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

Well, good morning, everyone. Thank you for joining us. I'm Danielle Antalffy, the U.S. MedTech analyst here at UBS. And happy to kick off our Annual Healthcare Conference with the AngioDynamics team. Jim Clemmer, President and CEO; Steve Trowbridge, Chief Financial Officer. So guys, thanks for joining.

Good morning.

And maybe just a quick start, quick intro to AngioDynamics, and we can launch into Q&A.

Sure. So Danielle, just to ground investors, AngioDynamics has a unique fiscal year. So we begin each fiscal year on June 1. So we're about 3 weeks away from completing our second quarter FY 2026. AngioDynamics is in a transformation. So investors who are new to the story, it would be interesting to learn. We've done a lot of work over the past 5 years to transform our portfolio in our company. So a company that's less kind of a device widget department store to a really focused MedTech company competing in large addressable markets high gross margins in areas that we can win, and we are winning. So Danielle, we'd love to share that with you today.

Well, great. Maybe -- well, you promised me you would tell us how the quarter is going. No, I'm kidding. Okay. Well, so maybe let's talk a little bit about the transformation sort of what inning you guys are in at this point with the transformation and sort of what's still to come?

Yes. So we started about 5 or 6 years ago, we really made the decision to change our portfolio. In 2019, we sold our largest business at the time. But it was a low-margin commodity business, where we didn't want to compete with really large players. So that was important symbolically and realistically. We took 1/3 of the proceeds from that sale that we received and later that year bought an Israeli-based start-up with a really unique science to treat peripheral arterial disease. Today, that's our Auryon system for PAD. We've gone from 0 revenue in 2020 when we launched to this year, we'll do well over $60 million organically growing it through a really great product in a market where we change outcomes in patients, and we can win competing with really good products. So Danielle, that's symbolically part of our transformation. But as we sit here today, we've got 2 reportable segments, our older, slower growth products is what we call our medical device portfolio. And those are great products, but grow really kind of flat is what we've guided flat growth. And they provide us with EBITDA and cash to invest during this cycle than our MedTech business is what we'll spend more time with you on. That's really where we think investors are excited to learn about our company. We're in really good markets. And they're growing fast, and we're winning there.

Yes. I think the point to understand is we're probably in the sixth or seventh inning of the transformation. So we're not in the very early stages like we were a few years ago. And as Jim mentioned, the MedTech business that we have, has grown to a point where there's critical mass in that business now. A few years ago, when we started the transformation, less than 17% of our total revenue base was coming from the MedTech business. we're now about 45% and ready to go over that majority of our revenue coming from MedTech. That's driving gross margin. It's getting us to a point, where last fiscal year, we were able to become EBITDA positive adjusted EBITDA positive. We're going to be adjusted EBITDA positive going forward. And for this fiscal year that ended May 31, we're going to be cash flow positive in the business as well. So even though we've been doing some of those divestitures that Jim talked about, where you're, by definition, going to be giving up some of your profitability and your cash generation for those low-growth businesses. We've now been able to grow the MedTech to a point, where we've gotten over those -- that transom.

Right. And that's a big key in MedTech. It's all about getting your weighted average your WAMGR up into the right. So I guess I would ask, are you guys -- do you feel like you have the portfolio now in place in the MedTech business that will continue that trajectory? And I guess, in 3 years, what percentage do you think the MedTech business will be of sales?

Yes. So to back into the MedTech business, we believe in next fiscal year, we'll pass our med device. So we think it will become our largest segment in and continue going forward. So it will be really critical. It's also -- it's higher gross margin, and it's providing us a nice P&L drop. As Steve said, last year, they became adjusted EBITDA positive, that will only continue throughout our journey now. So investors will see a company with good top-line results good growing gross margins as the mix is really important. And then bottom line that will grow over time. We'll have plenty of money to invest back into our business to fund more growth. But really, you'll see a time with a really interesting P&L and a great balance sheet. We have no debt today and we're going to generate cash this year and every year going forward.

And on the growth question, the MedTech segment that we've had has grown quite a bit over the last 3 years. Over the last 5 years, we've had about a 25% CAGR for that MedTech segment. But the thing that really excites us is that all of the businesses that we have in MedTech are platform technologies that we think with not too much additional effort, it's mostly clinical and regulatory. It can get us into new total addressable markets, so that growth can continue, not just the 25% that we've seen over the last 5 years. But we're excited about the opportunities for the growth for the businesses that they're in now for the next 3 to 5 years, but we've got opportunities in those platforms to use that same technology and continue that growth trajectory beyond the 5-year period.

Okay. Got you. And maybe let's dig into the MedTech business and the total addressable markets that you're addressing or participating in there and what you see as the most critical growth drivers?

Yes. So if you take a look at our MedTech portfolio, it's 2 cardiovascular areas we're focused on, in 1 interventional oncology area. I'll back into it for a minute, the interventional oncology area is our NanoKnife product. We just got our label last December to treat intermediate-risk prostate patients. Really, really large market, we estimate over $2 billion globally, over $700 million in the U.S. of patients, who are diagnosed with intermediate risk, we'll call it. Prostate cancer. About 40% of the men every year need a focal treatment option, which we give them now. So we're really excited to share more with you there. Then on our cardiovascular side. We compete on arterial and venous diseases. On the arterial side, we treat PAD with our NanoKnife, excuse me, with our Auryon system. And that's about $1 billion market in the U.S., larger globally. And over time, part of our expansion going forward, we're going to get into the coronary space, which is about double the potential side. We know our product is safe and effective and works really well. So we want to get a label and treat there then back to our venous side for VTE, many investors know how exciting this market is. So we have -- our AlphaVac system was approved last year. We treat PE. We're #3 in a really large fast-growing market. So we're going to take share from #1 and #2, but we'll also expand the share as we're all 3 working to grow the addressable market there as doctors get more comfortable using interventional devices to treat PE.

Yes. Yes. And I want to dig into that a little bit more. But maybe we can talk a little bit about how you see -- I don't think you guys have given sort of long-term guidance or any of that. But maybe you mentioned you're just ending or almost close to ending your second fiscal quarter. How you feel the year has started? I'd love your just sort of high-level views on where you think health care is going -- I'm asking this question in the context of we've got 1 big beautiful bill and what's going to happen from the capital purchasing perspective, hospital budgets, things like that, procedure volume trends have been healthy, but how you guys are thinking about, since you are an off-cycle and so you are guiding for a little bit of 2026, what's going to happen?

I'll give a quick note and I'll let Steve give you detail. Macro-wise, we're all watching the space. Our customers are under pressure. They're trying to deal with Medicare, Medicaid changes, reimbursement. So they're under pressure. We get that. The good news for us is some of our products do have a capital and a the disposable component. We're not capital-intensive. We don't rely upon that. We have alternative methods for folks to get our capital if they need it. We really want to sell the probes or the catheters that provide care and delivery of our technology. And that's a really, really good place to be today. So there's some uncertainty in the marketplace, as we know, but it's not going to hold us back, we don't believe. And Steve, on our Q1 and where we're at today?

Yes. So just on the macro point, being in health care, it's great. It's very -- it's not complex at all, right? It's very easy and simple and straightforward. As Jim said, there's a lot going on there and procedure volumes, reimbursement pressure on the hospital system. The good thing is the markets that we are moving into with our MedTech business, we feel that they're pretty well set up for the future. So there's still physician preference items. If you look at where reimbursement has been going in the areas, the trend has actually been okay in the markets we're going into, particularly, when you think about PAD, was pretty well pressured maybe 3 years ago that seems to have we've kind of gotten through that. So on the macro side, there's absolutely going to continue to be challenges. We're watching that to the point about the Omnibus bill. We're keeping an eye on that. We think that there's some opportunities maybe for some R&D credits that we'll take advantage of, but nothing that's derailing the overall strategy that we have. In terms of our first quarter, we were really pleased with the quarter that we announced that ended in August. We were -- we grew double digits. We had our MedTech business that was growing over 20%, seeing the right trajectory in terms of margins. So we expect to continue to see a good trajectory for this year. We guided at the very beginning of the year. We raised guidance in terms of expectations for top line as well as the bottom line coming out of our Q1, which we tend to like to see a little bit more of the year going as we think about it. But we're pleased with the trajectory that we're seeing at this point.

Okay. Got you. Well, let's actually talk about some of the key businesses here. So you mentioned BTE Thrombus Management. I mean that's a great market, very underpenetrated. Maybe you can talk about you grew 40% from your mechanical thrombectomy systems in Q1, I believe. Help us understand some of the drivers here of growth? Is it share gains? Is it market growth, a combination of both? And how you're helping -- there's been a building body of clinical evidence in this market and sort of what Angio is doing to contribute to that?

Yes. So entering this year, FY '25, we had over a $40 million base in this space. So we're a legit player in the space. We've got an AlphaVac and an AngioVac product, each specifically designed for different reasons. But they're really unique and special. AngioVac has been kind of our lead device for many years. It uses a centrifugal pump to help reinfuse the blood back in the body for a very complex right heart cases, other things. A couple of years ago, doctors said, "Hey, we love the AngioVac. You could take that off the pump, give us a purpose-built handle to control aspiration and power." We would love it and we compete really well with the burgeoning market to treat PE with interventional devices. So we did that. So AlphaVac now Danielle does a really good job, gave the doctor the vortex funnel tip that pulls more clot burden than anybody else into the device and a control mechanism that they don't have with other devices. So we've seen really great growth. So #1, we're taking share in PE from the #1 and #2 players. We have the best product in the market, really well designed to treat PE in a safe and effective manner. Our APEX data showed that in our study. We pulled more clot out faster. And then second, we're going to help the market grow. The other 2 companies are really, really good. With us now entering here, you got 3 really good companies in this space, giving doctors confidence to stop using lytic-based therapies, which have been the historic treatment for PE and really trying an interventional device like 1 of our 3 to get the clot out of the body right away. So Danielle, we'll all 3 work together to grow that market to do market development. We all believe the market is about $3 billion potentially in the U.S. just to treat PE with these devices.

Yes. And I mean we've had a lot of clinical data over the last few weeks here actually on PE. Just curious about what you're seeing hearing in the real world as far as adoption of mechanical thrombectomy. It sounds like docs are pretty excited.

Sure. I think that's exactly right. I mean we applaud Penumbra for the STORM-PE trial. That was a landmark trial that was randomized. They were doing the right things, and we think that that's going to be a rising tide that's going to lift all...

Class effect...

Yes. Absolutely because we firmly agree with the other competitors in the space that we're moving the clot. Is the most important thing that's going to benefit the patients. And so we applaud the trial that they did. We've got our own data that came out with our PE trial. We're going to committed to also generate data in this space. We think it's going to be important to continue to have that steady drumbeat of additional data supporting mechanical thrombectomy. Because as we sit now, your question, for the most part, we're taking share, right? So we know that this market is growing. But given the size that we are and the timing that we came in, for the most part, the procedures that we're getting today are share shift. We're going to move into the Blue Ocean as well and try to do the market expansion. But as we sit here today, a lot of our growth has been mostly in that share shift. As Jim mentioned, we went from $30 million to $40 million last year in our overall mechanical thrombectomy business. We said we expect to grow from $40 million to $50 million this year. So really good growth. We've got some tougher comps coming up in the back end. But we're excited about the growth we're seeing.

Okay. Got you. What about from a pricing perspective, are you guys at parity? And what are you seeing in this market from a price side of things?

Yes. We haven't seen price move much in the last few years. They just set their points and when we fit right where they do. So we don't think price is really a factor in this place. It's really about care delivery and safety.

Yes. What do you think the barriers to adoption still are at this point? I mean, we've talked about PRET teams, for example, and it's shocking that that's not more widely implemented. I mean, how are you guys doing on the ground sort of helping hospitals build these -- the infrastructure to really focus on mechanical thrombectomy?

Yes. So it's a great point. We believe in the process, the theory and how it works, how we can treat patients faster and more safe manner. So as more hospitals adopt the PRET process into their flow -- we'll be part of that process with our other peer competitors as well. But it's a really great way to give a patient a much more urgent need to treat a PE, we think using a mechanical product like ours or the others or the best way for PRET team to do what it can do best. So there's really so much upside. I think investors have seen that. and they're really bullish on how much upside exists in this space, how us 3 and maybe others will help solve that. But that PRET team approach has been a really, really great way to get customers used to treating people in a new way.

Yes. Totally.

And Jim mentioned that we think we have the best products on the market. And so one of the things that we're doing to help aid that move is making sure that we've got the features and benefits that we think are going to be important to physicians, when they decide to choose mechanical thrombectomy for the first time. So one of the things that's unique about AngioVac, as you mentioned, we've got the simultaneous reinfusion circuit. That's for more complex cases. But when we set that up, there's 0 blood loss, and they can have continuous aspiration for the time you can't do with any other product that's on the market. Our AlphaVac product, we were listening to the physician and we designed that product with them in mind. So we added steerability. We added the ability for them to go out and have the tactile feel to find out, when they're on the clot. We added some blood limiting switches, so they can decide between a 10 cc pull or a 30 cc pull. Let them use their skill as they decide to go after these disease states. And so we think continuing to innovate, listening to those physicians, make it easier to do these procedures is one of the way that you're going to continue to facilitate that change.

Do you think that the body of clinical evidence is there yet that this market should start to inflect? Or do you think there's still ways to go? Like I'm just curious.

Yes. Well, it's funny asking myself and probably the other 2 companies on the stage, they said there's enough evidence. Ask a physician, they'll say there's never enough evidence.

Right.

But I think it's a combination of both, Danielle. I think companies like us and what Penumbra did is really remarkable. We're all going to invest in the space. We have a new trial we're running now, too. We'll continue to show that these are safe and effective treatment tools. And the physicians will still expect more. And that's okay. We'll meet in the middle there. I think there's also a groundswell of people, who've now used the devices and are gaining confidence in the patient outcomes and what they can expect. And really lytics and drug therapy has been around so long, and it's unpredictable the outcomes, nobody really loves it. So think the space is really going to burgeon and grow with a combination of data to support it and just use and the comfort in practice.

I think, it's the use case, right? Because I think the data is there that says, off the bat, it's safe, right? I think a lot of the trials that have been published are indicating that, yes, mechanical thrombectomy is a safe option. It's when you use it and if you're in the room, and I've been in the room a couple of times, the patients get better immediately. Like on the table, they feel better when you go in and you're moving clots from their lungs. And so, I think as more physicians get experience with that, they're going to realize that this is the right answer as opposed to just giving systemic lytics and hoping that the clots will break out on their own.

Yes. Okay. agree with all of that. So maybe let's talk about Auryon, So solid 20% growth exiting Q1. And -- can you maybe talk a little bit about where Auryon stacks up versus other atherectomy modalities and how is specifically BTK penetration trended as you scale randomized and registry evidence there?

Yes. We're really excited with the Auryon product. This is the product I mentioned that we acquired in 2019. We launched it in September of 2020, 6 months into pandemic, not a great time to launch a new product as hospitals are telling us, hey, don't come with either product today. So we focus on the OBL market first, which treats a lot of the PAD treatments here in the U.S. We gained a lot of share initially. We have a laser-based product the way it works. Laser energy is directed through our catheter to break up the soft or hard calcium or plaque clogging up the arterials. Our product is better than the other laser because it can do above and below the knee, which was the other product didn't deliver there. And we can break up the hard calcification and plaque below the knee. And that's what we're measuring now with our new AMBITION study. So we've taken share from the other 5 companies in the space. They're really big companies we all know who they are. And we're a small company. We can't bundle or tie it to other things in the lab, but our product is that much better we've taken a lot of share. So today, we've gone from the sixth entrant to #3 in the market. We're growing taking share over year. So the market isn't growing at the rate we are. So we're #3 out of 6 really good companies in the space in PAD. We continue to grow double digits for years to come. What we're also excited about Auryon as a platform, the way we deliver energy through the device, we think it can do other things. Our European customers, now we have a CE Mark are really excited about it as a coronary product. So they've done some work overseas to double check that it's safe and effective. We believe it is. So we've talked to our investors, we're going to look to get on label here in the U.S. It's probably going to be a 4-year PMA, but we'll give you more detail when we have it, but we're really excited about what that market can do. We've also seen from customers who have used that, "Hey, guys, this breaks up the needle calcification, kind of like Shockwave. A shock wave effect." We said, "Great." So the customers are leading us to new areas where we can really look at how we can penetrate larger addressable markets with the same science and technology. So Danielle we will grow Auryon for years to come, not just in the OBLs, we've shifted our focus to the hospitals in the last couple of years and a lot of growth is coming from there. So above and below the knee, instant restenosis, OBL hospital, coronary, peripheral, we really love this device.

Okay. What is the mix right now of Auryon revenue in the OBL versus hospital?

So hospital is now over 40%. So it's coming up to near the OBL mix. It probably pass it soon. It will stay around 50-50 over time. But it's really important for us, it's a higher ASP, it's a more stable customer that we'd love to get. We want to get it in that cath lab, have it used for more devices.

Yes. Sure.

And this has been a big switch for us. As Jim mentioned, we launched the product right in the middle of COVID. And so hospitals were saying that they were just building up capacity to treat COVID patients, but the OBLs were open. So when we were doing our due diligence on this technology, it was about a 60-40 split hospital to OBL. That flipped when we got to COVID and it went to probably 60-40 OBL versus hospital. Originally, when we launched our product, we were probably over 90% in the OBL because that's where the customers were. That's where we were looking to grow. But then over the last 2 years, our team has done a great job having this initiative to get more into the hospitals to get us to where we are at that 60-40 split. OBL versus hospital. A lot of times, we get asked, where you want to end up. I don't -- 50-50 is probably a good goal. I don't think we'll get to a point where it's more than that. I think we still have some runway to grow within the hospital, but we're also growing in the OBLs as well. So we're going to continue to open up new customers in the OBL setting. We're going to continue to open up customers in the hospital setting, getting ready for the future with coronary. We think we've got a good runway to continue to take share.

And pricing in this market, you mentioned there are 5 very big competitors here, right? And reimbursement has been volatile over the last few years in this market. How durable do you think pricing is here? Is this a market, where you do think you're going to have a little bit more pricing pressure?

We did our -- thesis to enter the market, we expect the pricing to come down. And it did along with our expectations. But recently, we've seen some kind of bottoming. Yes, if anything, even next year, some of the work we've seen will help OBLs. There's some new pricing models, some medicare reimbursement that we think is slightly favorable. So we don't think it's going to be a headwind as it has been anything, maybe a slight tailwind. Either way, we're going to take share. We're at a place where we're pleased with our ASPs, our margins and where the competitive pricing is. So we think we're in a pretty good spot. And if it gets a little better, like it looks like it might, then terrific.

And you talked about the data in the mechanical thrombectomy space. We think data is just as important here in these space, which is why we're running the AMBITION-BTK study. So to your question about stabilizing the market, we think that, that study is actually going to be pretty important to show that balloon angioplasty with atherectomy is just as safe and potentially even more effective than just balloon angioplasty alone, particularly below the knee. As Jim mentioned, this is the first laser product that can work below the knee. So we're excited about doing that. Since we've launched this product, just about 50% of our cases have actually been below the knee. So we've had about 10% in instant restenosis and then the other half has been even -- or the other has been evenly split in half between above and below the knee. So we know our product works. Continue to provide that data foundation to show that atherectomy is a good choice, is a safe choice and is really effective for these patients. We want to make sure that we limit the amount of amputations that are going forward.

Which is it's wild how many amputations are still done?

And we don't think they have to happen all of them.

Right, right. And so I was -- I wanted to ask as well, like what do you think at this point, the below the knee intervention market is growing. And one of the -- not issues, I guess, but 5 to 10 years ago, what lack of clinical evidence, right? There's a little bit of Wild Wild West. How you think it's evolved? Are we there yet where this can really be the standard of care?

Yes. We believe it can be. About a month ago, we sponsored a cardiovascular scientific forum. And one of our keynote speakers stood up on the podium and told her colleagues, 150,000 patients are going to have an invitation this year in the U.S., that's unacceptable. There are ways to treat these patients better than doing that guys. So our point is really valid. We know Auryon is the best and safest way the way it works. So sponsor in the AMBITION-BTK study, we believe, shows our faith in what we can do in a randomized controlled trial. And we think it will give the outcomes that then physicians can trust. We can reduce those patients, getting amputations and then gain traction in the space.

Yes. So we firmly believe in our product. We firmly believe in this treatment. We still think there's probably a little bit more data that's necessary. That's why we're doing AMBITION and the AMBITION-BTK study. So I don't know that we're quite there yet, but we think we will -- we think we can get there.

Are the majority of these sponsors doing these procedures still vascular surgeons or interventional cardiologists as well?

For Auryon, it's mostly vascular surgeons. So you get more there. You've got some mix of treatment, but vascular surgeons primarily is the main treatment.

Okay. So it's still the same call point that's doing the amputation as well. Is it just a matter of getting these like the patients diagnosed earlier? You think earlier intervention like stop the progress, don't let them get critical limb ischemia.

Exactly.

I think there's a part of that. I mean early diagnosis is going to help in almost any setting that you think of, right? And particularly when we talk about the prostate market. That's another area where we think that earlier diagnosis would be helpful. And as we have with NanoKnife and pancreas too. But when you think about PAD, yes, early diagnosis, but then also awareness of the treatment, right? And I think the difference between the mechanical type, the rotational devices that were really working below the knee, historically and then laser above the knee. You understand that sometimes you got to go in and open up that vessel, but those rotational devices, they have some safety concerns for some legitimate safety concerns, which is why we think the Auryon technology is such a good option. The safety profile of laser, it uses a wavelength that's very different than the laser that had been on the market before. It's actually absorbed by the vessel walls. So the safety profile is fantastic. If you look at the IDE that we had 0 dissections. And then the way that the energy is delivered to be able to break up that hard calcification, which is usually what you see below the knee. The versatility that Jim talked about with Auryon, we think makes it a perfect solution. And that's why we think we're going to continue to keep this ball rolling.

Yes. Yes. Okay. And I want to make sure we touch on NanoKnife here. So maybe some of the momentum in prostate following the FDA clearance in 2024. You're now a year into this and how market adoption has progressed? Maybe let's start there.

Yes. So we're really excited in what we received. We knew that NanoKnife, which is a nonthermal ablation tool uses energy, electricity actually to break down the cell wall in the disease tumor. And that's a body flush the cancer out and die naturally in the body. It's a unique product we got on label last December, a PRESERVE study showed it safe and effective showed really good outcomes in the men, who need to be treated. We're talking about Gleason 7 intermediate risk patients. Today, we're kind of focusing on that intermediate market. Maybe we can do more above and below that. But today, that's over 40% of the men being diagnosed. It's a really large market today. We're excited by the way it treats and how it works. We've seen really good feedback. So for the first time, we can actually talk about it, educate men and the urology community about the device create awareness for the men, who are diagnosed every day, tonight, 500 men will go home and tell their family, I just got diagnosed with intermediate-risk prostate cancer. What does that mean? Well, now they go home and Google it or go on Facebook. They're going to learn about our product, which they couldn't have done a year ago. So we're getting a lot of inbound interest. You've also got urologists that always believe men needed a good focal treatment option because too many men were getting radical prostatectomy that didn't need it -- didn't need to have those side effects. So today, the urology community, the awareness with men are really leading to really great growth. You've seen that in our numbers. Q1 was terrific, even last year was. And what's important for us, January 1, our CPT1 code kicks in. So our team did a really good job. We got on label and got our CPT1 code approved, both last year, we're really excited by what this will do to open up more avenues for us.

Yes. So Jim talked about the options that we think are important to give to them. We've seen a tremendous amount of interest from the urology community in the NanoKnife procedure. Because we think that they believe the way that we do that men have been given the wrong choice up to this point. When they're diagnosed with prostate cancer. It's at this point, they've had 1 of 2 choices on the polls, either do nothing, so have active surveillance or watchful waiting or have a radical prostatectomy. Now overall survival has been good in terms of treating prostate cancer, but then they've had to deal with side effects. Tremendously, a large percentage of men, who have a radical are going to end up with really debilitating quality by side effects in terms of impotence or incontinence. What's where we think NanoKnife can play a role. So Jim mentioned we can destroy the tissue cells, but what's really unique about NanoKnife is that critical structures that are in the ablation zone, blood vessels, bile ducts, mer vendings aren't impacted, and they remain patent. So that allows us to do that treatment for those intermediate risk patients, who are right on the cusp of saying, do we either do nothing or go to a really invasive procedure, where you're probably going to end up with habilitating side effects?

Yes.

Now you can get treated, where you can destroy the tissue, we can destroy the cancer cells, but preserve that quality of life?

Yes. So is this 1 looks like you're really growing the intervention market here versus really competing because it sounds like it's all about earlier intervention?

Yes. It's a great point. If you think about some of the other technologies that we talked about, each of our growth drivers is in a different life stage of its life cycle, right? So we talked about Auryon a bit more of a mature market. That's a share shift, right? That market isn't growing much, but we think we've got the technology that can continue the share shift that we've seen. Mechanical thrombectomy is pretty well understood, but it's a growing market. And really the story there is to continue to turn the served market into the total addressable market -- total addressable market into the served market, excuse me, in mechanical thrombectomy. NanoKnife is a little different. We're doing a little bit more market development there, right? Because there's a unique technology, there's a unique way of thinking about delivering this therapy now that we're going to have to continue to educate the market on.

Okay. And last question on NanoKnife. As far as innovation in the quarter, you talked about a lot of your products and platforms. I mean, what would innovation look like here?

So we believe NanoKnife also could be safely used to treat other difficult tumors. We've done a study called DIRECT that will launch soon to data for people with Stage III pancreatic cancer, really, really difficult treatment option. We think NanoKnife is a safe and effective way to give them a new hope. And then what we've learned through the PRESERVE study, now following patients afterwards doctors, who treated men with intermediate risk prostate are now telling us, "Hey, guys, there's a BPH effect you have here." NanoKnife treatment seems to shrink the prostate and men are now flowing better and is a really large market. The BPH market, as we all know, is much larger than just the prostate market. We're watching that very carefully and very closely, but we believe we have a really unique way to treat men with BPH in a different way. So Danielle, it's almost embolic of our company as a whole. Each of the 3 platforms we just talked about, has a lot of room to grow. So we're going to focus our energy and our efforts on investing into these 3 platforms and opening up more TAMs and larger markets throughout the science that we have today.

And I think that's going to be the key for innovation for Angio going forward, right? Innovation and growing our markets and thinking about future growth is what's imperative if you're going to have a really well-performing stock in MedTech these days. What's -- where I think we're uniquely set up is for us, the innovation is really data generation and increasing our opportunity to get into those markets with the existing technology.

Right, leveraging the existing platform technology.

We don't have a lot of R&D that's necessary to take Auryon into the core area, right? There isn't a lot of R&D that's going to be necessary to take our AngioVac product from being focused on the right-sided interventions to potentially going into the left side of the heart where there's a huge unmet need. And with NanoKnife, we don't have to change the product, but we just have to continue to get the data and increase awareness and make those changes in areas like prostate, potentially BPH. And in other solid tumors as well.

Got you. Well, we didn't really talk about the medical device, med devices business, but maybe let's touch on that a little bit. You mentioned basically flat-ish growth there sort of walk us through what's going on there. Will that ever return to growth? Or how do you look at the sort of midterm outlook for that business?

Yes. So we're not investing in the space. We've got a few really good products there in good markets, but it's a spot that we've decided we're not going to invest resources and compete heavily our share gains there. It's doing it's job for us. We're serving the market with really good products there. But it's also giving us a means to an end. We've used the cash and the capital that's showing off to invest in these really interesting markets we talked about. But over time, it's gone from 85% of our revenue now to a little over 50%. It will soon be passed -- so it gets less important to us. But today, it helps us get EBITDA and cash that we can use and stabilize our company. But over time, the MedTech business is the growth engine for our company. We think most investors are looking there.

And we tell people to think of that overall segment as about a 1% to 3% grower kind of in the short to medium term. So it's not going to go backwards. As Jim said, we're not going to invest a lot in it. So we're going to get that kind of very low single-digit growth. It is lower gross margin, but it definitely provides a ton of EBITDA and a kind of cash generation, which has facilitated this transition that we talked about at the very beginning.

Well, and Steve, I wanted to ask you or Jim as well. So you did talk about the -- a very healthy balance sheet, no debt. Maybe talk a little bit about capital allocation and how you're thinking about that over the next few years?

Sure. Yes. So I think we hit on it. It's going to be investing in the innovation related to the MedTech business. So right now, we think we've got a ton of opportunities in each of those growth drivers that we have in MedTech. That's where our focus is going to be. And we get the question a lot, what about external M&A? Do you want to add more growth drivers to your business? At some point, probably, but not in the next 3 to 5 years I would say.

Sounds like you don't need to...

I don't think we need to. I don't think we want to add more complexity. We're still a small company. We're still a little hard to understand. We want to continue to refine our story -- we want to focus on the growth areas, and we've got the opportunity, as we said, to invest in data and indication expansion. M&A is always hard, right? It's always a crapshoot, the only R&D is tough. The only thing that less of a hit rate is external M&A. So we think we can focus on what we've got right now.

Yes. That makes sense to me. Okay. Maybe let's touch more specifically on the fiscal '26 guide the midst was 5% to 7% sales growth. Can you talk about some of the puts and takes. We have a minute here, but maybe wrap this up and sort of what are the puts and takes to the guide? And I always like to ask this question, where do you think there is a disconnect from an investor perception perspective versus what you think AngioDynamics?

Yes, that would probably take us 35 minutes to talk about because we think -- we think that there is a big disconnection in terms of the valuation we're seeing in the market today and the value that our assets have in the way that we've been running the business. That's okay. We're going to continue to execute. And I think it really goes to what you said. It's hitting the numbers that we put out there. So putting out the growth, you said 5% to 7%, that's on an overall corporate perspective, but we think it's important to look at kind of the level down, the growth that we expect, the double-digit growth we expect to see in the MedTech segment, and then we've guided flat, and we said assume 1% to 3% kind of in the long term as a growth in the med device. So we're pretty confident in setting it up that way and then seeing gross margin expansion coming from this revenue shift as the MedTech business grows, and then seeing that drop down to being positive adjusted EBITDA than getting to positive cash flow this year.

Yes. Well, sorry, I didn't give more time for that question because I think it's an important one. There's a lot of disconnect. Yes, great. But listen, guys, thanks so much for being here. Really appreciate it. Honored to kick off with you guys.

Thank you for having us. Appreciate it. Thank you.