AngioDynamics (NASDAQ:ANGO) released fourth-quarter financial results and hosted an earnings call on Tuesday. Read the complete transcript below.

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Summary

AngioDynamics reported strong financial performance for fiscal year 2026 with an 8% revenue increase in Q4 to $86.6 million, driven by 16.7% growth in the MedTech segment.

The company's MedTech segment now represents 47% of total revenue, reflecting a strategic shift towards high-growth areas like cardiovascular and interventional oncology.

Looking ahead to fiscal 2027, AngioDynamics expects 5-6.5% revenue growth, with MedTech sales projected to grow 12-15%, supported by ongoing investments in clinical data and new product introductions.

Notable Q4 highlights include 20 consecutive quarters of double-digit growth for the Aureon platform and strong performance in NanoKnife with a 64.5% revenue increase.

Management emphasized the successful transformation of the business, the strategic importance of clinical trials, and the commitment to maintaining a debt-free balance sheet while investing in future growth.

Full Transcript

OPERATOR

Good morning and welcome to the AngioDynamics Fiscal Year 2026 Fourth Quarter and Full Year Earnings Call. At this time, all participants are in a listen-only mode. A question and answer session will follow the formal presentation. As a reminder, this conference call is being recorded. The news release detailing AngioDynamics fiscal 2026 fourth quarter and full year results crossed the wire earlier this morning and is available on the Company's website.

This conference call is also being broadcast live over the Internet at the Investors section of the company website at www.angiodynamics.com. A webcast replay of the call will be available at the same site approximately one hour after the end of today's call. Before we begin, I'd like to caution listeners that during the course of this conference call, the Company will make projections or forward-looking statements regarding future events, including statements about expected revenue, adjusted earnings, and gross margin for fiscal year 2027, as well as trends that may continue.

Management encourages you to review the Company's past and future filings with the SEC, including, without limitation, the company's Forms 10-Q and 10-K, which identify specific factors that may cause the actual results or events to differ materially from those described in the forward-looking statements. The Company will also discuss certain non-GAAP and pro forma financial measures during this call. Management uses these measures to establish operational goals and review operational performance and believes that these measures may assist investors in analyzing the underlying trends in the Company's business over time.

Investors should consider these non-GAAP and pro forma measures in addition to, not as a substitute for or as superior to, financial reporting measures prepared in accordance with GAAP. A slide package offering insight into the Company's financial results is also available in the Investors section of the Company's website under Events and Presentations. This presentation should be read in conjunction with the press release discussing the Company's operating results and financial performance during this morning's conference call.

Unless otherwise noted, all metrics and growth rates mentioned during today's call are on a pro forma basis, which exclude the results of the dialysis and BioSentry businesses that were divested in June 2023, the PICC and Midline products that were also divested in February 2024, and the radiofrequency and Syntax support catheter products that we discontinued in February 2024. Also, unless otherwise noted, all comparisons will be the fourth fiscal quarter of 2026 versus the fourth fiscal quarter of 2025 and the full fiscal year 2026 versus the full fiscal year of 2025.

Now I would like to turn the call over to Jim Clemmer, AngioDynamics President and Chief Executive Officer.

Jim Clemmer, President and CEO

Thank you and good morning everyone, and thank you for joining us for AngioDynamics fiscal 2026 fourth quarter and full year earnings call. Joining me today is Steve Trowbridge, our Executive Vice President and Chief Financial Officer. I am proud of our performance in fiscal 2026. We capped off a year of consistent execution across the business with a strong fourth quarter full year. Med tech growth of more than 18% tells the story. Our platform technologies across cardiovascular and interventional oncology took share in large fast-growing markets, and because of the discipline this team brings every day, that growth came with increasing profitability even as we absorb tariffs that were not in our business a year ago. With a full year now behind us, I want to step back and talk about what this team accomplished in fiscal 2026, what we built, and why I believe this company is in the strongest position it ever has been in. Steve will then take you through the financial details and our outlook for fiscal 2027. A number of years ago, we set out to transform AngioDynamics into a fast-growing profitable company by bringing innovation to large global markets.

Fiscal 2026 was another year of proof that the strategy is working and is playing out the way we said it would. Our Med tech segment was 47% of our total revenue this year, up from roughly 22% at the end of fiscal 2020. Over the past six years, that business has grown at a compound annual rate of approximately 24%, and we have done all of this while driving sustained profitability. I want to be clear about why that matters because it did not just happen by accident and it's not because we did one thing right.

This is years of work coming together. It is a group of people doing the right things every day in the right markets for the right patients. Now let me take you around the portfolio starting with Aureon, which delivered its 20th consecutive quarter of double-digit year-over-year growth. We keep winning by taking share across all sites of care. Aureon remains a really strong performer for us, and we are excited about where this platform can go from here.

Turning to mechanical thrombectomy. Collectively, this portfolio grew double digits during the year driven by strong performance with both AlphaVac and AngioVac. Physician feedback on both products remains consistently strong. Our work in an increasingly competitive market is getting these products into more hands, and that is squarely within our control. We have sharpened our commercial execution and accountability here. We are still early in the life cycle of this portfolio, and we have meaningful catalysts directly ahead, including our Alpha Return Blood Management system where we now have IDE approval and an active pivotal trial along with our AngioVac Right Heart program. We expect this to be one of our key growth engines for a long time to come. Turning to NanoKnife, this unique product was a standout this year and had an exceptional fourth quarter in the U.S. The story is prostate physician interest in procedure volumes keep building, and as a result, we hit record procedures during the quarter. Behind those results is a lot of deliberate work on the fundamentals that drive this business.

We generated strong two-year data from our PRESERVE study. Our Category 1 CPT code for prostate and liver became effective on January 1st, and during the quarter, we received a Medicare coverage framework that further supports patient access. All of that is coming together, and we expect NanoKnife to keep growing. What connects all of this is intense. We built this portfolio purposefully around large markets with real clinical need, and the strength of our technology is allowing us to win and deliver value for everyone we serve, from patients and physicians to our shareholders.

Underpinning that growth is our med device business that plays an essential role and continues to do exactly what we ask of it. A terrific team delivering steady, profitable growth from a portfolio of sticky market-leading products. Importantly, this business generates the cash generation profile and earnings foundation that lets us keep investing in our higher growth medtech platforms. If there is one theme that I want you to take away from in fiscal 2026, it is this.

We are delivering above-market profitable growth consistently. We are taking share in the markets we set out to win, and we are doing it while expanding profitability and proving that the business can generate positive cash flow. We continue to invest in the clinical data behind our platforms, and Steve will highlight that shortly. It is really important for us, but the headline for the year is simple. We are growing, we are profitable, and we are continuing to invest for the future.

That balance reflects how we run this business, and it is exactly what gives me confidence in the years ahead. Before I hand it to Steve, a quick word on the leadership transition that we announced earlier this year. As I shared then, after a decade with our company, I intend to retire, and the board is running a comprehensive search with help from a leading executive search firm to identify our next CEO, which we expect to occur during the first half of fiscal 2027.

Until my successor is in place, I will keep leading the team alongside Steve, and I am committed to a seamless handoff. With that, let me turn the call over to Steve to take you through the quarter, the full year, and our outlook for fiscal 2027. Thanks, Jim, and good morning everybody. As always, before I begin, I'd like to direct everyone to the presentation on our Investor Relations website summarizing the key items from our quarterly. Unless otherwise noted, all metrics and growth rates mentioned during today's call are on a pro forma basis, which exclude the results of the dialysis and biocentry businesses that we divested in June 2023, the pick and midline products that we divested in February 2024, and the radiofrequency and Syntrax support catheter products that we discontinued also in February 24th.

And unless otherwise noted, all comparisons will be 4Q26 versus 4 fiscal quarter of 25. Company Top Line revenue performance was strong again in the quarter. Revenue increased 8% to $86.6 million driven by growth across both our segments. MedTech revenue was 41.8 million, a 16.7% increase. For the fourth fiscal quarter, our MedTech platforms comprised 48% of our total revenue compared to 45% of total revenue a year ago, reflecting the ongoing shift in our business mix within our MedTech segment.

Our Aireon platform contributed $17.8 million in revenue, growing 14.4% compared to last year. Aureon has now delivered double-digit year-over-year growth for 20 consecutive quarters. This growth continues to be supported by our strategy to shift more of our atherectomy business towards the hospital side of care. While we keep growing our customer base across both the hospital and OBL settings along with ongoing international adoption. Following our CE Mark approval, mechanical thrombectomy revenue which includes AngioVac and AlphaVac sales was 11.1 million, a decrease of 1.1% year over year.

In the quarter, AlphaVac revenue was 4.2 million, a 38.4% year over year increase, continuing its strong trajectory and AngioVac revenue was 6.9 million, a 15.8% year over year decrease. We are very encouraged by the catalysts ahead, including the IDE approvals for our Alpha Return Blood Management system and our AngioVac right-sided Infective Endocarditis study. We're confident in the long-term opportunity for the combined portfolio. Mechanical thrombectomy remains an attractive market in its early stage with many competitors working to actively move patient care towards mechanical interventions from lytic-based therapies which can lead to lumpiness quarter to quarter. This is a crowded space for good reason and we have built the best portfolio illustrated by our 13.4% growth in the year. We believe mechanical thrombectomy will grow faster for us. For the full fiscal year 2027, total NanoKnife revenue was 11.8 million, an increase of 64.5% with probes growing 47% and capital sales growing 132.5%. Probe sales were primarily driven by demand for NanoKnife and prostate care and we hit record procedure volumes during the quarter.

As these systems are placed and new physicians and providers experience the improved patient outcomes our technology enables, we expect them to drive increased probe utilization going forward. I will note that capital sales are always lumpy quarter to quarter, so we would not expect capital to grow at this rate going forward, but we continue to view disposables as the bellwether for this business. In the fourth quarter, our Med Device segment increased 1.1% year over year with revenue of 44.8 million.

This business generates consistent cash and profitability allowing us to keep investing in the growth of our MedTech platforms. Now, moving down the income statement, our gross margin for the fourth quarter of FY26 was 54%, a 130 basis point increase from the fourth quarter of FY2025, driven primarily by the continued product mix shift towards our higher margin MedTech sales partially offset by tariffs. Total operating expenses in the quarter were 57 million representing 66% of sales compared to 48 million or 60% of sales last year.

Turning to R&D, our research and development expense was 8.2 million or 9% of sales compared to 6.6 million or 8% of sales a year ago. We remain committed to investing in R&D initiatives to support the long-term growth of our MedTech segment and are targeting approximately 10% of sales going forward. SGA expense for the fourth quarter of FY2026 was 41.4 million representing 48% of sales compared to 36.7 million or 46% of sales a year ago. On a GAAP basis, our net loss for the fourth quarter was 11.4 million or a loss per share of $0.27 compared to a net loss of 6.1 million or a loss per share of $0.15 a year ago.

Our adjusted net loss for the fourth quarter of FY26 was 2.8 million or an adjusted loss per share of $0.07 compared to an adjusted net loss of 1.1 million or an adjusted loss per share of $0.03 in the fourth quarter of last year. Adjusted EBITDA in the fourth quarter of FY2026 was 3.3 million compared to adjusted EBITDA of 3.4 million in the fourth quarter of 2025. Touching briefly on tariffs, tariff expense of approximately $500,000 in the fourth quarter was in line with our expectations and compared to 1.6 million in the prior year quarter.

Now turning to a quick review of the fiscal full year results, revenue increased 9.4% to 320.2 million, primarily driven by growth across our MedTech segment. MedTech revenue was 150 million, an 18.4% increase. Our Aireon platform contributed $66.9 million in revenue, growing 17.7% compared to last year. Clinical thrombectomy revenue, which includes AngioVac and AlphaVac sales, increased 13.4% to $45 million year over year. AlphaVac had a strong year with revenue of $15.5 million, a 44.1% year over year increase, and AngioVac revenue was $29.5 million, a 2.1% year over year increase, growing for the full year.

Total NanoKnife revenue was 33.1 million, up 35.2% with disposables up 28.7% and capital up 61.8% for the year. In fiscal 2026, our med device revenue was 170.2 million, an increase of 2.5%. Our gross margin for fiscal year 26 was 54.6%, a 70 basis point increase from 53.9% in the prior year. For the full year, total gross margin saw an approximate 150 basis point negative impact from tariffs. Turning to operating expenses, total operating expenses for the full year were 214.8 million, or 67% of sales, compared to 197.8 million or 68% of sales a year ago.

Our adjusted net loss for fiscal year 26 was 10 million, or an adjusted loss per share of $0.24, compared to an adjusted net loss of 10.2 million, or an adjusted loss per share of $0.25 last year. On a GAAP basis, our total net loss for the full year was 36.7 million, or a loss per share of $0.88 compared to a net loss of 34 million, or a loss per share of $0.83 a year ago. Adjusted EBITDA in the full fiscal year 2026 was 13.2 million compared to 7.6 million in fiscal year 2025.

This year over year improvement is largely attributable to our MedTech revenue growth and the success of our gross margin and operating efficiency initiatives, and we delivered it while absorbing tariff costs that were not in our business a year ago. For the full year, tariff expense was approximately 4.8 million compared to 1.6 million in the prior year and this was in line with our expectations that landed right within the $4 million to $6 million range we guided to at the start of the year, which I think speaks to our ability to forecast and manage these costs even in a dynamic environment.

Turning to cash in the fourth quarter, the company generated $17.5 million of cash from operations. In line with our expectations for the full fiscal year, the company generated $3.1 million of cash from operations. I want to put that full year number in context because it is inclusive of approximately $4.8 million of tariffs as well as the working capital and inventory actions we took during the year to proactively manage through the sterilization vendor maintenance shutdown.

The fact that we still generated cash from operations for the year while absorbing all of that really speaks to the underlying cash generation profile of our business model. We ended fiscal year 2026 with $53.9 million in cash and we maintained a strong debt-free balance sheet. Turning now to guidance for the fiscal year 2027, we anticipate net sales to be in the range of 336 to 341 million, representing growth of between 5 and 6.5% over fiscal 2026 revenue of $320.2 million.

Within each of our businesses, we expect MedTech net sales to grow 12% to 15% year over year, and we expect Med device sales to be roughly flat. For fiscal 27, we expect gross margin to be in the range of 54 to 55%, we expect adjusted EBITDA to be in the range of 13 to 16 million, and finally, we expect adjusted loss per share in the range of $0.29 to $0.24. We expect the impact from tariffs to be broadly similar to fiscal 26. Based on our current view of the tariff situation, this remains dynamic and subject to change.

Stepping back from the numbers, our fiscal 2027 outlook reflects our execution of the same playbook that allowed us to deliver the strength we saw in 26: compete in large, fast-growing markets, take share of better technology backed by strong clinical data, invest for growth, and turn that growth into increasing profitability. Let me give you some color on how we're thinking about the MedTech portfolio in fiscal 2027. Starting with Aireon, we expect it to remain a solid grower in the mid-teens range as we continue to expand on the hospital site of care while growing across both the hospital and OBL settings and as international adoption builds in mechanical thrombectomy, we expect AlphaVac to continue its strong trajectory and for AngioVac to return to growth against more normal comparisons. And at NanoKnife we expect continued momentum in prostate with disposables as the primary driver and capital remaining lumpy from quarter to quarter as reimbursement and awareness continues to build. Underpinning all of this is our commitment to clinical data. We're not resting on the growth we've already built.

We are prudently investing in high-quality clinical data across the portfolio to drive adoption and to expand the markets we can compete in. On the cardiovascular side, in addition to the alpha return and PAVE studies we are currently running, we have formed a Global Cardiovascular Medical Advisory Board of leading physicians to help guide our clinical and product strategy and we are expanding our ambition BTK study internationally in interventional oncology.

NanoKnife continues to build one of the strongest data engines in our space from the two-year durability data from PRESERVE through FDA approval of the IDE for our Relief Feasibility study which takes our IRE technology into benign prostatic hyperplasia, one of the most common conditions in men's health. In addition, at the AUA conference in May, independent investigators from Weill Medical College of Cornell University presented results from an investigator-initiated study radiation therapy and Irreversible Electroporation for Intermediate risk Prostate cancer or rtire, which combines IRE with reduced dose radiation therapy.

Key findings from the presentation included 42 patients enrolled, a 100% negative biopsy rate at 12 months, 90% reduction in PSA from baseline at 3 months, rapid recovery of quality of life following treatment and no grade 3 or higher adverse events. These fantastic results suggest that combining focal NanoKnife IRE treatment with reduced radiation may offer a powerful new treatment paradigm and convince the investigators to conduct a follow-on RCT IDE study.

The common thread is that we are committed to generating high-quality data to expand indications and reach more patients over time. We are well aware of the broader environment for our industry right now and what I would emphasize is that AngioDynamics is built to be a consistent performer. Through it, we see real demand for the procedures our platforms enable, we are positioned in markets that are growing and we have a clean debt-free balance sheet that gives us the flexibility to keep investing, and we intend to do all of it the way that we did this year, investing for tomorrow while delivering improved profitability today.

There's one thing fiscal 2026 demonstrated that our business model can fund growth, absorb outside headwinds like tariffs, generate cash, and still expand profitability. We fully expect to keep delivering on that balance in fiscal 2027 as we drive sustained, profitable growth and create value for our shareholders.

OPERATOR

With that, operator, let's open the line for questions. Thank you. If you'd like to ask a question, please press star one on your telephone keypad. A confirmation tone will indicate your line in the question queue. You may press star two if you'd like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. One moment please, while we poll for questions. Thank you. Our first question comes from the line of John Young with Canaccord Genuity.

Please proceed with your question.

John Young (Equity Analyst at Canaccord Genuity)

Hey Jim and Steve, thanks for taking the question and congratulations on the strong end to the fiscal year. Just a couple for me. Maybe first on NanoKnife if I can, Palmetto, the LCD going live as of January 5th. What change in neurologic adoption or account additions have you seen so far? And you know, what's the timeline for any expected benefit from this? And then maybe you could walk us through what the regional coverage to broader national coverage pathway looks like.

Steve Trowbridge, Executive Vice President and CFO

Yeah, thanks John. This is Steve. Appreciate the question. We were very excited about receiving that information from Palmetto decision for us and it was a lot of work that our team put into getting to that spot. You know, as we said, going back to the time that we announced the CPT code going effective, we didn't expect that that was going to be by itself a hockey stick that would drive business going forward. But what we've seen since that CPT code went into effect in January of this year is consistent good anecdotes around adoption for the technology and seeing that payers are covering that code.

Palmetto is a very important piece of that and making sure that we got now the first positive LCD out there is going to be an important element for us to grow on and continue to drive adoption. So I would say that what you've seen in our results are the early stages of good indications coming from those types of decisions. It's not the full amount yet and there's still work to do. We're going to follow the same playbook. We're going to talk to the other MACs and to the other regional decision makers to make sure that we're finishing the work to get consistent reimbursement across the country.

But we like what we're seeing so far.

John Young (Equity Analyst at Canaccord Genuity)

Got it, thanks. And then on relief BPH, how large is the BPH opportunity for NanoKnife relative to prostate cancer? And then what's the timeline to first data?

Jim Clemmer, President and CEO

So, John, we're being cautious here and trying to understand how large this market can be. The feedback we've received from a lot of the physicians who used NanoKnife to treat tumors is when they do the patient follow-ups, they're saying, hey, by the way, the follow-up was terrific on the tumor, but you cured his BPH. So we're hearing these anecdotes in the field. So it really inspired us to do this. As you know, John, the BPH market dwarfs the prostate market.

We're being careful. That's why we launched this study. We think it's really important for us to learn more with the physicians, learn what we can do. And we'll be really transparent with you once we learn from this study. But there's a lot of interest in the product, a lot of interest in this space looking for really a good BPH opportunity for a company to solve. But we haven't yet sized the market or talking about that beyond this yet.

John Young (Equity Analyst at Canaccord Genuity)

Got it. And then one more quickly for me, just on mechanical thrombectomy, what are you seeing that led to the quarter over quarter declines in the business? Is this a slowdown in usage in active accounts or is this less than expected new account openings in the quarter? Just any additional color there would be helpful. Thank you again.

Jim Clemmer, President and CEO

Thank you. John, it's Jim again. So we saw a lot this past year. Again, we're pleased that AlphaVac grew 44% over prior. We wanted to do a little bit more, so we had goals to do a bit more. We told you guys AngioVac for the year would have been single digits. It was. We still wanted to do a bit more there. So the market is terrific. It's very competitive. We're still all working together with our peer companies and competitors to get more adoption, more physicians coming over to use mechanical interventions as a standard of care.

We all want to grow the TAM that we compete in, but we've also looked internally. We can't control all the external factors. We have a great product. You've seen the data. We get feedback every day on how intuitive it is to use, how safe and effective it is in the field and how we're getting more and more adoption every day. What we can control is our ability to take as much share as we can as fast as we can in this growing market. So even there, we've made some changes in Q4.

We changed our commercial approach, put a couple new people in place, new leadership structure, and did a lot of work on training our sales force to be effective as fast as we can. We've got new people joining us that come with experience as well. So John, keep an eye on the next couple quarters coming out. We've got a great product in a great marketplace and we expect this to be a growth driver for a long time to come.

OPERATOR

Thank you. As a reminder, if you'd like to join the question queue, please press star one on your telephone keypad. Our next question comes from the line of Frank Takanen with Lake Street Capital Markets. Please proceed with your question.

Frank Takanen (Equity Analyst at Lake Street Capital Markets)

Good morning, Jim and Steve. Thank you for taking the question. I was hoping to start with one on the guidance. Maybe if you could point us directionally in the cadencing of revenues. I think historically we've seen August step down quarter over quarter and then growth really throughout the year from that point, with sometimes the third quarter being down a little bit from the second quarter. But any context on the cadencing would be helpful. And then if you could also overlay the cadencing of cash generation and cash generation expectations for the year, that'd be great.

Thank you.

Steve Trowbridge, Executive Vice President and CFO

Hi Frank, thanks for the question. So we don't guide specifically quarterly, but the seasonality that you talked about I think is the right way to think about the business going forward. We typically see Q4 being our highest quarter in terms of both revenue and cash generation. Q1 is usually a step down from the previous Q4 in revenue. It's certainly also our highest use of cash quarter. That's typical for most businesses where Q1 is going to be the highest utilization of cash.

We're no different. So expect that we'll have some cash usage here in Q1. With Q2 and Q3 being a sequential step up from where you saw Q1. Sometimes Q3, given our structure, is down from Q2, it's usually a little bit less pronounced. And Q4, of course, is going to be the highest generation quarter in terms of both revenue as well as cash. I would expect that to continue. Now, some of the quarterly trends that you've seen in the middle of the year with Q2 and Q3, I expect those to continue to mitigate a little bit given the fact that we're in growth mode and then you've got our med tech products that are continuing to grow.

So you may see some mitigation of some of that lumpiness within the year. But overall I would expect that you're going to see the same cadence that we've seen last year and the year before, just based on some of the structural constructs of our fiscal year.

Frank Takanen (Equity Analyst at Lake Street Capital Markets)

Okay, that's helpful. I wanted to ask one specific on NanoKnife, heard the comments around capital can be lumpy, but expect disposables to continue to trend positively. Could we read that as the 8.4 million in disposable revenue in NanoKnife being kind of a baseline level of disposable revenue to grow off of, or would the seasonality impact that number too?

Steve Trowbridge, Executive Vice President and CFO

Yeah, so a little bit of both. I do think what you're seeing here is if you look at our results in Nano disposables, you're seeing that increase in the adoption by urologists. You're seeing a little bit of a step up in terms of how we expect Nano probes to continue to progress through the quarter. You may still see some of that seasonality with Q4 being our strongest quarter, Q1 being a little bit of a step down and following that same pattern that we just talked about.

But I definitely expect that you're going to see Nano probes coming from a little bit of a higher baseline than they had before because of all the really exciting growth that we've seen and the adoption from the urologists.

Frank Takanen (Equity Analyst at Lake Street Capital Markets)

Okay, helpful. And then just last one for me, Jim wanted to follow up on one of your previous answers on the mechanical thrombectomy business. You hinted towards some commercial changes that were made, new leadership structure and some new people coming in. Can you go a little bit deeper into that maybe? How many new reps have you hired and what kind of commercial changes are you referring to?

Jim Clemmer, President and CEO

So we took a look at how we were performing in the field, watching the competitors in the market. Remember, there's really three factors we look at every day. One is the actual market at people transitioning, how they're delivering care to PE patients, going from lytic based therapies as the standard of care over to mechanical intervention. So watching that market shift, we're helping that market shift with the use of AlphaVac. Second, look at our competitors.

The competitors. We've got two really good big ones that everyone knows about and a bunch of small guys trying to get in the space. So it's an active space. We're doing really well there. When someone tries our product, uses it a few times, the feedback is terrific on how intuitive it is, how safe and effective it is. We pulled more clot burden out than anybody. The Apex study showed that. Then finally, Frank, you look at the thing that we most care about, what we can control, which is our ability to be the best we can every day in the field with our clinical teams, our selling and marketing teams.

So we thought we could do a little better there. Just as we learn the messaging that we can do, train our teams and effect change in the field, so we change a little bit of the structure we have internally. We've added more people. We're excited that every time we seem to have a sales opening. We've got people now with experience that know the marketplace, have sold products like these for other companies and want to come join us. You know, salespeople are really smart and they want to sell products they can make the most money on, have the most fun and work for a company with a great culture.

We seem to offer that got a lot of people joining us. So we'll watch you during the course of the year. Frank, be really transparent. The product is solid. We've got a great team now. So we changed that structure, added to it, strengthened it to make sure we can continue to take share above market.

Frank Takanen (Equity Analyst at Lake Street Capital Markets)

Got it. That is helpful. Thank you for taking the questions.

OPERATOR

Our next question comes from the line of Yi Chen with HC Wainwright. Please proceed with your question.

Katie Richardson, VP, Controller

Good morning. This is Katie on for Yi Chen. I'm still stuck on the mechanical thrombectomy. With the lumpy growth, how would you characterize the competitive intensity from like Boston Scientific and Thrombectomies and Medtronic in atherectomies? Are you really starting to see any of that pricing pressure show up?

Jim Clemmer, President and CEO

Hi, good morning. In neither of the two categories you mentioned, our two cardiovascular categories, we don't hear a lot of pricing pressure. You go back to the question you mentioned on thrombectomy. You now have Boston and Penumbra going to market differently than it was in the past. You've got Inari and Stryker going to market differently. Our product competes really, really well with both of those. Those are great products and great companies behind them.

But our product is really, really good. Pricing has not been an issue in the marketplace probably for any of the three of our companies based on what we do and the value we provide for the patient and the caregiver, removing clot quickly and safely and effectively, and we really take cost out of the system, keep people out of the ICU, extended stays, a lot of drug therapies. So each of us in the space take a lot of cost out of the system for providers, so price is not an issue on the device.

Switching over to the PAD side, we're just taking share in that space, way above market rates for two reasons. We've got the best product. Aureon now has been proven in the field. It's been used over 200,000 times in the last five years, and it's really safe and effective what we do there. So we're taking share because the product is the best product in the market. It works above and below the knee. And about 10% of the procedures we do is for instant restenosis that a lot of the other products in the market cannot do.

Then finally, we've got a great selling and clinical team that supports our customers. We're winning new customers all the time, and each of the customers we have seem to do more and more procedures with Aureon as they trust the device. So we've got a great cardiovascular business. We'll continue to hone our game and make sure we're the best we can be, but we'll be transparent with you during the course of the year in both of these avenues.

OPERATOR

Thank you. Our final question this morning comes from Aralyn Kanakazi with Free and Broker.

Aralyn Kanakazi

Hi. Thanks for taking the questions and congrats on the strong finish of the year. I actually want to start with Nana Naif. Now that Medicare coverage is in effect, what are you guys actually seeing on the ground? Has a conversation with physicians and hospitals started to shift, for example, from proving the clinical case to more practical things like logistics and capacity.

Jim Clemmer, President and CEO

Really good question. You know, it's funny, we spent the day yesterday, we're spending the day today with our commercial team, the NanoKnife commercial team that's giving us a lot of feedback on what they're seeing and hearing in the field. And, you know, it really starts first with the clinical conversation, what the product does. It's so unique, the way that NanoKnife directs energy to treat that tumor. So the clinical conversation is what we hear from our field team is the most active conversation.

A lot of urologists have been looking for years at a good focal option to keep the gland intact and to treat it. Now NanoKnife is giving them that great focal option. The preserve study shows that. So we're excited at first, urologists are asking how they can learn about NanoKnife, try NanoKnife and treat their patients. Then second, the economic story, what you just mentioned, getting the coverage that we want, not just with Medicare but now with privates coming on.

Getting the LCD from Palmetto is really important. It shows again, how safe and effective the device is and it can pass those economic tests as well, so patients can get treated and doctors and hospitals can get paid. So we're excited, first clinically and second, back to your question. We'll watch over the course of the year as we get more and more of the reimbursement hurdle out of the way. The field team's excited because they're getting so much interaction with urologists who want to come on and if we can make sure we get the reimbursement hurdle cleared.

We're really excited about the future. But good question.

Aralyn Kanakazi

Thank you so much. And my last question is about the guidance. We can see that the adjusted EBITDA range implies that you're investing most of the gross profit back into the business, even with the mix continuing to shift toward higher margin med tech. I can see that a lot of that is clinical pipeline because you have Apex ambition and many more. Can you help us think about how that clinical spend phases over the next couple of years, whether fiscal 2027 is a peak investment year and at one point the model starts showing the operating leverage.

Steve Trowbridge, Executive Vice President and CFO

Great question, Aslan. I appreciate that. So what we've historically said is that we're targeting about 10% of sales as our R&D spend going forward in the year. The clinical spend is within that 10%. So I wouldn't expect that you're going to see a significantly higher investment year in 2027, particularly when it comes to R&D and clinical spend above and beyond what we've guided to, which is that expecting about 10% going forward. The question around growth and how it drops to the bottom line, it's a constant balancing act for us.

We are in investment mode. We're continuing to invest in our business. It's very important for us to continue to invest in all three of the growth drivers within MedTech to continue to grow at the above market rates that we've been growing at. At the same time, we're balancing that with dropping some profit to the bottom line to prove that we can do both. You saw that this year with the EBITDA contribution that we gave at the end of the fiscal year.

And then we're targeting growing about 20% from that elevated baseline from 2016 into 2027 while we're continuing to invest back in the business in terms of clinical trials, new product line introductions that Jim talked about, continuing to invest in our sales force and the feet on the street to drive those MedTech products going forward. So expect that balance to continue. Expect us to do both, invest in our businesses, drive above market growth as well as we continue to drop profit to the bottom line at a healthy pace.

But it's going to be a balance of both of those things going forward. And then add to that the fact that we're proving that our business model can generate cash while we make those balancing decisions. Very good in terms of generating cash flow from operations last year and we're going to have positive cash flow going into 2027 as well.

Aralyn Kanakazi

Perfect. Very helpful. Thanks again.

OPERATOR

Thank you ladies and gentlemen. That concludes our question and answer session. I'll turn the floor back to Mr. Clemmer for final comments.

Jim Clemmer, President and CEO

Thank you for joining us today. I think today you can see the validation of the strategy we put in place years ago to change AngioDynamics to transform the company from what was a slow growth company in slow growth markets that were small. Today our company competes in larger markets that are faster growing where technology and innovation matter and patient outcomes can be measured and we can show improvement on patient wellness. AngioDynamics is part of that shift.

We have the team in place, the people who joined our company now, how to do what we've just said, how to deliver that message to our customers. We've got the products and the innovation in these markets to change and win. These are really exciting markets for us. This company has a good balance today with our medical device products that provide us with the cash and stability to fund our medical technology investments going forward. So my message to investors is keep an eye on our company.

We think we've got a great balance of being in the right place at the right time with great products. We'll continue to show we can grow above market rates in these markets and we'll drop profitability down through the company each year that goes by. We continue to grow above those rates and drop profit that enables us to be strong, keep the debt-free balance sheet in place and use our cash and capital to continue to invest in our company going forward.

We couldn't do this without our great team of people. So thank you to each of our employees who make it all work. Thanks to the investors for joining us today. We'll see you soon.

OPERATOR

Thank you. This concludes today's conference call. You may disconnect your lines at this time. Thank you for your participation.

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