Goodwill and Intangible Assets

9 Months Ended

Sep. 30, 2018

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets. The changes in the carrying amount of goodwill for the nine-month period ended September 30, 2018 were as follows (in thousands):


	2018
Goodwill balance at January 1	$	238,147
Effect of foreign exchange	(881)

Additions as the result of acquisitions	11,757
Goodwill balance at September 30	$	249,023

As of September 30, 2018, we had recorded $8.3 million of accumulated goodwill impairment charges. All of the goodwill balance as of September 30, 2018 and December 31, 2017, is related to our cardiovascular segment.

Other intangible assets at September 30, 2018 and December 31, 2017, consisted of the following (in thousands):


	September 30, 2018
	Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount
Patents	$	18,676	$	(4,665)	$	14,011
Distribution agreements	8,012		(5,509)		2,503
License agreements	24,913		(6,895)		18,018
Trademarks	21,514		(6,039)		15,475
Covenants not to compete	1,028		(993)		35
Customer lists	35,590		(21,987)		13,603
In-process technology	920		—		920

Total	$	110,653	$	(46,088)	$	64,565


	December 31, 2017
	Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount
Patents	$	16,528	$	(3,737)	$	12,791
Distribution agreements	7,262		(4,686)		2,576
License agreements	23,783		(5,568)		18,215
Trademarks	16,224		(4,686)		11,538
Covenants not to compete	1,028		(968)		60
Customer lists	31,935		(18,482)		13,453
In-process technology	920		—		920

Total	$	97,680	$	(38,127)	$	59,553

Aggregate amortization expense for the three and nine-month periods ended September 30, 2018 was approximately $10.5 million and $29.4 million, respectively. Aggregate amortization expense for the three and nine-month periods ended September 30, 2017 was approximately $7.0 million and $19.4 million, respectively.

We evaluate long-lived assets, including amortizing intangible assets, for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We perform the impairment analysis at the asset group for which the lowest level of identifiable cash flows are largely independent of the cash flows of other assets and liabilities. During the three months ended September 30, 2018, we compared the carrying value of the amortizing intangible assets acquired in our July 2015 acquisition of certain assets from Quellent, LLC, all of which pertained to our cardiovascular segment, to the undiscounted cash flows expected to result from the asset group and determined that the carrying amount was not recoverable. We then determined the fair value of the amortizing assets related to the Quellent acquisition based on estimated future cash flows discounted back to their present value using a discount rate that reflects the risk profiles of the underlying activities. Some of the factors that influenced our estimated cash flows were slower than anticipated sales growth in the products acquired from our Quellent acquisition and uncertainty about future sales growth. The excess of the carrying value compared to the fair value was recognized as an intangible asset impairment charge. We recorded an impairment charge for Quellent of approximately $657,000. We did not record any impairment charges during the three and nine months ended September 30, 2017.

Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of September 30, 2018 (in thousands):


Year Ending December 31
Remaining 2018	$	10,140
2019	39,647
2020	38,386
2021	31,025
2022	29,141