Good afternoon, everyone. I'm Robbie Marcus, the MedTech analyst at J.P. Morgan. Very happy to host our next session with Silk Road Medical. Gonna bring up CEO Chas McKhann, and to do a presentation, and then we'll jump into some Q&A. Chas? So thank you, and good afternoon, everyone. It's nice to see everyone and have a chance to really give you an introduction to me and an update on Silk Road Medical, because I am now 60 days in as the new CEO at Silk Road. I'm joined today by Lucas Buchanan, our COO and CFO, and Lucas will join me for our Q&A. Just excited to provide an update. I see this very much as kind of an interim check-in after kind of initial start of the job, give you some of my reflections 60 days in around a great company. But first, I thought I would start with a little bit of an introduction. I know a number of faces in the room, and it's great to see you again. But for those I haven't met, I've been in the device world for 25 years. I started in big companies. I started at J&J, was part of the team at Cordis that launched the first coronary drug-eluting stent. That was also around the same time that we were developing the initial market for carotid stenting with things like the SAPPHIRE trial, so have some experiences in that as well. I then went to Boston Scientific, where I led marketing globally for the cardiac rhythm management business, so pacemakers, defibrillators, remote patient monitoring, about a $2.5 billion global business. And then for the last 14 years, I've been in more smaller, emerging growth kinds of companies, at a similar scale to where we are, and it's. I love being in these size companies. My most recent was at Apollo Endosurgery. Some of you may know Apollo. We were a publicly traded company in the GI space. We had a multiple product lines, global company. We're in 75 different countries around the world. While I was there, we were able to get a nice growth trajectory, get some new indications, get some key papers published in The Lancet, and then subsequently were acquired by Boston Scientific. And so that deal closed in April of last year. It's been a really good outcome for the company, a good fit within Boston Scientific, and allowed me some time over the summer to take a step back and really think about what I wanted to do next, which is kind of a luxury to really have a chance to do that. For me, at this stage of my life and my career, it really does come down to patient outcome and patient impact, right? So I've known about Silk Road for a very long time. I have a lot of respect for the company and for what Lucas and Erica, my predecessor, and the rest of the team here has accomplished, because I know how hard it is to develop a brand new therapy and a brand new company in this space. And I love, I'll get more into this, what the TCAR procedure, our main procedure, can do for patients. But it's also somewhat personal for me as well, because I've come from a medical family, and I come from a brain family. Those of you who know Silk Road know that we're focused on the prevention of stroke. The picture in the middle there is my father. My father was the founding chairman of neurology at Johns Hopkins, so he started the neurology department, spun it out of the Department of Medicine in 1970, and built it into what was objectively ranked as the top program in the country. So we're pretty proud of that. That's his portrait that hangs on the wall at Hopkins, which is very cool. My brother is the apple that fell pretty close to the tree. He's a neurosurgeon at Columbia, focused mostly on epilepsy work. So I'm really happy to be now also focused on brain health with them as well. My dad passed away recently, and late in his life, he had a series of strokes, so I also experienced stroke as a, you know, family member, saw it firsthand in my dad, saw it as a caregiver for my stepmom. And so I really do have a good feeling for how impactful and horrible this disease can be. And I actually fully believe that if my dad had been diagnosed properly years ago, he probably could have gotten a CEA at the time, or he actually would be a great candidate for TCAR, but his strokes happened before the company was around. So at Silk Road, we are the only company of any kind of real scale focused on carotid artery disease, right? You think about the level of impact of stroke and stroke that's caused by CAD and how big it is. It's pretty amazing that we really are the only company focused on that, and we've got a dedicated team ready to go after it and already really building a nice market in that. It starts with our leadership team. This is some of the key leaders on our team. You know, what you'll notice is a tremendous amount of experience in companies that have been doing this for a long time. Lucas was at Medtronic, and that was part of the original founding of Silk Road. Andy Davis, our Chief Commercial Officer, also has Medtronic background. We've got others coming from Cordis, where I was, or Boston Scientific, or Abbott and Guidant, all of the areas. We've got a lot of vascular experience and knowledge. I, in particular, highlight Dr. Sumaira Macdonald, who really is one of the global experts in carotid artery disease. She is a practitioner herself, but also incredibly well-published. She's on the podium. She's just an incredibly valuable person on our team. I think I don't need to spend a lot of time on stroke and how important and impactful stroke is. I would imagine many of us in the room have a personal experience in our family or personal otherwise, that we know friends. But just to highlight that one out of three strokes, ischemic strokes, are because of carotid artery disease. You can see some of the numbers on the page, and suffice to say there's a big gap between the number of people diagnosed each year and the number of people treated. You know, Lucas, in one of our meetings today, was talking about the fact that there are more people who die from stroke, from carotid artery disease, than the number of treatments. So there is still an ample opportunity here to go after and grow this market. We fully believe that it should be preventable. Start with medical therapy. Patients should be on best medical therapy, and there are opportunities to do that, but medical therapy doesn't solve all the problems, and so then you talk about procedures. The gold standard procedure is a carotid endarterectomy. This is a surgical procedure that involves a cut down in the neck. It's been being done for decades. Involves basically opening up the neck, cleaning out the artery, and then sewing it back up, typically performed by vascular surgeons. Going back 20, 30 years ago, there was initial efforts, as I mentioned, to start doing carotid stenting. You know, basically tracking a stent up through the groin, up, you know, all the way up to the carotid artery, similar to cardiac stenting. And in doing that, placing a stent, but you got to go through the aorta and the arch of the aorta, which is a difficult place to navigate, and then while you're placing the stent, the blood flow is going up towards the brain. And so the Achilles heel of transfemoral stenting has been and continues to be stroke, a high risk of stroke, and with that, a very long learning curve. It's a difficult, challenging procedure. And so TCAR was envisioned and developed a number of years ago as an alternative, provide the benefits of being less invasive, but to also have the safety profile that you see with CEA. So this is just a schematic that gives you a little flavor for what that means. Our secret sauce, for those who aren't familiar with it, is the ability to reverse the blood flow during the procedure. So you do a very small incision in the neck, you reverse the blood flow into the leg and then place a stent. And so any debris, first of all, you're not going through the aorta, so there's less debris, but any debris that does happen is captured in a filter. And then so I think our investor deck online, you actually have seen nice images of the gunk that comes out of the filter. But just gives you that satisfying feeling of making sure you're doing a great procedure. The safety profile and benefits, patient benefits compared to CEA are extensive. Lower risk of heart attack, lower risk of cranial nerve injury, less bleeding. It is a more efficient procedure. It can be done in about half the time. Patients typically can go home in a shorter period, in, like, the next day. Many of these procedures can now be done under local anesthesia. The patient experience also is just simply better, right? A smaller scar, less pain, faster recovery time. And when TCAR was being first envisioned, by our founders, by Lucas and others who were involved in it, the physicians, the pioneering physicians who worked on this, and engineers, the hope was to be able to provide these kind of benefits and be as good as CEA from a safety profile. That was the bar. That was what the aspiration would be. And I'm pleased to tell you that with recent data, we're actually exceeding that bar in some studies. This is one of multiple. This one's out of the University of Miami, done completely independently. There's another group out of Johns Hopkins who's had similar analyses. And what this one was, is looking at the National Inpatient Database and looking and comparing the rates of death and stroke and MI. And I know it's a small chart, but all you need to do is in that little chart in the middle is see on the left side of the page means TCAR is better. And TCAR is better than both CEA and better than both carotid stenting across a very large dataset. You can see the quote from the investigators that in this analysis that was done as of 2019, that despite better outcomes, we are underutilized compared to these other procedures. We've grown a lot since then, but we firmly believe that that still is a true statement. So it really does come down to the patient. This is Donna. Donna is a cardiac nurse. I actually spoke with her last week because I wanted to hear firsthand about her experience. In 2020, she had a stroke event that required an intervention, and so she got a CEA. In her words, it was a horrible experience, right? She basically had a lot of swelling. She had a huge scar. She has a nerve injury to this day. The recovery took a long time. She had trouble driving, all the things I just talked about. But Donna had bilateral disease and needed to do a second procedure, and she was dreading having to do another CEA. Her surgeon had at that point in his career done one TCAR. But because she was so adamant, he's like: "We'll do the, well, next case, we're going to do a TCAR." So it was his second case, and as she says here, it was a night—she said to me, night and day was the term she used. Totally different on as she's on the page, right? Just she was simple procedure, she was out the next day. She had it late in the week, was able to go back to work on Monday. Just an entirely different patient experience. The company is has been developing in the market for quite a while here. As well as your perspective, it's still a relatively new procedure, but we've had five or six years of growth before I got here, and you can see a really nice growth trajectory, which we feel really good about. By the way, just to be really clear, so the guidance for the year was set before I had joined. We reiterated on the call that I joined in November, but we are really just using this slide to show the growth trajectory over the multi-year period, and then we will provide an update both on the quarter and guidance for the year ahead on our earnings call here in about six weeks. So I'm 60 days in, and I wanted to give you the, you know, share some thoughts of what I have heard and learned and found over those 60 days. I've been busy. I've spent a lot of time. I went to the VEITH meeting, where I met a ton of customers. VEITH is one of the large vascular surgery meetings. I've been in cases, I've talked to referring physicians, I've talked to patients, I've spent a lot of time with the team. And so three key insights I want to share with you. First, is that TCAR works, and it works incredibly consistently. I'm going to show you some data around that. Secondly, we've got a healthy base of adopters that is growing. And then third, we've got a fabulous team that really is in place to drive growth, and as I said earlier, the only team that really is dedicated to this space at any kind of scale. So on the procedure front, this is a very well-studied procedure. 300 publications for TCAR, more than 75,000 patients that we've treated so far. We're looking forward to, in this year, we will pass the 100,000 milestone, which we're actually gonna. We're already talking to from a broader standpoint how we celebrate that milestone. Not to give ourselves a pat on the back, but to use that as a milestone to really talk about a procedure that really is moving towards becoming standard of care. From the data standpoint, every patient, up until recently, that we treated in the U.S., had to go into a registry. That was a requirement for the procedure. And so this is data that was presented at VEITH. And first of all, just notice the N. It's in 45,000 patients. As I mentioned, I've worked in a lot of device spaces over a long period of time. We don't see this level, this amount of data, in a device situation very often. The second thing is then looking at. So the presenter was Dr. Marc Schermerhorn, who is from Beth Israel in Boston, and works at Harvard as well. And what he and what Dr. Schermerhorn presented was what he called acceptable thresholds of safety profiles, for whether it's symptomatic patients or asymptomatic patients. And again, in these two large, very large data sets, you can see the TCAR is well below, well within the acceptable thresholds. By the way, he did present data on transfemoral stenting. It was above the line in both cases. So but the other piece to this, this database allows us then to look across lots of different data sets. And whether you're looking at different settings of care, so the academic centers of the world or the rural community hospitals, we get very consistent outcomes, and that's been proven, it's been documented. Experience levels, whether you've got experienced physicians who are just starting TCAR or have done a ton of them, new adopters, as I mentioned, fellows and trainees. Again, we've got documented evidence. We get consistent outcomes from the first few cases. And then lastly, patient cohorts. We get very consistent results and predictable results across some of the areas that I mentioned here, as well as others that have been studied. I don't have references on this slide because we have so many publications against these. This is now published online. We've got a whole page of, I think, 40 different references just on these points alone. And so the level of data really is impressive, and I really just want to emphasize the generalizability of these results, and the predictability gives us a lot of confidence as we continue to grow the market. So moving on to our TCAR base of adopters. We've trained a lot of surgeons before I got here, over the, you know, first few years of adoption. But a couple things to note: so the learning curve, as I mentioned, is very, very short. First few cases, like the second case with Donna. The adoption curve takes time. CEA is a good procedure. Vascular surgeons, who are our primary customers, have been. Many of them have been doing them for decades. So what we see is that people start to adopt TCAR, they keep growing. And over time, they do more. And so our data, and this is across, averaging across all of our customers, that their usage in year five compared to year one is growing by 70%. So there's a nice continued progression, and we've got hundreds of physicians who are kind of in that phase. And it doesn't stop at year five, by the way. It keeps going beyond there as well. The other thing that I was looking at was asking the question is, you know, did we sort of, you know, pick off all the great customers first, and we've got diminishing returns, as it were? In fact, the data show the opposite. The people we've trained over the last couple of years are adopting faster, at a rate, both in terms of their initial adoption, and then their curve keeps going beyond that. And that just tells me that we've got an environment that's becoming more conducive to doing TCAR, and they are able to then embrace it and do it faster. And then a group that I'd like to highlight within that is then the fellows. So similarly, the fellows now are TCAR is becoming part of what they're trained on. It is in most of the... In fact, I think all of the training centers now, just recently, is now part of the boards for the vascular surgeons, and they are coming out doing just on an average monthly utilization, 60% more than a typical adopter, and that's on a lower base, lower denominator, 'cause they're just starting their practices. By the way, this is an area that I really think we can actually build and expand on. We do a great job of fellows' education, but I think we can do even more to make sure that when they come up, they are fully embracing TCAR. A little bit about the referral network for the people who are then referring into the proceduralist. To start with, 80% of all carotid procedures, all three versions, whether it's TCAR, CEA, or carotid stenting, more than 80% is done, are done by vascular surgeons, who are our primary customer base. We have some neurosurgeons, we have some other general surgeons, but primarily vascular surgeons. The vast majority of their referring physicians and referring channels have been in, well-entrenched for well over a year or more, three, four, five, 10 years in some cases. And then this gives you a flavor of where those referrals are coming from. It is a really good mix of different specialties, who know that if you've got carotid artery disease, go see the vascular surgeon in their specialty. They are the experts in this, in this disease state. So as to talk about the base of adopters, I'd like to spend a moment on the recent National Coverage Determination. So those of you who've been following the company know that last year, CMS issued a new NCD. This is for carotid stenting, and it basically approved reimbursement broadly for carotid stenting. And so for our case, we no longer necessarily need to have that registry in order to be able to participate and get fully reimbursed from CMS. This is the culmination of a lot of work by the company over many years to develop that. All of the data I was just referencing before, and was a big development and in many ways a very important achievement for the company. And there are some very tangible benefits to the new NCD for us, right? We expect just a broader increased awareness about carotid stenting and the availability of carotid stenting. I mentioned someone this morning. I mean, when I was talking to my brother about this role, one of the first things he says, "I heard you guys just got new reimbursement." There's no reason, like, this is not the space he enters in, but it's just sort of that sort of filters into, into the thought process. There is an emphasis in the NCD about patient preference and presenting all three options, treatment options, and letting the patients decide. That favors TCAR. When patients know about the procedures, they want, they want a TCAR. We've got data around that. And then there's some really very tangible near-term benefits. So for... I mentioned the registry. It was a requirement to get reimbursed. Registries take work, right? They take their money, they're expensive, and you got to take work. And so we had certain accounts that just decided, "You know what? I'm going to keep doing CEA."... But we've now identified more than 100 institutions who don't have to do a registry now, and now want to get trained and start doing TCAR. So there are real, very real positive benefits in the here and now. That being said, included in the new NCD was also traditional carotid stenting. And so we fully do expect that in some cases, there will be some additional carotid stenting that's done. It's not in indications that we're seeing; it's not a wave of users. Carotid stenting currently is done by a relatively small number of physicians. Again, those of us who lived in this space 20 years ago saw a growth, but then, there's been a decline. There has been reimbursement for carotid stenting for high-risk patients for a long time. It's still not a huge portion of the market, but there will be pockets, right? There will be pockets where that happens, and broadly speaking, what we expect is a broader move towards endovascular treatments, and we fully expect that TCAR is well-positioned to take the lion's share of all of that. And so my third point is just about the team. You know, the carotid space is a really important, big, and growing space, and we are the only company that has scale in this space. We've got more than 200 commercial professionals. We've talked in the past about our sales team, and we've got great sales reps, but we also have our clinical specialists. We've got a marketing team, very good marketing team. We've got our reimbursement team, health economics, whole group in the commercial side, dedicated to ensuring excellent patient outcomes, the kind of results I've just talked about, as well as supporting our customers and being there with them. Medical education, we've got a whole range of programs for training, for education, for therapy awareness in the referring community, supporting allied professionals, as well as the fellows. I think we did more than 200 different kinds of programs of this nature last year. Our clinical regulatory team is outstanding. We've had a whole series of studies that we've sponsored. Our most recent is the ROADSTER 3 study. That is making great progress, and will be another important data set to add to the clinical body of evidence. And then R&D. We haven't talked a lot about the R&D pipeline in the past, and I think that's important for competitive reasons. All I'll say is we are the leaders in this space, and we are not standing still. We've got some really interesting programs that we're working on, and at the appropriate time, we will provide some additional updates on what those look like. So again, in summary, I'm really pleased to be here. I did a lot of homework before I joined, in terms of spending time talking to physicians, talking to referring physicians, people in the industry. I came in with a set of hypotheses of what I thought the opportunity was, and I'm really pleased to see them confirmed, right? To be able to see the ability to have, you know, the strength of the procedure and the data we have, the quality of the base of customers that we have, and the team we have in place. So with that, I'm going to invite Lucas Buchanan to come up and join me, and then happy to do some Q&A. Maybe we could pick up where you left off with your diligence, right? I'm sure after the company had a, let's call it a bumpy beginning of the year, you did your diligence. You're here, so you obviously felt very comfortable with what you saw. What's your best understanding, what happened exactly, and how you plan to correct it and steer the company in a different direction moving forward? Sure. Yeah, no, I appreciate the question. And, you know, it's interesting because I started the recruiting process, you know, this was a well-done, you know, third party, you know, headhunter involved, and I started that over the summer of last year. And those of you who follow the company closely know that there was a lot happening over the summer of last year into the fall. And I tend to think of it that there's at least three or four different things that happened kind of at the same time or in parallel, but that are relatively unrelated, and I think and addressable, basically. So first, there was a research report early last year that talked about the market size by a different analyst that was raising questions about the market size. In my own checks, I didn't feel like that was an accurate reflection, but then, especially when I got here with the team, we've got really good analytics at Silk Road, as good as I had or better than I had, frankly, at J&J or Boston Scientific. We've triangulated it three different ways. We've got a lot of data that suggests the market is right around 170,000 procedures in the U.S., so I feel good about the market. The second one is the NCD, and the NCD will have, you know, changed the market dynamic some, but I think there was a reaction to it of almost the sky is falling element to it, and I wasn't picking that up in my conversations. As I now am here and having additional conversations, again, we expect some impact, but that rising tide element of continuing to drive under, the, you know, the market away from surgery and more towards less invasive, we think we are well positioned for that. So I feel good about that one. The third one, which again was horrendous timing, but coincided with some of the NCD stuff, was we had a slowdown in sales in Q3, and that was announced in October. And I think a lot of people connected those dots, but I don't think they do. The short version of that, and I really spent a lot of time looking into this with my team over the last few months, is there was a lot of change in the sales organization, last year. Some of it planned, some of it just things that sort of happen when you do a sale—you know, when you have a big sales force, and you make changes. So, for example, we made some promotions into our account manager level. That creates some or sorry, into, into the management level. That creates some openings. We had some attrition, but nothing more than is sort of standard in the industry. We had a few mishires we had to let go, and then we had, we grew quickly from 70 to 85 territories and split them. So you add all that up, 31 out of our sales reps, out of our 85, had been hired within the last year. So it's a lot, right? And then, so the order of magnitude of change is real. But we've hired into all those roles. We hired great people. Silk Road is a place people want to be, and they are now building their way up the learning curve, from their experience standpoint. I now view that as, you know, while disruptive last year, a bit of a tailwind to this year to help us move forward. And then the last one, throw in, oh, by the way, let's throw in a CEO change, you know, in terms of just sort of the disruption factor. So I feel good about where we are, and now it's a matter of forward-looking and executing. If I rewind, right, sales force, promotions, backfilling, it's normal turnover. That all seems like run-of-the-mill, sales force execution. So what exactly was it, the changes? Were there any leadership changes in sales? Was there, you know, poor calculations that, that led up to it, right? Because that seems like a significant direct disruption for pretty run-of-the-mill changes at a growing organization. Yeah, and I appreciate that, Robbie, is the question. And so one, that's impressed me as I've looked into it, is we have a very consultative sales process. And so we work very closely with the physicians, as much as any I've seen in my career, where we are helping in the process. They evaluate the patients, they look at the, you know, the imaging and other aspects of the diagnosis, and then help make that decision. And as we have physicians who are climbing up the learning curve, or not learning curve, adoption curve, when they're, you know, doing some TCAR, but starting to do more, having the rep there can make a big difference in terms of that individual decision, right? And so on the margin, they're making a choice, TCAR versus CA. When there's a disruption to that existing rep relationship, they go back and may, maybe go back to what they know better, which is CA, right? It doesn't mean they're giving up on TCAR. It's just in that moment, in that decision, and we had enough of that happen. And so the, you know, with a benefit of hindsight, the company moved very quickly to add those 15 territories and do the splits, and that came to a head right around Q3. I imagine that'll factor partly into my next question. Sure. But, if I look to the implied guidance or the guidance for the year, the implied fourth quarter shows a sequential step down from third quarter. Normally, what's one of the strongest, if not the strongest quarter of the year. So maybe Chas or Lucas, what's embedded in that fourth quarter guidance? I imagine there's a decent amount of conservatism, given the third quarter results, but what's embedded in there, and what's the delta between the normal seasonality and the fourth quarter implied in guidance? Sure. I'll give you an initial kind of disclaimer element to it, and I'll let Lucas answer as well, because the guidance was set before I joined, and then we reiterated on my first call on day five. So, you know, we haven't then commented on it beyond that to say, we will provide the update in six weeks. And so there was a lot happening during that period, the Q3 element, and then a CEO change, and some other things. So, Lucas, you know, anything else you'd like to add? Yeah, I mean, fundamentally, everything's derivative of gaining that incremental procedure on the margin or losing it, right? So we talked about the disruptive effect of kind of moving, splitting territories and disrupting that time and territory or tenure with your doctor and the way they make decisions on the margins. So that's one factor. The other thing we talked about on the call itself was kind of the seasonal pattern, right? Seasonality, which also can affect procedure volume. You know, in Q3, it's usually in the form of vacations by physicians and staff. And I've talked to some other companies, saw the same thing. We had an abnormally strong July and an abnormally weak August and September. You usually see the opposite, right? When school gets back in session, everybody goes back to work and returns from their vacations. And so we took the productivity regain from the sales force, the little bit of uncertainty from the seasonality and how that would affect our momentum into Q4, as well as the more standard fundamentals of price, which is good, and kind of ordering patterns and par levels of inventory and all that gets factored in, in the broader context of, you know, providing some uncertainty, kind of discounting, so to say, with a CEO change and you know, trying to make sure that expectations are level set. Chas, one of the biggest questions I get from investors is sort of thinking about the dynamic of, you've trained the vast majority of surgeons in the U.S. today on TCAR, and your penetration is still on the low end of the spectrum of with 175,000 procedures a year. So if doctors are trained today, what's needed to get them to use more TCAR, right? Yeah. 'Cause at this point, it's not a training function, it's a utilization function. You know, so what can you do as an organization to improve that? And then we'll talk about the NCD- Sure. And how that might interact with it. Sure. Excuse me. Yeah, now we are making a kind of natural progression from growth that was primarily driven by training new users, to now moving more towards going deep with the existing adopters, right? And it's not binary, right? We still have about 200 fellows a year that come out. We have groups like the 100 new people that I mentioned relative to the NCD, and other people who just had maybe been slower to the game, as it were, in terms of joining. So we still are training new users. And as I mentioned, the ones that we're training are actually adopting faster than their predecessors. But still, our primary driver is going to be continuing to go deep with existing users. And there, I think it's, it's a aspect of really refining our targeting and segmentation for our very top customers. How do we help them kind of grow their practices? So that's a market development kind of element, and having the right tools in the toolbox to get out to the referring physicians and the patients. Then, just as importantly, that next wave of people who are in kind of the middle. We talk about that there's a sort of mental shift that people make when early on they're thinking about: Okay, when should I do a TCAR? Like, select the cases, the beachhead cases, almost. Then at some point, they make that shift to saying: When wouldn't I do a TCAR? What we call TCAR first. We don't have enough physicians in that phase yet, but we have people moving in the right direction. The trends are good, and I've seen some of the data on that. So it's a very—it's been the sales team and working with marketing, others. It's a segmenting and targeting aspect and then bringing the right resources to bear. But it's a pretty natural element that happens with a lot of procedures, and it's not a massive, like, left turn in terms of what we're doing. It's just refining. The team is good. We got good tools. It's just refining the approach in certain ways. And I've been talking a lot to Andy Davis, our Chief Commercial Officer, about how we do that, and he's driving with his team and his business plans, exactly that kind of thinking. How concentrated is your group of TCAR first users? Is it 20% drive 80% of the volumes, more, less? Lucas, you're probably closer to the specific data there. Yeah, but we've said this quite a bit in the past, and this is typical for the rollout of a new therapy over time, which is the majority of users drive the majority of the business, and so the goal is to make that minority ever bigger over time. And so we like the trends we see. We like the fact that newer adopters are adopting at a faster rate than previous. And as you know, we have a lot of analytics. So, it's always a thin business, but it's less and less than over time. And as the, y ou know, time is our friend, as a function of more and more experience with TCAR builds the same confidence that they have with CEA, and time and tenure with the sales rep-physician relationship helps drive that. And then, as we've also talked about, just from an opportunity cost perspective, there's been so much time and energy focused on opening accounts, training physicians, getting five products through clinical and regulatory processes, building this evidence and splitting territories and expanding the sales team. Now we can really shift our energy and focus to really going deep and creating a broader user base that's adopting faster, and that's the goal. You've always heard us be incredibly respectful of the end organ in the brain and the consequences of what could go wrong. So we're partners in helping them adopt fast and safe, so to say. Is there any element of experience, meaning doctors who were doing CEA for 15, 20 years, are less interested in adopting a new technology like TCAR, and younger doctors are more interested? Is there any element of that? I'll give you my high-level answer, then Lucas has years of experience with this. I think the short answer is there is some of that, right? You know, CEA has been around for a long time. People who've, i t's a good procedure, right? It, it, and they, the vascular surgeons, it's a part of what they do, and that they've trained on, and if you've been doing it for many, many years, there are certain people, especially when they've gotten kind of later in their career, will say, "You know, that's what I do," right? And, and that's not uncommon, right? It happens. And so part of the emphasis I had on fellows, and I would broaden that out to even early career physicians, is they are more open-minded. They don't have the same sort of entrenched element to it, and we can help them really become kind of that TCAR first, faster, we believe. And so, Lucas, anything else you'd add to that? Yeah. I mean, we study every individual physician, every cohort, every kind of behavior type. That sentiment is true, but we have taught some old dogs new tricks, and we had a very strategic angle at the early days of the company to go to the older physicians that were very pro-CEA, to try to, you know, get their critical feedback, right? You know, there's a lot of early adopters, and there's a lot of people that love new technology. We kind of took the opposite tack of, let's go to the toughest critics. And so that's helped us get kind of the blessing around this procedure, underwritten by real clinical evidence, to then take advantage of the youth movement. But sometimes you need, in a very clubby, kind of concentrated specialty, you need the blessing from above, even if you don't have the same rate of adoption, and that's helped the other folks lean into it more and more. May I, if I turn over to the financials for a minute, and I imagine this is going to be entirely informed by the revenue guidance for 2024. How do you feel about your cash preservation and your cash burn of the company? And in this environment, with high interest rates, everyone's focused on cash flow profitability. So how far away are you, and how do you think about your ability to preserve, and burn as little cash as possible in the near term? You want me to take that? Sure. Yeah. So I feel good. I've said—we've said a couple times, you know, we feel really good about our balance sheet. We feel really good about our potential for operating leverage. Keep in mind that a big chunk of our expense base is non-cash stock comp expense, and so when you look at actual cash burn, it's been going in the right direction. This is also an area where Chas obviously came in to do a lot of diligence around, in addition to the other aspects he spoke about. And so we continue to be excited about the investments we're making to drive growth, but we're very focused on being good stewards of the business and being capital efficient. We did raise money in 2022 to make sure we had the cash we need to get to profitability. We do have very favorable cost of capital relative to the debt facility we have in place. And so we are very aware that new capital is very expensive, and we've got to really drive the business with the balance sheet that we have, and revenue growth is the most important thing there, to your point. And we are at critical mass across most of the functions in the company, including the sales organization. After many years of building, we have manufacturing capacity and infrastructure to support a much higher unit volume and revenue base, and so we do see operating leverage ahead. Chas, I'm gonna end with a question, then I'm giving you 2 minutes to answer. It probably will take half an hour- Okay. In reality, though. Thank you for that. What should investors expect from you over the next 12+ months? What are some of the things they should look for and grade you on? Yeah, no, I appreciate that question. I think, you know, this today is very much a check-in on kind of initial views and my belief around the opportunity and belief around the market, the team, the user base, all of that. But as we get into the next earnings call, I'll provide a bit more update on sort of forward looking and where I see things going. Then I'm a big believer in having a high say-do ratio, right? You know, when we set our objectives on things like guidance, when we talk about other milestones and things that we're going after, that we really have a high, high level of focus to execute against it. So certainly, I expect my board to grade me on that, right? In terms of when we put out our budget and all those different elements to things to have a very high predictability aspect. It's not always easy. There are a lot of moving parts in our market, but that's what I'm gonna aspire to be with the team and just be able to deliver and execute on the areas we talked about. So obviously, revenue growth will be a huge part of it, as well as working towards and reiterating what Lucas just said. We're improving our overall use of capital and moving towards. I don't have a direct timeline for you yet around breakeven, but we have that very much in our sights and moving towards that. So tracking in the right direction there. They're quarter-to-quarter variations, by the way, in use of cash, but moving the trend line in the right direction, I would put on there as well. Great. We're just about out of time. Maybe we can end there. Thank you so much, and thanks, everyone, for joining today. Thank you. Thank you, Robbie.