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Artivion executives said the company delivered double-digit revenue growth and increased adjusted EBITDA in the first quarter of 2026, while lowering its full-year revenue outlook due primarily to softer stent graft trends and timing around U.S. AMDS account stocking.
CEO Pat Mackin said Artivion continued to execute its strategy aimed at long-term profitable growth. He cited first-quarter constant currency revenue growth of 12% and adjusted EBITDA growth of 26% year over year.
COO and CFO Lance Berry reported total revenue of $116.3 million and adjusted EBITDA of $22.1 million, up from $17.5 million in the prior-year period. Adjusted EBITDA margin was 19%, an increase of about 130 basis points, driven by SG&A leverage and gross margin improvement.
A key focus of the call was Artivion’s decision to exercise its option to acquire Endospan following FDA premarket approval of Endospan’s NEXUS Aortic Arch Stent Graft system for chronic aortic dissections.
Mackin described NEXUS as a branched endovascular stent graft system intended for minimally invasive treatment of aortic arch disease. He said the chronic aortic arch dissection cohort of the TRIOMPHE trial showed 93% survival from lesion-related death, 90% freedom from disabling stroke at one year, and 95% freedom from intervention due to endoleaks (excluding type II endoleaks) at one year.
Artivion estimated the annual U.S. addressable market opportunity for both NEXUS cohorts at about $150 million, including about $100 million from dissections. Mackin said the company plans to pursue a label supplement for aortic aneurysms through formal regulatory processes after the acquisition.
Berry said Artivion drew $150 million under its existing term loan facility to fund the $135 million upfront purchase price for the anticipated acquisition. The company expects the transaction to close in the second quarter of 2026, subject to customary conditions. Berry added that quarterly interest expense would rise to about $8 million beginning in the third quarter if the deal closes as expected.
Management expects immaterial U.S. NEXUS revenue in 2026 while it completes value analysis committee approvals, builds supply, and expands U.S. sales support. The company is targeting a full U.S. launch on Jan. 1, 2027.
Artivion reduced its 2026 revenue outlook. The company now expects adjusted constant currency growth of 7% to 11%, corresponding to reported revenue of $480 million to $496 million. Berry said the updated guidance assumes foreign exchange will provide about a one percentage point tailwind to reported revenue.
For adjusted EBITDA, Artivion now expects full-year 2026 adjusted EBITDA of $100 million to $107 million excluding the planned Endospan acquisition. If the acquisition closes as expected, the company anticipates about $8 million in incremental 2026 expenses tied to launch costs, commercial infrastructure, operating costs, R&D, and clinical expenses, reducing expected adjusted EBITDA to $92 million to $99 million.
Berry said the guidance reduction primarily reflects stent graft factors. He noted stent graft revenue grew 10% in constant currency during the quarter, but was below expectations due to lower-than-expected U.S. AMDS set sales and softer international results, particularly in the Middle East. Mackin also cited tougher European comparisons following recovery from the company’s 2024 cybersecurity event.
Management said the guidance reduction was roughly split between AMDS set sales and international stent grafts, with the international issue further split between Middle East conditions and supply chain factors.
Mackin and Berry emphasized that U.S. AMDS implant and reorder activity was stronger than expected, even though initial account stocking was below plan. Mackin said the company is prioritizing implant and reorder patterns over the immediate impact of starter set sales because reorders reflect user experience and potential long-term adoption.
Management said hospitals typically purchase four AMDS devices for about $100,000 as an initial starter set. Berry said Artivion is encountering barriers to that upfront purchase, including financial considerations and the need for institutional review board processes while AMDS remains under a Humanitarian Device Exemption. Mackin said some accounts may be waiting for anticipated PMA approval rather than completing IRB-related steps.
Artivion continues to expect AMDS PMA approval around midyear 2026. Mackin said PMA approval should remove the need for new accounts to go through the IRB process, which he expects will help account conversion.
On consignment, Berry said Artivion is not pursuing that approach now, adding that “you can always flip to consignment, you can never flip back.” He said AMDS is used in emergency cases and that management believes hospitals should stock it given the product’s differentiation and reimbursement dynamics.
Outside stent grafts, Artivion reported stronger growth across multiple product areas. On-X revenue grew 17% in constant currency, which Mackin attributed to global market share gains and early traction tied to data supporting mechanical valves versus bioprosthetic valves in younger patients. He said the company continues to view On-X as the best aortic valve option for patients under age 65.
Tissue processing revenue rose 23% in constant currency as tissue volumes normalized following the late-2024 cybersecurity incident. Berry said the business performed slightly above expectations in the quarter and advised investors to think of it as roughly a $24 million-per-quarter business, with normal quarterly fluctuations.
BioGlue revenue was relatively flat in constant currency. Mackin said performance was slightly below the company’s mid-single-digit full-year growth expectation but within normal quarter-to-quarter variability given distributor and stocking dynamics.
Mackin said Artivion has enrolled 26 patients in the ARTIZEN clinical trial for Arcevo LSA. The non-randomized trial is expected to include 132 patients in the U.S. and Europe at up to 30 centers. The product is being studied for treatment of aortic dissection and aneurysm in the arch. The company expects full enrollment in mid-2027 and, assuming endpoints are met, FDA approval in 2029. Mackin said Arcevo LSA represents an incremental $80 million annual U.S. market opportunity.
Management said the pending Endospan acquisition would complete what Mackin called Artivion’s “three-pronged aortic arch portfolio,” alongside AMDS and Arcevo LSA. He said NEXUS is also a platform technology with three additional PMA programs in development.
Artivion, Inc. (NYSE: AORT) is a global medical technology company that develops, manufactures, and markets implantable tissue products and surgical devices for cardiac and vascular surgery. Its portfolio includes biologic implants derived from human and animal tissue, such as allografts and xenografts, as well as synthetic scaffolds and surgical adhesives used to repair, reinforce, or replace damaged cardiovascular and thoracic tissues during procedures including aortic repair, heart valve surgery, and vascular reconstruction.
Originally founded in 1984 under the name CryoLife, the company rebranded as Artivion in early 2022 to reflect its broader mission in cardiovascular innovation.
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