Silk Road Medical Inc (SILK)·Q1 2024 Earnings Summary

Executive Summary

• Q1 2024 delivered solid top-line growth and margin expansion: revenue $48.5M (+21% Y/Y) and gross margin 75% (+600 bps Y/Y), with GAAP EPS of -$0.36 and adjusted EBITDA loss improving to -$3.9M .
• Results exceeded widely cited street expectations (non-S&P sources): revenue beat vs ~$44.7M and EPS beat vs -$0.40; S&P Global consensus was unavailable via our estimates tool; we reference public consensus sources below .
• 2024 revenue guidance maintained at $194–$198M (10–12% growth); management flagged Q2 gross margin step-down and normalization thereafter, still expecting modest full-year GM improvement vs 2023 .
• Call commentary highlighted healthy TCAR demand, early tapered stent uptake, and “go-deep” commercial execution (2,800+ trained physicians, 85 territories, 200+ field professionals); management opted not to raise FY guide given early-year timing and transitory factors (stocking/pricing normalization) .

What Went Well and What Went Wrong

What Went Well

• Strong growth and margin execution: revenue +21% Y/Y to $48.5M; gross margin 75% (+600 bps Y/Y) on favorable variances and improving execution .
• Commercial progress and utilization: CEO emphasized “meaningful commercial progress” and steps toward “sustainable profitability”; demand supported by TCAR adoption and early tapered stent uptake .
• Operating leverage trend: adjusted EBITDA loss improved to -$3.9M (from -$7.4M Y/Y), reflecting better gross profit and disciplined OpEx growth (+16% vs +21% revenue) .

Quote: “We made meaningful commercial progress while also taking steps toward sustainable profitability.” — CEO Chas McKhann .

What Went Wrong

• GAAP losses persist: net loss of $14.1M and EPS -$0.36; OpEx rose 16% Y/Y to $51.4M, driven by commercial headcount .
• Near-term margin headwind guide: management expects a step-down in gross margin in Q2 before normalization (transitory benefit in Q1), tempering near-term flow-through .
• No raise to FY24 guide despite beat: management cited early-year timing and transitory dynamics (e.g., launch/pricing normalization, possible stocking) when asked why guidance was not raised .

Financial Results

Headline P&L vs Prior Periods

Non-GAAP and Liquidity

Q1 2024 Actuals vs Street Consensus (non-S&P sources; S&P Global unavailable)

Notes: S&P Global consensus was not retrievable via our estimates tool for SILK; public sources (Seeking Alpha/Yahoo-GuruFocus) indicate consensus of ~$44.7M revenue and -$0.40 EPS for Q1 2024 .

KPIs

Segment breakdown: not applicable; SILK reports as a single product platform in the releases used herein .

Guidance Changes

Management noted they will revisit 2024 guidance on the Q2 call .

Earnings Call Themes & Trends

Management Commentary

• CEO (press release): “Our team delivered a strong start to 2024… made meaningful commercial progress while also taking steps toward sustainable profitability” .
• CFO (call): “Gross margin for the first quarter of 2024 was 75%… we expect gross margin to decline modestly in Q2 and begin to normalize thereafter… expect a modest improvement in full year 2024 gross margin over 2023” .
• CFO (call): “We plan to revisit our 2024 guidance on the Q2 earnings call… our Go Deep focus remains our priority… over 2,800 trained physicians, 85 sales territories and over 200 professionals in the field” .

Q&A Highlights

• Why not raise 2024 guidance after Q1 beat? Management cited early-year timing and potential transitory dynamics (stocking/pricing normalization; competition) and plans to revisit guide on the Q2 call .
• NCD impact: CEO noted positive dynamics in awareness/treatment and new account opportunities post-NCD, but no large wave of new transfemoral training; TCAR adoption remains healthy .
• Gross margin/OpEx cadence: CFO expects Q2 GM step-down then normalization; OpEx to remain around Q1 level as the org is at scale across R&D and SG&A .
• Pricing: Product-level price performance was strong with temporary lifts from launches; revenue per procedure expected to normalize toward ~$7,000 over time .

Estimates Context

• S&P Global (Capital IQ) consensus could not be retrieved through our estimates tool for SILK; therefore, we reference public consensus proxies. Public sources indicated Q1 2024 consensus revenue of ~$44.7M and EPS of -$0.40; SILK reported $48.5M and -$0.36, respectively, implying beats on both metrics .
• Estimate updates: Given the beat and reaffirmed FY guide, models may lift near-term revenue/GM but temper Q2 GM due to management’s step-down commentary; full-year GM modestly higher vs 2023 per management’s view .

Key Takeaways for Investors

• Beat-and-reaffirm: Q1 outperformed visible consensus, but FY revenue guide held; expect investors to focus on the Q2 GM step-down comment and the potential for a guide update on the Q2 call .
• Structural demand intact: Post-NCD environment and deepening TCAR adoption underpin procedure growth (+~15% Y/Y), with early tapered stent benefits supporting near-term revenue .
• Margin trajectory: Expect near-term GM normalization after Q1 variance benefits; management still targeting modest FY24 GM improvement vs 2023, supporting improving EBITDA losses .
• Commercial capacity in place: 2,800+ trained physicians, 85 territories, and 200+ field staff should support “go-deep” strategy and utilization gains .
• Watch pricing normalization: Revenue per procedure likely trends toward ~$7,000 as launch tailwinds fade; model ASP normalization accordingly .
• Catalyst path: Potential Q2 guide update, ongoing product launch uptake (tapered stent/balloon/NPS Plus), and continued reimbursement tailwinds could be stock drivers .
• Risk checks: Operating losses persist; OpEx discipline and GM execution are key to the profitability path; competitive dynamics and pricing normalization are near-term sensitivities .

Additional source for Q1 press release text: GlobeNewswire copy of 8-K Exhibit 99.1 .