Full-Year Revenue and EBITDA Growth
Total adjusted constant currency revenue grew 13% for FY2025 to $443.6M, while adjusted EBITDA grew 26% year-over-year with an adjusted EBITDA margin of 20.2% (up 190 basis points).
Strong Fourth Quarter Results
Q4 adjusted revenues were $118.3M (excluding Italian payback), up 18.5% YoY. Q4 adjusted EBITDA increased ~29% from $17.6M to $22.7M, and adjusted EBITDA margin improved to 19.2% (up ~110 basis points YoY).
Stent Graft Momentum
Stent graft revenues grew 36% YoY in Q4 on a constant currency basis (28% growth when adjusting for the 2024 cyber incident), cited as a foundational growth driver with plans to expand U.S. and Japan commercialization.
On-X Growth and Market Opportunity
On-X revenues grew 24% YoY in Q4 on a constant currency basis. Management forecasts mid-teens growth for On-X in 2026 and identifies a $100M incremental U.S. market opportunity based on new clinical data.
Clinical and Regulatory Progress
Positive clinical updates: AMDS PERSEVERE two-year data reinforced benefits; NEXUS TRIUMPH one-year IDE results showed 94% survival from lesion-related death, 91% free from stroke, and 97% free from renal reinterventions. Fourth/final AMDS PMA module filed; AMDS PMA targeted mid-2026; NEXUS and other PMA timelines noted.
Regional Revenue Strength
Q4 regional constant currency growth: Asia Pacific +32%, North America +18%, EMEA +17%, Latin America +9% YoY, indicating broad geographic momentum.
Balance Sheet and Leverage Improvement
Year-end cash of ~$64.9M and debt of $215.1M; net leverage ratio improved to 1.8x from 3.8x year-over-year, signaling meaningful deleveraging.
2026 Outlook with Continued Growth and Margin Expansion
Guidance for 2026: constant currency revenue growth of 10%-14% (reported revenue $486M-$504M) and adjusted EBITDA of $105M-$110M (18%-22% growth), with expected ~150 basis points of adjusted EBITDA margin expansion at midpoint and slightly positive free cash flow.
Pipeline and Longer-Term TAM Opportunities
ARTISAN (Arecibo LSA) enrollment underway (8 of 132 patients), expected enrollment complete mid-2027 and potential FDA approval in 2029, representing an incremental ~$80M U.S. market opportunity.