Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Net cash flows from operating activities:
Net loss	$ (13,359)	$ (30,690)	$ (19,192)
Adjustments to reconcile net loss to net cash from operating activities:
Depreciation and amortization	24,205	23,076	22,442
Non-cash compensation	14,242	14,422	12,344
Non-cash lease expense	4,915	4,541	4,666
Write-down of inventories and deferred preservation costs	4,434	4,785	4,374
Non-cash interest expense	3,866	1,858	1,832
Deferred income taxes	(1,511)	(1,385)	(1,717)
Change in fair value of contingent consideration	(11,010)	23,490	(9,000)
Endospan fair value adjustments	4,329	5,000	0
Loss on extinguishment of debt	3,669	0	0
Gain from sale of non-financial assets	0	(14,250)	0
Other	5,699	1,358	2,268
Changes in operating assets and liabilities:
Receivables	(15,395)	(4,050)	(13,340)
Inventories and deferred preservation costs	(6,137)	(14,360)	(8,404)
Prepaid expenses and other assets	(5,209)	535	(2,234)
Accounts payable, accrued expenses, and other liabilities	9,498	4,495	808
Net cash flows provided by (used in) operating activities	22,236	18,825	(5,153)
Net cash flows from investing activities:
Capital expenditures	(11,188)	(9,752)	(10,715)
Payments under Endospan agreements	(17,000)	(5,000)	0
Proceeds from sale of non-financial assets, net	0	14,250	0
Net cash flows used in investing activities	(28,188)	(502)	(10,715)
Net cash flows from financing activities:
Proceeds from issuance of long-term debt	184,000	0	0
Proceeds from revolving credit facility	28,500	0	0
Repayment of debt	(211,831)	(2,772)	(2,753)
Proceeds from exercise of stock options and issuance of common stock	5,728	3,955	3,368
Payment of debt issuance costs	(2,544)	(249)	0
Proceeds from financing insurance premiums	0	3,558	0
Principal payments on short-term notes payable	(1,027)	(2,531)	0
Redemption and repurchase of stock to cover tax withholdings	0	(559)	(1,795)
Other	(623)	(537)	(459)
Net cash flows provided by (used in) financing activities	2,203	865	(1,639)
Effect of exchange rate changes on cash and cash equivalents	(1,728)	401	1,848
(Decrease) increase in cash and cash equivalents	(5,477)	19,589	(15,659)
Cash and cash equivalents, beginning of year	58,940	39,351	55,010
Cash and cash equivalents, end of year	$ 53,463	$ 58,940	$ 39,351