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Artivion, Inc. (AORT)

Q4 2017 Earnings Call· Thu, Mar 8, 2018

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Transcript

Operator

Operator

Greetings and welcome to the CryoLife Fourth Quarter and Year End 2017 Financial Conference Call. At this time, all participants are in a listen-only mode. A brief question-and-answer session will follow the formal presentation. [Operator Instructions] As a reminder, this conference is being recorded. It is now my pleasure to introduce you to your host, Pat Mackin, Chairman, President and CEO and Ashley Lee, CFO for CryoLife. Thank you and you may begin.

Ashley Lee

Analyst

Good morning and thanks for joining the call. I am Ashley Lee, the CFO of CryoLife. Before we begin, I would like to make the following statements to comply with the Safe Harbor requirements of the Private Securities Litigation Reform Act of 1995. Comments made in this call that look forward in time involve risk and uncertainties and are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. The forward-looking statements include statements made as to the Company’s or management’s intentions, hopes, beliefs, expectations or predictions of the future. These forward-looking statements are subject to a number of risks, uncertainties, estimates and assumptions that may cause actual results to differ materially from these forward-looking statements. Additional information concerning certain risk and uncertainties that may impact these forward-looking statements is contained from time-to-time in the Company’s SEC filings and in the press release that was issued last night. Now I will turn it over to our CEO, Pat Mackin.

Pat Mackin

Analyst

Thanks, Ashley and good morning, everyone. I am very pleased to announce that we had a very solid fourth quarter capping off a highly successful 2017. As you will hear on today’s call, we have an abundance of good news to report on. We generated double-digit growth in tissue processing, BioGlue, and On-X. Our sales organization is direct in more geographies than ever before and the list is growing. And our clinical programs are advancing on or ahead of schedule. Furthermore, we expanded our gross margin, while at the same time we made significant progress integrating JOTEC. Over the past several years, CryoLife has transformed considerably with the acquisitions of On-X and JOTEC. And we have increased our addressable markets by more than $2.2 billion. In addition, the On-X acquisition has been a success and is now generating the type of returns we envisioned when we completed the transaction. Further, you will hear today that the integration of JOTEC is also well on track and we are even more excited than we were about On-X for JOTEC’s potential to drive growth. Finally, one of the first things I did after coming to CryoLife was to begin the process of building a leadership team that was capable of running a much larger company and I am confident we have done so. I have little doubt the successful integration of On-X in the acquisition and rapid integration of JOTEC is due in part to the quality of our current leadership team driving that process even more indicative of our leadership team’s strong capabilities with our ability to post strong Q4 results, while integrating the acquisition of JOTEC. So, now let’s get into specifics. During the fourth quarter, we delivered double-digit revenue growth across all three of our non-JOTEC core product lines, while…

Ashley Lee

Analyst

Thanks, Pat. I will now review our results for the fourth quarter. Compared to the fourth quarter of the prior year, total company revenues increased 17% to $52.8 million. Excluding revenues from the JOTEC acquisition, fourth quarter revenues were $48.7 million, an increase of 8%. Importantly, we saw double-digit growth in tissue processing, BioGlue and On-X despite temporary disruption as we transition to a direct sales model in Spain, Italy and Poland as a result of the JOTEC acquisition. On a geographical basis Q4 North American revenues, which includes the U.S. and Canada, were $36 million, an increase of 7% year-over-year. The increase was driven by 24% increase in On-X revenues and a 9% increase in tissue processing revenues. Revenues from our European region, excluding JOTEC were $8.2 million, an increase of 6% compared to the prior year despite the fact that we elected to terminate distributors and go direct in Italy, Spain and Poland. Revenues from Asia-Pacific and Latin America, excluding JOTEC, were $4.6 million for the fourth quarter, an increase of 26% compared to the prior year primarily as a result of distributor ordering patterns. I’d like to spend some time focusing on our individual product lines and specifically on On-X, tissue processing and BioGlue. On-X revenues for the fourth quarter were $10 million, an increase of 10% year-over-year despite the distributor terminations that we have discussed. On-X revenues in our North American direct markets were up 24% year-over-year excluding the OEM business and increased 9% year-over-year for the fourth quarter in our European direct markets. On-X revenues decreased to 19% in Asia-Pacific and Latin America, primarily due to distributor ordering patterns. On-X revenues decreased 4% overall in Europe primarily due to the loss of 4Q revenues from distributors who were terminated in the third quarter. Total tissue…

Pat Mackin

Analyst

Thanks Ashley. Before we move to take your questions, let me outline our key operating initiatives for 2018. First, we are focused on achieving our 2018 financial guidance that Ashley just outlined. Second, we will complete the integration of the JOTEC business in 2018 and strive to deliver double digit non-GAAP revenue growth for the JOTEC business. Third, we will continue the momentum in On-X and expect to deliver double digit revenue growth in 2018 for the On-X business. Fourth, we look forward to completing the transition to direct sales for CryoLife products in Spain, Italy and Poland. Fifth, through the acquisition of JOTEC and investment in our pipeline, we will expand our current total addressable market opportunity from roughly $600 million to approximately $3 billion over the next 5 years. These initiatives include continuing to pursue future growth drivers for the company through our clinical programs which include the completion for patient enrollment in BioGlue China and PerClot clinical trials and the initiation of the PROACT 10A trial. As a reminder the PROACT 10A trial will seek to obtain FDA approval with the On-X aortic valve using Eliquis rather than Coumadin as the blood thinner. We will provide more details on this exciting trial if and when we receive FDA approval for the IDE. In addition, by this time next year we are expecting to be launching the following new products in Europe. Our next generation frozen elephant trunk called the E-Vita Open Neo. Our next generation thoracic stent graft called [indiscernible] and our next generation thoracoabdominal device called [indiscernible]. These are the same products that we will be seeking to bring to the U.S. markets and expect to commence U.S. clinical trials this time next year. So in closing we are very pleased with all that we have accomplished in 2017. And I am very confident 2018 will be another successful year for CryoLife. The company has never been better positioned, more competitive, but on a larger addressable market opportunity than it does today. The combination of highly competitive products with a well-trained 125 person direct sales force is the strategy we worked hard to put in place since the day I arrived. We expect the combination to drive strong performance in 2018 and beyond. I would like to thank all of those at the company for the contributions that brought us to where we are today. We have always taken pride in the difference our products make in people’s lives and now with JOTEC on-board we will be helping even more patients around the world. With that we will now open the lines for questions, operator please proceed.

Operator

Operator

Thank you. [Operator Instructions] The first question comes from the line of Jason Mills with Canaccord Genuity. Please go ahead.

Jason Mills

Analyst

Hi, thank you very much, Pat and Ashley. Congratulations on a good quarter. Just as aside there, I think folks are having problems entering the queue, so just FYI. So, several questions and again congratulations on the strong fourth quarter bit of surprising strength really up and down the P&L, but especially on the top line in the quarter. Maybe we will start with the question of how sustainable you think the double-digit growth that you saw in your three core organic franchises is as you move into 2018 and that sort of segues to the second part of that question, which is your 2018 guidance on the top line, your organic growth of 6% to 8% sort of in line with what you have been doing for a little while. I am just wondering the upside potential there if you continue to integrate and cross-trained, it sounds like that’s going well and potentially where organic growth could go? And I guess the other thing with respect to the top line that is what organic growth is implied in the guidance if you assume you owned JOTEC for all of 2017 and you included that part in the organic growth calculation? And then also as far as the guidance goes, Ashley, maybe give us a sense for the gross margin, you have been adding back that $3.5 million to gross margin infrastructure for 2018 is a little over than what we were modeling. And I am just wondering where you see gross margins going once you sort of mature the integration of the JOTEC acquisition over time?

Pat Mackin

Analyst

Yes. Thanks, Jason. Yes, so good questions. Let me start with the revenue. Yes, I mean we were very pleased with the fourth quarter. I think one of the things that we talked about with our M&A strategy, the product lines, the core product lines for CryoLife, the legacy product lines, tissue and glue have been growing kind of in the mid single-digit range. And we have commented previously particularly on tissue that we expect tissue to kind of grow in the let’s call it 4% to 6% range. We grew tissue 6% last year, some quarters were 4% or 5% some quarters were 9% or 10%. It can be a kind of a lumpy business we have talked about that, but I think the important part of the message is we executed an acquisition strategy to drive growth for the corporation. And if you look at BioGlue and tissue as the legacy product lines growing in the kind of the mid single-digit range and then you book in those product lines with On-X and JOTEC both growing double-digits that, that was the strategy and that’s pretty much what you are getting with the guidance and what we are expecting. When we announced the On-X transaction, we said we felt we can get double-digit growth over the next 5 years. When we announced the JOTEC acquisition, we felt we could get double-digit growth over the next 5 years. And so when you put those kind of bookings up against our core and you add together the double-digit growth of those new products with kind of mid single of our legacy products that’s where you get to the revenue growth that we are at. So your second question was kind of the – if you do the pro forma as if…

Ashley Lee

Analyst

Yes. So if you look at our consolidated gross margin guidance, it’s – if we are at the top end of the range, we will be in the upper 67% range. For 2018 there are a couple of things that are impacting that. One is that the JOTEC gross margins are slightly below where our consolidated corporate gross margins were prior to the acquisitions, so that’s having a little bit of an effect to way down the margin number. The other thing is we are expecting a slight decrease in our tissue processing gross margins for the year. We implemented some processes to optimize our inventory levels that’s reduced – that’s resulted in a little bit of reduced throughput through our facility, which is slightly impacting our unit costs. We are still expecting tissue processing gross margins to be in the low 50% range, but that’s down slightly from the mid-50% range that we posted last year.

Jason Mills

Analyst

Okay, that’s helpful color. I guess Pat and Ashley as we think about this business, in fact you gave some color to this in the remarks to my first question just how you see the growth in JOTEC and On-X was double-digits and then the other parts of the business that you had single digits as you look – as to P&L over the next 3 years and you are standing here probably not there to give granular 3 year guidance here, but just trend guidance, trend analysis here for us as you look over the longer term, how do you see this business developing sort of on our baseline basis or maybe you can think about best and worst case growth rates in margin percentages. You have talked in the past about this business now being really setup to deliver not only strong top line growth, but bottom line performance, I presume you still think that and then maybe as the last question, I will get back in queue, just maybe give us an update on the AEP certification for On-X in France? And thanks I will get back in queue. Congrats on the good quarter.

Pat Mackin

Analyst

Thanks, Jason. Yes. So I think I mean one I can say we are very excited about what’s happening with On-X and what’s happening with the recent JOTEC acquisition. I mean I think it’s in both cases they pretty much – On-X we have a couple of years under our belt and you heard about the market share gains we have had. I mean the same with JOTEC I mean the more I have learned, the more excited I get. And I think there is a – but there are a few things about if you look over the next 3 years that are going to be new for our shareholders. One, when you look – you start at the top of the P&L if you have double digit growth in On-X and double digit growth in JOTEC and we kind of keep the core at the mid-single that’s going to and if we can push the growth rates on the newer products the On-X and the JOTEC that could give us – get us in the higher end range of this upper single-digits, that’s the first piece. The second piece is as move down the P&L into the gross margin, we really have not done a lot as a company on kind of cost down which is a disappoint in larger companies is quite good. Our new Head of Operations is a gentleman I brought in from that I worked with previous at Medtronic. His last job was the Head of Global Supply Chain for Baxter, their $2 billion supply chain. One of his goal – his major goals over the next 5 years is to take off down in our cost of goods line and we are going to be looking to move margins from 70 to 75…

Jason Mills

Analyst

Thanks, Pat. Thanks, Ashley.

Operator

Operator

The next question comes from the line of Suraj Kalia with Northland Securities. Please go ahead.

Suraj Kalia

Analyst · Northland Securities. Please go ahead.

Good morning gentlemen. Can you hear me alright?

Pat Mackin

Analyst · Northland Securities. Please go ahead.

Yes, good morning.

Ashley Lee

Analyst · Northland Securities. Please go ahead.

Good morning.

Suraj Kalia

Analyst · Northland Securities. Please go ahead.

Pat my apologies for the background noise. So, Ashley, the 9% year-over-year decrease in On-X in the direct geographies, I guess specifically that you are going to look at Canada and Benelux, can you give us more precise information, what was in gross margins and what were the ASP increases, if any?

Pat Mackin

Analyst · Northland Securities. Please go ahead.

Yes. Hey, Suraj, it’s the background noise it’s really hard to hear. I think what I heard you ask is, so full year On-X growth?

Ashley Lee

Analyst · Northland Securities. Please go ahead.

Yes. So, in our direct markets, we were up 22% year-over-year in the fourth quarter and that was 9% in our European direct markets and 24% in our North American direct markets.

Suraj Kalia

Analyst · Northland Securities. Please go ahead.

And then the second question I think was the impact of Canada and Benelux, what happened with the margin in the pricing when we go direct in those markets?

Ashley Lee

Analyst · Northland Securities. Please go ahead.

Yes, it obviously just varies country by country. We get anywhere from a 30% to 70% increase in the ASP with increase in cost. And again, so it just varies in the various countries within Benelux and Canada.

Pat Mackin

Analyst · Northland Securities. Please go ahead.

Yes, I think the other important part, if I could just hold a bit, we don’t just go direct to do get a one-time benefit out of eliminate the middleman and get the end user pricing, end user margin. That’s the first kind of benefit. The second benefit is we have three – we hired three great reps in Canada. We have got a rep in Montréal, a rep in Toronto, a rep in Vancouver. They are carrying the whole product line. That business is growing significantly faster, 5 times as fast as company. So, it’s not just getting rid of the middleman, it’s putting your own people in with our sophisticated product portfolio, their contact with customers on tissue, on On-X, on Glue in driving our products into the marketplace, because they are the best-in-class and that’s really why we do it from a more strategic standpoint.

Suraj Kalia

Analyst · Northland Securities. Please go ahead.

Got it. And again apologies for the background, Pat. On JOTEC, 14% year-over-year growth in FY ‘17 I presume there must be some discussion from a sales force perspective integration, because that growth was slightly lower, then if I remember correctly from the previous years?

Pat Mackin

Analyst · Northland Securities. Please go ahead.

Yes, I would say, look, so I would say, I don’t think there was that much disruption in the channel, I would tell you JOTEC is an extremely well run company when we acquired them. Their CEO, who is now the Head of our European operations from a commercial standpoint is extremely professional, is an excellent leader. And if we had him locked up for 8 months during this acquisition thinking it’s a small company and you know the amount of due diligence we have to do on financials, on patents, on employment and it’s just a lot of work and we literally had him totally consumed last year for the majority of the year, where he wasn’t out driving the business and they still posted 14% top line growth. So, I don’t think there has really been much of a channel disruption and now that we have got this transaction behind us and the integration is well on its way, I expect to have the – all the right people driving towards – driving the top line, so I am not surprised, but again it was still good growth.

Suraj Kalia

Analyst · Northland Securities. Please go ahead.

And finally Pat, it’s surprised that people are not paying that much attention to select PROACT XA, but we have talked about it multiple times, but I would like you to give the audience how this could be a game changer and I know this is my [indiscernible] I am just – I am extremely bullish on the path that you guys are going down under as you gain further audience at large, just kind of walk them through why or how this could help you hit our targets on aspects and even in the [indiscernible] valve any color for the audience at large will be great? Thanks for taking my questions and congrats on the quarter.

Pat Mackin

Analyst · Northland Securities. Please go ahead.

Thanks Suraj. Yes. This has been one of the things, so what we used to call the PROACT II trial, which is kind of the follow-on to the PROACT I trial. We are now calling it PROACT XA because we are going to be studying one of the novel in a coagulant, which is a XA inhibitor that has been PROACT XA. This is what I would call a kind of a game changer for aortic heart valve surgery. One of the downsides of having to – when you get a mechanical valve over a tissue valve is having to take a blood thinner. And the trade off is do you take a blood thinner or do you have to experience a reoperation if you get a tissue valve. And we obviously made a big step in the right direction with the PROACT I trial, where we could reduce about 50% of the amount of Coumadin that a patient takes and enhanced 65% reduction in bleeding. That’s a great step forward, but still the fact of the matter is Coumadin requires you to it’s called maintain your INR level to check the level how thin your blood is to make sure that your blood is not going to clot and cause a stroke with your valve. And that requires you to go to a cardiologist clinic every week almost like a diabetic patient, prick your finger, check your blood, so you are somewhat kind of tethered to your blood thinner and always constantly monitoring and maintaining a certain INR level. You also have some diet restrictions. Coumadin is vita – is a vitamin K antagonist, so if you eat too much salad, you could actually throw off your INR levels. Switching to an Eliquis, I would just say that universally…

Suraj Kalia

Analyst · Northland Securities. Please go ahead.

Super. Thank you.

Operator

Operator

Your next question comes from the line of Brooks O’Neil with Lake Street Capital Markets. Please go ahead. Brooks O’Neil: Good morning guys and congratulations on the quarter, I was hoping you could just talk a little bit about the plans for getting JOTEC to the United States, I know it’s not for a bit of time, but can you just talk us through sort of the outlook over the next couple of years for moving here?

Pat Mackin

Analyst

Yes. So good morning Brooks and thanks for the comments. So we mentioned – I mentioned this a little bit in the script. I mean our plan basically is the JOTEC team is – they have got a great R&D team. They have come up with some fantastic products. And because the U.S. market is quite rigorous when it comes to getting these approvals, we want to make sure we have the latest products available, because it takes us several years to get these things into the market. So one of my comments was that at the end of this year, at the end of ‘18 the JOTEC R&D team is going to deliver next generation frozen elephant trunk called a Vita Open Neo, we are going to deliver next generation thoracic stent graft called [indiscernible] and they are going to deliver our next generation branch thoracoabdominal graft called E-inside. We are going to take those three devices, we will launch those in Europe about this time next year, but those will be the three devices that we take to the FDA and get our IDE setup for the PMA clinical trials. So we will start to have those meetings with the FDA this year, it’s one of our goals and to really get ready to start enrollment about this time next year in those three clinical trials. Again those are all PMA trials and from – you go from enrolling to your follow-up to your approval, it’s a four – probably 4-year timeframe you are looking at once you get the trial started. Brooks O’Neil: And along the way Pat you expect to drive growth in the other products in Europe and the U.S. to kind of bring you to the time when you get the significant JOTEC products to the U.S.?

Pat Mackin

Analyst

Yes. And again it’s almost like to your point, I mean as an investor, I mean that’s a long time to wait. And one of the things we liked about the JOTEC transaction is we think we can see nice growth over the next 5 years as we are waiting for these U.S. products to hit. Once those – I mean the U.S. market for stent grafts is $1 billion and we are going to be well poised to hit that market in the next 5 years. But along the way you are going to see nice growth as I commented earlier between the core products, the geographical expansion, the R&D pipeline outside of the JOTEC in the U.S. Brooks O’Neil: Great. And then the only other one I had was any update on the wound products that you developed them we are talking about maybe finding a partner for it?

Pat Mackin

Analyst

Yes. I think look – so we believe we have got a great product. This is our product called Neo-Patch, it’s an amniotic membrane used for diabetic foot ulcers, the DFU market. It’s a big market, it’s fast growing. This product had been developed and we – I thought it was a good idea to CryoLife did a nice job developing the product, we don’t have the sales force, so we did a clinical trial called closure, product was very effective. And basically we have been in partnership discussions looking for a partner to distribute this for us. We are still active in those discussions from. I mean from a shareholder standpoint, we are not spending really spending any money on it. It’s kind of it’s already been developed, it’s already been trialed. We are now just in kind of BD discussions and if we find a partner it’s all upside, if we don’t, I mean it’s – there is kind of no harm of valve. But it is the potential upside, but it’s not really material to what we are doing as a company. Brooks O’Neil: Okay. Thank you very much.

Pat Mackin

Analyst

Thanks Brooks.

Operator

Operator

Our next question comes from line of Jeffrey Cohen with Ladenburg Thalmann. Please go ahead.

Jeffrey Cohen

Analyst · Ladenburg Thalmann. Please go ahead.

Hi Pat and Ashley, can you hear me, okay?

Ashley Lee

Analyst · Ladenburg Thalmann. Please go ahead.

Yes. Good morning Jeff.

Jeffrey Cohen

Analyst · Ladenburg Thalmann. Please go ahead.

So just a couple of issues, lot of my questions have been addressed already, but can you talk a little bit about pricing, price increases, specific territories in which prices have been fluctuating particular areas where you have swap to go direct a little bit and as far s that affect? Thanks.

Pat Mackin

Analyst · Ladenburg Thalmann. Please go ahead.

Yes. We – and I think I have mentioned this before on previous calls. I mean when I got to CryoLife, I was a bit surprised that in the markets I have been competing and the price pressures were intense and it wasn’t are you raising prices, it’s like how far your price is going down. When I got to CryoLife, they have been you raising prices pretty substantially every year. And I think there is a point in this healthcare environment where you kind of you can only go so far. And I think we have – our prices are very stable frankly. And I will let Ashley comment, he made a comment earlier about when we go direct it varies by country and who your distributor is and what the market is and which product you are talking about, but those by eliminating the middleman you kind of can get between 30% and 70% of an increase in your pricing, it just depends on the country and the products. But in general in pricing, I mean our prices are very stable. I mean if you looked at tissue in the quarter, we had a 16% increase in cardiac units and a 16% increase in revenue. There was no difference in pricing. When I look across all of our product lines, we just don’t see much pricing movement and Ashley, I mean from your perspective.

Ashley Lee

Analyst · Ladenburg Thalmann. Please go ahead.

No, I don’t think I have any further to add. That’s pretty accurate.

Jeffrey Cohen

Analyst · Ladenburg Thalmann. Please go ahead.

Okay. And then secondly, could you give us a little color on Japan specifically, specific product lines being sold there now, introductions that you anticipate over the next year or two and perhaps some further clinical work?

Pat Mackin

Analyst · Ladenburg Thalmann. Please go ahead.

Yes. So, we currently have BioGlue in Japan and we have On-X in Japan, both are growing nicely. I don’t have those growth rates at the top my fingers. I would say that Japan BioGlue had been growing 20% after the new indication and we have reported on that a number of times. We still see nice growth in Japan in BioGlue after we get that indication approval. On-X is actually doing quite well in Japan and growing. We don’t have other products, JOTEC has no products there. So, there are discussions about taking some of the key JOTEC products to Japan and we are in the middle of exploring those opportunities as we speak.

Jeffrey Cohen

Analyst · Ladenburg Thalmann. Please go ahead.

Okay, got it. That does it from me. Thanks, again. Nice readout on the year.

Pat Mackin

Analyst · Ladenburg Thalmann. Please go ahead.

Thanks, Jeff.

Operator

Operator

There are no further questions at this time. I would like to turn the floor back over to Pat Mackin for closing comments.

Pat Mackin

Analyst

Well, I want to thank everybody for joining today. And as you could hear from the transcript in the call today, we are very excited we had a great Q4, double-digit growth in all of our key products. We beat our top line, we beat the bottom line. So, 2017 was, I think, a nice finish particularly with the transaction closing for JOTEC on December 1. We have been working very hard over the last 5 months. We start integrating this transaction the date we signed. So, we have been actively and aggressively integrating for 5 months. We are very excited to go live in our direct countries, Italy, Spain, Poland. On April 1, the back office is being setup and we are looking forward to a very successful 2018. Our channels are in place. Our products are in place. We got a great leadership team and our pipeline is extremely powerful, everything from BioGlue China to U.S. PerClot hitting in the second half of ‘19 to you heard my comments about PROACT 10A, you heard my comments about stent grafts, next generation stent grafts almost every product line in Europe and outside the U.S. coming this time next year and then using those products to trial in the U.S. going forward. So we are very excited and look forward to working with you as we build the company. It sounds like there was another question. Do you have someone in the queue for – is there anyone else in the queue.

Operator

Operator

Excuse me. Yes, I wanted to interrupt to. We have another question from the line of Jo Munda with First Analysis. Please go ahead.

Jo Munda

Analyst

Hey, Pat and Ashley. Sorry, having some issues getting into the queue here. Can you hear me, Okay?

Pat Mackin

Analyst

Yes, we hear you fine.

Jo Munda

Analyst

Yes, I will make this quick. Just lot of questions answered already. What was total debt at the end of the quarter?

Pat Mackin

Analyst

It was right at $225 million.

Jo Munda

Analyst

$225 million. Ashley, other thing is real quick, the breakout GAAP versus non-GAAP for the diluted weighted average shares outstanding 34 million, a 25 but then on the non-GAAP you have 35.90 million. I guess give us some color on the delta there maybe I am missing something on my end?

Ashley Lee

Analyst

You mean between the forecasted 37.5 million for 2018 compared to?

Jo Munda

Analyst

No, the fourth quarter, the reconciliations from GAAP to non-GAAP for this year has been on?

Ashley Lee

Analyst

The additional shares that we issued as part of the JOTEC acquisition, we are only outstanding for 1 month during the quarter. So, that’s why you have a lower share count in the fourth quarter.

Jo Munda

Analyst

Okay. That makes sense. And then Pat, just real quick BioGlue put up a really solid quarter in the fourth quarter you gave us some key points here, but it means could you give us a little bit more granularity, I know U.S. was up despite trailing against competing products, but I mean a little bit more color from our end would be very helpful, because it seems like a really nice solid breakout quarter for BioGlue?

Pat Mackin

Analyst

Yes. I think one of the things, so we actually it was nice to see growth in the U.S. I mean, it was up a couple of percent and we had some pressure against because of the competitive trial and we have talked all year. We saw nice growth in Europe. I think the big swing was – and we talked about this before as well both to the upside and the downside, some of the distributor ordering patterns I can’t control and we obviously had a big – we had a big order, I think coming out of Japan late in the year, which kind of boosted up the revenues. So, I mean, look we see that with tissue and Glue sometimes, where depending on the distributors, you are going to have a big quarter, one quarter and then it’s – the next quarter is a little lighter and then you kind of it smoothes out and I made that comment previously. So, I think the Glue growth was excellent. We did have a big – I think the only thing out of the ordinary was a big order of Japan late in the year.

Jo Munda

Analyst

Okay. And then last question here, Ashley, you talked about unit growth on the vascular, about 7% for overall growth is roughly 5% in the quarter. Are you seeing pricing pressure competition in the space? You talked about gross margins coming down for tissue, I just was wondering some of the dynamics there, is pricing at risk as far as the some of the tissue business is concerned?

Ashley Lee

Analyst

I think that the decrease that we are projecting in margins for 2018 versus ‘17 it is more a function of reduced throughput to the facility as we optimize our inventory levels.

Pat Mackin

Analyst

Yes, it’s on the COGS side, not on the price side.

Ashley Lee

Analyst

Yes.

Pat Mackin

Analyst

We manage our inventory and our throughput. And if you have high throughput, your margins are better and if you back off your throughput, your margins come down a little bit, I mean, that’s just the nature of the math, but it’s not a price issue, it’s a COGS issue.

Ashley Lee

Analyst

Yes. And as I indicated, I mean, we are still expecting gross margins for tissue processing business to be in the low 50% range.

Jo Munda

Analyst

Okay, thank you.

Operator

Operator

There are no further questions. I hand back to Pat Mackin for closing comments.

Pat Mackin

Analyst

I am not going to do this all over again. So, I just want to thank everybody for joining on the call and I look forward to keeping you updated with our progress. Have a great day. Thanks.