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Goodwill and Intangible Assets | 6 Months Ended
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Jun. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract] |
Goodwill and Intangible Assets | 6. Goodwill and Intangible Assets. The change in the carrying amount of goodwill for the six-month period ended June 30, 2021 is detailed as follows (in thousands): ​
​ | ​ | ​ | ​
​ |  | 2021
Goodwill balance at January 1 | ​ | $ | 363,533
Effect of foreign exchange | ​ |  | (723)
Goodwill balance at June 30 | ​ | $ | 362,810
​ Total accumulated goodwill impairment losses aggregated to approximately $8.3 million as of June 30, 2021 and December 31, 2020. We did not have any goodwill impairments for the six-month periods ended June 30, 2021 and 2020. The total goodwill balance as of June 30, 2021 and December 31, 2020 was related to our cardiovascular segment. ​ Other intangible assets at June 30, 2021 and December 31, 2020 consisted of the following (in thousands): ​
​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​
​ | ​ | June 30, 2021
​ | ​ | Gross Carrying | ​ | Accumulated | ​ | Net Carrying
​ |  | Amount |  | Amortization |  | Amount
Patents | ​ | $ | 25,036 | ​ | $ | (7,358) | ​ | $ | 17,678
Distribution agreements | ​ |  | 3,250 | ​ |  | (2,419) | ​ |  | 831
License agreements | ​ |  | 12,710 | ​ |  | (7,198) | ​ |  | 5,512
Trademarks | ​ |  | 30,260 | ​ |  | (13,865) | ​ |  | 16,395
Customer lists | ​ |  | 35,058 | ​ |  | (30,153) | ​ |  | 4,905
Total | ​ | $ | 106,314 | ​ | $ | (60,993) | ​ | $ | 45,321
​
​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​
​ | ​ | December 31, 2020
​ | ​ | Gross Carrying | ​ | Accumulated | ​ | Net Carrying
​ |  | Amount |  | Amortization |  | Amount
Patents | ​ | $ | 23,669 | ​ | $ | (6,460) | ​ | $ | 17,209
Distribution agreements | ​ |  | 3,250 | ​ |  | (2,319) | ​ |  | 931
License agreements | ​ |  | 14,453 | ​ |  | (6,647) | ​ |  | 7,806
Trademarks | ​ |  | 30,273 | ​ |  | (12,414) | ​ |  | 17,859
Customer lists | ​ |  | 35,154 | ​ |  | (29,103) | ​ |  | 6,051
Total | ​ | $ | 106,799 | ​ | $ | (56,943) | ​ | $ | 49,856
​ Aggregate amortization expense for the three and six-month periods ended June 30, 2021 was approximately $12.4 million and $24.9 million, respectively. Aggregate amortization expense for the three and six-month periods ended June 30, 2020 was approximately $14.8 million and $29.8 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 is largely independent of the cash flows of other assets and liabilities. We determine the fair value of our amortizing assets 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. During the three-month period ended June 30, 2021 and 2020, we identified indicators of impairment associated with certain acquired intangible assets based on our qualitative assessment, which led us to complete an interim quantitative impairment assessment. During the three-month period ended June 30, 2021, the primary indicator of impairment was our planned discontinuance of the Advocate™ Peripheral Angioplasty Balloon product line, sold under our license agreements with ArraVasc Limited (“ArraVasc”). We recorded an impairment charge for the remaining carrying value of ArraVasc intangible assets of approximately $1.6 million during the three months ended June 30, 2021, all of which pertained to our cardiovascular segment. During the three-month period ended June 30, 2020, the primary indicator of impairment was our planned closure of our procedural pack business in Australia acquired in our October 2017 acquisition of ITL Healthcare Pty Ltd. (“ITL”). We recorded an impairment charge for ITL intangible assets of approximately $2.4 million during the three months ended June 30, 2020, all of which pertained to our cardiovascular segment. See Note 14 for additional details regarding impairment charges recorded in the three-month periods ended June 30, 2021 and 2020. ​ Estimated amortization expense for the developed technology and other intangible assets for the next five years consisted of the following as of June 30, 2021 (in thousands): ​
​ | ​ | ​ | ​
Year Ending December 31, |  | Estimated Amortization Expense
Remaining 2021 | ​ | $ | 24,572
2022 | ​ |  | 48,149
2023 | ​ |  | 47,050
2024 | ​ | ​ | 44,113
2025 | ​ |  | 42,335
​

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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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