Penumbra Inc (PEN) 2025 Q2 法說會逐字稿

Ladies and gentlemen, good afternoon. My name is Abby, and I'll be your conference operator today. At this time, I would like to welcome everyone to Penumbra's second-quarter 2025 conference call. (Operator Instructions)

女士們、先生們，午安。我叫艾比，今天我將擔任您的會議主持人。現在，我歡迎大家參加 Penumbra 2025 年第二季電話會議。（操作員指示）

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

謝謝。我想介紹一下 Penumbra 的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 second quarter of 2025. 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，也謝謝大家參加今天的電話會議，討論 Penumbra 2025 年第二季的財報。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。

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, filed with the SEC.

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案》的安全港條款做出前瞻性陳述，包括有關我們的財務表現、商業化、臨床試驗、監管狀況、品質、合規性和業務趨勢的陳述。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 2024 年 12 月 31 日的 10-K 報告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有重大差異。

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 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，我們提醒您不要過度依賴這些前瞻性陳述，並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 表，以便更全面地討論這些因素以及可能影響我們未來業績或股票市場價格的其他風險。Penumbra 不承擔因新資訊、未來事件、發展或其他原因而更新或修改我們的前瞻性聲明的任何義務。

On this call, financial results for revenue and gross margin are presented on a GAAP basis while operating expenses, operating income, and adjusted EBITDA 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.

在本次電話會議上，收入和毛利率的財務結果以 GAAP 為基礎呈現，而營業費用、營業收入和調整後的 EBITDA 則以非 GAAP 為基礎呈現。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。

Non-GAAP operating expenses and operating income exclude amortization of acquired intangible assets of $2.4 million and impairment of our immersive healthcare business of $76.9 million in the second quarter of 2024, and adjusted EBITDA excludes impairment expenses, stock compensation expense, depreciation and amortization, provision for income taxes, and interest income expenses.

非公認會計準則營業費用和營業收入不包括 2024 年第二季收購無形資產的攤銷 240 萬美元和沈浸式醫療業務的減損 7,690 萬美元，調整後的 EBITDA 不包括減損費用、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 second quarter of 2025. And Jason Mills, our Executive Vice President of Strategy, will discuss our updated 2025 guidance.

Penumbra 董事長兼執行長 Adam Elsesser 將提供業務最新進展。我們的財務長 Maggie Yuen 隨後將討論我們 2025 年第二季的財務表現。我們的策略執行副總裁 Jason Mills 將討論我們更新後的 2025 年指導方針。

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

說完這些，我想把電話轉給 Adam Elsesser。

Thank you, Cecilia. Good afternoon. Thank you for joining Penumbra's second-quarter 2025 conference call. In the second quarter, we generated total revenue of $339.5 million, representing underlying year-over-year growth of 13.4% on a reported basis and 12.7% on a constant currency basis. Our second-quarter performance reflected extraordinary ongoing execution by our commercial team against our strategy, together with our focus on continuous innovation, clinical and health economic data generation, together with the work physicians are doing to further expand the total number of patients treated globally with our novel technologies.

謝謝你，塞西莉亞。午安.感謝您參加 Penumbra 2025 年第二季電話會議。第二季度，我們的總營收為 3.395 億美元，以報告基礎計算年增 13.4%，以固定匯率計算成長 12.7%。我們第二季的業績反映了我們的商業團隊對我們的策略的持續出色執行，以及我們對持續創新、臨床和健康經濟數據產生的關注，以及醫生為進一步擴大全球使用我們的新技術治療的患者總數所做的工作。

Our US thrombectomy business led overall growth in the quarter, with results reflecting strong continued adoption and ramping utilization of our CAVT portfolio. while our US embolization and access business, as well as our international business, delivered solid growth ahead of expectations. Second-quarter US thrombectomy revenue increased 22.6% year over year to $188.5 million, led by 42% year-over-year growth in our US VTE franchise as the clinical benefits of Flash 2.0 and Bolt 12 continue to support and drive further market penetration and competitive conversions.

我們的美國血栓切除術業務引領了本季度的整體成長，其結果反映了我們 CAVT 產品組合的持續強勁採用和利用率的提高。而我們的美國栓塞和通路業務以及我們的國際業務實現了超乎預期的穩健成長。第二季度美國血栓切除術收入年增 22.6% 至 1.885 億美元，其中美國 VTE 特許經營權同比增長 42%，因為 Flash 2.0 和 Bolt 12 的臨床優勢繼續支持並推動進一步的市場滲透和競爭轉化。

Below the top line, gross margin of 66% was in line with our prior announced expectation as we executed on our planned accelerated Ruby XL inventory build. We began shipments of XL at the end of the second quarter and enter the third quarter well positioned from an inventory standpoint to meet the strong interest in XL we've seen in the field to date.

在頂線以下，66% 的毛利率符合我們先前宣布的預期，因為我們執行了計劃的加速 Ruby XL 庫存建設。我們在第二季末開始出貨 XL，從庫存角度來看，進入第三季我們已經做好了充分的準備，以滿足迄今為止我們在該領域看到的對 XL 的強烈興趣。

We remain on track and are well-positioned to achieve a gross margin profile of over 70% by the end of 2026 and expect operating margin expansion to outpace gross margin expansion for the foreseeable future as we prioritize delivering profitable growth and an expanding profitability profile.

我們仍處於正軌上，並預計在 2026 年底實現超過 70% 的毛利率，並且預計在可預見的未來，營業利潤率的擴張將超過毛利率的擴張，因為我們優先實現盈利增長和不斷擴大的盈利狀況。

Turning to our US Peripheral business, our second-quarter thrombectomy performance reflected the competitive strength and clinical benefits of our comprehensive current CAVT portfolio, spanning Flash 2.0, Bolt 6x, Bolt 7, and Bolt 12 alongside purposeful and focused execution by our commercial team. We treated more VTE patients in the quarter than in any prior period, supported by our team's relentless focus and prioritization on improving patient outcomes, driving conversions from anticoagulation, lytics, and other mechanical thrombectomy platforms to CAVT in both PE and DBT.

談到我們的美國外圍業務，我們第二季度的血栓切除術表現反映了我們目前全面的 CAVT 產品組合的競爭實力和臨床優勢，涵蓋 Flash 2.0、Bolt 6x、Bolt 7 和 Bolt 12，以及我們商業團隊有目的、有重點的執行。本季我們治療的 VTE 患者比以往任何時期都多，這得益於我們團隊堅持不懈地關注和優先改善患者預後，推動從抗凝血、溶解劑和其他機械血栓切除術平台向 PE 和 DBT 中的 CAVT 的轉變。

In arterial, the clinical benefits of our modulated aspiration technology in Bolt 7 and Bolt 6x continue to support and drive physician conversions from open surgery or the use of lytics to CAVT. Based on our consistent success and our clear view of the opportunity ahead in peripheral thrombectomy, we strategically invested in the buildout of a separate peripheral embolization sales force so as to provide heightened focus in thrombectomy and embolization.

在動脈方面，Bolt 7 和 Bolt 6x 中調製抽吸技術的臨床優勢繼續支持和推動醫生從開放性手術或使用溶解劑轉向 CAVT。基於我們一貫的成功以及對外周血栓切除術未來機會的清晰認識，我們戰略性地投資建立了一支獨立的外周栓塞銷售隊伍，以便更加專注於血栓切除術和栓塞術。

We have added over 50 embolization sales reps and over 40 vascular clinical specialists. With these new hires in place, we will be able to have a team solely focused on our thrombectomy business, as well as a separate team focused on launching Ruby XL and driving long-term growth in our embolization business. Adding to the information we provided on our last earnings call, Ruby XL is a larger, softer, and longer coil than other commercially available coils, and allows us to now participate quite effectively in about 20% of the current market that we have not been able to in the past.

我們增加了 50 多名栓塞銷售代表和 40 多名血管臨床專家。隨著這些新員工的到位，我們將能夠擁有一個專注於血栓切除術業務的團隊，以及一個專注於推出 Ruby XL 和推動栓塞業務長期成長的獨立團隊。除了我們在上次收益電話會議上提供的資訊之外，Ruby XL 線圈比其他市售線圈更大、更軟、更長，這使我們能夠非常有效地參與到目前約 20% 的市場中，這是我們過去無法做到的。

With the early performance of Ruby XL, we expect to see ramping benefit from our investment in our commercial team through the back half of the year and beyond, with our thrombectomy team well-positioned to exclusively focus on continuing to address the significant unmet need in the treatment of clot burden throughout the body and our new embo team able to focus on providing our comprehensive coral portfolio to physicians and hospitals.

隨著 Ruby XL 的早期表現，我們預計在下半年及以後，我們對商業團隊的投資將帶來巨大的收益，我們的血栓切除術團隊將專注於繼續解決全身血栓負擔治療中尚未滿足的重大需求，而我們新的栓塞團隊將專注於向醫生和醫院提供全面的珊瑚產品組合。

As our team drives adoption of our technology on a day-to-day and account-by-account basis, we are simultaneously focused on positioning CAVT for long-term growth while enhancing our competitive position. Advancing the field through technology innovation and high-quality clinical data generation is our priority. During the quarter, we completed enrollment in STORM-PE, our prospective multi-center randomized controlled trial evaluating CAVT plus anticoagulation versus anticoagulation alone for the treatment of acute, intermediate, high-risk PE.

當我們的團隊每天、每個帳戶地推動我們技術的採用時，我們同時專注於定位 CAVT 的長期成長，同時增強我們的競爭地位。透過技術創新和高品質臨床數據產生來推動該領域的發展是我們的首要任務。在本季度，我們完成了 STORM-PE 的招募，這是我們的前瞻性多中心隨機對照試驗，評估 CAVT 聯合抗凝血治療與單獨抗凝血治療對治療急性、中度、高風險 PE 的效果。

We are committed to running trials which hold the potential to fundamentally shift patient treatment, and STORM-PE has the potential to provide Level 1 evidence to help inform PE treatment and impact standard of care. Enrollment in STORM-PE completed ahead of schedule, and we look forward to presenting the results from the trial at a major medical conference this fall.

我們致力於進行有可能從根本上改變患者治療的試驗，而 STORM-PE 有可能提供 1 級證據，幫助指導 PE 治療並影響護理標準。STORM-PE 的招募工作提前完成，我們期待在今年秋季的大型醫學會議上展示試驗結果。

On the arterial side, we recently announced the launch of our STRIDE II clinical study. Our initial STRIDE study, which incorporated primarily older generation technology, demonstrated compelling results, including a 98.2% 30-day limb salvage rate. With STRIDE II, we intend to both expand the patient sample size and broaden the geographic enrollment base in comparison to STRIDE, with STRIDE II focused on demonstrating the benefits of our latest-generation CAVT technology.

在動脈方面，我們最近宣布啟動 STRIDE II 臨床研究。我們最初的 STRIDE 研究主要採用了老一代技術，並且取得了令人信服的結果，包括 98.2% 的 30 天肢體挽救率。透過 STRIDE II，我們打算擴大病患樣本量並拓寬地理招募基礎（與 STRIDE 相比），STRIDE II 專注於展示我們最新一代 CAVT 技術的優勢。

Looking forward, we will continue to invest in high-quality clinical studies in tandem with our market access initiatives to highlight the significant benefits and value proposition of our differentiated current and forthcoming products.

展望未來，我們將繼續投資高品質的臨床研究，並結合我們的市場准入舉措，以突顯我們現有和即將推出的差異化產品的顯著優勢和價值主張。

Shifting to our neurovascular business, our US stroke thrombectomy franchise delivered another solid performance, growing ahead of the underlying stroke market. In its first full quarter on the market, Red 72 silver label, with its enhanced trackability, continued to generate strong physician interest and saw ramping adoption and utilization. Regarding Thunderbolt, we are currently in an active process with the FDA and will provide additional updates as soon as possible. We remain very excited to introduce Thunderbolt to the neurovascular field.

轉向我們的神經血管業務，我們的美國中風血栓切除術特許經營權再次取得了穩健的業績，成長速度領先於基礎中風市場。在上市的第一個完整季度，Red 72 銀標憑藉其增強的可追蹤性，繼續引起醫生的濃厚興趣，並實現了迅速普及和利用。關於 Thunderbolt，我們目前正在與 FDA 積極溝通，並將盡快提供更多更新資訊。我們仍然非常高興將 Thunderbolt 引入神經血管領域。

At SNIS earlier this month, there was a great deal of discussion about distal occlusions in stroke. We heard many physicians confirm that our Red 43 aspiration catheter is the preferred device to treat patients with distal occlusions. Finally, there was a lot of discussion among physicians about embolizing the middle menagerie artery, or MMA, as it is commonly known, and the unique properties of our swift coil that allows for the safest treatment modality.

本月早些時候，在 SNIS 上，人們對中風遠端閉塞進行了大量討論。我們聽到許多醫生證實，我們的 Red 43 抽吸導管是治療遠端閉塞患者的首選設備。最後，醫生們對栓塞中動脈（俗稱 MMA）以及我們的快速線圈的獨特性能進行了大量討論，這種特性可以實現最安全的治療方式。

It is estimated that there are more patients that could be treated in this category than traditional cerebral aneurysms. We are focused on investing in further innovation across our diversified neuro portfolio, spanning aspiration, access, and embolization. In summary, our second-quarter results reflect solid execution by our team as we continue to deliver long-term growth in multiple under-penetrated markets. We are committed to continuing to transform patient care across these markets and are excited to introduce new innovative products in the months and years ahead.

據估計，此類疾病中可治療的患者比傳統腦動脈瘤患者更多。我們專注於投資多元化神經產品組合的進一步創新，涵蓋抽吸、通路和栓塞。總而言之，我們的第二季業績反映了我們團隊的穩健執行，我們繼續在多個滲透率較低的市場實現長期成長。我們致力於繼續改變這些市場的患者護理，並很高興在未來的幾個月和幾年內推出新的創新產品。

I'll now turn the call over to Maggie to cover our financial results for the second quarter of 2025.

現在我將把電話轉給 Maggie，讓她介紹我們 2025 年第二季的財務表現。

Thank you, Adam. Good afternoon, everyone. Today, I will discuss the financial results for the second quarter of 2025. Financial results on this call for revenue and gross margin are on a GAAP basis, while operating expenses, operating income, and adjusted EBITDA are on a non-GAAP basis. The corresponding GAAP measures and our 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2025年第二季的財務表現。本次電話會議的收入和毛利率財務結果是基於 GAAP，而營業費用、營業收入和調整後 EBITDA 則基於非 GAAP。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 second quarter ended June 30, 2025, our total revenues were $339.5 million, an increase of 13.4% reported and 12.7% in constant currency, compared to the second quarter of 2024. Our geographic mix of sales for the second quarter of 2025 was 76.8% US and 23.2% international. Our US region reported growth of 19.5%, driven by 22.6% growth in our thrombectomy franchise compared to the same period last year.

截至 2025 年 6 月 30 日的第二季度，我們的總收入為 3.395 億美元，與 2024 年第二季度相比，報告增長 13.4%，按固定匯率計算增長 12.7%。2025 年第二季度，我們的銷售地理分佈為 76.8% 美國和 23.2% 國際。我們的美國地區報告增加了 19.5%，這得益於我們的血栓切除術特許經營權與去年同期相比增長了 22.6%。

As we anticipated, our international regions decreased 3.2%, reported, and 5.8% in constant currency, primarily due to a decrease in China revenue compared to the same period last year, which was partially offset by an increase in all other international regions. As we look ahead for the second half of 2025, we expect headwinds in China to ease, resulting in a return to growth across all of our international regions. The sequential growth in our total revenue of 4.7% was driven by both an increase in global thrombectomy and embolization and excess revenue across all regions compared to the first quarter of 2025.

正如我們預期的那樣，我們的國際地區收入按報告數字下降了 3.2%，按固定匯率計算下降了 5.8%，這主要是由於中國地區的收入與去年同期相比有所下降，但其他所有國際地區的收入有所增長，部分抵消了這一下降。展望 2025 年下半年，我們預期中國面臨的阻力將會緩解，使我們所有國際地區恢復成長。我們總收入環比增長 4.7%，這得益於全球血栓切除術和栓塞術的增長以及與 2025 年第一季相比所有地區的超額收入。

Moving to revenue by products, revenue from our global thrombectomy business grew to $230.3 million in the second quarter of 2025, an increase of 13.1% reported and 12.6% in constant currency compared to the same period last year, which was primarily driven by growth in our US thrombectomy business of 22.6%. Our international thrombectomy business increased by 16.2% in line with expectations primarily due to a decline in China revenue. Excluding the impact to the China region, our international thrombectomy revenue grew by 14.4% when compared to the same period last year.

按產品劃分的收入方面，2025 年第二季度，我們全球血栓切除術業務的收入增長至 2.303 億美元，與去年同期相比增長 13.1%，按固定匯率計算增長 12.6%，這主要得益於我們美國血栓切除術業務 22.6% 的增長。我們的國際血栓切除業務成長了 16.2%，符合預期，主要原因是中國收入下降。除去中國地區的影響，我們的國際血栓切除術收入與去年同期相比成長了14.4%。

Revenue from our embolization and access business was $109.2 million in the second quarter of 2025, an increase of 13.9% reported and 12.8% in constant currency, primarily driven by an increase in US embolization sales, underscoring the launch of our new XL product. Gross margin for the second quarter of 2025 is 66%, compared to 54.4% for the second quarter of 2024, which includes a one-time $33.4 million immersive healthcare inventory write-off. Excluding this one-time write-off, the gross margin slightly increased year over year.

2025 年第二季度，我們的栓塞和通路業務收入為 1.092 億美元，報告成長 13.9%，以固定匯率計算成長 12.8%，主要得益於美國栓塞銷售額的成長，突顯了我們新 XL 產品的推出。2025 年第二季的毛利率為 66%，而 2024 年第二季的毛利率為 54.4%，其中包括一次性 3,340 萬美元的沉浸式醫療庫存註銷。除去這筆一次性註銷，毛利率較去年同期略有增加。

As expected, our gross margin slightly decreased sequentially due to investment in the launch of our XL product and the high international mix of growth across all regions. As we move to the second half of 2025, we expect to see sequential margin expansion from favorable product mix and productivity improvements.

正如預期的那樣，由於對 XL 產品的推出進行的投資以及所有地區的國際成長組合較高，我們的毛利率較上季略有下降。隨著我們進入 2025 年下半年，我們預計利潤率將因有利的產品組合和生產力提高而連續擴大。

In addition, we are on track to achieve our full-year gross margin targets. However, as our separate thrombectomy and embo teams start ramping, we might see some month-to-month variability in product mix. Importantly, we remain well-positioned to deliver our long-term gross margin profile of 70% by the end of 2026.

此外，我們預計將實現全年毛利率目標。然而，隨著我們獨立的血栓切除術和栓塞術團隊開始加強力度，我們可能會看到產品組合逐月發生變化。重要的是，我們仍處於有利地位，預計在 2026 年底實現 70% 的長期毛利率。

And now onto our non-GAAP operating expenses, non-GAAP operating income and margin, and adjusted EBITDA. Total operating expense for the quarter was $183.2 million or 54% of revenue compared to $164.5 million or 54.9% of revenue for the same quarter last year. Our research and development expenses for Q2 2025 were $23.2 million or 6.8% of revenue compared to $24.9 million or 8.3% of revenue for Q2 2024, which reflects savings of $5.2 million due to our immersive business wind-down offset by continued investment in product development.

現在來看看我們的非公認會計準則營業費用、非公認會計準則營業收入和利潤率以及調整後的 EBITDA。本季總營運費用為 1.832 億美元，佔營收的 54%，去年同期為 1.645 億美元，佔營收的 54.9%。我們 2025 年第二季的研發費用為 2,320 萬美元，佔營收的 6.8%，而 2024 年第二季的研發費用為 2,320 萬美元，佔營收的 8.3%，這反映了我們沉浸式業務逐步結束而節省的 520 萬美元，但對產品開發的持續投資抵銷了這項節省。

SG&A expenses for Q2 2025 were $160 million or 47.2% of our revenue for Q2 2025, compared to $139.6 million or 46.6% of revenue for Q2 2024. To support the momentum in demand and ensure we are positioned to capitalize on long-term growth drivers, we made targeted hires in our commercial and market access teams.

2025 年第二季的銷售、一般及行政費用為 1.6 億美元，佔 2025 年第二季營收的 47.2%，而 2024 年第二季的銷售、一般及行政費用為 1.396 億美元，佔營收的 46.6%。為了支持需求動能並確保我們能夠利用長期成長動力，我們在商業和市場准入團隊中進行了有針對性的招募。

Sequentially, our expense increased by $6.5 million, which, as Adam mentioned, was primarily due to a deliberate front-loaded investment in our embolization sales team and additional vascular clinical specialists. With a favorable hiring market to attract top-tier talent, we acted to bring in a high-impact commercial team, which we expect will contribute to our results in the quarters ahead.

我們的支出連續增加了 650 萬美元，正如亞當所提到的，這主要是因為我們對栓塞銷售團隊和額外的血管臨床專家進行了刻意的前期投資。由於招聘市場有利，可以吸引頂級人才，我們引進了一支具有高影響力的商業團隊，我們預計這將有助於我們未來幾季的業績。

We recorded operating income of $40.8 million or 12% of revenue compared to an operating loss of $1.6 million for the same period last year, which includes one-time $33.4 million immersive healthcare inventory write-off. Excluding this one-time write-off, our operating profit increased by $9.1 million. We posted adjusted EBITDA of $61.4 million or 18.1% of total revenue compared to $13 million or 4.3% in the second quarter last year.

我們記錄的營業收入為 4,080 萬美元，佔營收的 12%，而去年同期的營業虧損為 160 萬美元，其中包括一次性 3,340 萬美元的沉浸式醫療庫存註銷。除去這筆一次性註銷，我們的營業利潤增加了 910 萬美元。我們公佈的調整後 EBITDA 為 6,140 萬美元，佔總營收的 18.1%，而去年第二季為 1,300 萬美元，佔總營收的 4.3%。

Turning to cash flow and balance sheet, we ended the second quarter of 2025 with cash, cash equivalents, and marketable securities balance of $424.6 million and no debt, which is an increase of $45.7 million sequentially driven by strong operating profitability. We expect positive operating cash flow trends to continue in 2025 and beyond.

談到現金流和資產負債表，截至 2025 年第二季度，我們的現金、現金等價物和有價證券餘額為 4.246 億美元，沒有債務，這比上一季增加了 4570 萬美元，這得益於強勁的營運獲利能力。我們預計 2025 年及以後的經營現金流量趨勢將持續為正。

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

現在我想將電話轉給傑森，討論我們更新後的 2025 年指導。

Thank you, Maggie, and good afternoon, everyone. Due to our performance in the second quarter, we are increasing our guidance for total revenue to a range of $1.355 billion to $1.370 billion, which represents 13% to 15% year-over-year growth. We maintain our guidance for US thrombectomy growth of 20% to 21% compared to 2024 levels. We also maintain our guidance for both gross margin and operating margin for full-year 2025.

謝謝你，瑪吉，大家下午好。由於我們第二季的業績，我們將總收入預期上調至 13.55 億美元至 13.70 億美元，年增 13% 至 15%。我們維持對美國血栓切除術成長率的預測，即與 2024 年的水準相比，成長率為 20% 至 21%。我們也維持對 2025 年全年毛利率和營業利益率的預期。

This concludes our prepared remarks. Operator, we can now open the call to questions.

我們的準備好的演講到此結束。接線員，我們現在可以開始提問了。

(Operator Instructions) Larry Biegelsen, Wells Fargo.

（操作員指示）富國銀行的 Larry Biegelsen。

Good afternoon. Thanks for taking the question and congrats on a nice quarter here. Adam, I wanted to start with STORM-PE and then ask a Thunderbolt question. So it's good that we're going to see the STORM-PE data this fall. Adam, it's a relatively small study, and we've seen many PE trials with RV/LV ratio as the primary endpoint. So why is this study important, and what impact could it have if it's positive? And I have one follow up.

午安.感謝您提出這個問題，並祝賀本季取得良好業績。亞當，我想從 STORM-PE 開始，然後問一個 Thunderbolt 問題。因此，今年秋天我們將看到 STORM-PE 數據，這很好。亞當，這是一項相對較小的研究，我們已經看到許多 PE 試驗以 RV/LV 比率作為主要終點。那為什麼這項研究很重要？如果它是正面的，它會產生什麼影響？我還有一個後續問題。

Yes, no, it's a great question. As you know, Larry, it's the first randomized study completed that we're aware of in the world comparing anticoagulation and mechanical thrombectomy to anticoagulation alone. So we've seen lots of single-arm studies and other things. It's the first randomized study that has that comparison, which is the question that everyone wants answered. So for that reason alone, it's significant.

是的，不，這是一個很好的問題。拉里，如你所知，這是我們所知的世界上第一個比較抗凝血和機械血栓切除術與單獨抗凝血的隨機研究。我們已經看到了很多單臂研究和其他研究。這是第一個進行這種比較的隨機研究，也是每個人都想知道答案的問題。因此，僅從這個原因來看，它就具有重要意義。

The size of the study is a testament to the confidence in the product. Obviously, the larger the study, the more room you have to have a difference. You have 100 patients. It's a lot smaller number of patients to show that difference. So it actually is a testament to, I think, the confidence in the study.

該研究的規模證明了人們對該產品的信心。顯然，研究規模越大，差異的空間就越大。您有 100 名患者。需要較少的患者數量才能顯示出這種差異。所以我認為這實際上證明了人們對這項研究的信心。

That being said, I think you're aware we put together an internationally very renowned group of physicians on the steering committee of this trial. They were the ones who came up with the endpoints and the size of the study and the powering of it all. And these are just not interventionalists. These are non-interventionalists in the field of treating PE. So I think it's -- again, we'll wait to see the results, but I think it could have a significant impact. And again, the design of the study is a testament to the work of some of the world's experts.

話雖如此，我想您知道我們組建了一組國際知名的醫生組成了這次試驗的指導委員會。他們提出了研究的終點、研究的規模以及所有研究的動力。這些人根本不是乾預主義者。這些是治療 PE 領域的非干預主義者。所以我認為——我們會等待看結果，但我認為它可能會產生重大影響。再次強調，這項研究的設計證明了一些世界專家的努力。

That's helpful. And then on Thunderbolt, Adam, any update on how we should think about the FDA review time? I think in the past, if I'm not mistaken, you've pointed to precedents that had about a six-month review time. And lastly, some investors, Adam, I think have construed some of your recent comments that your enthusiasm for Thunder has changed. Could you address those items, please? Thanks.

這很有幫助。然後關於 Thunderbolt，Adam，關於我們應該如何看待 FDA 審查時間有什麼最新消息嗎？我認為，如果我沒有記錯的話，過去您曾指出過大約需要六個月審查時間的先例。最後，亞當，我認為一些投資者已經將你最近的一些評論解讀為你對雷霆的熱情已經改變了。您能解決這些問題嗎？謝謝。

Sure. Yes, I don't remember saying six months for a clinical study. The product review times vary depending on the company. That being said, I can tell you the following. We've worked with the FDA for many, many years, the neuro division. I can tell you that they are thorough, which is something that I'm extremely supportive of. These are obviously products going up into people's brains, and I'm very supportive of that process.

當然。是的，我不記得我說過臨床研究需要六個月。產品審核時間因公司而異。話雖如此，我可以告訴你以下內容。我們神經部門已經與 FDA 合作很多年了。我可以告訴你，他們非常徹底，這是我非常支持的事情。這些產品顯然會進入人們的大腦，我非常支持這個過程。

The process is what we expected with the FDA. And to be honest, I've heard the rumors that I'm somehow not excited. Do not know how to say it any more than I've said it over and over. It is an amazing product, and I think it will have a huge, huge positive impact for many, many people for many, many years to come.

該流程正是我們對 FDA 的預期。老實說，我聽到一些傳言說我對此並不感到興奮。我不知道該怎麼說，我已經說過很多遍了。這是一款令人驚嘆的產品，我認為它將在未來許多年對許多人產生巨大的正面影響。

All right. Thanks so much.

好的。非常感謝。

Thank you.

謝謝。

Travis Steed, Bank of America.

美國銀行的特拉維斯·斯蒂德 (Travis Steed)。

Hey, thanks for taking the question. I guess the first question I'd ask about the sales force split, why now is the right time and how you're thinking about the kind of any near-term disruption from that and the kind of the margin question. I know there was a comment kind of made on the mix on margins.

嘿，謝謝你回答這個問題。我想問的第一個問題是有關銷售隊伍分割的問題，為什麼現在是正確的時機，以及您如何看待由此造成的任何短期幹擾以及利潤率問題。我知道有人對邊緣混合發表了某種評論。

Yes, so the -- well, the margin -- the comment I made about margins in my talk was we had said on the last quarter that we were accelerating the build of Ruby XL, so there would be a one-time, one-quarter impact to do that, which we saw a minor impact. That doesn't go beyond this quarter, and I think we reiterated very clearly that we are on track for our 70-plus percent at the end of 2026.

是的，所以 - 嗯，利潤 - 我在演講中對利潤的評論是，我們在上個季度說過，我們正在加速 Ruby XL 的構建，因此這樣做會產生一次性的、一個季度的影響，我們看到的影響很小。這不會超出本季度，我認為我們已經非常明確地重申，我們預計在 2026 年底實現 70% 以上的目標。

That being said, it is worth noting that the Ruby XL is -- their margin, given the nature of that coil and the price point, is actually accretive to our margin, and so that's a positive for us. Why now for the split here? It is essential given the success that we're having in the thrombectomy side on that business. And our view of where that continued growth will come.

話雖如此，值得注意的是，考慮到 Ruby XL 線圈的性質和價格點，其利潤實際上會增加我們的利潤，所以這對我們來說是積極的。為什麼現在要分裂？鑑於我們在該業務的血栓切除術方面所取得的成功，這一點至關重要。以及我們對持續成長前景的看法。

It's a pretty extraordinary opportunity that we really need to have people be able to focus. They're selling right now on the thrombectomy side alone into the arterial, DVT, PE, coronary. And then to add a whole bunch of different types of embolization procedures was a lot for our reps to do and to do it well across all of their customers. So this just makes sense to do it by focus.

這是一個非常難得的機會，我們確實需要人們能夠集中註意力。他們現在僅在動脈、DVT、PE、冠狀動脈血栓切除術方面進行銷售。然後，增加一大堆不同類型的栓塞手術，對於我們的銷售代表來說，這項工作非常繁重，而且需要為所有客戶做好這項工作。因此，透過集中精力來做這件事才有意義。

I think we have been lucky to be able to attract literally some of the best talent there is in the field, and I think it will prove to be great for our thrombectomy business because that focus -- and to be honest, it will be -- allow our peripheral coil business, our embolization business, to continue to be successful and probably accelerate growth given the launch of the product and the focus that that team has. So it makes sense all around.

我認為我們很幸運能夠吸引到該領域的一些最優秀的人才，而且我認為這對我們的血栓切除術業務來說將大有裨益，因為這種專注——老實說，它將——讓我們的外周線圈業務、我們的栓塞業務繼續取得成功，並且可能隨著產品的推出和團隊的專注而加速增長。所以這從各方面來說都是有意義的。

Thank you. And then kind of the second question is on the US thrombectomy business, the 20% to 21% guide. You kind of did 24% in the first half, kind of implies 18% in the second half. I know the stroke market flowed a bit. I know that's kind of the main reason there. If there's any kind of thing else you'd call out for the second half of the US thrombectomy business?

謝謝。第二個問題是關於美國血栓切除術業務的，指導價為 20% 至 21%。上半年的完成率為 24%，這意味著下半年的完成率為 18%。我知道中風市場有點流動。我知道那是主要原因。您對美國血栓切除術業務的下半年還有什麼其他展望嗎？

Yes, no, I think it's fairly obvious that we're pretty excited about our thrombectomy business going forward. Obviously, we raised our overall guide the quarter before we raised our US thrombectomy guide. And I think we're just, to be honest, trying not to get ahead of ourselves in spite of our enthusiasm right now.

是的，不，我認為很明顯我們對未來的血栓切除業務感到非常興奮。顯然，我們在提高美國血栓切除術指南之前就提高了本季度的整體指南。而且我認為，說實話，儘管我們現在充滿熱情，但我們只是試著不超越自己。

All right, great. Thank you. Congrats on the good quarter.

好的，太好了。謝謝。恭喜本季取得良好業績。

Thank you.

謝謝。

Robbie Marcus, JPMorgan.

摩根大通的羅比·馬庫斯。

Great. Thanks for taking the questions. I wanted to ask on margins and if there's any way you could quantify the impact of the additional sales force buildup here. Gross and operating margins came in below the Street, just trying to figure out if it's that or if it's maybe tied to the outside US embo and other outperformance. Maybe there was some stocking there or something like that. Thanks.

偉大的。感謝您回答這些問題。我想問一下利潤率，以及是否有任何方法可以量化額外銷售團隊建立的影響。毛利率和營業利潤率低於華爾街預期，只是想弄清楚是否是這個原因，或者是否可能與美國外部embo和其他優異表現有關。也許那裡有一些長襪或類似的東西。謝謝。

Sure. Maggie?

當然。瑪吉？

Yes, no, thanks. I can take on the margin impact first. In terms of our investment in our commercial team, it has no impact to our gross margin. I think the comment that I made about the mix as a result of the commercial team investment is because, like, at a mention, both of our thrombectomy and the new XL product are accretive, and they both lead to supporting eventually our 70% margin profile. But in terms of the timing of the margin mix, it just could vary from month to month, quarter to quarter.

是的，不，謝謝。我可以先承擔利潤影響。就我們對商業團隊的投資而言，它對我們的毛利率沒有影響。我認為我對商業團隊投資的組合所做的評論是因為，就像提到的那樣，我們的血栓切除術和新的 XL 產品都是增值的，它們最終都支持我們 70% 的利潤率。但就利潤組合的時間而言，它可能每個月、每季都會有所不同。

Nevertheless, we still continue to see expansion in Q3 and in Q4 at the same time. In terms of operating margin, I think investing in our commercial team has been in our strategic investment for the year. It's just for the right timing and right opportunity. We accelerate some of the investment in Q2. But at the same time, overall, we are still maintaining our full-year margin guidance, so no material impact to the out quarters. Thank you.

儘管如此，我們仍然看到第三季和第四季同時擴張。就營業利益率而言，我認為對我們商業團隊的投資是我們今年的策略投資。只是需要一個合適的時機和合適的機會。我們在第二季加快了部分投資。但同時，整體而言，我們仍維持全年利潤率指引，因此對其他季度不會產生重大影響。謝謝。

Great. Maybe a quick follow up. Adam, now that we don't really have a lot of detailed reporting now that your competitor has been acquired, as I'm thinking about US thrombectomy, I was wondering if you could just give us a quick State of the Union of what you think sort of the end market growth rates are in stroke in the different areas in Peripheral. As I'm looking at US thrombectomy, reiterating the guide implies a deceleration in the back half of the year. I'm just trying to figure out what's your weighted average end market growth in US thrombectomy relative to the Penumbra growth rate implied. Thanks a lot.

偉大的。或許可以快速跟進。亞當，既然你的競爭對手已經被收購了，我們現在實際上並沒有很多詳細的報告，而我正在考慮美國的血栓切除術，我想知道你是否可以給我們一個簡短的國情咨文，你認為外周不同地區中風的終端市場增長率是多少。當我觀察美國血栓切除術時，重申指南意味著下半年將會減速。我只是想弄清楚，相對於 Penumbra 成長率而言，美國血栓切除術的加權平均終端市場成長率是多少。多謝。

Yes, it's a fair question. It's, as you know, hard to get accurate market information, particularly when we're the only ones sort of talking about our numbers. You can't really triangulate them with other people's real numbers. So you're getting these partial data sets and trying to triangulate it. So I don't want to over-rely on those sources because they've proven not always to be accurate, as everyone knows.

是的，這是一個公平的問題。如你所知，要獲得準確的市場資訊非常困難，尤其是當我們是唯一談論我們的數字的人時。你無法真正將它們與其他人的實際數字進行三角測量。因此，您獲取這些部分資料集並嘗試對其進行三角測量。因此我不想過度依賴這些來源，因為眾所周知，它們並不總是準確的。

Let me -- I'll share the best I can how we're going. Obviously, our VTE growth is leading the way, third quarter in a row of over 40%. Obviously, the market isn't growing at 40%. It's growing somewhere around 20%, give or take, is our best guess. So again, we're continuing to take share there. The arterial business, again, it's less about a market growth there because you're really treating all those patients, but mostly with open surgery and lytic. So it's moving those patients from one modality to us.

讓我—我會盡我所能分享我們的進展。顯然，我們的 VTE 成長處於領先地位，連續第三個季度超過 40%。顯然，市場並沒有以40%的速度成長。我們的最佳猜測是，它的成長率大約是 20%。因此，我們將繼續在那裡佔據份額。再次強調，動脈業務與市場成長關係不大，因為您實際上在治療所有這些患者，但主要採用開放性手術和溶解術。因此，它將這些患者從一種治療方式轉移到我們這裡。

That had another very strong quarter. We grew similar to what we've done in the past couple of quarters. The market growth in neuro, I'll be honest, was a little soft, but we continue to grow well above that number, as best we can tell, because of the setup with Red 72 ascended, the silver label version. And frankly, it puts us in a really, really good position.

這又是一個非常強勁的季度。我們的成長情況與過去幾季類似。說實話，神經市場的成長有點疲軟，但據我們所知，由於採用了 Red 72 ascended（銀色標籤版本）的設置，我們的成長仍然遠高於這個數字。坦白說，這讓我們處於非常非常有利的地位。

I've always said that we want to try to move physicians to that product in anticipation of the Thunderbolt launch. And I think it's given us that opportunity to really do that. And having -- growing above the market shows that the share is shifting and the setup for Thunderbolt is great. And then obviously, our coronary business, it's a much more mature business, and it's obviously not growing at those same levels.

我一直說，我們希望在 Thunderbolt 推出之前嘗試讓醫生使用該產品。我認為這給了我們真正做到這一點的機會。並且——高於市場的成長表明份額正在發生變化，並且 Thunderbolt 的設置非常好。顯然，我們的冠狀動脈業務是一個更成熟的業務，而且顯然沒有保持相同的成長水平。

Very helpful. Appreciate it, Adam.

非常有幫助。非常感謝，亞當。

Yes, of course.

是的當然。

Richard Newitter, Truist.

Richard Newitter，Truist。

Hi, great. Thanks for taking the questions. Congrats on the quarter. I wanted to go back to the kind of some of the sales force initiatives you have going on here. Adam, you had -- in late '23, I believe you identified the need for an expanded sales organization with so many different call points kind of coming in. And that was kind of more feet on the street.

嗨，太好了。感謝您回答這些問題。恭喜本季。我想回顧一下你們在這裡開展的一些銷售團隊計畫。亞當，我相信您在 23 年末就意識到需要擴大銷售組織，以便引入更多不同的呼叫點。這就等於街上有更多的人。

And here, you're taking a little bit of a different approach, splitting the sales organization. You gave the rationale in an answer to a prior question. I'm just curious, how do we think about the impact to the business and the time that will take to get the return on that investment or the payoff before 1 plus 1 equals 2? And if you can compare and contrast this initiative versus the prior one.

在這裡，您採取了稍微不同的方法，並拆分了銷售組織。您在回答之前的問題時給出了理由。我只是好奇，我們如何看待對業務的影響以及獲得投資回報或 1 加 1 等於 2 之前的收益所需的時間？如果您可以將這項舉措與先前的舉措進行比較和對比。

Yes, it's a fair question. The good news is we aren't starting the process of hiring those people. We've already hired them all. The vast majority of them have fully been trained and in the last month or so have been sort of operational, if you will, in the field. And so we already are past that process of sort of going through that. And I have a lot of confidence that as we look at the back half, those teams will be operating exactly how they are -- should be focusing on what they should be focusing on.

是的，這是一個公平的問題。好消息是我們還沒有開始僱用這些人。我們已經把他們全部僱用了。他們中的絕大多數都已接受過全面培訓，並且在過去一個月左右的時間裡已經開始在現場工作。所以我們已經經歷了這樣的過程。我非常有信心，當我們看後半段時，這些球隊將會按照他們應該的方式運作——專注於他們應該關注的事情。

Obviously, we're still one team overall, and they're sharing managers. So there's going to be some capacity to help each other out and do all that, which I think is really important for the long-term success. But their incentives are aligned to focus on the parts of their business that they're assigned to.

顯然，我們總體上仍然是一個團隊，並且他們共享經理。因此，我們將有能力互相幫助並做到這一切，我認為這對長期的成功非常重要。但他們的動機是專注於他們所負責的業務部分。

And I think we're going to be in really good shape. I think a lot of the heavy work is done and has been moving in that position for the last number of months. So I think we're in pretty good shape. It's a great idea. I mean, the team came up with it. I'm thrilled. Their execution on it has been really extraordinary. And you always have a little bit of stuff going on, but I think all of that, very minor and is behind us.

我認為我們的狀態將會非常好。我認為很多繁重的工作已經完成，並且在過去的幾個月裡一直在那個位置上工作。所以我認為我們的狀況非常好。這是一個好主意。我的意思是，這個主意是團隊想出來的。我很激動。他們的執行確實非常出色。總是會有一些小事發生，但我認為這些都微不足道，已經過去了。

Got it. And then just maybe a follow up. So I appreciate you don't want to get ahead of yourself. The first half is clearly coming in a little bit better than expected on US Venus and then also on embolization. And there's the implied decel that's in your guide. Maybe that reflects some conservatism.

知道了。然後也許只是後續行動。所以我理解你不想超越自己。上半年，美國維納斯 (US Venus) 的表現明顯優於預期，栓塞治療的表現也同樣優於預期。指南中還隱含著減速。這或許反映出某種保守主義。

But assuming all trends were to hold, more or less, is there any one division that you anticipate a slowdown or you're seeing something in the underlying market? I'm just trying to get a sense for within our US arterial or US neuro thrombectomy or even coronary. Is there any anticipated slowdown or trend that's beginning to emerge that you're seeing?

但是假設所有趨勢或多或少都會保持不變，您是否預期某個部門會出現放緩，或者您在基礎市場中看到了什麼變化？我只是想了解美國動脈或神經血栓切除術甚至冠狀動脈的情況。您是否看到任何預期的放緩或開始出現的趨勢？

No, I think I sort of laid out the two areas that have a little bit softer growth, if you will. Obviously, stroke as a market, I think if you look at all the data that people can buy out there, it shows that it really didn't grow a lot in the last months or so, but we continue to take share. I think that that is great for us. I think that will continue, particularly as the market digests what the right size product is and how that all works, and that setup and getting ready for Thunderbolt continues.

不，我認為我已經列出了兩個增長稍慢的地區，如果你願意的話。顯然，中風作為一個市場，我認為如果你看看人們可以買到的所有數據，你會發現它在過去幾個月並沒有增長很多，但我們仍在繼續佔據市場份額。我認為這對我們來說非常好。我認為這種情況將會持續下去，特別是當市場消化了什麼是合適的產品尺寸以及它是如何運作的，並且 Thunderbolt 的設置和準備工作仍在繼續。

I think that puts us in an okay shape. Predicting the time of all that got to give us a little leeway to we don't control that, and we need to sort of be a part of that. And again, the coronary business is a great business. We treat a lot of patients, but it's a much more mature business with sort of analog technology, which is great in coronary, but that's obviously not growing at that level. So there's nothing other than that, and us just being -- obviously, we still have fresh memories of having our enthusiasm get the better of us, and we're going to try not to do that.

我認為這讓我們處於一個不錯的狀態。預測所有這一切的時間必須給我們一點迴旋餘地，我們無法控制它，我們需要成為其中的一部分。再次強調，冠狀動脈疾病是一項偉大的事業。我們治療了很多病人，但這是一個更成熟的業務，擁有模擬技術，這在冠狀動脈疾病中非常有用，但顯然還沒有發展到那個水平。所以除此之外沒有別的了，我們只是——顯然，我們仍然清楚地記得我們的熱情戰勝了我們，我們會盡量不這樣做。

Yes. No, I'm not criticizing. That's the right thing to do. Thank you.

是的。不，我不是批評。這是正確的做法。謝謝。

Okay, thank you.

好的，謝謝。

Bill Plovanic, Canaccord.

比爾‧普洛瓦尼克 (Bill Plovanic)，Canaccord。

Great, thanks. Thanks for taking my questions. Just first off, it looks like it was really the international and embo access that kind of drove some upside in the quarter, versus at least our expectations and I think consensus. But I'm just wondering if there's any sea change you saw there, or are some of these markets coming back sooner than you expected? And then maybe even specifically on China, I think there was some commentary there. I know you had zero in expectations for this year. Is that how that's coming in, or is that starting to come back on board? And then I have one follow up.

太好了，謝謝。感謝您回答我的問題。首先，看起來確實是國際和embo訪問推動了本季的一些上漲，至少與我們的預期和共識相符。但我只是想知道您是否看到了巨大的變化，或者其中一些市場是否比您預期的更快復甦？然後也許甚至具體地針對中國，我認為那裡有一些評論。我知道你對今年沒有任何期望。事情就是這樣發生的嗎，還是說事情又開始回到正軌了？然後我還有一個後續問題。

Yes, look, I think we have -- as you know, we had some headwinds internationally for a number of reasons over the last year or so. Obviously, the scale of the pullback on our China business has been a headwind for a couple of years. We got out of some markets because of gross margin issues. And so that was a headwind for a while.

是的，看，我認為我們有——正如你所知，在過去一年左右的時間裡，由於多種原因，我們在國際上遇到了一些阻力。顯然，我們中國業務的衰退規模在過去幾年一直是一大阻力。由於毛利率問題，我們退出了一些市場。因此，這在一段時間內是一個阻力。

So we've been really working pretty diligently for a while to make sure our international business is set up for success. Obviously, in certain markets, our CAVT products like Flash 2.0 and the Bolt products are in those markets now and starting to launch. So we're starting to see the benefits of all that work. And that's really what you're seeing right now. And it's great to see it come together.

因此，我們一直在非常努力地工作，以確保我們的國際業務成功。顯然，在某些市場，我們的 CAVT 產品（如 Flash 2.0 和 Bolt 產品）現在已經進入這些市場並開始推出。因此，我們開始看到所有這些工作帶來的好處。這確實就是您現在所看到的。很高興看到這一切得以實現。

But again, what ultimately will continue to drive it is the US thrombectomy business. But now a little bit with some of the embolization business, because I think we've got a good run ahead with that Ruby XL product, which is -- I'll be honest with you. Some of the great compliments are coming from physicians who are using that and really seeing just extraordinary things that they can do for their patients. So it's very gratifying. So I think we're set up.

但最終繼續推動其發展的是美國血栓切除術業務。但現在稍微談談栓塞業務，因為我認為我們的 Ruby XL 產品已經取得了良好的進展，這是——我會誠實地告訴你。一些高度讚揚來自那些使用該技術的醫生，他們確實看到了該技術可以為患者帶來的非凡效果。所以這是非常令人欣慰的。所以我想我們已經準備好了。

And China had a contribution in the quarter, Maggie?

瑪吉，中國在本季做出了貢獻嗎？

I'm sorry, you did ask that question. I apologize. I didn't write that question down. So when there was a lifting of the -- or pausing of the tariffs or whatever we call it, China did ask for a small order. It was not particularly material, but we did fill it.

抱歉，你確實問了這個問題。我很抱歉。我沒有寫下這個問題。因此，當取消或暫停關稅或無論我們怎麼稱呼它時，中國確實要求小額訂單。它並不是特別重要，但我們確實填補了它。

Okay, thanks. And then my follow up, I understand and appreciate kind of the process with the FDA on Thunderbolt. I'm just -- you've submitted your -- you ran your trial. You've submitted your filing. You're going through the process. I think your commentary was nothing surprising. At this point, you should be getting towards the end of that. Is there any more data or studies or anything else you need to provide, or is this just answering basic questions and labeling as we think about the process to get the product cleared from the FDA and on the market?

好的，謝謝。然後，根據我的後續了解，我理解並欣賞 FDA 在 Thunderbolt 方面的進程。我只是——你已經提交了——你已經完成了你的審判。您已提交文件。你正在經歷這個過程。我認為您的評論並不令人驚訝。至此，您應該已經接近尾聲了。您是否需要提供更多數據、研究或其他任何內容，或者這只是在我們考慮讓產品獲得 FDA 批准並投放市場的過程時回答基本問題和標籤？

I 100% appreciate and respect the question. I think there's only -- I'm only going to get in trouble if I answer that because it's going to be a nuanced thing that it's going to be misunderstood, and I don't want that to be done. Let me stick with what I said, which is we're going through the process. It's what we expected, and we can't wait to launch this product.

我百分之百地欣賞並尊重這個問題。我認為——如果我回答這個問題，我只會遇到麻煩，因為這是一個微妙的問題，會被誤解，我不希望發生這種情況。讓我堅持我所說的，那就是我們正在經歷這個過程。這正是我們所期待的，我們迫不及待地想要推出這款產品。

All right, great. Thanks, Adam. Thanks.

好的，太好了。謝謝，亞當。謝謝。

All right. Thank you.

好的。謝謝。

Brandon Vazquez, William Blair.

布蘭登·巴斯克斯、威廉·布萊爾。

Hey, everyone. Thanks for taking the question and congrats on the quarter. Adam, coming out of SNIS, I think there was a little discussion about potentially being able to reinvigorate some of these efforts or kind of like refocus the neuro community onto getting these patients into the stroke centers and prioritizing thrombectomy.

嘿，大家好。感謝您提出這個問題，並祝賀本季取得佳績。亞當，從 SNIS 出來後，我認為大家進行了一些討論，討論的重點是是否有可能重新激發這些努力，或者讓神經社區重新關注將這些患者送入中風中心並優先進行血栓切除術。

Appreciate we might be early in that. But as we're moving past COVID and this might become a little bit more of a focus now in the stroke markets, maybe the growth has been a little bit dampened. How do you think about what Penumbra can do? How do you think about what the industry is doing? Is there a point where, in the near future, where we can start to re-accelerate the growth of the stroke market?

感謝我們可能已經提前完成了這件事。但隨著我們逐漸擺脫 COVID，這可能會成為中風市場現在更加關注的焦點，成長可能會受到一些抑制。您認為 Penumbra 能做什麼？您如何看待這個行業正在做的事情？在不久的將來，我們是否可以開始重新加速中風市場的成長？

Yes, Bran, I think it's a really important question and one that I actually think a lot about since we've been here for many, many years. trying to make sure that that happens. There is no question there are some -- and frankly, a decent number of some just extraordinary centers, hospitals, physicians, leaders who are doing that work in their communities to make sure that everyone that can be treated should be treated, is getting treated. And that is the most heartening thing when we see that.

是的，布蘭，我認為這是一個非常重要的問題，而且自從我們在這裡已經很多年了，我一直在思考這個問題。努力確保這一點能夠實現。毫無疑問，有一些——坦率地說，相當多的傑出中心、醫院、醫生和領導者正在他們的社區中開展這項工作，以確保每個可以接受治療的人都得到治療。當我們看到這一點時，這是最令人振奮的事情。

Unfortunately, it's not at every town at every community at every hospital. And I don't know how fast the centers that aren't doing that will sort of get on board. I can't predict that. But it is still happening, and it's exciting to see that. I think, like anything, that has been sort of the big challenge with the neuro business, the stroke business, of making sure that people get to the right place to be treated.

不幸的是，並不是每個城鎮、每個社區、每家醫院都有這種做法。我不知道那些沒有這樣做的中心會以多快的速度加入。我無法預測這一點。但它仍在發生，看到這一點令人興奮。我認為，就像任何事情一樣，這對神經疾病、中風疾病來說是一個很大的挑戰，確保人們能夠到正確的地方接受治療。

That's obviously one of the reasons we're seeing such higher growth on the vascular side, because they don't have that issue. They go to a hospital, and they can be treated in almost every place they go. But I'm optimistic. I do think that Thunderbolt helps that because I do think it allows for a much faster, easier procedure, hopefully, that allows people to sort of, in effect, democratize it and feel like they can treat more of those patients. But let's wait and see. I don't want to get ahead of ourselves. We'll wait till that's approved, and we'll see what happens. But I'm optimistic.

這顯然是我們看到血管方面增長如此之快的原因之一，因為它們沒有這個問題。他們去醫院，幾乎在他們去的每個地方都可以得到治療。但我很樂觀。我確實認為 Thunderbolt 對此有所幫助，因為我確實認為它允許更快、更簡單的程序，希望這可以讓人們實際上使其民主化，並感覺到他們可以治療更多的患者。但我們還是拭目以待吧。我不想超越我們自己。我們將等待批准，然後看看會發生什麼。但我很樂觀。

Okay. And then maybe as a follow up on the embo side of the business, now that you're building out of sales force, there's some new products like Ruby XL and maybe Swiftpac and the MMA embolization. I'm kind of curious if you would categorize this as maybe a little bit of a turning port for embo.

好的。然後，也許作為業務的栓塞方面的後續行動，現在您正在建立銷售隊伍，有一些新產品，如 Ruby XL 和 Swiftpac 以及 MMA 栓塞。我有點好奇你是否會將其歸類為 embo 的轉向端口。

Is this in the sense of, can this be kind of a materially even better part of the business once this separate kind of sales force builds out? It seems like you're viewing a big opportunity there. Please rein me in if I'm getting ahead of my own skis here. But clearly, you're seeing something. Is this something in a year from now we're going to be looking back and saying, this is why Penumbra invested so much into this segment? Thanks.

從這個意義上來說，一旦這種獨立的銷售團隊建立起來，這是否能成為業務中實質上更好的一部分？看起來你正在那裡看到一個巨大的機會。如果我在這裡超越了自己的滑雪板，請控制我。但顯然，你看到了一些東西。一年後我們回顧時是否會說，這就是 Penumbra 在該領域投入如此多資金的原因？謝謝。

Yes, that's what I hope.

是的，我正是這麼希望。

Ryan Zimmerman, BTIG.

Ryan Zimmerman，BTIG。

Thank you. All right. Congrats on the quarter. Not to stir the pot here, Adam, I just want to understand. Can you just confirm that -- could we see clearance of Thunderbolt ahead of a possible data presentation at SVIN in November? Is that within the realm of possibilities?

謝謝。好的。恭喜本季。亞當，我並不是想在這裡挑起事端，我只是想了解一下。您能否確認一下—我們能否在 11 月 SVIN 上進行資料展示之前看到 Thunderbolt 的批准？這是有可能的嗎？

Again, I totally appreciate the question. I don't think you're stirring the pot at all. I don't mean to answer the question the way I've answered the last two or three times. We're in an active process. Obviously, I don't control it. We're going through that process, and it's what we expected. And as soon as we can, we will tell you something. I can't say more than that. I think it's pretty obvious. But I have a lot of respect for the various attempts to get me to say something else.

再次，我非常感謝你的提問。我認為你根本沒有挑起事端。我並不想用過去兩、三次回答過的方式來回答這個問題。我們正處於一個積極的進程中。顯然，我無法控制它。我們正在經歷這個過程，這正是我們所期望的。我們會盡快告訴您一些事情。我不能再多說了。我認為這很明顯。但我非常尊重那些試圖讓我說些別的話的人。

That's fine. I'll stick just two more around neurovascular. One, I was also at SNIS. We saw the distal trials early in February at ISC. Do you think you need to do a distal aspiration trial? Because clearly, all three of those trials were with stem retrievers. And we saw a subgroup analysis on aspiration in M2. And clearly, it was effective. So is a distal trial necessary to reinvigorate that market?

沒關係。我將在神經血管周圍再貼兩張。第一，我也在 SNIS。我們在二月初在 ISC 看到了遠端試驗。您認為您需要做遠端抽吸試驗嗎？因為很明顯，這三次試驗都是用獵犬進行的。我們看到了關於 M2 中願望的亞組分析。顯然，它是有效的。那麼，是否有必要進行遠端試驗來重振該市場？

And then the second part of the question is, just what do you consider successful in the Thunderbolt trial? Because if revascularization -- immediate revascularization is the endpoint, I guess, what do you consider kind of a good time reduction that we should be looking for in that trial? Thanks for taking my question.

那麼問題的第二部分是，您認為 Thunderbolt 試驗的成功是什麼？因為如果血管重建－立即血管重建是終點，我想，您認為我們在試驗中應該尋求什麼樣的好的時間減少？感謝您回答我的問題。

Yes, both really, really good questions. Let's start on the distal one. There's a lot of discussion and SNIS just sort of prompted it. We hosted a symposium -- dinner symposium. We hugely intended probably one of our biggest attended ones we've ever had at SNIS. So there's a lot of interest in this topic of distal. And there's not an easy answer. There's not a lot of consensus. I think people would not mind having the data that is directly supportive of our Red 43 catheter doing this, which is really considered the sort of catheter of choice to do these cases.

是的，這兩個問題都非常非常好。讓我們從遠端開始。有很多討論，SNIS 只是促使了這一點。我們舉辦了一場研討會—晚宴研討會。我們非常期待舉辦可能是 SNIS 有史以來參加人數最多的一次會議。因此，人們對遠端這個主題很感興趣。這個問題沒有簡單的答案。並沒有達成太多共識。我認為人們不會介意獲得直接支持我們的 Red 43 導管進行此項治療的數據，該導管確實被認為是治療這些病例的首選導管。

What does that trial look like? Who would randomize? For people who already believe in it, no one is going to want to randomize those patients because they already believe it. So I think it's a tricky trial, but there's a lot of conversations that are happening. We're privy to most of them about what is next and what should be done here. And we'll let you know when there's some additional information to share. But yes, I agree with you that it's an open question. Do we need it?

這次試驗是什麼樣的呢？誰會隨機化？對於已經相信它的人來說，沒有人會願意隨機分配這些病人，因為他們已經相信它。所以我認為這是一場棘手的審判，但正在進行很多對話。我們向他們中的大多數人透露了下一步該做什麼以及應該做什麼。當有更多資訊需要分享時，我們會通知您。但是的，我同意你的觀點，這是一個懸而未決的問題。我們需要它嗎？

And then the question around what the Thunderbolt studies should show, I'm not going to answer that quantitatively, obviously, but I will just sort of point to the thing that Thunderbolt does. So Thunderbolt is not the catheter. Thunderbolt is the product that attaches to the catheter and to our aspiration source and creates modulated aspiration. So its only work is done when the catheter is already at the face of the clot. And it's about how fast the clot can come out. Not the case itself time, but the clot removal time.

然後關於 Thunderbolt 研究應該顯示什麼的問題，顯然我不會定量地回答這個問題，但我只會指出 Thunderbolt 所做的事情。所以 Thunderbolt 不是導管。Thunderbolt 是連接導管和抽吸源並產生調節抽吸的產品。因此，只有當導管到達血塊表面時，它才會發揮作用。這與血塊排出的速度有關。不是病例本身的時間，而是血塊清除的時間。

So that's what we want to measure. Obviously, we have all the traditional endpoints that the trials have, but that's the thing that physicians are going to be looking for. Does that change? There's no standard for people, but if you talk to as many physicians as I talk to, everyone kind of has their own gut feel of what their average time is. Not their best time, which they share with most people, but their actual average time when you look at hundreds of cases. And that's what I think we'll be measuring up against.

這就是我們想要衡量的。顯然，我們擁有試驗的所有傳統終點，但這正是醫生所尋找的。這會改變嗎？對於人們來說，沒有標準，但如果你與我一樣多的醫生交談，你會發現每個人對於自己的平均時間都有自己的直覺。這並不是他們與大多數人共享的最佳時間，而是當你查看數百個案例時他們的實際平均時間。我認為這就是我們要衡量的標準。

Thank you.

謝謝。

Yes, thank you.

是的，謝謝。

Michael Sarcone, Jefferies.

薩科內（Michael Sarcone），傑富瑞集團。

Good afternoon and thanks for taking the question. You've got a few things going on here. You have the sales force ramping, you're ramping Ruby XL, and you also mentioned you're moving past some China headwinds. Do you think maybe just in the context of guidance, can you talk about how you're thinking about seasonality and quarterly cadence through the back half of the year?

下午好，感謝您回答這個問題。這裡發生了一些事情。您的銷售團隊正在不斷壯大，Ruby XL 也在不斷成長，您也提到您正在克服中國市場的一些不利因素。您是否認為可能只是在指導的背景下，您能否談談您對下半年季節性和季度節奏的看法？

Obviously, there's traditionally been a sequential gain from -- unless there's some unusual thing like product launches or something that change that between user build a little in the third quarter and ramp into the fourth quarter. So that is the fourth quarter is always the best, unless, again, that's -- something changes because of product launches. And so I expect that to be somewhat the same here now. And that's just been that way forever.

顯然，傳統上總是會有一個連續的成長——除非出現一些不尋常的事情，例如產品發布，或者一些事情，導致第三季的用戶成長略有改變，而第四季則有所增加。因此，第四季度始終是最好的，除非由於產品發布而發生一些變化。因此我預計現在這裡的情況會大致相同。並且一直都是這樣。

Okay, great. And the second question is just on the US VC business, really strong growth the past three quarters. You mentioned, obviously, the market's not growing at that level. Do you think maybe you can just give us an update on where you stand on the market care front in pulmonary embolism and DVT?

好的，太好了。第二個問題是關於美國創投業務，過去三個季度成長確實強勁。您提到，顯然市場並沒有達到那個水準的成長。您能否向我們介紹一下您在肺栓塞和 DVT 市場治療的最新進展？

We all try to guess based on all the data sources that everyone gets. I think it's always sort of a fool's errand to put an exact number on it. We have obviously continued to gain share both in DVT and PE. I think we've made enough movement in DVT to be over 50%. And I think we've made a pretty significant dent in the PE business.

我們都試圖根據每個人獲得的所有數據來源進行猜測。我認為給出一個確切的數字總是一件愚蠢的事情。顯然，我們在 DVT 和 PE 領域的份額都在持續成長。我認為我們在 DVT 方面已經取得了足夠的進展，超過了 50%。我認為我們在 PE 業務方面取得了相當大的進展。

I'm pretty excited about the cases we've seen, the excitement around that from new users. And I think if a STORM-PE is positive, that will simply continue, if not accelerate. So I think we're in pretty good shape. Again, it comes down to the product. It is a product that just does what it's supposed to do, simpler and faster and safer than other technologies.

我對我們所看到的案例以及新用戶對此的興奮感到非常興奮。我認為，如果 STORM-PE 為正，那麼這種情況將會持續下去，甚至加速。所以我認為我們的狀況非常好。再次，這歸結於產品。它是一款能夠完成應有功能的產品，比其他技術更簡單、更快速、更安全。

And at the end of the day, I think I've always said almost all doctors will ultimately use the best product. And I think that's just what we're seeing right now, that the proprietary sort of computer-assisted vacuum thrombectomy or CAVT is just a unique animal that isn't really something that anyone else can do and copy because of obviously IP, and we're in pretty good shape with it. And we're not done. We're going to keep making it better, and I think everyone knows that.

最後，我想我一直說的是，幾乎所有醫生最終都會使用最好的產品。我認為這就是我們現在所看到的，專有的電腦輔助真空血栓切除術或 CAVT 只是一種獨特的動物，由於明顯的 IP，它並不是任何人都可以做和複製的東西，我們在這方面做得相當好。我們還沒完成。我們會繼續努力讓它變得更好，我想每個人都知道這一點。

Great. Thanks, Adam.

偉大的。謝謝，亞當。

Thank you.

謝謝。

Joanne Wuensch, Citi.

花旗銀行的 Joanne Wuensch。

Thank you for taking the question and congrats on the quarter. I'd like to spend just a minute on STORM-PE with the announcement of the completion of enrollment. It seems to me that this is sort of the next wave of growth for you. And with the enrollment being completed, can you walk us through the timeframe to get from here to approval to commercialization and if there's anything specific that we should be aware of on that path? Thank you so much.

感謝您回答這個問題，並祝賀本季取得佳績。我想花一點時間在 STORM-PE 上宣布招生完成。在我看來，這對你來說就是下一波成長浪潮。隨著註冊的完成，您能否向我們介紹一下從現在到獲得批准再到商業化的時間框架，以及在此過程中我們應該注意哪些具體事項？太感謝了。

Yes, no, thank you. It's a great question. Well, first of all, our product is already cleared for use in PE, so there's no approval or clearance necessary here, which is great. It really is just data that is going to be looked at by the larger community, not just interventionalists, but everyone involved in the treatment of PE cases of patients to determine what the best treatment for these patients are.

是的，不，謝謝。這是一個很好的問題。嗯，首先，我們的產品已經獲準用於 PE，因此這裡不需要任何批准或許可，這很好。這實際上只是需要更大範圍的社區來查看的數據，不僅僅是介入專家，而且所有參與治療 PE 病例的人，都要查看這些數據，以確定這些患者的最佳治療方法。

And again, this is the first trial in the world that has finished that compares anticoagulation to anticoagulation and a mechanical device, in this case, our specific mechanical device. So I think that's what is driving the excitement because that's the standard of care versus something new. And I think if the trial is positive, it will obviously have some significant impact on the thinking around the physicians who are charged with caring for these patients and their referral patterns and what they want to do with these patients.

再次強調，這是世界上第一個完成的比較抗凝血與抗凝血和機械裝置（在本例中是我們特定的機械裝置）的試驗。所以我認為這就是人們興奮的原因，因為這是護理標準而不是新事物。我認為，如果試驗結果是正面的，它顯然會對負責照顧這些患者的醫生的想法、他們的轉診模式以及他們想對這些患者做什麼產生重大影響。

And again, to remind everyone, we're 10-plus percent penetrated this market just in the US. So there's a lot more patients that can benefit. And again, if the trial is positive and shows that, I think it will have some significant impact, again, on a market that is all in bigger than our stroke market. So it's a huge impact and a huge win for potentially lots of patients, again, assuming the trial is positive.

再次提醒大家，光是在美國，我們的市佔率就已超過 10%。因此，更多的患者可以從中受益。再說一次，如果試驗結果是積極的並且表明了這一點，我認為它將對比我們的中風市場更大的市場產生重大影響。因此，假設試驗結果是正面的，那麼對於許多患者來說，這將是一個巨大的影響和巨大的勝利。

Thank you.

謝謝。

Thank you.

謝謝。

Matthew O'Brien, Piper Sandler. Your line is open.

馬修·奧布萊恩、派珀·桑德勒。您的線路已開通。

Hi, this is Samantha on for Matt. Thank you so much for taking our question. I guess we'd like to continue that kind of thought with STORM-PE and we -- assuming the data is positive, and we definitely think it will be, how do you anticipate the market evolving? Is it appropriate to think of it like stroke, where you saw this almost immediate increase in thrombectomy usage after the readout?

大家好，我是 Samantha，為 Matt 服務。非常感謝您回答我們的問題。我想我們會繼續用 STORM-PE 來思考這個問題，假設數據是正面的，而且我們肯定認為它會是正面的，那麼您如何預測市場的發展？將其視為中風是否合適？在讀數之後，您看到血栓切除術的使用量幾乎立即增加？

Yes. We don't know, so let's wait till we get the data and present it this fall, which isn't that far away. That being said, the one thing that I want to point out that's different about stroke, and this is somewhat important, with stroke, you had and still have what I alluded to earlier, this fundamental structural problem in that the patients aren't always going to a hospital that does stroke intervention treatment.

是的。我們不知道，所以讓我們等到今年秋天獲得數據並展示它，這並不是那麼遙遠。話雖如此，我想指出的一點是中風的不同之處，這一點也很重要，對於中風，你曾經有過並且仍然存在我之前提到的這個根本的結構性問題，即患者並不總是去進行中風幹預治療的醫院。

So sometimes they have to be moved. Are they always moved? That is a structural impediment. You don't really have that in PE. There's got to be some hospital, one place here or there where maybe that's true. But the vast, vast majority of places where a patient will show up with a PE, they could be treated if that is becoming the standard of care. So it's a very, very different dynamic, and it's something that having spent the better part of 10 years sort of working on it, I'm incredibly excited to not have that impediment and be able to just do the right thing for all these patients. Again, assuming it's positive.

所以有時必須移動它們。他們總是感動嗎？這是一個結構性障礙。在 PE 中你確實沒有這個。肯定有某家醫院，某個地方，確實有這種情況。但是，如果這成為護理標準，那麼在絕大多數地方，當患者出現 PE 時，他們都可以得到治療。所以這是一個非常非常不同的動態，我花了近 10 年的時間致力於此，我非常高興沒有這種障礙，能夠為所有這些患者做正確的事情。再次假設它是正面的。

Right, yes. Thank you so much for that. It makes a lot of sense. And then just, we have one follow up on the neurovascular thrombectomy market, and specifically, I guess, kind of what the medium vessel occlusion, I guess, portion of the market is doing. I guess, could you talk a little bit about your exposure, maybe what percent of your stroke business happens in these medium vessel occlusions? And what revenue, if any, is impacted?

是的，是的。非常感謝。這很有道理。然後，我們對神經血管血栓切除術市場進行了跟踪，具體來說，我想，這有點像中型血管閉塞市場的一部分正在做的事情。我想，您能否談談您的經歷，也許您的中風業務中有多少百分比發生在這些中等血管閉塞中？如果有的話，哪些收入會受到影響？

Yes, that's a really, really good question. It's hard to pinpoint that exactly, because if you take the medium, as you call it, our catheters that would typically be used there, our a Red 62 and sometimes a Red 43. Both catheters are also used in other places, so it's hard for us to know and pinpoint that with the kind of numerical precision that I would like and you probably want.

是的，這是一個非常非常好的問題。很難準確地指出這一點，因為如果你採用你所說的介質，我們通常在那裡使用的導管，我們的導管是 Red 62，有時是 Red 43。這兩種導管也用於其他地方，因此我們很難以我希望的和您可能想要的那種數值精度來了解和確定這一點。

What I can tell you is it really is very much a site-specific thing. And it isn't just the interventionalist making those decisions. In fact, most of the time, it's a non-interventionalist making those referral patterns. It has happened. We have heard of centers that have become more conservative. I don't think it's the overwhelming view. And obviously, we did really quite well this quarter and continue to take share. The overall market didn't grow as much. And could that have had some small impact on that number? Potentially, but we don't know that definitively.

我可以告訴你的是，這確實是一個與地點密切相關的事情。做出這些決定的不僅是乾預主義者。事實上，大多數時候，都是非干預主義者制定這些轉診模式。它已經發生了。我們聽說有些中心變得更保守了。我不認為這是壓倒性的觀點。顯然，本季我們的表現確實相當不錯，並且繼續佔據市場份額。整體市場並沒有成長那麼多。這會對這個數字產生一些小的影響嗎？有可能，但是我們還不能確定。

Okay, that's helpful. Thank you. I appreciate it.

好的，這很有幫助。謝謝。我很感激。

Yes, thank you.

是的，謝謝。

Chris Pasquale, Nephron.

克里斯‧帕斯誇萊 (Chris Pasquale)，Nephron。

Thanks. I wanted to circle back to international embolization, just given how much that segment drove the upside this quarter and really deviated from the recent trend, both sequentially and year over year. First, Adam, if you wouldn't mind, could you quantify the China contributions just so we can tell the extent to which that order might have driven the beat?

謝謝。我想回到國際栓塞治療的話題，因為考慮到該領域在本季度推動了多大的上漲，並且確實偏離了近期趨勢，無論是環比還是同比。首先，亞當，如果您不介意的話，您能否量化中國的貢獻，以便我們能夠判斷該命令在多大程度上推動了這一節拍？

And then second, I think your original guidance for the year called for international embo to be about flat, for the US to be up to maybe mid to high single digits. Both pieces are running ahead of that midway through. So how are you thinking about the four-year growth for that business?

其次，我認為您最初對今年的指導意見是國際經濟成長率基本持平，而美國經濟成長率可能達到中高個位數。兩件作品都在中途超越了這一點。那麼您如何看待該業務未來四年的成長？

Yes, let me -- well, let me -- first of all, I'm trying to, they don't order any of our coils, so it has nothing to do with our embo number at all. As it relates to the larger the larger thing, I mean, they have some access products. They have some stroke products and thrombectomy products, rather. As it relates to the larger international business, I think you know that we have been in a rebuilding mode for a year and a half. I think we've been pretty open about that process as we want to sort of get the right products there. We want to be at a margin that is affordable in markets that do that.

是的，讓我——好吧，讓我——首先，我想，他們沒有訂購我們的任何線圈，所以這與我們的 embo 號碼完全無關。至於越大越好，我的意思是，他們有一些訪問產品。他們有一些中風產品和血栓切除產品。就更大的國際業務而言，我想您知道我們已經處於重建模式一年半了。我認為我們對這個過程持相當開放的態度，因為我們希望在那裡獲得正確的產品。我們希望在這樣的市場中，能夠維持可承受的利潤率。

And I think what we're seeing is the benefit of a lot of that work. And I'm pretty excited to see that work. It's easy to focus on our US business where there's so much good happening there, but it's also really important that we don't forget about the rest of the business, and I'm excited that we can do all of it at once. And I think -- again, none of this is linear, but I think we're in pretty good shape for a while as we move into not just this year, but in the future years, both in our US but also internationally.

我認為，我們看到的是這些工作所帶來的好處。我很高興看到這項工作。我們很容易專注於美國業務，因為那裡發生了很多好事，但同樣重要的是，我們不要忘記其他業務，我很高興我們可以同時完成所有業務。我認為——再說一次，這一切都不是線性的，但我認為我們不僅在今年，而且在未來幾年，無論是在美國還是在國際上，都會處於相當好的狀態。

Okay, thank you.

好的，謝謝。

Thank you.

謝謝。

Ladies and gentlemen, that concludes our question-and-answer session. At this time, I would like to turn the call back over to Ms. Furlong for closing remarks.

女士們、先生們，我們的問答環節到此結束。現在，我想將電話轉回給 Furlong 女士，請她做最後發言。

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 third-quarter call.

謝謝您，接線生。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。我們期待在第三季電話會議上向您通報最新情況。

This concludes today's call, and we thank you for your participation. You may now disconnect.

今天的電話會議到此結束，感謝您的參與。您現在可以斷開連線。