AngioDynamics (ANGO) Q4 FY26 earnings call: guidance and Q&A

What changes in neurologist adoption or account additions have been seen since the Palmetto LCD went live, what's the timeline for benefit, and the pathway to broader national coverage?

The Palmetto decision is important, but the CPT code alone wasn't a "hockey stick." Consistent positive anecdotes and payer coverage are emerging. The company will follow the same playbook to secure consistent reimbursement across the country, building on the first positive LCD.

“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.”

asked by John Young · answered by Stephen Trowbridge

How large is the BPH opportunity for NanoKnife relative to prostate cancer, and what's the timeline to first data?

The BPH market dwarfs the prostate market, and anecdotal feedback from physicians treating tumors with NanoKnife suggests it also cures BPH. The company is being cautious and learning from the ongoing study before sizing the market or providing a data timeline.

“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.”

asked by John Young · answered by James Clemmer

What led to the quarter-over-quarter declines in mechanical thrombectomy? Was it a slowdown in usage or less new account opening?

While AlphaVac grew 44%, overall performance was below goals. The market is competitive, and the company is working with peers to increase adoption of mechanical interventions. Internally, commercial approach changes were made in Q4, including new leadership and sales force training, to improve market share capture.

“What we can't 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 for us to be effective as fast as we can.”

asked by John Young · answered by James Clemmer

Provide directional cadencing for revenues and cash generation for FY27, given historical patterns.

Q4 is typically the highest for revenue and cash. Q1 is usually a step down in revenue and highest cash usage. Q2 and Q3 sequentially step up from Q1, with Q3 sometimes slightly down from Q2. This seasonality is expected to continue, though growth in MedTech may mitigate some lumpiness.

“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.”

asked by Frank Takkinen · answered by Stephen Trowbridge

Is the $8.4 million in NanoKnife disposable revenue a baseline to grow from, or will seasonality impact it?

It's a bit of both. The $8.4 million reflects increased urologist adoption and indicates a higher baseline for NanoKnife probes. However, seasonality (Q4 strongest, Q1 step down) will still apply, but the overall trend is positive.

“But I definitely expect that you're going to see nanoprobes 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.”

asked by Frank Takkinen · answered by Stephen Trowbridge

How is competitive intensity from Boston Scientific (thrombectomy) and Medtronic (atherectomy) affecting the business, and is pricing pressure emerging?

No significant pricing pressure is observed in either cardiovascular category. In thrombectomy, the market is competitive but the product performs well, and the value proposition (removing clot quickly, reducing ICU stays) offsets pricing concerns. In atherectomy (Auryon), the product's effectiveness (above/below knee, in-stent restenosis) and strong clinical/sales support drive market share gains, not pricing.

“in neither of the two categories you mentioned, our two cardiovascular categories, we don't hear a lot of pricing pressure.”

asked by Unknown Analyst · answered by James Clemmer

Have conversations with physicians and hospitals shifted from clinical proof to practical logistics and capacity now that Medicare coverage is in effect?

The primary conversation remains clinical, focusing on NanoKnife's unique energy delivery for tumor treatment and its focal option for urologists. The economic story, including Medicare and private payer coverage, is the second key area. As reimbursement hurdles clear, the field team is excited about increased urologist interaction.

“At first, urologists are asking how they can learn about nano, try nano, 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.”

asked by Unknown Analyst · answered by James Clemmer

How does clinical spend phase over the next few years? Is FY27 the peak investment year, and when will operating leverage start to show?

R&D spend is targeted at about 10% of sales, and FY27 is not expected to be a significantly higher investment year for R&D/clinical spend. The company balances investment for growth (clinical trials, new products, sales force) with dropping profit to the bottom line. They expect to grow EBITDA by about 20% from FY26 to FY27 while continuing investments and generating positive cash flow.

“So, I wouldn't expect that you're going to see a significantly higher investment year in '27, 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.”

asked by Unknown Analyst · answered by Stephen Trowbridge