AngioDynamics, Inc. (ANGO) Earnings Call Transcript & Summary

This presentation contains certain forward-looking statements. Additional information concerning factors that could cause actual results to differ materially from those in any forward-looking statement is contained in the slides accompanying this presentation, which will be available on the Investor Relations section of the AngioDynamics website.

Greetings, and thank you for joining us today for AngioDynamics Cardiovascular Investor Presentation. I'm Jim Clemmer, and I'll be joined by a few of my colleagues where we hope you'll get a better understanding of our cardiovascular business, how we got here, where we are today, and where we're going in the future, as we believe we have a great opportunity to drive value for investors in this really important space. Cardiovascular disease today is the leading cause of mortality around the globe. We think our company can help reduce that mortality. And we also think our investors will get a feel for the innovation that we bring through our products and how we affect the lives of patients around the globe. Our company intentionally changed over the past 5 years. We transformed our portfolio. We steered our ship to these waters where technology matters, where we can change the lives of patients and help the physicians who care for them have access to really new, innovative tools and solutions. Our transformation was driven by our portfolio changes. Today, you're going to see why we're so proud of our portfolio, our Auryon products to treat PAD, our AngioVac and AlphaVac products for thrombectomy. These will change how care is delivered. We're really proud of the innovation that we're bringing to doctors every day. We love to hear their feedback of how our ideas actually work and how we can be safe, efficient and effective in patient care, like none other. The bar is high in this category. We knew we had to do a better job in our design and development process to bring our innovative ideas to market. Capability here at AngioDynamics is really high. It matches our technology and matches our innovative spirit. We're really proud of the work we've done, opening up really large markets. So stay tuned, listen to our details. I can't wait to share with you our journey.

Hello. I'm Steve Trowbridge, AngioDynamics' Executive Vice President and Chief Financial Officer. Thank you for joining us today for AngioDynamics' Cardiovascular Virtual Investor event. Over the past 5 years, AngioDynamics has embarked on a strategic journey to transform our company. Our vision focuses on pursuing large, fast-growing Med Tech markets by driving portfolio optimization. Today, our business is composed of 2 segments: Med Tech; and Med Device. Our Med Tech segment comprises our high-growth, high-margin platform technologies. Our Med Device segment comprises our more mature businesses, which provide the earnings and cash generation foundation to facilitate the investments necessary to continue fueling the growth of our Med Tech segment. The execution on our strategy is evidenced by the growth we've achieved in our Med Tech segment. Five years ago our Med Tech business was about $40 million, and we projected that it will grow to over $120 million for our fiscal year-ending May 31, 2025, 5-year CAGR of over 25%. Today, we compete in total addressable markets of more than $10 billion, representing growth of over 230% related to the total markets we competed in at the beginning of our journey. And the most significant driver of this market opportunity expansion has been our strategic decision to develop a comprehensive cardiovascular business. Cardiovascular disease is the leading cause of mortality globally. AngioDynamics' cardiovascular business focuses on combating cardiovascular disease, leveraging leading technology platforms to keep blood moving to and from the heart on the arterial and the venous side. On the arterial side is our Auryon peripheral atherectomy platform. And on the venous side is our mechanical thrombectomy technology highlighted by AngioVac and AlphaVac.

AngioDynamics play a leadership role in the cardiovascular marketplace. Our portfolio stand out as a truly unique and comprehensive offering, addressing both venous and arterial disease with the best-in-class technology. Our solution set a new standard in cardiovascular care, and are designed to deliver superior clinical performance, ease of use and improve patient outcome. Together Auryon, AlphaVac and AngioVac form a powerful suite of innovative technologies, providing physician with a full spectrum of cutting-edge solutions to effectively treat both venous and arterial condition. This integrated approach not only announce procedural efficiency, but also enforce our commitment to advance patient care in driving long-term value for our customer and the patient they serve.

AngioDynamics acquired the Auryon technology in 2019. At that time, Auryon had not yet generated any revenue. And we made the deliberate decision to invest in this business, building a dedicated sales force and generating compelling clinical data. Since its launch in September of 2020, Auryon has treated over 100,000 patients and generated cumulative sales of over $180 million. What sets Auryon apart from other products in the atherectomy space is its unique revolutionary technology.

So Auryon is built on cutting edge solid-state technology, and one of its standout features is its unique 355 nanometer wavelength and super short pulse width, it's just 10 to 25 nanoseconds. So these technical details might not mean much at first glance, but they're actually the secret sauce that makes this system so effective. The 355 nanometer wavelength is a big deal because it creates a very specific type of photon energy that stays just below the point where it could actually cause damage to the surrounding vessel tissue. Plus, this wavelength is highly absorbed in blood, which is really important because that's what helps generate powerful shock waves and cavitation bubbles, kind of like an ablation booster that's great at tackling really tough blockages. And here's the cool part. So your vessel walls are naturally elastic, which allows them to absorb these forces without getting damage, and that's what makes the Auryon system so effective. It clears out blockages while preserving the healthy tissue around them. I kind of like to think of it like this. Imagine a sculptor working with stone, right? They're carefully chipping away at the extra material while keeping the natural shape of the stone intact. So the Auryon system works exactly the same way, precisely clearing artery blockages without causing unnecessary harm to the vessel wall. It's all about striking that perfect balance between being effective and staying safe. And that's where the science really, really shines. [Video Presentation] The Auryon system harnesses the power of laser to create an effective treatment that defines a new standard and safety outcomes for peripheral arterial disease. With 5 different hydrophilic-coated catheter sizes to choose from, the Auryon system was designed to treat the full spectrum of PAD. Let's dive in further to take a closer look at the key features that make our science different. The Auryon system delivers both photochemical and photomechanical treatment, as demonstrated via the acoustic shockwaves shown here. Two of our key differentiators are an optimized wavelength and short pulse width, allowing you to deliver safer energy in a more powerful way. The Auryon system's wavelength of 355 nanometers has a photon energy of 3.5 electron volts. This photon energy is important to understand since the biological threshold for destruction of the vessel wall is 3.6. The Auryon system's selective photon energy of 3.5 allows the system to effectively treat plaque while preserving the vessel wall. In other words, the laser can cause photochemical ablation and lesions while avoiding disruption of bonds in the vessel endothelium. And this has resulted in zero flow limiting dissections and minimal perforations as seen in our various prospective and retrospective studies. The other key property of our laser science is the short pulse width, 10 to 25 nanoseconds. This condensed pulse width results in increased peak power per pulse, allowing treatment to calcify lesions and creating the acoustic shockwave effect. Compared to other laser technologies currently on the market, the Auryon system's shorter and more concentrated pulse width gives more focused energy delivery to treat both soft and hard plaque. With clinically proven performance to bulking power and discerning precision, the Auryon system's advanced technology is designed to meet the ever-growing challenges of your atherectomy needs. Auryon, this changes everything.

Since its introduction, physicians have been choosing the Auryon technology over other competitive technologies due to its superior outcomes, reliable safety profile and versatility. The bedrock foundation of any medical technology is that it must be safe and effective.

So what differentiates Auryon from other devices in the market is its safety and efficacy. I think very rarely do you have a device that provides improved efficacy over the competitors, while at the same time maintaining a great safety profile. And I think Auryon has really hit a home run with that technology.

Probably one of the few things that has such an immediate impact. And when a patient tells you 30 minutes after you complete the procedure that my foot feels incredible. And they'll say it feels warm, I can wiggle my toes, these things you never think about. It's a wonderful device.

My practice has a significant portion of CLTI patients. And these are patients who have multiple levels of disease, limited runoff. And, often times you're dealing with patients who have fairly complex aortoiliac from [ Rupapatia ] disease and single vessel runoff. And so you want to choose an atherectomy device that will allow you to get maximum luminal gain, get a great result, but without causing embolization to that single vessel runoff, or without affecting your single vessel runoff. And case after case I can tell you that when used appropriately, Auryon has provided excellent outcomes with zero risk for embolization and specifically in the most difficult cases.

Auryon isn't just a market leading device in terms of safety and efficacy. It's also the most versatile atherectomy device on the market today. Prior Auryon hitting the market, laser-based technologies were primarily relegated to above the knee treatments. Rotational and mechanical technologies were more often selected for interventions below the knee.

In my mind what really sets Auryon apart isn't just its performance, it's also designed to be incredibly versatile. The laser itself, it's small, portable and easy to use in a variety of clinical settings. Plus the advanced technology is built to tackle all kinds of lesions from In-Stent Restenosis and Chronic Total Occlusion to Fibrotic lesions, Thrombus and soft plaque, both above and below the knee. And some of our catheters even come with an aspiration capability, adding another layer of safety to the mix. So the bottom line, Auryon really has it all, precision, safety and efficiency. [Video Presentation] Our range of catheter sizes provides the flexibility to treat large and small vessels both above and below the knee, including below the ankle. Additionally, this versatile laser offers femoral or pedal access with standard length catheter as well as radial access with the Auryon XL 225 centimeter catheters. This coupled with our easy-to-use console allows for seamless delivery of the Auryon system's unique mechanism of action.

The wavelength for the Auryon has really been critical to providing utility in my practice as far as atherectomy goes, particularly below the knee. So for tibial atherectomy intervention, it works excellent. We are treating long Chronic Total Occlusions most of the time and once we get it across and we're using the laser, the Auryon laser, its really effective. That with balloon angioplasty we've seen really good result. So I would say that its an extremely safe profile and very versatile as well across all vessel segments.

Auryon's really been a leader in the sense that it's offering products that can be used in a variety of access points, whether you're going radially, whether you're going femorally, whether you're going tibially. They've really been quick to address these different access points and making sure the appropriate catheters for those different lesions.

Since inception, Auryon has built an impressive clinical data profile. And AngioDynamics is continuing to invest in data generation to support and further facilitate this platform technology.

So we're really proud of the solid clinical evidence that we've built over the past few years. And honestly, it's impressive how much we've accomplished in such a short time. This research has just played a huge role in improving Auryon's safety and effectiveness and getting us to where we are today. And I would say out of all the publications we've put out since launching the device 5 years ago, 2 really stand out: the PATHFINDER 12-month Registry; and the MicroCT publication. So while Auryon had just fantastic results in our IDE study, which helped us gain market approval, which is important, the PATHFINDER 12-month Registry actually went a step further, and confirmed that those great outcomes held strong in real-world patients over the long-term. And what's more, we saw consistent results across all types of lesions and morphologies, just reinforcing how versatile this device really is. The MicroCT publication was another game changer, too. It showed that Auryon can crack medial arterial calcification in below-the-knee arteries. So we've got solid proof of the laser secondary mechanism of action. And that may help explain why we see lower dissection rates when using Auryon and why lower pressure balloon angioplasty is more effective. So together, the results from these 2 studies along with some other 12-month data from a multicenter below-the-knee study help pave the way for our newly announced AMBITION BTK RCT and Registry. This is a really exciting study because it's designed to compare the Auryon system combined with balloon angioplasty against standard balloon angioplasty alone in patients with CLI, or critical limb ischemia, which is a serious condito0n that affects millions and often leads to amputation. So this study is a big step toward improving outcomes for those patients. And we're just incredibly excited to get it underway and see the impact it could have.

Auryon has established itself as a market-leading technology with compelling data. And we have mentioned that the drivers in our Med Tech businesses are platform technologies, and Auryon is a perfect example of this. We're investing in product development initiatives to continually enhance our offerings, such as the recently launched radial access designs and 1.7 millimeter catheter. We're also investing in potential new applications to expand Auryon's addressable market in the future. We believe Auryon's unique mechanism of action can lead to great outcomes in coronary interventions. And while not currently indicated for use in coronary applications, we are investing in the R&D and clinical work necessary to potentially unlock this market. We believe the Auryon platform technology with its current market leadership and future opportunities will continue to be a growth driver for AngioDynamics in the short, medium and long-term.

We know that long-term success isn't just about having great technology, it's about constantly improving and evolving. And that's why we put such a big focus on listening to our customers, ongoing improvements and smart product expansions, doesn't just make Auryon a top-notch solution today. It's also setting the stage I would say for even more exciting advancements and future indications down the road.

You heard about our Auryon platform technology and why we're so proud of the business we have built and the opportunities in front of us. With Auryon, we have demonstrated our ability to successfully launch a new technology and disrupt the market. But we're now applying that skill to the other part of our cardiovascular business, on the venous side, mechanical thrombectomy. Mechanical thrombectomy is aimed at addressing venous thromboembolism, or VTE, one of the most dynamic promising markets in Med Tech today. VTE comprises deep vein thrombosis, pulmonary embolisms and right heart focused diseases. Combined, this total addressable market is approaching $6 billion. Now this market fits perfectly within our strategy of addressing high-growth, high-margin markets where platform technologies can generate improved outcomes. Currently, this market is driven by a few large competitors and many large competitors have invested in trying to enter this market. AngioDynamics has built what we believe to be the best, most comprehensive product portfolio offered today for mechanical thrombectomy. And we've established ourselves as a strong competitor with compelling future prospects. In fact, we were one of the innovators in mechanical thrombectomy space. Our first product offering was AngioVac.

AngioVac is extremely unique. It really is the only true large-bore aspiration technology that offers simultaneous aspiration, filtration and reinfusion in the market today. The proprietary funnel tip, catheter options, including multiple sizes, multiple tip angles, coiled or braided catheter construction, are all supported by our veno-venous bypass circuit offering as a best-in-class technology. Over 95% of our cases today are in the cardiac space, and it offers a stability from a clinical, hemodynamic standpoint that no other technology in the space offers today.

Well again, I think AngioVac with its various iterations and with the continued innovation with the different sizes and shapes that are provided now in the cannula, is a really useful tool in the armamentarium of a cardiac surgeon or an intensive care specialist with IR or with cardiology, that really gives us another way to treat these patients and their complex intracardiac problems.

AngioVac is a fantastic technology with a number of truly unique aspects, including the simultaneous reinfusion circuit and proprietary expanding funnel tip. The reinfusion circuit allows for continuous aspiration while eliminating blood loss and the expanding funnel tip facilitates the removal of a tremendous amount of clot burden, providing clinicians with a treatment option for exceedingly complex cases. Physicians love the tip and cannula design of AngioVac, and we're requesting an option that maintain those elements, but could also be used off-circuit for certain applications. And we listened to our customers and created AlphaVac. We believe that AlphaVac is an optimal device to treat pulmonary embolism, a roughly $3 billion addressable market. [Video Presentation] The AlphaVac F18 system. This system is now paired with a mechanical aspiration handle that acts as the engine and eliminates the need for perfusionist support, allowing for quick, emergent therapy. The AlphaVac system is intended to be an easy-to-use, percutaneous option for use in the venous system that offers additional benefits not seen in the market today. The AlphaVac system incorporates AngioDynamics' proprietary funnel-shaped distal tip technology, but now is a smaller and longer cannula option that encompasses a triple durometer braided shaft. Combining this new technology with the ergonomically designed AlphaVac handle creates a one-flow-through procedure without interruption and no need to reset the vacuum. The molded handle is designed for secure comfort and superior control when squeezing the handle. The aspiration handle also offers a volume-limiting switch to minimize blood loss while navigating to and hunting for thrombus. The vacuum-locking mechanism maintains negative pressure while freeing up a user's hand or while aspirating material through the cannula. Once the cannula is navigated to the desired anatomical location, pull the handle as needed, creating a controlled movement to engage with the material. Once engaged, you can continue to either manually pump and aspirate using the handle or use the 30cc setting and engage the vacuum-lock mechanism to maintain negative pressure. The material is then suctioned into the cannula through the syringe-like barrel and into the transparent waste bag, which measures how much blood has been removed.

What AlphaVac has been able to do is genuinely establish itself as a different class of thrombectomy device. We consider the other devices on the market today as proximity devices. They're going to pull whatever potentially is in the area of the tip of that catheter. With AlphaVac, because of its construction, because of its purpose-built design, it has the ability to be a selective thrombectomy device that truly offers you the ability to deliver the device where you need to go distally.

The unique elements of AlphaVac, off-circuit, aspiration handle and blood limiting switch and expanding funnel tip make it an optimal device for PE. But beyond these elements, the AlphaVac system also boasts unique steerability. AlphaVac is the only device currently on the market that can navigate from the left pulmonary artery to the right pulmonary artery without having to reinsert a guidewire. Now, most physicians don't believe us when we say this. I've actually been in the room when a physician uses AlphaVac for the first time and flips the funnel tip from one pulmonary artery to the other without reinserting a guidewire, and it is truly an aha moment. Clinical data plays a critical role in establishing a product offering in the PE space. AngioDynamics developed and executed on the APEX-AV trial to support the use of AlphaVac to treat pulmonary embolisms. APEX-AV led to the FDA clearance of AlphaVac for PE by demonstrating that the device was a safe and effective treatment for acute intermediate risk PE with a significant reduction in the RV/LV ratio with a low rate of adverse events. In addition, what we believe is particularly compelling, the APEX-AV trial demonstrated that AlphaVac achieved an approximately 35% reduction in clot burden, comparing favorably to the other mechanical aspiration devices on the market.

The mechanical thrombectomy market is extremely dynamic. We have established ourselves as one of the 3 market leaders with a true PE indication. We have shown excellent results with the publication of our APEX-AV data in JSCAI earlier this year, and it will be extremely important for us to continue to invest in this disease state as we advance the AlphaVac platform.

The uniqueness and power of AngioVac, combined with the customer-focused design and PE indication and data foundation of AlphaVac, give AngioDynamics a comprehensive and synergistic mechanical thrombectomy portfolio that is unmatched in the industry. AngioVac and AlphaVac are collectively driving adoption and growth for each other, improving patient outcomes.

So, I started with the APEX trial, and that was my first intro to AngioDynamics as a company. Working with the investigators there, we were able to obviously publish the APEX-AV study, which was great. But that was my first introduction to the product line, specifically working with the AlphaVac F18 system. And then working with that and understanding the fluidity of the device, we started in my lab with my colleagues, started doing more procedures, right-sided chambers of the heart, et cetera, working with other components of the system, including AngioVac. So I started working mostly with AlphaVac and then converted to using some AngioVac. And then through there, I was fortunate to get in and do some education with my colleagues, right? So with other cardiologists, interventional cardiologists coming to learn about the AlphaVac system.

I think what stands out to me is just the role that AlphaVac is now playing in PE space and VTE space. But also, quite frankly, AngioVac, which I was involved in from the outset, it's really exciting for me to see it now really hit its stride and make an impact on patients' lives in a positive way.

Yes, we are very excited as we are enforcing our leadership in cardiovascular space through our clear mission, vision and promise, which is based on partnering with our customer, listening and fulfilling their needs and exploring cutting-edge endovascular therapy for cardiac, venous and arterial system. We are focused on continuous improvement through clinical evidence generation and education. We are very well aware that maintaining a strong position and a competitive edge require more than just cutting-edge technology. It demands a deep understanding of customer needs, continuous innovation and strategic expansion. At the core of our approach is a commitment to listening to our customer. By engaging directly with physician, hospital and health care provider, we gain insight that drive our advancement in our technology and in our solution. Their feedback drive and define our innovation pipeline, ensuring that we are not only meeting current demands, but we're also anticipating future needs. A key pillar of our strategy is the expansion of our platform to additional disease state and applications. By broadening the scope of our technology, we are increasing our impact across the cardiovascular space, enhancing patient outcome and unlocking new growth opportunities. We are strongly improving our market position and pipeline advancement through our unique and best-in-class global customer-facing platform, the AngioDynamics Life Symposium and Cardiovascular Scientific Forum platform, where we are fostering collaboration, driving innovation and shaping the future of cardiovascular medicine. We are doing that by bringing together key opinion leaders, researchers and industry experts. We have created an ecosystem where the latest advancement in treatment and technology are not only showcased, but also critically discussed and defined. Our phenomenal global team, backed by a strong community of thought leaders that share a deep belief in our vision, mission, and prowess. This collective commitment fuels our innovation, strengthens our market position, and ensures we continue delivering life-changing solutions for patients worldwide.

We are now a serious competitor in this cardiovascular space, a space that we believe could grow value with our customers, the patients they treat, our employees here at AngioDynamics, and to each of you as potential shareholders of our company. Our company today is strong. We are in the right places at the right time. The combination of our cardiovascular business with our oncology business today, gives us a really good footprint for our Medical Technology segment. I appreciate you tuning in today to learn about our business. We're really proud of the work we've done, and we believe we have a great opportunity ahead of us. Thank you for joining.

[Operator Instructions] Our first question comes from the line of John Young with Canaccord Genuity.

Thanks for that great overview of the cardiovascular business. I'll ask one on AlphaVac and then maybe one on Auryon. Just AlphaVac to start, there's been M&A in the space recently. And you have a device that has benefits that you highlighted today versus those other on the market today. So can you just talk to us about what you're seeing for competitive switching to AlphaVac? Any color on the number of accounts that you have in the VAC process today that you highlighted this morning earlier? And then just plans for iteration on the device? And then I have a follow-up.

It's Jim. Sure. We're in a really great space here. You have 2 good market leaders that we know about, and we're obviously a strong third here with our spot here. So we've done a really great job with the design and development aspects. If you look at the AlphaVac product today, it was well designed. Our R&D team, our clinical teams did a great job listening to the customer, and exploiting an opportunity we felt was in the market for how to make our product perform. Now that being said, we've also known that other larger companies have tried to enter the space and have not been successful with their products they've tried to enter with. And there are other smaller companies kind of chasing behind. So this spot is really attractive. It's a large opportunity. A lot of market development will expand the market for all of us over time. We think we'll expand it by the way that our products work. So over time, John, we're focused on getting our product kind of approved in the hospitals and the value analysis committee process. That's happening as we speak. We track it every month. We don't share those numbers for competitive reasons, and I don't think we're going to, but it works really, really well. Our team is good, and they're on it. And then we're also expanding our usage within each account once we get on the shelf and get used, get more and more doctors comfortable with our product and choosing it over the other options. So John, we're measuring both, getting new accounts online and getting expansion within those accounts. And they're both going to give us what we think is sequential growth for years to come in this space.

Okay. Great. And then just on Auryon too, any details on what the hospital outpatient mix this quarter was? I know in the past it was around like 35%. Is that growing? And then how should we think about ASPs as that continues to grow?

Yes. This is Steve. Thanks for the question. So on your question around the hospital OBL mix, we continue to see that moving in the direction that we wanted to move into based on some of the strategic initiatives that we've made. As we've talked historically, when we first launched this product, it was right in the middle of COVID. So our customer base was much heavier when we weighed it towards the OBL than it was the hospital for all the reasons you can expect. OBLs were keeping their doors open, hospitals were trying to maintain capacity to treat those COVID patients. But we said over the last handful of quarters that we wanted to start to shift that mix and get into the hospital for a number of reasons in terms of the patient population that they have, but then also the ASP that you talked about. So as you had mentioned, in Q2, we were about 35% in terms of the hospital. That grew to just about 40% in Q3. So we're definitely making that mix shift. And if you compare that to where we were last year at the end of Q3, it was about 70-30 OBL. And so we're about 60-40 now in terms of OBL versus hospital. It's a good shift for us. That does provide us some benefit in terms of pricing, tailwinds, as you go into the hospital because the ASP in that hospital site of care is higher than it is in the OBL. We're going to continue to grow both for Auryon. We're going to continue to grow within the OBL segment, but we're also going to continue to focus on this mix shift and growing hospital as well. It gives us a nice balance between driving that procedural volume, but then also getting that nice ASP tailwind.

Our next question comes from the line of Steven Lichtman with Oppenheimer.

I guess first on AMBITION, I know from clinicaltrials.gov that the final readout won't be for a few years. But since it's a Phase IV, I'm wondering if there are interim looks that you anticipate could be released to start increasing the knowledge of Auryon's potential in BTK even before the final data?

Yes. So we do have an interim look that we have planned. Not 100% sure whether that will get published, but we'll certainly give you more detail as we move forward. This is a comprehensive study. We're very excited about getting into it, and there is a very strong rigory that we're going through with the data. So we'll keep you posted on that. We do have an interim look planned, and then we'll keep you posted on whether or not you'll see an interim readout from that.

Okay. Got it. And then on AlphaVac, during the prepared remarks here, Steve, you mentioned a surprise from some surgeons when learning about certain functionalities that it brings. Beyond the sales force and education efforts, are there more papers and/or podium presentations at conferences that we could see to sort of further get the word out on AlphaVac in what's obviously a competitive market?

Yes. We think that's a pretty important aspect of this is to continue to, as you said, get the word out. As you know, this is a market that today is defined by 2 pretty large competitors, but we feel very proud of the fact that we've been able to establish AngioDynamics as a solid third player in this market. We feel we've got the best product. And a lot of what you heard today is why we think that. All the elements of AlphaVac related to the expanding funnel tip and particularly that handle and that steerability give us an advantage over the other products that are on the market today. We've got a lot of commitments and a lot of relationships that we've built out with KOLs, both here in the United States as well as in international markets. And so I would expect that we're going to continue to have increasing podium presence and paper publications that talk about all of the features that AlphaVac has that some of our competitors don't, as we continue to try to take share within this market.

Our next question comes from the line of Marie Thibault with BTIG.

I wanted to ask one here first on Auryon. We've been seeing some increasing interest from players in the IVL market. And I just wanted to sort of understand how you view Auryon fitting in with other modalities for treating the peripheral arterial disease? Are there distinct advantages in terms of treating certain types of calcium? Is there a way to maybe segment the patient population where you feel atherectomy is a better choice? Any detail on that would be helpful.

Thanks for the question. One of the things that always attracted us to the Auryon technology from the first time that we were assessing it all the way through today is the versatility. And so Auryon and the mechanism of action that we detailed in that presentation, particularly the wavelength as well as the pulse parameters, prove out that Auryon can be used effectively above the knee, below the knee, in In-Stent Restenosis and in hard and soft calcifications. So it's tremendously versatile and that sets it apart from other atherectomy devices that are on the market. And so honestly, when you talk about patient segmentation, one of the things that sets Auryon apart from other technologies is that there isn't that defined segmentation that physicians have to make trade-offs about which technology they're going to use. Historically, laser technologies had been relegated to above the knee and some of those mechanical and rotational devices were the ones that were chosen more frequently below the knee. If you look at the case percentage breakout for Auryon since we've launched this, about 8%, 8% to 10% of our cases are for In-Stent Restenosis. And then after that, almost 50% of our cases are above and below the knee. So what we're seeing in the marketplace is really proving out the theory that we had around the versatility of Auryon. Now your question about IVL is a great one. One of the things that we think differentiates Auryon from IVL at the high level is that we do 2 things. We both will debulk the atheroma and we will prepare the vessel, if you were going to go into a balloon angioplasty. It's one of the reasons why we're really excited about this AMBITION BTK study and proving out the benefit that you get with balloon angioplasty after you prep the vessel with Auryon. But we also will debulk. And that's something that IVL doesn't do. IVL is really just a vessel prep. And so we think in the long-term, there's really compelling reasons to choose the Auryon technology specifically when you're doing it in both peripheral arterial and then as we said, in future applications, potentially into coronary as well.

Very well said. A quick follow-up here on AlphaVac. Any latest thoughts on where we might be with society guidelines? I know there's some hope of formalizing the shift to mechanical thrombectomy in society guidelines. Would love to hear your views on that.

Yes, Marie. So we certainly think that physicians should be using mechanical thrombectomy when they're treating their patients that have clots. We think that, that is a much better outcome for patients than it is just treating it with systemic ileitis. We've seen the market moving that way. And I think all the competitors that are in this space are going to do the work that's necessary to try to get that point to an ultimate guideline. I think it's a long process. But at the end of the day, I think all of us firmly believe that it makes much more sense to remove that clot and then to help restore flow to those areas that may have been occluded than it is to just rely on systemic ileitis. Does that complete your question?

Does that complete your question?

It does.

Our final question comes from the line of Yi Chen with H.C. Wainwright.

This is Eduardo on again for Yi. A quick question, I guess, on -- if you had any more details on how you guys view expanding into coronary applications, specifically for Auryon? You mentioned that. Is there a time line for that in place? Is that kind of further down the line, just kind of get some more color there?

Yes. So we haven't given you a specific time line on that, Eduardo. It is a little further down the line. That is a new study that would be required to get that indication. We're doing the R&D work now. We're doing the prep work. We'll give you more details as we continue to move forward. We're committed to take Auryon -- the Auryon platform technology into the coronary space. And so we wanted to highlight that and why we think it will work so well when we move into coronary. It is a bit of a process though, we have to go through a new clinical study. So as we continue to go down that path, we'll give you some more details as we get there.

That's very helpful. And then regarding Auryon, you mentioned about the suction component. And I was curious if, kind of, the traction or discussions you've been having with KOLs and physicians about how they're viewing that? Do you imagine that to be a complement or supplement or kind of ultimate displacement of existing technology given the added feature?

Yes. So we think it's a great feature when you think about some of the larger catheter sizes that we have in Auryon, the ability to go ahead and do atherectomy as well as have that aspiration capability. We think it provides an extra layer of safety for some of the patients that may be treated with those catheters. I wouldn't think of it as something that would replace the mechanical thrombectomy aspiration technologies. I think they are 2 different technologies. Think of Auryon as being primarily here in the PAD space and then our other AlphaVac, AngioVac as being on the BTE space. Ultimately, in the future, is there something that you could see those roads start to converge? Potentially. But specifically with respect to the aspiration capabilities of those Auryon catheters, we think it is something that does set us apart from other technologies in that PAD space today.

Thank you. Mr. Clemmer, I would now like to turn the floor back over to you for closing comments.

Thank you, and thanks for joining us today. I think if you look at AngioDynamics today, we're a very different company than we were 5 years ago. We decided to embark on this portfolio transformation, changing our mix of our products. Today, we have a great mix of our medical device portfolio, enables us to fund investments in a lot of these spaces we've talked about today. Med device portfolio is made up of great products with great historic customers that trust us. But our Med Tech portfolio is our growth segment. And today, you got to see why we're so proud of our cardiovascular business. Our research, development, manufacturing teams, our clinical research teams, our marketing, sales and clinical support teams in the field have done a great job getting our products into the field, into the hands of users who have given us great feedback around the world. We've used innovative ideas to create these products, and now they're helping patients around the world and treating these patients. So we'll continue our mission, continue to change our company. We think we'll drive value with the people that we serve, our patients and the customers, and we will drive value for investors over time. Thank you for joining us today. We'll talk to you soon.

Ladies and gentlemen, this does conclude today's teleconference. You may disconnect your lines at this time. Thank you for your participation, and have a wonderful day.