Penumbra, Inc.

to ask a question during this time, simply press star, followed by the number one on your telephone keypad. If you would like to withdraw your question, press the pound key. Thank you. I would like to introduce Ms. Cecilia Furlong, Business Development and Investor Relations for Penumbra. Ms. Furlong, you may now begin your conference.

Thank you, operator, and thank you all for joining us on today's call to discuss Penumbra's earnings release for the first quarter of 2024. A copy of the press release and financial tables, which includes a gap to non-gap 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 31st, 2023, filed with the SEC. As a result, we caution you against placing undue reliance on these forward-looking statements, and we encourage you to review our periodic filings with SEC including the 10K 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 stocks. The number disclaims any duty to update or revise our forward-looking statements as a result of new information, future events, developments, or otherwise. On this call, 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. Non-GAAP operating expenses and operating income exclude amortization of acquired intangible assets of $2.4 million in the first quarter of 2024 and 2023 and $4.8 million of non-recurring litigation-related expenses, including settlement costs and legal fees associated with wage and hour complaints filed against the company in 2023 in the first quarter of 2024. An adjusted EBITDA excludes such non-recurring litigation-related expenses and stock compensation expense. Adam Elsesser, Penumbra's Chairman and CEO, will provide a business update. Maggie Yuen, our Chief Financial Officer, will then discuss our financial results for the first quarter of 2024. and Jason Mills, our Executive Vice President of Strategy, will discuss our 2024 guidance. With that, I would like to turn the call over to Adam Elsesser.

Thank you, Cecilia. Good afternoon. Thank you for joining Penumbra's first quarter 2024 conference call. Our total revenues for the first quarter were $278.7 million, a year-over-year increase of 15.4% as reported, and 15.2% on a constant currency basis. Our U.S. thrombectomy revenue grew 35.2% compared to the same quarter a year ago, to $150.3 million, driven by continued strong market growth and share gain with Lightning Flash and Lightning Bolt 7. International thrombectomy also exceeded our expectations in the first quarter, growing 10.7% year over year, against a challenging comparison last year. Overall, we had a strong start to the year and see positive trends in our core markets and our business with our computer-assisted vacuum thrombectomy products in VTE and arterial and market-leading portfolio in stroke. This reinforces our confidence we can deliver strong growth of 27% to 30% in U.S. thrombectomy and 16% to 20% overall in 2024. In addition to our commitment to strong revenue growth, we're also focused on margin expansion and increasing profitability. We are ahead of schedule to deliver 100 to 150 basis points of gross margin expansion in 2024 and are confident we can increase our gross margins to more than 70% within the next 24 to 30 months. We're also on track to deliver at least 100 to 200 basis points of operating margin expansion this year, inclusive of investments we are making in our U.S. commercial team and market access initiatives, both of which should help us sustain strong growth into the future. Operating income in the first quarter was $19.3 million, representing 6.9% of revenue, increasing 260 basis points over the same period a year ago. Looking forward, we expect our operating margin expansion to outpace gross margin expansion for the foreseeable future. Notwithstanding the strong growth we have seen in U.S. thrombectomy over the past few years, clinically significant clot burden is still one of the most undertreated acute issues in healthcare today. We are well positioned to expand access to CAVT and make the treatment of these patients safer, simpler, and faster, which we strongly believe and are committed to continually prove accrues to the benefit of patients, physicians, and hospital systems. Over the past several quarters, we have delineated our strategy to deliver outsized revenue growth in thrombectomy over the near, medium, and long term through a combination of continued innovation with our CAVT platform, optimizing our commercial team in both the US and international markets, and developing robust clinical and health economics evidence on our CAVT products. With this collective work, we are confident we will continue to catalyze adoption of CAVT and drive utilization to the majority of the hunt 1.25 million applicable clot patients in the United States each year across the five vascular beds we addressed today. We fully launched Lightning Flash 2.0 in late April on the heels of outstanding outcomes from the evaluation cases done in early April. Flash 2.0 is proving in practice what we saw on the bench. The product further optimizes the advantages of CAVT in VTE. We are seeing pent-up demand for FLASH 2.0, and coupled with the larger commercial team we've developed over the past two quarters, our U.S. thrombectomy business is in a strong position to continue to catalyze growth for us in these markets through this year and beyond. We're also seeing meaningful progress within our innovation pipeline and are on track to launch three additional CAVT products within the next 12 months, at least one of which we expect before the end of 2024. Overall, we are committed to continued innovation to augment the utility and reach of CAVT head to toe. In addition to VTE and arterial, stroke will be the next vascular bed we address with CAVT. Enrollment in our thunder study is going very well, and we are very encouraged by outcomes and physician engagement. We now hold nearly 60% market share in the US stroke market and expect to gain more share through 2024 ahead of a thunderbolt launch, which will further extend our leadership position. We're also seeing more energy and engagement from large healthcare systems seeking to work with us as the industry leader on ways to further extend interventional stroke care to many more patients within their networks. Our proprietary technology portfolio in stroke, our reputation in the field, and our scale gives us the unique ability to do this work with healthcare systems going forward. I'll now turn the call over to Maggie to go over our financial results for the first quarter of 2024. Thank you, Adam.