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GOODWILL AND INTANGIBLE ASSETS
12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
GOODWILL AND INTANGIBLE ASSETS

5.GOODWILL AND INTANGIBLE ASSETS

The changes in the carrying amount of goodwill for the years ended December 31, 2025 and 2024, are as follows (in thousands):

2025

2024

  ​ ​ ​

Cardiovascular

Endoscopy

Total

  ​ ​ ​

Cardiovascular

Endoscopy

Total

Goodwill balance at January 1

$

446,514

$

16,997

$

463,511

$

382,240

$

$

382,240

Effect of foreign exchange

 

2,813

 

 

2,813

 

(1,623)

 

 

(1,623)

Additions and adjustments as the result of acquisitions

 

37,607

 

2,906

 

40,513

 

65,897

 

16,997

 

82,894

Goodwill balance at December 31

$

486,934

$

19,903

$

506,837

$

446,514

$

16,997

$

463,511

We did not have any goodwill impairments for the years ended December 31, 2025, 2024 and 2023. Total accumulated goodwill impairment losses aggregated to $8.3 million as of December 31, 2025 and 2024.

Other intangible assets at December 31, 2025 and 2024, consisted of the following (in thousands):

December 31, 2025

Gross Carrying

Accumulated

Net Carrying

  ​ ​ ​

Amount

  ​ ​ ​

Amortization

  ​ ​ ​

Amount

Patents

$

33,979

$

(14,760)

$

19,219

Distribution agreements

 

3,250

 

(3,069)

 

181

License agreements

 

14,590

 

(10,218)

 

4,372

Trademarks

 

52,556

 

(28,293)

 

24,263

Customer lists

 

63,775

 

(40,096)

 

23,679

Total

$

168,150

$

(96,436)

$

71,714

December 31, 2024

Gross Carrying

Accumulated

Net Carrying

  ​ ​ ​

Amount

  ​ ​ ​

Amortization

  ​ ​ ​

Amount

Patents

$

31,489

$

(12,824)

$

18,665

Distribution agreements

 

3,250

 

(2,994)

 

256

License agreements

 

11,557

 

(9,125)

 

2,432

Trademarks

 

47,613

 

(24,177)

 

23,436

Customer lists

 

57,933

 

(36,223)

 

21,710

Total

$

151,842

$

(85,343)

$

66,499

Aggregate amortization expense for the years ended December 31, 2025, 2024 and 2023 was $85.1 million, $65.6 million, and $56.1 million, respectively.

Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of December 31, 2025 (in thousands):

Year ending December 31, 

  ​ ​ ​

Estimated Amortization Expense

2026

$

83,865

2027

 

80,268

2028

 

78,601

2029

67,281

2030

 

54,968