Executive Summary

Q2 delivered double-digit topline growth and sustained 75% gross margin, but losses widened as OpEx rose; management withdrew FY24 guidance following the announced Boston Scientific acquisition. Revenue was $51.2M (+13% YoY), gross margin 75%, and net loss per share was ($0.42) .
Versus consensus, SILK beat revenue (~$51.24M vs $49.60M) but missed EPS (−$0.42 vs −$0.38); SPGI (S&P Global) estimates were unavailable in our tool, so third-party sources are used for consensus figures
Management attributed performance to continued TCAR adoption; adjusted EBITDA loss improved to $(1.1)M from $(3.4)M YoY, while Q2 OpEx rose 20% YoY (SG&A-led), and included acquisition-related costs .
Guidance: prior FY24 revenue outlook of $194–$198M given in Q1 was withdrawn in Q2 in light of the pending BSX acquisition announced June 18, 2024 (closed Sept. 17, 2024), framing the stock’s near-term catalyst path around deal completion and integration .

What Went Well and What Went Wrong

What Went Well
- Continued TCAR adoption drove 13% YoY revenue growth to $51.2M, with gross margin maintained at 75% (up from 71% YoY); CEO: “Our solid second quarter performance demonstrates continued TCAR adoption and growth” .
- Adjusted EBITDA loss narrowed to $(1.1)M from $(3.4)M YoY, reflecting better underlying operating leverage despite higher OpEx .
- Balance sheet liquidity remained strong with cash, cash equivalents and investments of $186.2M at 6/30/24, supporting runway through the acquisition period .
What Went Wrong
- EPS missed consensus as OpEx increased 20% YoY to $55.7M; net loss widened to $(16.6)M, or $(0.42) per share vs $(0.35) a year ago .
- Guidance visibility reduced: the company withdrew FY24 guidance given the pending BSX acquisition, limiting standalone outlook for H2 .
- Acquisition-related costs ($4.4M in Q2) and continued stock-based compensation ($11.0M) weighed on GAAP profitability .

Financial Results

Metric	Q4 2023	Q1 2024	Q2 2024
Revenue ($USD Millions)	$47.27	$48.48	$51.24
Gross Margin (%)	74%	75%	75%
Operating Expenses ($USD Millions)	$49.17	$51.44	$55.70
Loss from Operations ($USD Millions)	$(14.37)	$(14.93)	$(17.20)
Net Loss per Share (Diluted, $)	$(0.33)	$(0.36)	$(0.42)
Adjusted EBITDA ($USD Millions)	$(4.11)	$(3.93)	$(1.11)

Q2 2024 vs Estimates (SPGI unavailable; third-party sources shown)

Revenue: Actual $51.24M vs Consensus $49.60M → Beat by +$1.64M (+3.3%) .
EPS: Actual $(0.42) vs Consensus $(0.38) → Miss by $0.04 .
Note: S&P Global/Capital IQ estimates were unavailable in our tool for SILK at this time; third-party consensus is cited.

Additional KPIs

KPI	Q4 2023	Q1 2024	Q2 2024
Cash, Cash Equivalents & Investments ($USD Millions)	$190.9	$176.5	$186.2
Adjusted EBITDA ($USD Millions)	$(4.11)	$(3.93)	$(1.11)

Notes:

Segment breakdown: SILK does not report multiple operating segments in the press releases/8-K; revenue is driven by the TCAR platform .

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Revenue	FY 2024	$194–$198M (as of Q1 release on Apr 30, 2024)	Withdrawn (Aug 7, 2024)	Withdrawn

Context: Guidance withdrawal followed the announced agreement for Boston Scientific to acquire Silk Road Medical (June 18, 2024) .

Earnings Call Themes & Trends

Note: A Q2 2024 earnings call transcript was not available in our document corpus; narrative below for Q2 is based on the company’s Q2 press release. Prior-quarter themes use Q4’23 and Q1’24 disclosures.

Topic	Previous Mentions (Q4 2023 and Q1 2024)	Current Period (Q2 2024)	Trend
Product performance/TCAR adoption	Q4: “increased TCAR adoption” supporting growth; tapered stent limited release initiated . Q1: “strong start… 21% YoY growth… supported by more than 6,700 procedures; deepening TCAR adoption; early tapered stent uptake” .	Ongoing “continued TCAR adoption and growth” .	Adoption holding strong; product cycle support continues .
Regulatory/coverage	Q4: Expanded CMS national coverage decision for TCAR; new distribution agreements in Japan & China following clearances .	No new regulatory update in Q2 press release; focus on operations/M&A .	Supportive backdrop maintained; no incremental Q2 updates .
Margin trajectory	Q1 management noted 75% GM and anticipated a step‑down in Q2 then normalization thereafter (CFO commentary) .	Gross margin held at 75% in Q2 (flat QoQ; up YoY) .	Better‑than‑feared on GM vs prior commentary; stability at 75% .
Operating expenses	Q1: OpEx discipline discussed alongside investments to drive adoption .	OpEx up 20% YoY to $55.7M; included acquisition-related costs .	OpEx pressure; some non-recurring M&A-related .
M&A/strategic	N/A in Q4/Q1 company results beyond normal ops (Q4 guided FY24; Q1 reiterated revenue guidance) .	Agreement to be acquired by Boston Scientific; withdrew FY24 guidance .	Major strategic shift underway.

Management Commentary

“Our solid second quarter performance demonstrates continued TCAR adoption and growth driven by the unwavering dedication of our team. We look forward to continuing our mission as part of Boston Scientific and, together, expanding patient access to our minimally invasive approach to stroke prevention.” — Chas McKhann, CEO (Q2 press release) .
“Strong start to 2024… first quarter revenue of $48.5 million, reflecting 21% year-over-year growth, supported by more than 6,700 procedures… deepening TCAR adoption among trained physicians… encouraging early uptake from our tapered stent launch.” — Chas McKhann (Q1 call prepared remarks) .

Q&A Highlights

A Q2 2024 earnings call transcript was not available in our corpus or open sources we could access without paywall; highlights below reflect Q1 call topics for context:

Impact of CMS coverage/NCD: Management cited positive dynamics increasing awareness and treatment, opening new account opportunities .
Margin/OpEx cadence: Q1 gross margin benefited from favorable variances; CFO signaled a step-down in Q2 with normalization thereafter; OpEx to remain around Q1 levels as the company is “at scale” in R&D and SG&A .
Pricing/product launches: Q1 saw strong price performance and temporary lifts from new products (tapered stent, balloon, NPS Plus) factored into outlook .

Estimates Context

SPGI (S&P Global) consensus was unavailable via our tool for SILK at this time. We relied on third-party sources for consensus: revenue ~$49.60M and EPS −$0.38 for Q2 2024 .
Results vs consensus: revenue beat by ~3.3%; EPS missed by $0.04 .

Key Takeaways for Investors

Topline momentum intact: 13% YoY revenue growth with sustained 75% GM underscores durable TCAR adoption and product cycle support .
Profitability path improving underneath: adjusted EBITDA loss narrowed YoY; however, GAAP losses widened on higher OpEx and acquisition-related costs .
Visibility shift: guidance withdrawn pending BSX transaction—near-term stock narrative centers on deal closure, regulatory timeline, and integration plans .
Watch OpEx discipline into H2: SG&A investment and any further M&A-related items are key variables for EPS trajectory until integration .
Strategic upside with BSX: expanded commercial reach and potential manufacturing/SG&A efficiencies could accelerate adoption and margin improvement post-close .
Near-term trading lens: revenue beat vs EPS miss, guidance withdrawal, and M&A overhang likely drove mixed reactions; positioning hinges on perceived deal certainty and synergy confidence .

Appendix: Additional Comparative Detail

YoY and Sequential Change (selected)

Revenue: +13% YoY (Q2), driven by TCAR adoption ; sequentially up from Q1 ($48.48M → $51.24M) .
Gross Margin: 75% in Q2 vs 71% in Q2’23; flat vs Q1 at 75% .
Operating Expenses: +20% YoY to $55.7M ; up sequentially from Q1 $51.4M .
Net Loss per Share: $(0.42) vs $(0.35) YoY; sequentially wider than Q1 $(0.36) .

Sources:

Q2 2024 press release and tables (Form 8-K Ex. 99.1) .
Q1 2024 press release and tables (Form 8-K Ex. 99.1) .
Q4 2023 press release and tables (Form 8-K Ex. 99.1) .
BSX acquisition announcement and close .
Q1 2024 call transcript (themes/quotes) .
Q2 2024 consensus (non-SPGI) .

Silk Road Medical Inc (SILK)·Q2 2024 Earnings Summary