LeMaitre Vascular, Inc.

LeMaitre Vascular, Inc.

75.00
EUR
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1.92BMarket Cap
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Q4 FY2025 · Earnings Call TranscriptFebruary 25, 2026

Operator

Welcome to the LeMaitre Vascular Q4 2025 financial results conference call. As a reminder, today's call is being recorded.

At this time, I would like to turn the call over to Mr. Dorian LeBlanc, Chief Financial Officer of LeMaitre Vascular.

Please go ahead, sir.

Dorian LeBlanc

Thank you. Good afternoon, and thank you for joining us on our Q4 2025 conference call.

With me on today's call is our CEO, George LeMaitre, and our President, Dave Roberts. Before we begin, I'll read our Safe Harbor statement.

Today, we will be making some forward-looking statements within the meaning of the US Private Securities Litigation Reform Act of 1995, the accuracy of which is subject to risks and uncertainties. Wherever possible, we will try to identify those forward-looking statements by using words such as believe, expect, anticipate, pursue, forecast, and similar expressions.

Our forward-looking statements are based on our estimates and assumptions as of today, February 25th, 2026, and should not be relied upon as representing our estimates or views on any subsequent date. Please refer to the cautionary statement regarding forward-looking information and the risk factors in our most recent 10-K and subsequent SEC filings, including disclosure of the factors that could cause results to differ materially from those expressed or implied.

During this call, we may discuss non-GAAP financial measures. A reconciliation of GAAP to non-GAAP measures discussed in this call is contained in the associated press release and will be available in the Investor Relations section of our website, www.lemaitre.com.

I'll now turn the call over to George LeMaitre.

George LeMaitre

Thanks, Dorian. Q4 featured 16% sales growth, a 71.7% gross margin, and 47% op income growth.

Q4 sales were led by grafts, up 27%, valvulotomes, up 20%, and shunts, up 18%. EMEA grew 29%, APAC 20%, and the Americas 10%.

Artegraft grew 29% worldwide in Q4 as our OUS launch continues. We now have approvals to sell Artegraft in 52 countries.

International sales were $1.9 million in Q4 and $4 million in full-year 2025. We expect to sell approximately $10 million of Artegraft internationally in 2026, contributing $6 million of sales growth for the year.

In Q4, RFA vascular grew 19% and RFA cardiac grew 90%. As a reminder, we currently distribute RFA tissues in just three countries: the US, Canada, and the UK.

German distribution should begin in Q2, and we now expect to receive Irish approval in Q3. We also plan to file for approval in Austria, Holland, Belgium, Spain, and Switzerland this year.

On a related note, we will be consolidating our Chicago RFA facility into Burlington in 2026 as we seek to simplify operations and reduce costs. We ended 2025 with 160 sales reps, up 5% year-over-year, and we plan to end 2026 with 170 to 180.

We also expect to go direct in Poland in Q4. We've begun hiring a Polish general manager.

This project will include an office, warehouse, customer service team, and several sales reps. We currently sell approximately $650,000 a year to our Polish distributor, and this will be the 32nd country where LeMaitre sells direct to hospitals.

As mentioned on our November call, the 2026 US price list reflects a blended 8% increase across the portfolio. On January 1, the price increase was installed, and early results indicate hospital acceptance.

Our US customer service team tells us that this year's transition has been smoother than in years past. Our European customer service team also reports positive customer acceptance to a similar January 1st price increase.

2025 was another year of operating leverage at LeMaitre. Sales were up 14% and op income was up 30%, and our 2026 guidance indicates another nice year on the horizon: 12% sales growth and 21% adjusted op income growth.

We recently hung our 5-year goals on the conference room wall. We call them the 2030 planks.

Our playbook remains simple: produce quality devices, build our vascular sales force, go direct in new countries, acquire niche products, and focus on profitability, cash flow, and dividends. I'll now turn the call over to Dorian.

Dorian LeBlanc

Thanks, George. Q4 organic revenue growth was 15% with 9% price growth and 6% unit growth.

Organic growth was broad-based both by geography and by product category. In Q4, our gross margin increased 240 basis points year-over-year to 71.7%.

This increase was a result of higher ASPs and manufacturing efficiencies. Operating expenses in Q4 were $27.4 million, a 6% year-over-year increase.

Our margin expansion and moderate expense growth in Q4 led to operating income increasing 47% year-over-year to $18.8 million, an operating margin of 29%. Q4 fully diluted earnings per share were 68 cents, a 39% increase year-over-year.

Our Q4 EPS includes a one-time loss on a mark-to-market adjustment in our investment portfolio of $0.5 million for an investment that has subsequently been sold. Overall, 2025 was a year of 14% organic revenue growth with 9% price growth and 5% unit growth, adjusted gross margin of 70.4%, a 180 basis point improvement over 2024, adjusted operating margin of 26%, and adjusted EPS growth of 23%.

Our adjusted numbers exclude the one-time benefit from the employee retention tax credit we received in Q3 2025. We ended 2025 with $359 million in cash and securities.

Our free cash flow, cash from operations less capital expenditures, in 2025 was $74.5 million. In January 2026, we experienced a cyber incident that affected certain of our systems and data.

We securely restored our critical systems and experienced minimal to no disruption in sales to our customers or in the manufacturing release of product. We do not believe the incident has had a material impact to our financial position or results, and we believe we have adequate insurance coverage.

The estimated impact is reflected in our 2026 guidance. However, our review of the incident remains ongoing, and we are subject to various risks described in our SEC filings, including in our upcoming Form 10-K.

On February 19th, our board of directors approved a new $100 million share repurchase program and a Q1 2026 dividend of 25 cents per share, an increase of 25% year-over-year. This is our 15th consecutive year increasing our dividend.

Our increasing dividend underscores our continued focus on profitable growth, and that commitment is reflected in our 2026 guidance. We anticipate full-year 2026 revenue of $280 million, organic sales growth of 12%, a gross margin of 72.1%, and operating income of $77.8 million, up 21% adjusted from a very strong 2025.

We are guiding EPS of $2.91 per share, up 22% adjusted. The manufacturing transfer of our Chicago RestoreFlow processing to Burlington and the opening of our new 34,000-square-foot warehouse will drive an increase of capex to approximately $11 million for the year.

Our guidance implies a constant euro-US dollar exchange rate of 1.18 for the year and an anticipated yield on our invested cash of 4%. The LeMaitre franchise delivered in 2025 with a focus on niche markets, our direct-to-hospital sales model, our growing commercial organization, and our disciplined expense and capital management.

Thanks to our focused and dedicated global teams, we believe we are poised for another successful year in 2026. Finally, we would like to welcome Kyle Bauser to the call.

Kyle has picked up the coverage of LeMaitre at Roth. Thank you, Kyle, and we look forward to the continued coverage.

With that, I'll turn the call over for questions.

Operator

To ask a question, please press star 1 1 on your telephone and wait for your name to be announced. To withdraw your question, please press star 1 1 again.

Please stand by while we compile the Q&A roster. Our first question comes from Kyle Bauser with Roth Capital Partners.

Your line is open.

Kyle Bauser

Hi. Good afternoon, and thank you for the welcome.

It's a pleasure to be following the company. Maybe I'll just start off on guidance.

Really nice finish to the year. Continued operating leverage, and 2026 looks to have some nice, continued operating leverage in the business.

Can you maybe rank the factors that will be key to achieving the operating growth, kind of that's north of what the sales growth rate is, kind of explaining the leverage in the business?

George LeMaitre

Sure. This is George, Kyle.

How are you doing? Welcome to the call, and welcome to covering the company.

Maybe looking backwards is a little bit of a look at the leverage, but we've been pretty good at keeping headcount at a fairly stable level. We've been good at growing our sales pricing, our ASPs, to the customers.

You're seeing that again here at the beginning of 2026. Our gross margin, we're getting a little more efficient also manufacturing our products.

Old-fashioned operating leverage was what we showed last year to get to that, what was it, 14% sales growth and 30% profit growth, and we expect more of the same next year.

Kyle Bauser

Gotcha. Appreciate that.

George, in your prepared remarks, you talked about the 8% blended increase for this year in prices and it sounds like this year's transition was smoother than in the past. I guess any additional color around maybe why it was more difficult in the past and moreover, kind of the outlook for future price increases.

Is 8% still kind of what you're looking for going forward?

George LeMaitre

Sure. It's always on everyone's minds with us, let's talk about prices a little bit.

This year we decided to send the price lists out in November, on November 1st, instead of December 1st, and I feel like that gave everyone a little bit more time, the sales reps, the customer service reps, and the hospital purchasers, time to prepare for the transition in January. We had a really nice transition, really smooth transition.

It may also be worth pulling out, everyone's like, "Well, is this business as usual?" I think why I'm calling it out in my script is I just want to communicate to folks it feels like business as usual, maybe a little smoother than normal for bureaucratic reasons, but feels like business as usual.

The US, what I'll call rack rate price list increases, Kyle, you're new to this group, but we've read them out the first call in February previously, I'll do it again here. In '22, we had a 6.1% price hike for the US hospitals, 5.6% the next year, 5.8% the next year, 8.1% the next year, and finally this year, 8.3%.

I'd say it's been getting a little bit higher, but I would call this business as usual in the US, and we're getting word back from our European colleagues that it's business as usual as well over there.

Kyle Bauser

Okay. Appreciate.

Then just quick lastly, I think reps 160, and you expect to end the year at 170 to 180. What does the cadence look like there?

Is it kind of steady, evenly distributed across the year? More back-end weighted?

Just curious. Thank you.

George LeMaitre

Right. Kyle, of course you bumped into this one.

I had been giving this quarterly, and I think this is the first time we're going to try not to give this quarterly and just give it annually. It's really hard to keep track of individual sales reps and when they're going to quit and when they're going to get hired and things like that.

I think we're not going to try to give you quarterly check-ins, well, we might check in with it, but we won't tell you what we're trying to get to. I think you can think broadly that we're trying to tell you we're going to grow our sales force, and you already know a couple of them are going to be in Poland as well.

That includes the Polish move that we've talked about in my script. I hope that suffices, something like 170 to 180 at the end of the year.

Kyle Bauser

No, that makes sense. Appreciate that.

Thanks again and congrats on a really strong finish to the year.

George LeMaitre

Thanks a lot, Kyle, and welcome.

Operator

Thank you. As a reminder, to ask a question, please press star 1 1 on your telephone.

Again, that is star 1 1 to ask a question. Our next question comes from Rick Wise with Stifel.

Your line is open.

Rick Wise

Good afternoon, George. Great to see the excellent quarter.

A couple things. You highlighted in your starting remarks sort of the who we are and what we do, the M&A, we acquire niche products, etc., etc.

Hate to always hit the M&A question, but gosh, what a great job you're doing with cash. Cash generating $359 million.

Surely, all things equal, that number is going to be higher in 12 months, depending on how you manage the share buyback. How do we think about the set up for M&A in '26?

How important is it to you now? Just what are you thinking about?

Thank you.

George LeMaitre

Maybe I give you a quick intro, and then Dave will handle most of it. Obviously, Dave's here.

I would say in a good way, one of the things we've been trying to prove over the last 5 years is that this company was a great operating company by itself and didn't have to rely on M&A. I think the proof's in the pudding.

We've had all these years of organic growth rate of 17, 13, 14, and now who knows what happens this year. We have had a bit of a chip on our shoulder about trying to prove to you guys that we could do it organically.

Of course, we went out and raised all this money, we're really in the game for M&A. Maybe Dave can expand a little bit more on how he sees the field right now.

Dave Roberts

Yeah. Hi, Rick.

Thanks for the question. Obviously, the center of the fairway for us is still that open vascular area where we get 80% of our revenue.

There are about 22 targets there, I think as we've talked about, and frankly, we're in discussions with all of them, some more actively than others. It's not that broad a universe.

As you also know, we've started looking for acquisition targets in the cardiac surgery field, and that's 12% of our revenue. The sweet spot for us is revenues of anywhere from, I don't know, 50 $15 to $150 million.

I think there are a few large ones in open vascular, but some of the larger ones are in cardiac surgery. Do I feel more pressure to do an acquisition?

I don't know. I feel it's always the same.

I always feel a lot of pressure to do a good acquisition. In terms of the timing, I would say it's nice to have cash because the cash creates optionality, allows us to look larger.

As I've often said, it's more important to do a right acquisition that might not be as large than to just use all the cash. That's not what we're here to do.

We'd love to find a great large acquisition, but we're looking for the right acquisition. Sure.

Thank you,

Rick Wise

Dave. Just one more from me.

Just maybe you could unpack the stellar really Artegraft performance in the quarter, and you highlighted a couple points. Just help us understand.

It's sort of two things: one, maybe, is the opportunity perhaps bigger than the $8 million in Europe, for example, you talked about in the past, and you're already at $2 million quarterly run rate in the fourth quarter, I think, if I'm remembering saying it right. How sustainable is this?

Any updated thoughts on the TAM? Thank you.

George LeMaitre

Okay. Rick, we knew we were going to have to get to this, and I would say I just take the blame for that one.

We put that TAM out there. I guess we didn't exactly understand what we had in our hands.

It's a lot better than what we thought. For fun, again, this is not too scientific, but maybe we're going to call the TAM $30 million now instead of $8 million, and that's new for this phone call, thanks for calling us out on that.

You are right on that. The TAM, you can also add up right now.

Forget about TAM, but the actual market that we're selling right now, remember that Omniflow ovine graft, that sheep graft, it's a piece of it. Then we also have this new thing, the Artegraft in Europe, which you now know is $4 million, and the other one is $6 million.

I'll give you that on this phone call. We're looking backwards, it's always sort of okay, not going forward.

There's 10 right there, and maybe we call the TAM 30 right now. It's going great.

I think it's ahead of expectations. The doctors are more excited about it.

In some ways, the Omniflow, which is the ovine sheep product, sort of it smoothed out the path for the doctors to be ready for the bovine version, which is more robust and, I would say, more healthy, less prone to issues, post-implantation issues, and things like that. All good stuff over there.

The market's ready for it, and we have a fantastic sales force of about I think 55 reps over there maybe right now, 55 or 60, I should know the number. 55 reps over there, Rick.

We're ready to go. We keep going direct in all these new places.

It feels great. It's a great launch at the right time for that company.

You can see what happened last year, organic growth in Europe was 17%. Is that quarter, or is that year?

Is that year? Okay.

So 17% organic growth driven a lot by that product line. Hope I gave you what you wanted, Rick.

Dave, you want to add something about the different products maybe?

Dave Roberts

I might add, Rick, that Artegraft in the US is used primarily for dialysis access procedures, and in Europe the algorithm for dialysis treatment is fistula first, and then frankly they go right to a catheter, which is difficult for patients due to the infection risk. They skip over the middle step that we have in the US, which is to implant access graft, and that's where Artegraft does really shine.

In Europe, Omniflow, the graft that George is referring to, is used predominantly as a leg bypass graft. We're seeing in early days Artegraft is that the hospitals and doctors are ordering the longer ones for use in the leg.

I think we'll be developing the market for AV access graft, dialysis access graft, in the arm, but we believe it's there strictly because we see this success in the US, and the patients benefit. I think we're delighted by the uptake of Artegraft in Europe and outside the United States now, and I think we have a long-term growth potential there by expanding the use of it more into dialysis access.

Rick Wise

Thanks so much. Appreciate all the color.

George LeMaitre

Thanks a lot, Rick.

Operator

Thank you. Our next question comes from Michael Petusky with Barrington Research.

Your line is open.

Michael Petusky

Hey, good evening, guys. George, I guess I'm curious about Europe and the strength there, and obviously Artegraft gets some of the credit, but I'm just curious, do you feel like the way you guys approached MDR and sort of really got after it when some other competitors didn't or just decided to sort of throw in the towel on some products, is that part of what's driving that, too?

If that's the case, I'm just wondering, any anecdotes about picking up share and that sort of thing? Thanks.

George LeMaitre

Sure. Okay.

It's a little bit of that. We've been pretty aggressive with MDR.

In fact, just to sit on that point for a second, we got our final necessary MDR approval for our PTFE LifeSpan product. We're couldn't be more excited about that.

I think we have 22 approvals and our regulatory gang has just done a knockdown job getting those things early for us. As to whether it's taking share because other people have fallen down on the job, other companies have not gotten their approvals, I think early on we were getting word that that was the case.

I don't have additional stories. You've heard a lot about our shunt where we were sort of left as the only man standing for a while.

I think some one or two of them are coming back on the market. No?

I would say we're thrilled where we are MDR-wise. I don't have new stories about material players dropping out of the market vis-a-vis MDRs.

I will tell you every time a company gets acquired in and around our space, I think the Edwards embolectomy catheters were acquired by BD a year and a half ago. Somehow the larger companies that they get traded into, they don't treat these as well, and they leave opportunities for us.

Maybe we have some opportunities around catheters because a very large competitor now owns the Edwards catheters. Of course Edwards was large to start with.

No new great war stories there. Just maybe we go direct What did we go direct in?

Portugal last year, we went direct in Czechia, you're hearing us talk about Poland. We're really covering the map over there and at some point we're going to be one of the largest vascular distribution channels in Europe, maybe that always plays into our help over in Europe.

I don't know.

Michael Petusky

Great. Let me ask one more question, my almost obligatory question on China.

I know it's a tiny market for you, but I also know you're trying there and I'm just wondering any updates in China?

George LeMaitre

Sure. I think the last three or four calls, Mike, and I appreciate you staying on the topic, it's been good news over there and I've got another good one for you, which is I think we were up 24% in revenue in Q4.

It's happening there for us as just a regular company. We're a $2 million company over there.

It's small versus our guidance this year for revenues is 280. You and I are now talking about a $2 million entity inside of a 280.

It's small, but it's growing like you'd expect it to grow in China. We're over the tariff thing.

The way we got over that was we just raised prices. That's helped us a lot over there.

We're profitable over there now for the first time ever. I think Q4 was a profitable quarter.

That's saying a lot. That's having come a long way from losing a million dollars a year over there on regulatory filings.

The one sort of I don't know what you'd say negative over there is that we went over there to get XenoSure cardiac approved, and we got it approved after a long, arduous clinical trial, and then quite honestly, it's been a big nothing burger over there. It's not happening because of that, it's happening because of everything else.

We also, separately, have now finalized our application for XenoSure vascular in China. We shall see what that leads to.

I don't want to make a big deal out of it here, but as an organic operating business, forget about XenoSure and all the clinical trials on that, it's going great over there. We're thrilled.

We got a new manager who he started about a year and a half ago or so. He's doing a fantastic job.

Michael Petusky

Great. I've got to ask this because I sort of almost can't believe the number.

The 20% valvulotomes, I think that product came out when I was roughly in college. I may be exaggerating, but it's pretty close, I think.

How do you put up a 20, a plus 20, on a product that's been around three decades or more? Thanks.

George LeMaitre

Right. It's just a lot of focus, and we have the perfect channel.

The whole channel was built around valvulotomes. For how long we've been at this.

You're talking about that, I've been here 33 years and we've been building brick by brick a channel that's supposed to sell valvulotomes and then other stuff that Dave would buy. It's a perfectly built channel for that.

You don't want to get too far over your skis on it. We had a great quarter, but it's roughly flat.

We're not here in a market that's growing fast, I don't want to oversell everything here. It keeps working for us.

I don't know what the unit number was in Q4. We had a 20% organic no, 20% reported sales number in Q4, and

Dorian LeBlanc

17% organic.

George LeMaitre

17% organic. I can't right now break that down for your units, Mike.

I will say in general, it's a flattish unit market, and we're doing it by spreading our wings around the world and finding new opportunities.

Dave Roberts

Mike, it's Dave. I would just add that the procedure in which a valvulotome is used is a peripheral vein bypass, and I agree with George, we don't want to get over our skis, overexcited, but a couple of years ago there was this huge study done here in the United States, the BEST-CLI study from the NIH, and it showed that peripheral bypass was a more robust procedure.

It held together longer with less complications, etc., than endovascular. Now, the big endovascular companies, they have the marketing firepower to grow their businesses, no question.

If you're wondering why the valvulotomes are resilient and the units are staying flat and not going away in the face of a lot of endovascular competition and alternatives, I would say it's because it's a procedure that works. Good for us to have a good product offering in a procedure that works for patients long-term.

Michael Petusky

Great. I actually it you just brought to mind, I just want to ask before I get off, did you give the split between unit unit growth overall, not just for Valvu, but overall for the company in the quarter?

Dorian LeBlanc

This is Dorian, Mike. We did.

It was 9% price, 5% units.

Michael Petusky

Got it. All right.

Thank you so much.

Dorian LeBlanc

That's the year.

Michael Petusky

That's the year

Dorian LeBlanc

of 2025,

Michael Petusky

and

Dorian LeBlanc

the quarter was 9 and 6.

Michael Petusky

9 and 6. Great.

Thank you.

George LeMaitre

Thanks, Mike. Thanks a lot.

Those are good questions.

Operator

Thank you. Our next question comes from Jakub Mlejnek with Oppenheimer.

Your line is open.

Jakub Mlejnek

Hi, and good evening, guys. Just to start with, what impact do you envision the CREST-2 trial in carotid revascularization to have on your carotid artery stenting business, and how has that been factored into the guidance?

Dave Roberts

Hi, Jakub. It's Dave.

Thanks for the question. It's funny.

We just had a record quarter for our carotid shunt business. How do you square that with the fact that CREST-2 came out?

I'll get to the takeaways in a second, but to give you a sense of the scale, 15% of LeMaitre worldwide sales are used on carotid procedures. Those are shunts and patches.

We get a little over 50% of our revenue OUS, but 80% of our shunt units are sold OUS. These CREST-2 results, that's another NIH trial, I don't know.

I don't know how long it will take to impact our US business. Our US business has been impacted by TCAR, that alternative stenting procedure for a while.

I think we're really well-positioned because we're so diversified geographically. Then CREST-2 is a level-one NIH study, but I would emphasize that if you peel back the onion, the exclusion criteria for stenting, they were able to exclude patients with long lesions, calcified lesions, tortuous arteries, etc., etc., whereas the carotid endarterectomy cohort did not have lesion-based exclusions.

It was a little bit of an apples-to-oranges comparison. It turns out if you just had three of the patients of the 600 patients in the stenting cohort have incidents after their procedure, there would have been no statistical benefit to stenting.

It was really pretty close to a jump ball. Then when you factor in the exclusions, I think we have to see where this goes long-term.

In the meantime, I think we're pretty well-positioned. Our carotid shunt business is kind of transitioning into an OUS business, and I think it's resilient for a long time to come.

Jakub Mlejnek

Got it. Appreciate all the color on that.

Then I guess, back to the price versus units growth, would you be able to break out for this last quarter the price versus volume contributions within the various categories?

George LeMaitre

Jakub, we've tried to stay away from that just for simplicity, no, would prefer not to, if you don't mind.

Jakub Mlejnek

Gotcha. No problem.

Thanks for the questions.

George LeMaitre

Thanks a lot, Jakub. Appreciate it.

Operator

Thank you. Our next question comes from Michael Sarcone with Jefferies.

Your line is open.

Michael Sarcone

Hey, good afternoon, and thanks for taking the questions. Yes, just wanted to start on the gross margin side.

Do you think you can walk through the puts and takes as we make our way through 2026? It would be helpful to get some color there.

Dorian LeBlanc

Mike. Thanks.

It's Dorian. I think you saw a really nice step-up throughout 2025.

We had an 80 to 90 point basis point step-up each quarter. When you adjust out the benefit of that tax credit, which on a reported basis gave us an extra 110 basis points, we're up 180 basis points from 2024 to 2025 adjusted, and we're guiding to be up 170 basis points from 2025 to 2026.

We're seeing a nice continuation of that gross margin story. Obviously, we get the benefit from the pricing increases coming through.

We've done a nice job of getting underperforming products out of the bag. We got rid of the Xeno midway through the year, so that helped with that cadence of improvement in the gross margin in the second half of the year.

We've got some good manufacturing efficiencies that have come through, and all that offsets the normal inflationary pressures in cost of sales, but also some of that mix of the OUS business growing faster than the US business, and we all know that the US business has higher ASPs in general. Back half of the year, we'll have a little bit of pressure from the manufacturing transfer for the RestoreFlow business and a little bit of pressure from opening the new 34,000-square-foot warehouse we have here near the Burlington headquarters.

Overall, it's just been a great gross margin story for us, up 180 and guiding for another up 170.

Michael Sarcone

That's great. Thanks for the color, Dorian.

I guess second one for me, and I apologize if it's been asked, hopped between calls, just any update on the M&A environment and what the pipeline looks like there?

Dave Roberts

Yeah. Hi, Mike.

I answered the question a little bit earlier for Rick, but yeah, the summary is the pipeline is in good shape. We're pretty busy these days, still hunting in open vascular surgery where there are 22 targets and cardiac surgery as well.

The revenue sweet spot, as I mentioned, $15 to $150 million. We're out hunting, and as soon as we have anything to report, we'll report back.

Michael Sarcone

Thanks so much, and sorry for the repeat question.

Dave Roberts

Thanks a lot,

George LeMaitre

Mike.

Operator

Thank you. As a reminder, to ask a question, please press star 1 1 on your telephone.

Again, that is star 1 1 to ask a question. Our next question comes from Brett Fishbin with KeyBanc Capital Markets.

Your line is open.

Brett Fishbin

Hey, guys. Thank you very much for taking the questions.

Just wanted to start with a follow-up on the OUS Artegraft launch again. Just we saw a really significant upside to your original expectations in 2025, the year coming in at $4 million rather than $2 million.

Wanted to just double-click on where you saw the outperformance, just curious on what countries are performing the best. Then just thinking about the $10 million guidance for 2026, just curious on your approach to that, just thinking about the sequential progression the past few quarters, where it seems to be heading, if you view that as maybe a conservative approach to the year-over-year ramp.

Thank you.

George LeMaitre

Great. First part of the question is what countries, and it does feel like it's mostly a Central Europe type thing right now, and I would call what we call DACH, Germany, Austria, Switzerland, and then also I would say Holland has been, or Netherlands if you will, has been really good, maybe that's the strength so far.

It's just getting going in our very strong markets of Italy and Spain. Kind of we're trying to figure out, should we allow them to have consignment, and we weren't going to do it, and then all of a sudden we changed, we decided to do it, we're starting to ramp up specifically in Italy and Spain.

Then in the UK, we really haven't gotten going as strongly as these other places. I think you've gotten Central Europe really off to a fantastic start, and now you have Southern Europe, which we define as sort of France, Italy, Spain, and then Northern Europe, which is the UK, the Nordics, to give, if you will.

I think you have a long long way to go here, and we're not going to get involved in what inning we're in because we always get ourselves in trouble doing that, but feels like you got a long way to go. As for quarterly cadence, we thought a lot about it and we decided to skip the brouhaha of all that and just give you one yearly number.

We really don't feel comfortable guiding on one product line, they're so small versus Europe Artegraft, what is it, 10 this year versus 280 for the whole guidance? It's still we don't want to get too zoned in on that topic, we're going to give you 10 and try not to break this down for the quarters, but still, a nice answer, you're going to pick up $6 million in growth from that product line in Europe alone.

Then also to isolate, it's mostly a European and South Africa thing, and it's not as much in other places. Far, you have Canada to give, you have Australia to give, you just got the approvals, but it's really a European and South Africa thing right now.

Brett Fishbin

All right. That was super helpful.

Then I'll ask one other question. I think it was more of a topic on the last earnings call, but just wanted to ask about the overall health of the APAC market.

You commented on China already, but looks like a bit of a bounce-back quarter here, and just curious if you're still seeing any signs of softness in certain countries or back to business as usual in '26.

George LeMaitre

Okay. It was a fantastic quarter.

I think it was 20% up organically and reported, it was a real solid 20%. It seemed like in Q4 everything sort of came back, maybe with the exception of Japan came back a little bit, but not as much as we would have wanted it to, I would say I still feel a little softness in Japan.

We're going into the year with all kinds of optimism because China is now in terms of the size of APAC, China is getting there. Korea also had a very specific incident around direct for embolectomy catheters in Seoul, it's a long story, I'm not going to get into it, and that's over now and we're direct everywhere in Korea now.

That should get some nice action out of Korea as well as China and that should bring you along here this year, but felt much better in Q4. We'll see what the next 12 months brings in Asia.

Brett Fishbin

All right, great. Thank you, George.

George LeMaitre

Yep.

Operator

Thank you. Our next question comes from Danny Stauder with Citizens JMP.

Your line is open.

Danny Stauder

Great. Thanks for the questions.

First one, wanted to ask on the RestoreFlow cardiac call point. It sounded like it accelerated, I believe I heard 90%, and that's after a strong 2Q and 3Q.

I was curious what you saw in 4Q that's driving this performance, and then, just more broadly, are there any recent trends in the area that are playing out thus far in 2026 that we should keep in mind here? Okay.

George LeMaitre

Maybe this thing called the Ross procedures sort of starting to dominate conversation inside of our company, and the sales manager in the US is a fellow who lives in Toronto, and he's been the guy who's generally been building the Canadian business around allografts. He's now in charge of North America, he's been in charge for a year and a half, and I would say he's been pushing the cardiac side of allografts a lot harder in the US proper, not just Canada anymore, but in all of what we call North America.

We really don't have much of a presence in Mexico, it's mostly Canada and the US. I would say it's a bit of that.

We did a big training course down at Mount Sinai in New York in October around the cardiac device, and that sort of brought a lot of interest to that device. We're in a spot where we don't have a lot of cardiac sales, when you sell some stuff, it looks like a lot, but still, it's out of nothing 5 years ago, right?

We had zero in sales 5 years ago, and now it is something. It's been a satisfying run, and I would say it's about the focus on cardiac.

The vascular business itself is pretty good, too. It's a lot bigger, but it grew, what, 19% in Q4, the vascular business is also doing well, but maybe the excitement is around cardiac.

Danny Stauder

Great. That's great color.

Just one follow-up for me, staying with RestoreFlow, just with the manufacturing transfer of RestoreFlow from Chicago to Burlington, I may have missed this, but should we see this have benefit to gross margin in 2026? Is it already in that guidance or is this more of a 2027 event?

How should we be thinking about that?

Dorian LeBlanc

It's probably a slight headwind to margin in 2026 as we ramp up in one location and wind down in another. We do think that we're bringing it here, as we have with other manufacturing transfers, to have it centralized, to have better control over it, whether or not it improves gross margins long-term.

I think that's our hope, but we'll get it transferred first and think about 2027 when it comes, but all the costs are fully baked into our 2026 guidance.

Danny Stauder

Great. Appreciate it.

Thank you.

Dorian LeBlanc

Thanks, Danny.

Operator

Thank you. Our next question comes from Jim Sidoti with Sidoti & Company.

Your line is open.

Jim Sidoti

Good afternoon. Thanks for taking the questions.

A couple modeling questions. For 2026 guidance, can you tell me what you're assuming for tax rate and share count?

Dorian LeBlanc

Yeah. Tax rate I can give you.

We had a Q4 '25 tax rate of 23.2, and that was the same for the full year, about 23.2 for 2025. That's probably a pretty good number to plug in for for your 2026 models.

Share share count, you you know it doesn't change a whole lot, just the option activity. We'll we'll hit publish on the 10-K in the morning, and I think you can pick up the pick up the numbers from there, or we can get them to you offline if you need them earlier.

Jim Sidoti

Okay. It looks like it was down in the fourth quarter.

Is that a good number for 2026?

Dorian LeBlanc

If you're looking at it being down off of 23, remember off of Q3 rather, remember in Q3 we had this nuance where because of the excess income from the tax credit, we actually flipped from the convertible being excluded to being included, we had to take the dilutive impact of that. It was a little bit wonky on the one-time, the Q4 number is though the right number to look after.

Jim Sidoti

Okay. All right.

Then you talked about RestoreFlow in Ireland. Is that approved already?

George LeMaitre

No, it's not, Jim. You're right to call that out.

We had expected approval by the end of Q2 at the last call, and we're now calling for approval in Q3. The filing was a little bit delayed.

It will go in in March, and we thought it was going to go in earlier.

Jim Sidoti

Okay. All right.

Then you've also talked about that headwind to consolidate Chicago into Burlington. Is that significant or is that a million, less than a million, more than a million?

Can you give us some sense on that?

Dorian LeBlanc

I think we'll say it's fully baked into the guidance, and you can see we've got a pretty consistent gross margin guide here, 72.1 for the quarter, 72.1 for the year, obviously not having a material impact.

Jim Sidoti

Okay. All right.

Then the last one, can you give me the operating cash flow in the quarter?

Dorian LeBlanc

Cash from operations was 23.1, capex was 1.8, free cash flow of 21.3.

Jim Sidoti

Great. Thank you.

George LeMaitre

You bet, Jim. Thank you.

Dorian LeBlanc

Thanks a lot, Jim.

Operator

Thank you. Ladies and gentlemen, that concludes today's conference.

I would like to thank you for your participation, and you may now disconnect. Have a great day.