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Goodwill and Intangible Assets | 6 Months Ended
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Jun. 30, 2018
Goodwill and Intangible Assets Disclosure [Abstract] |
Goodwill and Intangible Assets | Goodwill and Intangible Assets. The changes in the carrying amount of goodwill for the six-month period ended June 30, 2018 were as follows (in thousands):
| 2018
Goodwill balance at January 1 | $ | 238,147 |
Effect of foreign exchange | (906 | )
Additions as the result of acquisitions | 11,757 |
Goodwill balance at June 30 | $ | 248,998 |
As of June 30, 2018, we had recorded $8.3 million of accumulated goodwill impairment charges. All of the goodwill balance as of June 30, 2018 and December 31, 2017, is related to our cardiovascular segment. Other intangible assets at June 30, 2018 and December 31, 2017, consisted of the following (in thousands):
| June 30, 2018
| Gross Carrying Amount |  | Accumulated Amortization |  | Net Carrying Amount
Patents | $ | 18,196 |  |  | $ | (4,334 | ) |  | $ | 13,862 |
Distribution agreements | 8,192 |  |  | (5,278 | ) |  | 2,914 |
License agreements | 23,845 |  |  | (6,419 | ) |  | 17,426 |
Trademarks | 21,516 |  |  | (5,550 | ) |  | 15,966 |
Covenants not to compete | 1,028 |  |  | (985 | ) |  | 43 |
Customer lists | 35,737 |  |  | (20,680 | ) |  | 15,057 |
In-process technology | 920 |  |  | — |  |  | 920 |
Total | $ | 109,434 |  |  | $ | (43,246 | ) |  | $ | 66,188 |
| 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 six-month periods ended June 30, 2018 was approximately $10.4 million and $18.9 million, respectively. Aggregate amortization expense for the three and six-month periods ended June 30, 2017 was approximately $6.2 million and $12.4 million, respectively. Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of June 30, 2018 (in thousands):
Year Ending December 31 |
Remaining 2018 | $ | 20,132 |
2019 | 39,154 |
2020 | 37,881 |
2021 | 30,488 |
2022 | 28,688 |

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- Definition The entire disclosure for goodwill and intangible assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -URI http://asc.fasb.org/topic&trid=2144416 + Details
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