internationally, we expanded CAVT's footprint into Europe and additional OUS geographies, and took steps to optimize our geographic presence to support long-term growth and profitability.

我們向美國商業市場推出了九款新產品，包括新的 CAVT 產品、Flash 2.0、帶有 TraX 的 Lightning Bolt 6x 和 Lightning Bolt 12。在國際上，我們將CAVT的足跡擴展到歐洲和其他美國以外地區，並採取措施優化我們的地理分佈，以支持長期成長和獲利能力。

At the same time, 2024 also demonstrated the strong profitability profile of our business. In the fourth quarter, gross margin of 67.4% expanded 170 basis points over the prior year period, while operating income of $48.6 million, or 15.1% of revenue increased 200 basis points over the prior year period. In the quarter, we generated $49.1 million in operating cash.

同時，2024年也展現了我們業務強勁的獲利狀況。第四季度，毛利率為 67.4%，較去年同期增加 170 個基點；營業收入為 4,860 萬美元，佔營收的 15.1%，較去年同期增加 200 個基點。本季度，我們產生了 4,910 萬美元的營運現金。

Looking forward, we are on track to achieve a gross margin profile over 70% by the end of 2026, which is consistent with the timeline we previously communicated. And we expect operating margin expansion to outpace gross margin expansion for the foreseeable future.

展望未來，我們預計在 2026 年底實現 70% 以上的毛利率，這與我們先前傳達的時間表一致。我們預計，在可預見的未來，營業利潤率的擴張速度將超過毛利率的擴張速度。

In addition, we recently signed a contract to build a manufacturing facility in Costa Rica for efficiently expanding our manufacturing capacity. Therefore, we are well-positioned, leveraging favorable product mix shift, operating efficiencies, and disciplined spend to continue to increase our profitability and operating cash flow going forward.

此外，我們最近還簽署了在哥斯達黎加建立製造工廠的合同，以有效擴大我們的製造能力。因此，我們處於有利地位，利用有利的產品結構轉變、營運效率和有紀律的支出來繼續提高我們的獲利能力和未來的營運現金流。

Turning to our US peripheral business. Lightning Flash 2.0 continued to lead overall growth in the fourth quarter, with its competitive benefits versus analog technologies. Namely, the speed and safety with which Flash 2.0 removes blood clots in VTE patients, driving expanded physician interest and adoption, as well as broader and deeper account penetration.

轉向我們的美國週邊業務。Lightning Flash 2.0憑藉其相對於類比技術的競爭優勢，在第四季持續引領整體成長。即，Flash 2.0 能夠快速且安全地清除 VTE 患者的血栓，從而引起醫生的興趣和採用，並實現更廣泛和更深入的帳戶滲透。

In the quarter, we also commenced the commercial rollout of Lightning Bolt 12, introducing our proprietary modulated aspiration technology to the venous anatomy and larger arteries, offering the latest generation CAVT solution for these vessel sizes.

本季度，我們也開始推出 Lightning Bolt 12 的商業化推廣，將我們專有的調製抽吸技術引入靜脈解剖和較大的動脈，為這些血管尺寸提供最新一代 CAVT 解決方案。

Initial feedback has been very positive, and we look forward to continuing to roll out the technology on a broader scale in 2025. Overall, our US VTE franchise continued to gain momentum and market share throughout the fourth quarter, with December representing our highest month of VTE procedure volumes ever.

初步回饋非常積極，我們期待在 2025 年繼續更大規模地推廣這項技術。總體而言，我們的美國 VTE 特許經營權在第四季度繼續獲得發展勢頭和市場份額，12 月是我們 VTE 手術量有史以來最高的月份。

In our US arterial business, Lightning Bolt 7 delivered another strong performance, supporting sequential growth acceleration in our arterial franchise. Lightning Bolt 6x provided initial contributions in the fourth quarter, with Bolt 6x's commercial introduction expanding our arterial-focused CAVT portfolio's reach to smaller vessels, including arteries that are below the knee.

在我們的美國主幹道業務中，Lightning Bolt 7 再次表現強勁，支持了我們主幹道特許經營的連續成長加速。Lightning Bolt 6x 在第四季度提供了初步貢獻，Bolt 6x 的商業化推出擴大了我們以動脈為重點的 CAVT 產品組合的覆蓋範圍，包括膝蓋以下的動脈等較小的血管。

While early feedback on Bolt 6x and our increasingly comprehensive arterial CAVT portfolio is positive, and looking to 2025, we view a meaningful opportunity for the combination of Bolt 7 and Bolt 6x to accelerate physician conversion from open surgery or the use of lytics to CAVT.

雖然對 Bolt 6x 和我們日益全面的動脈 CAVT 產品組合的早期反饋是積極的，但展望 2025 年，我們認為 Bolt 7 和 Bolt 6x 的結合將為醫生從開放性手術或使用溶解劑轉向 CAVT 帶來重大機會。

Similar to our venous business, in December, we treated more patients in the US suffering from an arterial clot than in any prior month. The proprietary mechanism of our CAVT technology consistently removes blood clots faster and safer than analog technology.

與我們的靜脈業務類似，12 月份，我們在美國治療的動脈血栓患者比以往任何一個月都多。我們的 CAVT 技術的專有機制能夠比模擬技術更快、更安全地清除血栓。

That said, we are in the early stages of reaching and treating the over 800,000 patients annually in the US who suffer from VTE and arterial clot, as well as the even greater number of patients internationally with venous and arterial clot burden.

儘管如此，我們仍處於早期階段，每年接觸和治療美國超過 80 萬名患有 VTE 和動脈血栓的患者，以及國際上更多患有靜脈和動脈血栓的患者。

To further expand CAVT's reach and ability to treat a greater number of patients, we commenced what we refer to as our market access initiatives. These initiatives are focused on increasing awareness, not only of CAVT's clinical benefits, but also the economic benefit to hospital systems.

為了進一步擴大CAVT的覆蓋範圍和治療更多患者的能力，我們啟動了所謂的市場准入計畫。這些措施旨在提高人們對 CAVT 的臨床益處以及其對醫院系統的經濟益處的認識。

This past November, during a late breaking session at the VIVA Conference in Las Vegas, Dr. Parag Patel presented the first public view of some of the results of our market access initiatives. The retrospective outcomes analysis presented by Dr. Patel looked at intermediate risk PE patients treated with either CAVT or anticoagulation, catheter-directed lytics, or other forms of mechanical thrombectomy.

去年 11 月，在拉斯維加斯舉行的 VIVA 會議的最新消息發布會上，Parag Patel 博士首次公開介紹了我們的一些市場准入舉措的成果。Patel 博士提出的回顧性結果分析研究了接受 CAVT 或抗凝血、導管定向溶解或其他形式的機械血栓切除術治療的中度風險 PE 患者。

The data demonstrated that compared to other treatment modalities, treatment with CAVT resulted in a reduction in composite complications, as well as a significant improvement in the economics for hospitals. We intend to continue to update our analysis to reflect the benefits of our latest generation CAVT technologies, and look forward to highlighting Flash 2.0's outcomes in the future.

數據表明，與其他治療方式相比，CAVT 治療可減少複合性併發症，並顯著改善醫院的經濟效益。我們打算繼續更新我們的分析以反映我們最新一代 CAVT 技術的優勢，並期待在未來突出 Flash 2.0 的成果。

Looking ahead, we are scheduled to present additional data sets focused on CAVT's utilization in DVT and arterial patients at a major medical conference in the next few months.

展望未來，我們計劃在未來幾個月的一次大型醫學會議上展示更多資料集，並專注於 CAVT 在 DVT 和動脈患者中的應用。

Shifting to our neurovascular business. Our US stroke thrombectomy business once again posted strong results, with revenue accelerating versus the third quarter. For the full year, our market leading FDA-cleared aspiration portfolio, led by RED 72 with our proprietary SENDit technology and RED 43, alongside RED 62, RED 68, and RED 72 grew nearly 20% versus 2023, well ahead of underlying US stroke growth -- market growth.

轉向我們的神經血管業務。我們的美國中風血栓切除術業務再次取得強勁業績，營收較第三季加速。全年來看，我們市場領先的、經 FDA 批准的抽吸產品組合，以採用我們專有的 SENDit 技術的 RED 72 和 RED 43 為首，再加上 RED 62、RED 68 和 RED 72，與 2023 年相比增長了近 20%，遠遠超過美國中風市場的增長。

We enter 2025 as the dominant market leader, and looking forward, we are preparing to bring Thunderbolt, our proprietary CAVT technology, to the neurovascular field, follow up in our THUNDER trial completed as expected in late December, and we will provide additional future updates as appropriate.

我們將以市場主導者的身份進入 2025 年，展望未來，我們正準備將我們專有的 CAVT 技術 Thunderbolt 引入神經血管領域，並跟進我們於 12 月下旬按預期完成的 THUNDER 試驗，並將在適當的時候提供其他未來更新。

We have seen the benefits of our proprietary Bolt technology delivers to patients with peripheral vascular clot, specifically the speed with which the technology can extract a range of clot morphologies in a safe and simple procedure.

我們已經看到了我們的專有 Bolt 技術為患有外周血管血栓的患者帶來的好處，特別是該技術能夠透過安全、簡單的程序快速提取各種血栓形態。

We are excited to bring this technology to the neurovascular field, ushering in a new chapter in the treatment of stroke and further enhancing our market-leading position in the field of stroke thrombectomy. We enter 2025 with significant momentum behind our CAVT technology portfolio. With CAVT, we are driving a shift from analog to digital.

我們很高興將這項技術帶入神經血管領域，開啟中風治療的新篇章，並進一步增強我們在中風血栓切除領域的市場領先地位。進入 2025 年，我們的 CAVT 技術組合將擁有強勁發展勢頭。透過CAVT，我們正在推動從類比到數位的轉變。

We are positioning our organization to be able to intensely focus on the meaningful thrombectomy opportunity ahead for CAVT while also augmenting our leadership position in both embolization and access through additional innovation and commercial focus.

我們正在對我們的組織進行定位，以便能夠集中精力於 CAVT 未來有意義的血栓切除術機會，同時透過額外的創新和商業重點增強我們在栓塞和治療途徑方面的領導地位。

As we demonstrated in 2024, we will continue to drive gross margin expansion and operating efficiencies and deliver increasing profitability while investing aggressively in innovation, clinical and health economic data, and our commercial team to expand and strengthen our position as the world's leading thrombectomy company.

正如我們在 2024 年所展示的那樣，我們將繼續推動毛利率擴張和營運效率並實現不斷增長的盈利能力，同時積極投資於創新、臨床和健康經濟數據以及我們的商業團隊，以擴大和加強我們作為世界領先的血栓切除公司的地位。

I'll now turn the call over to Maggie to go over our financial results for the fourth quarter and full year 2024.

現在，我將把電話轉給瑪吉，讓她來介紹我們 2024 年第四季和全年的財務表現。

Thank you, Adam.

謝謝你，亞當。

Good afternoon, everyone. Today, I will discuss the financial results for the fourth quarter and full year of 2024. Financial results on this call are on a non-GAAP basis, which excludes the adjustment highlighted by Cecilia, including the $5.8 million reserve pertaining to the Italian government's legislation requiring medical device companies to contribute to any deficit created by Italian budget overspending on medical devices from 2015 to 2023 which was recently upheld as constitutional by the Italian courts.

大家下午好。今天，我將討論 2024 年第四季和全年的財務表現。本次電話會議的財務結果基於非 GAAP 基礎，不包括 Cecilia 強調的調整，其中包括 580 萬美元的儲備金，該儲備金與意大利政府的一項立法有關，該立法要求醫療器械公司彌補 2015 年至 2023 年期間意大利在醫療器械方面的預算超支造成的任何赤字，意大利法院最近裁定該立法符合憲法。

Given that this amount related to prior years, we have normalized for this amount when calculating our anticipated revenue growth rates for 2025. The corresponding GAAP measures and our reconciliation of GAAP to non-GAAP financial measures are provided in our posted press release.

鑑於該金額與前幾年相關，我們在計算 2025 年預期收入成長率時對該金額進行了標準化。我們在發布的新聞稿中提供了相應的 GAAP 指標以及 GAAP 與非 GAAP 財務指標的對帳。

For the fourth quarter ended December 31, 2024, our total revenues were $321.3 million, an increase of 12.9% adjusted and 13% in constant currency compared to the fourth quarter of 2023. Our geographic mix of sales for the fourth quarter 2024 was 77.2% US and 22.8% international.

截至 2024 年 12 月 31 日的第四季度，我們的總營收為 3.213 億美元，與 2023 年第四季相比，調整後成長 12.9%，以固定匯率計算成長 13%。我們 2024 年第四季的銷售地理分佈為 77.2% 美國和 22.8% 國際。

Our US region reported growth of 21.7%, driven by 27.3% growth in our thrombectomy franchise. Our international regions decreased 9.4% adjusted and 9.1% in constant currency, primarily due to a decline in China revenue of $15.4 million, partially offset by an increase of $7.8 million in all other international regions.

我們美國地區的業務報告增長了 21.7%，這得益於我們的血栓切除術特許經營權增長了 27.3%。我們的國際地區調整後收入下降 9.4%，按固定匯率計算下降 9.1%，主要由於中國地區收入下降 1,540 萬美元，但其他所有國際地區收入增加 780 萬美元，部分抵消了這一影響。

The sequential growth in our total revenue of 6.7% was primarily driven by an increase in US thrombectomy revenue of $18.6 million and relatively flat revenue internationally.

我們總收入季增 6.7%，主要得益於美國血栓切除術收入增加 1,860 萬美元以及國際收入相對持平。

Moving to revenue by products. Revenue from our global thrombectomy business grew to $222.7 million in the fourth quarter of 2024, an increase of 16.8% adjusted and 16.9% in constant currency compared to the same period last year.

轉向按產品計入收入。2024 年第四季度，我們全球血栓切除業務的營收成長至 2.227 億美元，與去年同期相比，調整後成長 16.8%，以固定匯率計算成長 16.9%。

Our US growth of 27.3% is primarily due to strong growth in both vascular and neuro thrombectomy. Our international business declined 13.9%, primarily driven by a decrease in China revenue of $15.8 million partially offset by an increase in all other international regions as compared to the same period last year.

我們在美國達到 27.3% 的成長率主要得益於血管和神經血栓切除術的強勁成長。我們的國際業務下降了 13.9%，主要原因是中國地區收入減少了 1,580 萬美元，但與去年同期相比，其他所有國際地區的收入都有所增長，從而部分抵消了這一影響。

Revenue from embolization and access business was $98.6 million in the fourth quarter of 2024, an increase of 5% adjusted and 5.1% in constant currency, which is in line with our expectation and primarily driven by an increase in the US.

2024 年第四季栓塞和通路業務收入為 9,860 萬美元，調整後成長 5%，以固定匯率計算成長 5.1%，符合我們的預期，主要得益於美國的成長。

Gross margin for the fourth quarter of 2024 is 67.4% compared to 65.7% for the fourth quarter of 2023, which represents a 170 basis point improvements driven by favorable thrombectomy product mix across all regions and strong productivity improvements.

2024 年第四季的毛利率為 67.4%，而 2023 年第四季為 65.7%，這意味著毛利率提高了 170 個基點，這得益於所有地區良好的血栓切除產品組合和強勁的生產力提高。

Sequentially, we had an 80 basis point improvement in our gross margin which reflects higher thrombectomy product mix due to new product launches and favorable regional mix. Total operating expense for the quarter was $167.9 million or 52.3% of revenue, compared to $149.6 million or 52.5% of revenue for the same quarter last year.

環比而言，我們的毛利率提高了 80 個基點，這反映了由於新產品的推出和有利的區域組合而導致的血栓切除產品組合的提高。本季總營運費用為 1.679 億美元，佔營收的 52.3%，去年同期為 1.496 億美元，佔營收的 52.5%。

Our research and development expenses for Q4 2024 were $20 million or 6.2% of revenue, compared to $21.9 million or 7.7% of revenue for Q4 2023. SG&A expenses for Q4 2024 were $147.9 million or 46.1% of revenue, compared to $127.7 million or 44.8% of revenue for Q4 2023.

我們 2024 年第四季的研發費用為 2,000 萬美元，佔營收的 6.2%，而 2023 年第四季的研發費用為 2,190 萬美元，佔營收的 7.7%。2024 年第四季的銷售、一般及行政費用為 1.479 億美元，佔營收的 46.1%，而 2023 年第四季的銷售、一般及行政費用為 1.277 億美元，佔營收的 44.8%。

We recorded operating income of $48.6 million or 15.1% of revenue compared to an operating income of $37.4 million or 13.1% of revenue for the same period last year. We posted adjusted EBITDA of $63.7 million or 19.8% of total revenue, compared to $53.4 million or 18.8% in the fourth quarter last year.

我們記錄的營業收入為 4,860 萬美元，佔收入的 15.1%，而去年同期的營業收入為 3,740 萬美元，佔營收的 13.1%。我們公佈的調整後 EBITDA 為 6,370 萬美元，佔總營收的 19.8%，而去年第四季為 5,340 萬美元，佔 18.8%。

For the full year 2024, our total revenue was $1.2 billion which represents an increase of 13.4% adjusted and in constant currency compared to full year 2023. Our geographic mix of sales in the year were 75.1% US and 24.9% international.

2024 年全年，我們的總收入為 12 億美元，與 2023 年全年相比，調整後和固定匯率計算增長 13.4%。我們今年的銷售地理分佈為 75.1% 美國和 24.9% 國際。

For the full year 2024, US reported growth of 19.1% was primarily driven by growth from our vascular thrombectomy business, while our international regions decreased 1% adjusted and 1.1% in constant currency, primarily due to a reduction in China revenue of $39.5 million partially offset by an increase in all other international regions.

就 2024 年全年而言，美國報告的增長為 19.1%，主要得益於我們的血管血栓切除術業務的增長，而我們的國際地區調整後收入下降 1%，按固定匯率計算下降 1.1%，主要是由於中國收入減少 3950 萬美元，但其他所有國際地區的收入增加部分抵消了這一影響。

Revenue from our global thrombectomy business for the full year of 2024 was $818.1 million, an increase of 20.8% adjusted and in constant currency. Revenue from our global embolization and access business for the full year of 2024 was $382.3 million, an increase of 0.3% adjusted and 0.2% in constant currency.

2024 年全年，我們全球血栓切除術業務的收入為 8.181 億美元，按調整後和固定匯率計算成長 20.8%。2024 年全年，我們全球栓塞和通路業務的收入為 3.823 億美元，調整後成長 0.3%，以固定匯率計算成長 0.2%。

Our gross margin for the year was 63.4%, which includes a one-time $33.4 million Immersive Healthcare inventory write-off compared to 64.5% of revenue for the full year of 2023.

我們今年的毛利率為 63.4%，其中包括一次性 3,340 萬美元的沉浸式醫療庫存註銷，而 2023 年全年收入的毛利率為 64.5%。

In 2025, after removing this one-time item, which had a 280 basis point impact to our gross margin in 2024, we target at least 100 basis point expansion in gross margin to over 67% for full year 2025. This reflects continued favorable thrombectomy product mix, productivity improvements and investment to support new product launches.

到 2025 年，在剔除這項一次性項目（該項目對我們 2024 年的毛利率產生了 280 個基點的影響）後，我們的目標是將 2025 年全年的毛利率擴大至少 100 個基點，達到 67% 以上。這反映了持續有利的血栓切除產品組合、生產力提高和支持新產品發布的投資。

We had operating income for the full year of $106.6 million which includes a one-time $33.4 million Immersive Healthcare inventory write-off compared to operating income of $101.3 million for 2023. And to provide an update on the impact of winding down the Immersive Healthcare business, we had GAAP operating expense savings for 2024 of approximately $16 million and we are still on track to create GAAP operating expense annualized savings of approximately $40 million.

我們全年的營業收入為 1.066 億美元，其中包括一次性 3,340 萬美元的沉浸式醫療庫存註銷，而 2023 年的營業收入為 1.013 億美元。為了提供有關逐步淘汰沉浸式醫療業務的影響的最新信息，我們在 2024 年的 GAAP 營運費用節省了約 1600 萬美元，我們仍有望實現約 4000 萬美元的年度 GAAP 營運費用節省。

Our adjusted EBITDA in 2024 was $171 million or 14.2% of total revenue compared to 16.1% last year. Looking forward to 2025, as Jason will discuss soon, we forecast operating margin to expand to a range of 13% to 14% of total revenue.

我們 2024 年的調整後 EBITDA 為 1.71 億美元，佔總營收的 14.2%，而去年為 16.1%。展望 2025 年，正如 Jason 即將討論的那樣，我們預測營業利潤率將擴大到總收入的 13% 至 14% 之間。

Turning to cash flow and balance sheet. We ended the fourth quarter with cash, cash equivalents, and marketable securities balance of $340.1 million and no debt, which is an increase of $49.1 million sequentially driven by strong operating profitability and improvement in working capital management.

轉向現金流和資產負債表。截止第四季度，我們的現金、現金等價物和有價證券餘額為 3.401 億美元，且沒有債務，這比上一季度增加了 4,910 萬美元，這得益於強勁的營運盈利能力和營運資本管理的改善。

We expect positive operating cash flow trends to continue in 2025 and beyond.

我們預期 2025 年及以後經營現金流將持續呈現正向成長趨勢。

And now I'd like to turn the call over to Jason to discuss our 2025 guidance.

現在我想把電話轉給傑森，討論我們 2025 年的指引。

Thank you, Maggie, and good afternoon, everyone.

謝謝你，瑪吉，大家下午好。

Consistent with our guidance philosophy communicated on our second quarter 2024 earnings call, our total revenue guidance for 2025 is a range of $1,340 billion to $1,360 billion which represents year over year growth of 12% to 14% compared to 2024 GAAP total revenue.

與我們在 2024 年第二季財報電話會議上傳達的指導理念一致，我們對 2025 年的總收入指導範圍為 1,3400 億美元至 1,3600 億美元，與 2024 年 GAAP 總收入相比，同比增長 12% 至 14%。

For our US thrombectomy business, we expect growth in the range of 19% to 20% year over year.

對於我們的美國血栓切除業務，我們預計成長率將在 19% 至 20% 之間。

Moving down to the income statement, we expect both gross margin and operating margin to expand in 2025. For gross margin, after excluding the one-time expense Maggie described earlier, we forecast at least 100 basis points of expansion in 2025 to more than 67% for the full year.

從損益表來看，我們預期 2025 年毛利率和營業利益率都會擴大。對於毛利率，在剔除 Maggie 之前描述的一次性費用後，我們預測 2025 年將擴大至少 100 個基點，達到全年 67% 以上。

On the operating margin line, we expect expansion to 13% to 14% of total revenue for full year 2025 compared to operating margin in 2024, which excludes the one-time expense previously described.

在營業利潤率方面，我們預計 2025 年全年總收入將比 2024 年的營業利潤率擴大至 13% 至 14%，其中不包括前面描述的一次性費用。

Looking forward, as Adam said in his remarks, we are on track to achieve a gross margin profile over 70% by the end of 2026, which is consistent with the timeline we previously communicated. And we expect operating margin expansion to outpace gross margin expansion for the foreseeable future.

展望未來，正如亞當在演講中所說，我們預計在 2026 年底實現 70% 以上的毛利率，這與我們之前傳達的時間表一致。我們預計，在可預見的未來，營業利潤率的擴張速度將超過毛利率的擴張速度。

This concludes our prepared remarks.

我們的準備好的演講到此結束。

Operator, we can now open the call to questions.

接線員，我們現在可以開始問答環節。

(Operator Instructions)

（操作員指令）

Larry Biegelsen, Wells Fargo.

富國銀行的拉里·比格爾森。

Congrats on a strong finish to the year here.

恭喜您今年取得了圓滿的收官。

Adam, I had one on the guidance and one on Thunder. So I think you did 13.5% or 13.4% adjusted revenue growth in 2024. You're guiding it to 12% to 14% in 2025. Why shouldn't we see an acceleration in '25 given the one-time headwinds in '24, such as the delay in the European launches, some of the sales impact in China and Thunderbolt?

亞當，我有一個關於指導的，還有一個關於雷霆的。因此我認為 2024 年的調整後營收將成長 13.5% 或 13.4%。您預計到 2025 年這一比例將達到 12% 到 14%。考慮到24年的一次性阻力，例如歐洲產品的發布延遲、中國和Thunderbolt部分銷售受到影響，為什麼我們不應該看到25年的加速？

So how are you thinking about the guidance this year from a philosophical standpoint and getting back some of those headwinds we saw in '24? And I had one follow up.

那麼，從哲學的角度來看，您如何看待今年的指導方針，並如何扭轉我們在 24 年看到的一些逆風？我還有一個後續行動。

Yeah. Larry, thanks for the question, and I think it's appropriate one.

是的。拉里，謝謝你的提問，我認為這是一個合適的問題。

I think we tried to be pretty clear in giving that guidance that this was sort of in line with the philosophy that we talked about in the second quarter of not getting ahead of ourselves. So obviously, there are a number of things that we don't yet totally control, Thunderbolt being your follow up question, one of them.

我認為，我們在給出這一指導時試圖非常清楚地表明，這與我們在第二季度談到的「不要超越自己」的理念是一致的。顯然，有很多事情我們還不能完全控制，Thunderbolt 就是你後續的問題之一。

So we're not going to put that into the guidance until we have more information around that. So you're correct to acknowledge that we had a lot of headwinds last year that we got through and that we don't have most of them this year.

因此，在我們獲得更多相關資訊之前，我們不會將其納入指導。因此，您承認我們去年遇到了很多阻力，但我們都克服了，而今年我們不會遇到太多阻力，這是正確的。

And we're going to, in our minds guide appropriately so we don't get in the same trouble we got in last year.

我們將在心中做出適當的引導，以免陷入去年那樣的困境。

And Adam, just my follow up is on Thunder. How should we -- it sounds like the follow up is done. How should we think about the timeline for data readout, filing and clearance?

亞當，我的後續問題是關於雷霆的。我們該怎麼做——聽起來後續工作已經完成了。我們該如何思考資料讀出、歸檔和清關的時間表？

And as a follow up, we did see three negative medium and distal vessel trials at ISC a couple of weeks ago. What are the implications for Penumbra?

作為後續行動，我們幾週前在 ISC 確實看到了三次中型和遠端血管試驗的陰性結果。這對於 Penumbra 有何影響？

Yeah. So on Thunderbolt, we will definitely update you as appropriate when there's more information to update you on, as to both, when it gets cleared and presentation of the date and so on.

是的。因此，關於 Thunderbolt，當有更多資訊需要更新時，我們一定會適時向您更新，包括何時清除以及日期的呈現等等。

It's just premature to do that and start to put guesses out there. Obviously, I think you appreciate that. As it relates to the distal trials, it was a little bit sort of deja vu. As those trials, primarily used stentrievers and the use of stentrievers in particularly distal vessels as a primary mechanism as opposed to an adjunct.

現在這樣做並開始做出猜測還為時過早。顯然，我想您很欣賞這一點。由於它與遠端試驗有關，所以有點似曾相識的感覺。在這些試驗中，主要使用支架取栓器，特別是在遠端血管中使用支架取栓器作為主要機製而不是輔助機制。

For the most part, not something that should be done primarily. And I don't think we were surprised with that result. We've always talked about the opportunity really including just large vessel occlusions, which is the M1, not the more distal.

大多數情況下，這不是應該主要做的事情。我認為我們對這個結果並不感到驚訝。我們一直在談論的機會實際上包括大血管閉塞，即 M1，而不是更遠端的。

I know people have had great success using aspiration, particularly our smaller catheters, RED 43 and RED 62 in some of those distal vessels. And I think that like everything, particularly as we've watched over 20 years in stroke, the story is not written yet.

我知道人們在使用抽吸技術取得了巨大的成功，特別是在一些遠端血管中使用我們的較小導管 RED 43 和 RED 62。我認為，就像所有事情一樣，特別是我們已經觀察了 20 多年的中風史，故事還沒寫完。

And I think we'll see the constant move toward aspiration as the primary mechanism in part because it's just logical and part from studies like that.

我認為，我們會看到不斷向願望邁進作為主要機制，部分原因是因為它合乎邏輯，並且部分來自於類似的研究。

Robbie Marcus, JPMorgan.

摩根大通的羅比馬庫斯 (Robbie Marcus)。

I'll echo congratulations on a good quarter.

我將對本季的良好業績表示祝賀。

I wanted to ask on the rest of the business, embolization and access. What you're seeing there? If I'm doing my math right, it implies flat to minus 5% sales growth in 2025.

我想詢問其餘業務、栓塞和通路的情況。你在那看到了什麼？如果我的計算正確的話，這意味著 2025 年的銷售額成長率將持平至負 5%。

So just wanted to get a sense of what you're seeing there, US versus OUS. And how to think about what's driving the guide for 2025.

所以只是想了解你在那裡看到了什麼，美國與 OUS。以及如何思考推動2025年指引的因素。

Yeah. So when you look at our embolization and access business, we have an incredibly strong business in both those segments. We're really the market leader in the vascular side, on coils and access on the neuro side.

是的。因此，當您查看我們的栓塞和通路業務時，您會發現我們在這兩個領域都有非常強勁的業務。我們確實是血管領域、線圈領域和神經通路領域的市場領導者。

And that is an incredibly important part of our business. We're very proud of it. I think you heard in my prepared remarks that we're not done innovating in those areas. And I think that will be something that we'll watch and focus on as the year progresses.

這是我們業務中極為重要的一部分。我們對此感到非常自豪。我想你們從我準備好的發言中已經聽到了，我們在這些領域的創新還沒完成。我認為這將是我們在未來幾年關注和重點關注的事情。

And also as we've gotten bigger and our interest in CAVT has expanded so dramatically, we need to make sure we have the ability to focus. And I use that term very particularly. So I think there are a lot of opportunities, particularly in the US in the short term to continue to see that grow.

而且隨著我們的規模不斷擴大，我們對 CAVT 的興趣也急劇增加，我們需要確保我們有能力集中註意力。我非常特別地使用這個術語。因此我認為有很多機會，特別是在美國，短期內可以繼續看到這種成長。

By definition, last year we did a little bit of retrenching. We specifically said in markets where we weren't successful, and we're going to sort of go into the areas and double down on areas where we can be more successful internationally as well.

根據定義，去年我們做了一些縮減開支的措施。我們特別提到了我們在哪些市場未能取得成功，以及我們將進入哪些領域，甚至加倍努力，在國際上取得更大的成功。

There's a lot of demand. And with the ability to, particularly for non-US markets, but US markets, if appropriate. As we expand our manufacturing facility into Costa Rica, there's an opportunity to have a cost basis that is also more appropriate for some of these markets as well.

需求很大。並且有能力，特別是針對非美國市場，但如果合適的話，也可以針對美國市場。隨著我們將製造工廠擴展到哥斯達黎加，我們有機會獲得更適合這些市場的成本基礎。

Margaret Kaczor, William Blair.

瑪格麗特·卡佐爾，威廉·布萊爾。

This is Macauley on for Margaret tonight.

今晚，由麥考利為瑪格麗特主持。

So wanted to follow up around the question on guidance and appreciate the comment on US throm, specifically. But just given the 41% VTE growth in the US we saw this quarter, just wondering if you can help parse out what that includes either for vascular versus neuro.

因此想跟進有關指導的問題，並特別感謝對美國 throm 的評論。但鑑於本季度美國 VTE 成長率為 41%，我想知道您是否可以幫助分析其中包括血管疾病和神經疾病。

And I know that does not include Thunderbolt launch or just any commentary focusing on vascular in particular between PE, DVT and arterial in the US.

我知道這不包括 Thunderbolt 的發布，也不包括任何關注血管的評論，特別是美國的 PE、DVT 和動脈之間的評論。

Yeah. Look, the guide is a holistic guide for all of the businesses. We don't break it out by each segment in the form of a guide. But obviously, given how we exited 2024, we're feeling particularly confident about the markets where CAVT is driving that growth.

是的。你看，該指南是針對所有企業的整體指南。我們不會以指南的形式將其按每個部分進行分解。但顯然，考慮到我們在 2024 年的退出方式，我們對 CAVT 推動成長的市場特別有信心。

And that's the focus obviously on that you saw the outsized number, the 41% in the VTE business. We also have a fairly tenacious competitor in that market. And we still were able to have that kind of growth because the product gets the clot out faster and safer.

顯然，這正是我們所關注的重點，因為您看到了巨大的數字，即 VTE 業務中的 41%。我們在那個市場上也有一個相當頑強的競爭對手。而且我們仍然能夠維持這種成長，因為該產品能夠更快、更安全地清除血塊。

We've said that for a bit. They're -- all products are not the same. You can't just have one and be part of the market. You have to have something that does it as well as the current best in class. And I think that's pretty clear right now that CAVT is making that mark.

我們已經說過這​​一點了。它們——所有產品都不一樣。你不能只擁有一個並成為市場的一部分。你必須擁有某種東西，能夠做到與當前同類產品一樣好。我認為現在很明顯，CAVT 正在取得這一成就。

So by definition, as we look out, we're going to be careful not to get ahead of ourselves. We're not going to -- how much more share is there, how much market growth is there. And we're going to watch all of those things on a quarterly basis and we'll update them as appropriate.

所以，按照定義，當我們觀察時，我們會小心，不要超越自己。我們不會去想有多少份額，有多少市場成長。我們將每季關注所有這些情況，並酌情進行更新。

But obviously, we want to be appropriate as we start the year with our current guide.

但顯然，我們希望在以現有指南開始新的一年時能夠做到恰當。

And then maybe just as a follow up, I wanted to -- or saw there was an update to the RED 72 510(k) status the other day. And Adam, can't help but notice you emphasized the FDA cleared that aspect in your script. So was there any modification made to the catheter there?

然後也許只是作為後續行動，我想 - 或看到前幾天 RED 72 510（k）狀態有更新。亞當，我注意到你在劇本中強調了 FDA 批准了這一方面。那麼那裡的導管有做過什麼改造嗎？

I guess bigger picture, what should we expect from that pipeline of catheters moving forward?

我想從更大的角度來看，我們應該對導管管道未來的發展抱持著怎樣的期待？

Yeah. I think it's a fair question. I'm glad that you picked that up.

是的。我認為這是一個合理的問題。我很高興你注意到了這一點。

So as I think you all know, we are constantly improving our products. That has been the hallmark of our success for the better part of 20 years. We've never sort of said we're done. And RED 72 was launched, now what, three, four years ago. I've lost track of time.

我想大家都知道，我們正在不斷改進我們的產品。這是我們二十年來成功的標誌。我們從來沒說過我們已經完成了。三、四年前，RED 72 就已推出。我已經忘記時間了。

And so it's natural that we would update that catheter with technology that we've developed as we've developed additional catheters. So this is just making the RED 72 that much more trackable. We just got cleared at the end of last week. We've already done, I think roughly half of our evaluation cases in a short period of time.

因此，當我們開發出更多導管時，自然會利用我們開發的技術來更新該導管。所以這只是讓 RED 72 更加容易追蹤。我們上週剛得到清關結果。我認為我們在短時間內已經完成了大約一半的評估案例。

And we'll give more information as we go. But obviously, having a suite of catheters that contract to the clot faster and better than anything else on the market, and then you add Thunderbolt on top of that, when it gets cleared, it puts us in a position for being able to help the maximum number of patients that we can help.

我們將會提供更多資訊。但顯然，擁有一套比市場上任何其他產品更快更好地收縮血塊的導管，然後在其上添加 Thunderbolt，當它被清除後，它使我們能夠幫助盡可能多的患者。

And you combine that with the best in class sales team and I think we're going to have a pretty good opportunity to have additional impact this year with our stroke business.

再加上我們一流的銷售團隊，我認為我們今年的中風業務將有相當好的機會產生更大的影響。

Congrats on the quarter again.

再次恭喜本季取得佳績。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

Looking at the US thrombect guide here of 19% to 20%, end of the year, obviously 27%, how should we think about the seasonality of that growth like comps you had in 2024? Your fourth quarter exit rate was such a high number that we straight line that growth as almost flat sequentially, which we haven't really seen that since you launched and you talked about how strong December was.

看看美國血栓治療指南，今年年底的成長率為 19% 至 20%，顯然是 27%，我們應該如何看待這種成長的季節性，就像 2024 年的同類產品一樣？你們第四季的退出率如此之高，以至於我們將這一增長直線拉低為幾乎與上一季度持平的增長，自從你們推出產品並談到 12 月份的強勁表現以來，我們還沒有真正見過這種情況。

Yeah. Let me start and Jason can speak to sort of the rhythm a little more. There's always a combination of seasonality based on -- I mean we've always sort of seen the fourth quarter maybe it's the stress of the holidays and so on. For example, the stroke business goes up and things like that.

是的。讓我先開始，傑森可以再多講一下節奏。總是存在基於季節性的組合——我的意思是，我們總是看到第四季度可能是假期的壓力等等。例如，中風業務的成長等等。

That being said, we've also overlaid various launches. And obviously, we haven't talked about launches in timing for 2025. But that changes again the ability to just straight line things out and run it out. And then you also add the thing I alluded to in the answer to the last question that as you are taking share, whether it's in stroke or in VTE, that share doesn't come in an even way.

話雖如此，我們也涵蓋了各種發布。顯然，我們還沒有討論 2025 年的發射時間。但這又改變了直接將事物排列出來並運行的能力。然後，您還添加了我在回答上一個問題時提到的內容，即當您佔據份額時，無論是在筆劃中還是在 VTE 中，份額都不是均勻的。

It sort of comes in chunks. And then it sort of pause and then you take more and that -- and we've seen that for many, many, many years.

它以塊狀的形式出現。然後它會暫停，然後你會採取更多行動，而且這種情況我們已經看到很多年了。

With that sort of as a baseline, Jason, can you add some color to that?

以此為基礎，傑森，你能添加一些顏色嗎？

Yeah. Pito, thanks for the question.

是的。Pito，謝謝你的提問。

As you can see, the fourth quarter was the biggest quarter in terms of sequential growth in the US thrombectomy business. And on a year over year growth perspective, as you can also see, it was one of the fastest.

如您所見，第四季度是美國血栓切除業務連續成長最大的一個季度。從年成長率來看，你也可以看到，它是成長最快的國家之一。

It was an outstanding quarter from a US thrombectomy, which sets up the fourth quarter of 2025 just in those terms to be the most challenging comp, which would therefore suggest that if you -- as you're modeling within that 19% to 20% range, you can probably start in the beginning of the year at the midpoint or better, and then the fourth quarter can reflect the fact that we don't have Thunderbolt in our guidance.

這是美國血栓切除術的一個出色季度，從這些方面來看，這使得 2025 年第四季度成為最具挑戰性的季度，因此這表明，如果您 - 當您在 19% 到 20% 的範圍內建模時，您可能可以在年初的中點或更好的時間開始，然後第四季度可以反映出我們的指導中沒有 Thunderbolt 的事實。

And can be sort of at the midpoint or lower. So more of a front end loaded year from the standpoint of the growth guidance we gave.

並且可以處於中間點或更低位置。因此，從我們給出的成長指引來看，今年將是前端重點發展的一年。

And then sticking with the 27% growth this quarter, is there any color on what the pricing versus volume was in the quarter? And how should we be thinking about 2025 in terms of a US thrombectomy in terms of just pricing versus volume within the guidance range?

然後堅持本季 27% 的成長率，本季的價格與銷售量有什麼關係嗎？那麼，就價格與指導範圍內的數量而言，我們該如何看待2025年美國血栓切除術的發展？

Yeah. At this stage, we're several years into this. It's almost -- it's volume. It's volume. There's not a pricing element now. This was just -- and that's why I went out of my way to say this -- we ended the year with the strongest case volume we've ever seen both in VTE and in arterial.

是的。現階段，我們已經為此努力了好幾年。這幾乎是——這是體積。這是音量。現在還沒有定價因素。這只是——這就是我特意這麼說的原因——我們以 VTE 和動脈疾病領域有史以來最高的病例數結束了這一年。

Will Plovanic, Canaccord.

卡納科德的威爾普洛瓦尼奇 (Will Plovanic) 說。

Just first up on THUNDER, I just wanted to clarify, one, have you submitted to the FDA? Two, have you had discussions with them yet? And three, are they asking for any additional information including any additional clinical studies? Just trying to figure out where we're in the process. Then I have a follow up.

首先關於 THUNDER，我想澄清一下，第一，你已經向 FDA 提交了嗎？二、你已經與他們討論過了嗎？第三，他們是否要求提供任何其他信息，包括任何額外的臨床研究？只是想弄清楚我們處於這個過程的哪個階段。然後我會跟進。

Those are a good series of questions. I'll make it easy. We have not yet submitted. So therefore, we have not had any of those conversations. Again, just less than a month plus ago, we finished the trial and got all the data. And obviously, it takes a little bit of time to get that organized and adjudicated and there's a process there.

這是一系列很好的問題。我會讓它變得簡單。我們尚未提交。因此，我們沒有進行過任何此類對話。再次，就在不到一個多月前，我們完成了試驗並獲得了所有數據。顯然，這需要一點時間來組織和裁決，而這是一個過程。

So the fact that it could be ready earlier in that would mean you were obviously skipping a step along the way, which we obviously don't do.

因此，如果能夠提前做好準備，就意味著你顯然跳過了某個步驟，而我們顯然不會這樣做。

And then just on R&D, $20 million is really a low point that we haven't seen in almost two years. Is this a new normal in terms of the kind of the R&D spend nominally? And should we use this as a base point going forward and expect most of the leverage off of this in terms of operating margin expansion?

然後僅在研發方面，2000 萬美元確實是我們近兩年來未見過的低點。從名義上的研發支出類型來看，這是一種新常態嗎？我們是否應該以此作為未來的基點，並期望在營業利潤率擴大方面發揮大部分槓桿作用？

I think it was pretty clear that we're -- I think I used the term we're going to aggressively invest in innovation. So R&D spend changes quarter by quarter depending on what's on the docket, whether we have certain types of testing or certain this and that.

我認為很明顯的是，我們——我想我用過「我們將積極投資創新」這個詞。因此，研發支出每季都會發生變化，具體取決於議程上的內容，以及我們是否進行某些類型的測試或某些這方面的測試。

And so you're going to see that move around based on the work that's in front of us, not by some kind of sort of organized or sort of artificial spend budget. So I wouldn't read anything into the quarter per se, i.e. our general spend has been a pretty accurate way to read it.

所以，你會看到，這種變動是基於我們面前的工作，而不是某種有組織的或人為的支出預算。因此，我不會對本季本身做出任何解讀，也就是說，我們的一般支出是一個相當準確的解讀方式。

And I think everyone would agree, launching nine products last year, we have a pretty efficient R&D department and a team that can continue to innovate incredibly effectively and at a decent amount of spend.

我想每個人都會同意，去年我們推出了 9 款產品，我們擁有一個相當高效的研發部門和一個能夠以相當多的投入繼續進行高效創新的團隊。

But we are not going to back away from that. There is a lot of innovation ahead. I think we're have years of continued innovation ahead of us. We won't get into the specifics, but we're going to not stop innovating for quite a while.

但我們不會退縮。未來還有很多創新。我認為我們未來幾年還會繼續創新。我們不會談論具體細節，但我們在相當長的時間內不會停止創新。

And Bill, the only thing I would add to that is Maggie in her remarks mentioned the savings to date so far with the Immersive Healthcare exit. And a very solid percentage of those expenses are in R&D.

比爾，我唯一想補充的是，瑪吉在她的評論中提到了退出 Immersive Healthcare 迄今為止的節省。其中很大一部分費用用於研發。

So we don't break out the investments on the interventional side vis-a-vis the investments we were once making in R&D and Immersive Healthcare. But suffice it to say as Adam said in his prepared remarks, we continue to aggressively invest in innovation, i.e. obviously on the interventional side.

因此，我們不會將介入方面的投資與我們曾經在研發和沈浸式醫療方面的投資分開。但正如亞當在其準備好的演講中所說，我們將繼續積極投資創新，顯然是在介入方面。

Richard Newitter, Truist Securities.

Truist Securities 的 Richard Newitter。

Congrats on the performance and solid finish to the year.

恭喜您今年取得的優異成績和圓滿的收官。

Maybe, I think Adam, you had mentioned several new product launches and the ebbs and flows of when those hit can dictate quarterly performance. Could you just remind us, you said nine launches in '24, how many are you thinking about in '25?

也許，我想亞當，你提到了幾款新產品的發布，而這些產品的起伏會決定季度業績。您能否提醒我們一下，您說 1924 年發射了 9 次，那麼您認為 1925 年會發射多少次呢？

And any direction on where those could be value add and fill the bag where there's an unmet need that you don't have today?

有什麼建議可以說明這些可以在哪裡增加價值並填補目前尚未滿足的需求？

Yeah. I mean I'm not going to specify just like we didn't last year. No one -- we didn't start the year saying we're going to have nine launches and we don't even announce them. I think the three that were CAVT related, everyone knows, but the other six, I don't think most people have focused on.

是的。我的意思是我不會具體說明，就像我們去年沒有說明的那樣。沒有人——我們年初並沒有說過要進行九次發射，甚至也沒有宣布過。我認為與 CAVT 相關的三個是大家都知道的，但其他六個，我認為大多數人並沒有關注。

They've had a very positive impact on our overall business as well. So we're not going to go through that. The only one that obviously is possible on that list, we've talked about a couple of times already and that's Thunderbolt, of course.

它們也對我們的整體業務產生了非常積極的影響。所以我們不會經歷這件事。在這個清單中，唯一明顯可行的方案，我們已經討論過幾次了，當然就是 Thunderbolt。

But the rest, we're going to wait till we get those things -- products cleared and then we'll be happy to talk about them.

但其餘的問題，我們要等到產品清關後才能討論。

But -- and just to be clear though, Thunderbolt is not needed to hit your guidance range. In other words, it's not explicitly --

但是——需要明確的是，Thunderbolt 不需要達到你的導引範圍。換句話說，它沒有明確--

Yeah. Revenue for Thunderbolt is not currently in our guide for the simple reason not because we don't think it's a great product, not because we're not incredibly confident about the -- where we stand on it, but because we don't totally control that process.

是的。Thunderbolt 的收入目前不在我們的指南中，原因很簡單，並不是因為我們認為它不是一個好產品，並不是因為我們對它的立場不十分有信心，而是因為我們無法完全控制這個過程。

And because of that, we're going to be careful so we don't have to change our guide based on something we don't control.

正因為如此，我們會非常小心，以免因為一些我們無法控制的事情而改變我們的指南。

And just one last one on Thunderbolt. Do we expect you to have this presented at a conference, or is this something that we could get press released mid-year? Just how are you thinking about that?

最後一個關於 Thunderbolt 的問題。我們是否希望您在會議上展示這一內容，或者我們可以在年中發布這一內容？您對此有何看法？

Yeah. It depends on the timing. There are really two major US -- since the US approval -- US conferences, one in July and one in November. And so to the extent that the clearance happened in a time when no one -- it's not right around that time, we would obviously not wait to present the data to launch the product, which means, obviously, there's a possibility of hearing about it before the formal presentation of the data.

是的。這取決於時間。自美國批准以來，美國實際上舉行了兩次重要的會議，一次在七月，一次在十一月。因此，如果批准發生在沒有人的時間——不是在那個時候，我們顯然不會等到提交數據後才推出產品，這意味著，顯然，在正式提交數據之前有可能聽到消息。

Matthew Obrien, Piper Sandler.

馬修·奧布萊恩，派珀·桑德勒。

This is Samantha on for Matt.

這是薩曼莎 (Samantha)，代替馬特 (Matt)。

There's a handful of clinical trials going on for aspiration-based thrombectomy devices, kind of both on the peripheral and the neuro side. How are you thinking about enrollment in these trials potentially impacting sales growth in the near term or potentially helping grow the market in the longer term?

目前正在進行一些基於抽吸的血栓切除裝置的臨床試驗，包括週邊和神經方面的試驗。您認為參加這些試驗是否會在短期內影響銷售成長或是否會在長期內幫助市場成長？

Yeah. They're not -- there's a handful of them. I think you described it the right way. It's not really an impact on our sales, obviously. I think that was pretty obvious this quarter. I think when you actually speak to the physicians using a lot of those products, it sort of gives you the real story.

是的。不是——他們只有少數。我認為你描述的很正確。顯然，這對我們的銷售並沒有太大的影響。我認為本季這一點非常明顯。我認為，當你真正與使用過這些產品的醫生交談時，你就會了解到真實的情況。

And I think we'll focus. We don't think that will -- that changes our strategy, changes our momentum or anything like that.

我想我們會集中註意力。我們認為這不會改變我們的策略、改變我們的動力或諸如此類的事情。

Michael Sarcone, Jefferies.

傑富瑞（Jefferies）的麥可‧薩科內（Michael Sarcone）。

Just to start, China was a pretty big headwind in 2024, maybe 300 basis points or 350 basis points. Could you just talk about what kind of assumptions you've got for China baked into 2025 guide? Is it kind of stabilized from here? How are you thinking about that?

首先，2024 年中國面臨的阻力相當大，可能達到 300 個基點或 350 個基點。您能否談談您在 2025 年指南中對中國做出了哪些假設？從現在起情況穩定了嗎？您覺得這個怎麼樣？

Yeah. There's no question China as everyone's talking about the market and what it means for US-based medical device companies. Our deal that we outlined had a number of different elements to it, but the element that mattered at this phase would have been sort of for the US-based or manufactured product.

是的。毫無疑問是中國，因為大家都在談論這個市場以及它對美國醫療器材公司意味著什麼。我們提出的協議包含許多不同的要素，但現階段最重要的要素是美國本土或美國製造的產品。

And that market really isn't available for a while. There's a little bit of headwind at the beginning of the year. But more than that, I think we're sort of have that behind us. And again, I think if you think about what we've said and the opportunity we have, there are international markets that will matter a lot. And we've talked about those markets.

而那個市場確實暫時不會開放。今年年初有一些逆風。但更重要的是，我想我們已經把這些都拋在腦後了。而且，我認為，如果你考慮我們說過的話和我們所擁有的機會，你會發現國際市場非常重要。我們已經討論過這些市場。

What matters, in terms of scale and growth, it changes, from year to year. And I think we've -- to just remind everyone, we've been selling internationally for 18 plus years. And we have a pretty good knowledge of the international markets and what's viable and not.

重要的是，就規模和成長而言，它每年都在變化。我想我們——只是提醒大家，我們已經在國際上銷售了 18 多年。我們對國際市場以及什麼可行、什麼不可行有相當好的了解。

It's also why you're going to see a continued outsized growth in the US, with the scale of patients. Again, 800,000 patients in the US alone, more than 90% of the market available to us if we do the work that we outlined, which is continue taking share and continue the market access work, so we can grow the market through the hospitals doing the work necessary to make sure they're treating everyone that they can treat.

這也是為什麼你會看到美國患者數量持續大幅增加的原因。再說一遍，僅在美國就有 80 萬名患者，如果我們按照我們概述的方式開展工作，即繼續佔領市場份額並繼續開展市場准入工作，那麼我們就可以獲得 90% 以上的市場份額，這樣我們就可以透過醫院開展必要的工作來擴大市場，確保醫院能夠治療所有他們能夠治療的患者。

When you add that together, I think we're in a really, really strong position for a number of years. And then the international markets ebb and flow based on sort of their own economies and all that as we go forward.

如果把這些因素綜合起來，我認為我們將在未來幾年內處於非常非常強勁的地位。然後，隨著我們前進，國際市場會根據其自身經濟狀況等而起伏。

Yeah. Michael, just to add to that, you're right. The headwinds just from China alone in 2024 were actually slightly greater than what you posed in your answer. And as Adam mentioned, we're going to -- we'll see sort of the last headwinds of that in 2025. So next year, the headwinds will be de minimis to nothing.

是的。邁克爾，補充一下，你是對的。2024 年僅來自中國自身的阻力實際上比您在答案中提出的要大一些。正如亞當所提到的，我們將在 2025 年看到這種趨勢的最後阻力。因此明年，逆風將會變得微乎其微，甚至沒有。

It won't be quite as much of a headwind in 2025 as 2024, but some headwind, especially in the first half of the year. So as you're looking at our guidance and you're parsing out the US growth versus international growth, if you exclude China, there's actually an acceleration in growth across businesses.

2025 年的阻力不會像 2024 年那麼大，但也會有一定阻力，尤其是在上半年。因此，當您查看我們的指導並分析美國成長與國際成長時，如果不包括中國，您會發現各行各業的成長實際上都在加速。

And the headwind from China again will land in the first half of the year. So as it relates to the 12% to 14% guidance, you'll see that hit in the first half of the year in terms of the year over year growth because of China.

而來自中國的逆風將在今年上半年再次來臨。因此，就 12% 至 14% 的預期而言，由於中國因素，您會看到上半年同比增長率會受到影響。

And maybe just for the follow up, we've seen some M&A activity in the space earlier this year. Just wanted to get your stance on whether or not you're bracing for any change in competitive dynamics or if there's any potential disruption coming down the pike that you may be able to capitalize on.

也許只是為了後續行動，我們在今年早些時候看到該領域的一些併購活動。只是想了解您的立場，即您是否準備好迎接競爭態勢的任何變化，或者是否存在任何潛在的顛覆性變化可供您利用。

I'm not going to sort of get into particular tactics and things like that, competitively at this stage. I can tell you that generally, overall, we certainly welcome new ownership into the field, but it really doesn't have any change on our strategy or we believe our momentum in the field right now.

目前我還不想在競爭方面深入討論具體的戰術和類似的事情。我可以告訴你，總的來說，我們當然歡迎新的所有權進入該領域，但這對我們的策略沒有任何改變，我們相信我們目前在該領域的發展勢頭。

Ryan Zimmerman, BTIG.

瑞安·齊默爾曼（Ryan Zimmerman），BTIG。

I wanted to ask about gross margins for a bit just because doing the math, it does imply a pretty significant step up in '26 in gross margins to hit that 70% exiting '26. Help me understand. I mean is that just a -- go ahead, or Maggie.

我想問毛利率，因為計算後發現，這確實意味著 26 年毛利率將有相當顯著的上升，到 26 年底將達到 70%。幫我理解一下。我的意思是這只是──繼續，或是瑪姬。

Yeah. No, thanks for the question. Well, basically, there's no fundamental changes in our underlying drivers that you have seen this year. I mean majority of our margin expansion drivers came from product mix, thrombectomy product mix, and also regional mix.

是的。不，謝謝你的提問。嗯，基本上，今年我們的根本驅動因素沒有根本性的改變。我的意思是，我們的利潤擴張驅動力主要來自產品組合、血栓切除產品組合以及區域組合。

If you look back at '24, I mean we have seen pretty good momentum in our sequential quarterly growth. We expect similar trend continue in 2025. And if you continue that momentum, I think you can see us reaching exactly at our target of 70% sometime in 2026.

如果回顧 24 年，就會發現我們的季度連續成長動能相當良好。我們預計類似的趨勢將在 2025 年繼續延續。如果保持這種勢頭，我認為我們可以在 2026 年的某個時候準確地達到 70% 的目標。

But just to be clear, Maggie, that is just a function of product mix. That is not a function of any pricing strategies or anything else that you're contemplating to kind of get you that extra effort in margins in '26.

但要明確說明的是，瑪吉，這只是產品組合的功能。這與任何定價策略或其他您正在考慮的旨在讓您在 26 年獲得額外利潤的措施無關。

Nothing. It is primarily product mix. And of course, I mean our operation team has been very focused on leveraging our overhead spend and scaling our capacity. So all those drivers altogether --

沒有什麼。它主要是產品組合。當然，我的意思是我們的營運團隊一直非常注重利用我們的管理費用和擴大我們的產能。所以所有這些司機--

It is between product mix and manufacturing efficiency that is driving it. It is definitely not price.

推動這項變化的是產品結構和製造效率。這絕對不是價格的問題。

And then the second question, Adam, I guess I should direct it to you. Is the scale up in sales force? And the amount of additional heads you've hired to grow your thrombectomy business? And so what I want to understand is just where you're at in that process. How you think about that kind of coming into its own and its contributions in either now or early '25?

然後第二個問題，亞當，我想我應該直接問你。銷售團隊規模擴大了嗎？為了發展血栓切除術業務，您還僱用了多少名員工？所以我想要了解的是您目前處於這個過程的哪個階段。您如何看待這種現像在現在或 25 年代初期的形成及其貢​​獻？

And similarly, that same question, on market access, which is arguably underappreciated in how you're attacking kind of the market with the market access initiatives. But when do you expect the impacts of both of those dynamics to be felt from your efforts?

同樣，關於市場准入的同一個問題，可以說在您如何利用市場准入措施進軍市場時沒有得到充分重視。但是，您預計何時能夠從您的努力中感受到這兩種動力的影響呢？

Well, if you competed with us in VTE, you certainly felt it in the fourth quarter. I think that's pretty obvious. I think we've started that process. I've always said it's not linear, and nothing in this field is.

好吧，如果你在 VTE 中與我們競爭，你肯定會在第四季度感受到它。我認為這很明顯。我認為我們已經開始了這一進程。我一直說這不是線性的，而且這個領域中沒有任何東西是線性的。

So I want to be very clear that it is not linear. That being said, we have done a great job hiring an incredible team. Right now, I really, really mean this. We have the best commercial team ever assembled in med tech. And I know a lot of people say that about their teams, and I appreciate it. I'm glad they do.

所以我想非常清楚地表明它不是線性的。話雖如此，我們還是出色地組建了一支出色的團隊。現在，我是真心實意地這麼說。我們擁有醫療科技領域最優秀的商業團隊。我知道很多人都這樣評價他們的球隊，我很感激。我很高興他們這麼做。

But it really is true. Our team is extraordinary. And when you add the data that we now have, and that we're talking to hospitals about directly, and opening their eyes to what they could be doing to help more and more patients, you're in a really good spot.

但這確實是事實。我們的團隊非常出色。當你加入我們現在擁有的數據，以及我們直接與醫院交談的數據，並讓他們了解他們可以做些什麼來幫助越來越多的患者時，你就處於一個非常好的位置。

Again, it's not a linear process, it never has been, but I think we have started that process. A lot of that is because we now have technology with CAVT that is worth doing that for. It is clearly better. You can get the clot out faster and safer. We've shown that over and over again. We have now data -- large quantity of data that says the same thing.

再說一遍，這不是一個線性的過程，從來都不是，但我認為我們已經開始了這個過程。這在很大程度上是因為我們現在擁有了值得這麼做的 CAVT 技術。顯然這樣更好。您可以更快、更安全地取出血塊。我們已經一次又一次地證明了這一點。我們現在有大量的數據表明了同一件事。

And I think that's just crystal clear. So I think that will continue. And again, it will be a multi, multi-year effort because we're only 10% penetrated with this market. And we're going to keep going until we get them all, and help all these patients. I will, if you will indulge me with a short story, we had our national sales meeting several weeks ago.

我認為這是非常清楚的。所以我認為這種情況將會持續下去。而且，這將是一項多年的努力，因為我們在這個市場的滲透率只有 10%。我們會繼續努力，直到救出所有傷者，並幫助所有患者。我會的，如果你願意讓我講一個簡短的故事的話，我們幾週前舉行了全國銷售會議。

And a patient came to discuss and share with the entire vascular team what happened. She had a big -- a massive PE. If I'm not mistaken from her story, she had coded. She was revived. And turned out to have a great recovery.

一位患者過來與整個血管團隊討論並分享所發生的事情。她有一個很大的——巨大的PE。如果我沒有弄錯的話，她的故事裡已經寫好了密碼。她復活了。結果證明他康復得很好。

And at the end of her telling her story, she asked the entire commercial team that was assembled to do one thing. And she said, I have one request of everyone in this room, and that is, don't stop until everyone that can benefit from this technology gets this technology.

在講述自己的故事的最後，她要求整個商業團隊做一件事。她說，“我對在座的各位都有一個要求，那就是不要停下來，直到每個可以從這項技術中受益的人都獲得這項技術。”

We didn't ask her to say that. We didn't set her up for it. She said it from the bottom of her heart as somebody who received the best technology available. And that's going to motivate us. It certainly did in the room. And that's what we're going to do for many, many years.

我們並沒有要求她說這些。我們並沒有為她安排這些。作為一個接受了最先進技術的人，她發自內心地說了這句話。這將激勵我們。房間裡確實如此。這正是我們未來許多年要做的事。

Shagun Singh, RBC Capital Markets.

加拿大皇家銀行資本市場 (RBC Capital Markets) 的 Shagun Singh。

Just a quick one for me. For your US venous thrombectomy business, 41% year over year growth, how should we think about the durability of that? And given that we've seen that growth rate accelerate sequentially in the past few quarters, I'm just wondering if there is anything else going on.

對我來說這只是一個快速步驟。貴公司的美國靜脈血栓切除術業務年增 41％，我們該如何看待這種成長的持久性？鑑於我們已經看到過去幾季的成長率連續加速，我只是想知道是否還有其他事情發生。

Is it just your commercial team expansion, are you seeing greater acceptance given the benefits you talked about, greater ability to get into the door? Just anything incremental to what you've shared that you may be able to share with us.

這只是您商業團隊的擴張嗎？考慮到您談到的好處，您是否看到了更大的接受度，更大的進入能力？只要是與您所分享的內容相關的增量內容，您都可以與我們分享。

Yeah. Again, I want to stress, no growth rates in a situation where there's market growth and share shift is linear. So you just -- it just can't be seen that way, and it's not. That being said, obviously, both are happening.

是的。我再次強調，在市場成長和份額變化呈線性的情況下，不存在成長率。所以你只是——它只是不能被這樣看待，而且它也不是。話雖如此，顯然，兩者都在發生。

And that is not so much a direct impact on we have more people. Therefore, we can sell more. It's the product. The product is that good. It takes out the blood clot faster than any other product on the market. And therefore, as people hear about it, as people want to try it, and move from analog technology to digital technology, they have to be trained, they have to be -- go through the process.

這對我們擁有更多人口並沒有太大的直接影響。因此，我們可以賣更多。這是產品。產品就是那麼好。它比市場上任何其他產品去除血栓的速度都快。因此，當人們聽到它、想要嘗試它並從類比技術轉向數位技術時，他們必須接受培訓，他們必須經歷這個過程。

But that will continue, I think, for quite a while. You overlay the opportunity to treat more and more people. And as more and more hospitals become aware of that information and what they can do to do that, I think you're going to see continued strong growth, not in a linear fashion, quarter by quarter, but over the course of the next number of years, you're going to see particularly strong growth continue.

但我認為，這種情況還會持續相當長一段時間。您就有機會治療更多的人。隨著越來越多的醫院意識到這些資訊並了解他們可以採取哪些措施來做到這一點，我認為你會看到持續強勁的成長，不是線性成長，不是逐季度成長，而是在接下來的幾年裡，你會看到特別強勁的成長持續下去。

Mike Kratky, Leerink Partners.

麥克‧克拉基 (Mike Kratky)，Leerink 合夥人。

So obviously, great acceleration in US thrombectomy growth, 41% US VTE growth. Sorry to bother you with another one on guidance, but without providing specifics, can you help frame where you're expecting your different verticals between VTE, arterial, stroke, and coronary to land relative to that 19% to 20% overall US growth?

顯然，美國血栓切除術成長大大加速，美國 VTE 成長率為 41%。很抱歉打擾您提供另一個指導，但在沒有提供具體細節的情況下，您能否幫助描述您預計 VTE、動脈、中風和冠狀動脈之間的不同垂直領域相對於美國 19％ 至 20％ 的整體增長率的位置？

Yeah. I think it's premature to be that -- to give you that kind of detail at this stage. Obviously, all of those have drivers. We have Flash 2.0. That's continuing to attract a lot more customers together with the market access work.

是的。我認為，現階段向您提供此類細節還為時過早。顯然，所有這些都有驅動因素。我們有 Flash 2.0。這將與市場准入工作一起繼續吸引更多的客戶。

We have the arterial, which has new products as well. And then of course, whatever happens ultimately with Thunderbolt, which isn't technically in our guide, so we can't include it. But obviously, it's going to have an impact.

我們有主幹道，也有新產品。當然，無論 Thunderbolt 最終發生什麼，從技術上講它並不在我們的指南中，所以我們不能將其納入。但顯然，它會產生影響。

That's not even talking about the new RED 72 catheter which if it continues to do what the first three days of cases show is going to be a significant benefit as well.

這還沒有提到新的 RED 72 導管，如果它繼續發揮前三天病例所顯示的作用，那麼它也將帶來顯著的益處。

So I think we have a lot of drivers. So the exact numbers within that, let's wait and see and we'll give you more updates when we have more information.

所以我認為我們有很多驅動因素。所以，我們還是拭目以待吧，當我們有更多資訊時，我們會為您提供更多更新。

And maybe just as one follow up, can you comment on some of the early adoption trends for Lightning Flash and Bolt 7 in Europe following the recent launches?

也許只是作為一個後續問題，您能否評論一下最近推出的 Lightning Flash 和 Bolt 7 在歐洲的一些早期採用趨勢？

Yeah. There -- again, the limitation is there's some countries that aren't yet at a place where they're fully reimbursable. And so it's not in every single country, in a big way, but where it is, we're seeing the same benefit that we're seeing in the US.

是的。再次強調，限制在於有些國家尚未達到完全可報銷的水準。因此，並不是每個國家都存在這種現象，但在存在這種現象的國家，我們都看到了與美國相同的好處。

Again, the clot is taken out faster and safer. And obviously, I've yet to meet a physician who says that's not a positive goal.

再一次，血塊被更快、更安全地取出。顯然，我還沒有遇到說這不是一個積極的目標的醫生。

And this concludes the Q&A portion of today's conference call. Ms. Furlong, I turn the call back over to you.

今天電話會議的問答部分到此結束。弗隆女士，我把電話轉回給您。

Thank you, operator.

謝謝您，接線生。

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 first quarter call.

我代表我們的管理團隊，再次感謝大家今天的參與以及對 Penumbra 的關注。我們期待在第一季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。您現在可以斷開連線。